Archive for the ‘Vaccines’ Category

Top Autism Stories of 2015

Tuesday, December 29th, 2015

An end-of-the-year GoogleScholar.com search for publications using the term AUTISM returned ~ 58,000 entries:
√ Treatment = 32,000 results
√ Diagnosis = 19,000 items
√ Cause = 19,000 records
√ Prevention = 10,000 entries

Here are the stories that represent this year’s salient research and experience (according to TheAutsimDoctor, at least):

December
Reduced GABAergic Action in the Autistic Brain
Evidence of this neurotransmitter showing reduced activity in the autistic brain. The supplement form is not able to cross into the brain However, it is sometimes helpful as a calming agent, though the opposite effect also occurs.

Cell cycle networks link gene expression dysregulation, mutation, and brain maldevelopment in autistic toddlers
“Further underscoring the prenatal origins of ASD, researchers… describe for the first time how abnormal gene activity… may underlie abnormal early brain growth in the disorder.”

Antidepressant Use During Pregnancy and the Risk of Autism Spectrum Disorder in Children
This is a BIG DEAL, to be discussed in a future posting.

November
Transcranial Direct Current Stimulation Treatment in an Adolescent with Autism and Drug-Resistant Catatonia
A possible new (and really expensive) treatment for ASD?

October
Oxytocin ‘Love Hormone’ Nasal Spray Shows Promise in Kids With Autism
Previously reviewed here.

EARLY SCREENING OF AUTISM SPECTRUM DISORDER: RECOMMENDATIONS FOR PRACTICE AND RESEARCH
Someone at the American Academy of Pediatrics gets it.

September
Association Between Obstetric Mode of Delivery and Autism Spectrum Disorder
This research bears out my experience as a neonatologist; the type of birth, per se, does not appear to lead to ASD.

August
Draft Recommendation Statement
Autism Spectrum Disorder in Young Children: Screening
A formal recommendation not supporting a toddler screen for ASD! Discussed in depth here.

A New Interactive Screening Test for Autism Spectrum Disorders in Toddlers.
But, if a screen is used, here is a better mousetrap.

An Autism-Linked Mutation Disables Phosphorylation Control of UBE3A
How gene function/malfunction can lead to downstream CNS processing errors.

July
A Mechanistic Link between Olfaction and Autism Spectrum Disorder
Patients don’t have Sensory Processing Disorder AND autism. Until it’s called something else, the condition is ASD.

Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder
“This is the first study to examine the role of early… behavioral intervention initiated at less than 30 months of age in altering the longer-term developmental course of autism.”

June
Autism risk associated with parental age and with increasing difference in age between the parents
If this is more than a mere association, it provides evidence of the environment interacting on genes (epigenetics).

May
Heritability of Autism Spectrum Disorder in a UK Population-Based Twin Sample
Nature > Nurture study.

April
Long-Term Outcomes of Early Intervention in 6-Year-Old Children With Autism Spectrum Disorder
Yes, Virginia, early detection and intervention DOES matter.

Prediction of autism by translation and immune/inflammation coexpressed genes in toddlers from pediatric community practices.
A comment from the New England Journal of Medicine: “A Blood Test for Predicting Autism?
It can’t be used for diagnosis just yet, but its findings may form the foundation for a more predictive test.”

Autism Occurrence by MMR Vaccine Status Among US Children With Older Siblings With and Without Autism
Another study proving that ALL vaccinations, given at ANY age, in ANY combination, are good for ALL children, ALL of the time. Lies, damn lies, and statistics.

March
Autism Spectrum Disorder and Particulate Matter Air Pollution before, during, and after Pregnancy: A Nested Case–Control Analysis within the Nurses’ Health Study II Cohort
Higher maternal exposure to toxins during pregnancy, particularly in the last few months, were associated with greater odds of a child having ASD.

The autism-associated chromatin modifier ​CHD8 regulates other autism risk genes during human neurodevelopment
Discussion of epigenetics – how the environment works on genes.

Common polygenic risk for autism spectrum disorder (ASD) is associated with cognitive ability in the general population
It’s not news to the ASD community… “Autism Genes Found to Be Associated with Brighter Minds

February
Shorter spontaneous fixation durations in infants with later emerging autism
Even the youngest children may demonstrate high risk signs. 

A Pilot Proteomic Analysis of Salivary Biomarkers in Autism Spectrum Disorder
An important step in diagnosing and treating any condition, is to have reproducible lab tests to assess risk, degree of involvement, and efficacy of intervention(s).

January
Explaining the Increase in the Prevalence of Autism Spectrum Disorders
The Proportion Attributable to Changes in Reporting Practices
It’s merely reassignment of diagnosis. NOT.

Is the U.S. Prepared for a Growing Population of Adults With Autism?
Since we aren’t prepared for the present growth of children on the spectrum, how could it be possible that future resources will be available?

Conclusion
Promising Forecast for Autism Spectrum Disorders
This editorial, which appeared in a respected medical journal, crystalizes the differences between what pediatricians think they know about ASD, and what parents actually experience. In practice, progress seems anemic and glacial. Autism is rocket science, mired in a political, emotional, and financial morass.

The top autism stories of 2015 are not enough. We need to recognize the epidemic, publish more information that assures vaccine safety for susceptible populations, address causes, safe and effective treatments, possible preventions, and how to address the aging of the autism population. Affected families just need more of everything.

As always, readers are invited to share their thoughts about this research,
and any other scientific papers 
that should be included.

Top 10 Reasons Why Autism Remains a Mystery

Sunday, October 18th, 2015

As regards the explosion of individuals who are diagnosed with autism, progress  seems agonizingly slow. It is the parents of affected children who are leading the way, and traditional explanations are, literally, the thinking of the last century. Why is information about prevention, cause and treatment so sparse?

Researchers are still debating the existence of an Autism Epidemic. Why should it matter whether there are more affected individuals because of reason “A” or reason “B”? That confusion holds up funding for studies, however.

Professionals continue to argue about the ‘when, how, and who’ of assigning an accurate diagnosis, which impedes trials seeking to explore prevention or treatment.

The likelihood of discovering a ‘magic bullet’ is low. There will probably need to be multiple treatments for the signs and symptoms documented in the DSM 5.0, depending on the myriad of causes and presentations.

There are no practical, accepted biomarkers for diagnosis. This is especially important in order to evaluate treatments(s) in an acceptably objective manner. This discovery alone could significantly advance research.

Surrounding the topic of ASD are highly charged issues, such as vaccinations, or complicated treatments, such as HBOT and chelation. Rather than stimulate further investigation, the situation appears to impede conventional researchers from documenting efficacy (or the lack thereof) in such controversial interventions.

Successful treatments of the various co-morbidites displayed by autistic patients, such as those offered at The Child Development Center of America, which combine biomedical and conventional protocols, are frequently viewed with skepticism, at best. These protocols deserve the attention of the medical establishment.

 We drink red G-2 and it comes out yellow.
Ever wonder where the red goes?
(hint… it’s not digested)

Proven associations, such as toxins, poisoned food and the environment, are not popular areas for discussion. Preventive measures receive little promotion or even acknowledgment. Cleaning up can be accomplished, at a cost. This involves not only public education and policy making, but personal choices, as well.

Antibiotics and steroids continue to be overprescribed by doctors, and are requested or too readily accepted by patients. There is a price to be paid for taking strong pharmaceuticals for every ‘cold’ or rash.

Research findings that implicate genetic variations imply feelings of futility about the plausibility of successful intervention. “If it’s genetic, we can’t fix it.” But, every day there are new discoveries about personalized medical treatments for autoimmune conditions or cancer, for example. Tiny chromosomal errors are not insurmountable.

Tools for early diagnosis and intervention, already proven successful, continue to elude the pediatrician’s black bag. Psychiatrists and neurologists, likewise, employ old-fashioned thinking and potent, risky medications that are barely and rarely effective.

In order to take autism research and treatment into the 21st century, organizations that are responsible for actually providing answers need to address these concerns and get serious about forming a unified and thoughtful approach to this medical puzzle.

Notes from the Autism Education Summit

Sunday, September 27th, 2015
theo and me

September 26, 2015 Dr. Theoharides and me

In the beginning of the autism epidemic, conferences included practitioners and families interested in assisting patients in their journey toward recovery. As the information has become more extensive and complicated, the needs and expectations of various parties have spawned more specific meetings.

Tufts University professor, eminent autism researcher and program sponsor, Dr. T C Theoharides, invited me to lecture at this year’s Generation Rescue conference in Dallas. It was a chance to speak to, and with, a worldwide audience of over 700 parents whose children had an ASD diagnosis.

An Alternative Biomedical Approach to Autism Spectrum
A group of ~ 50 ‘newbies’ attended. The topic was chosen because I wished to simplify the issues and offer hope that, despite what the conventional doctors have declared, recovery is possible.

The take home messages were:
1. Traditional medicine only offers bandaids for very complicated signs and symptoms. When the only tool that a person has at hand is a hammer, everything looks like a nail. The usual medications are very powerful with lots of side effects, and provide little in the way of genuine relief.

2. There is more than one way to skin a cat. Many of the other ‘DAN’ practitioners seem to utilize more complicated and expensive protocols, not necessarily superior to the approach that I find most successful. A basic workup was offered to identify laboratory variances indicating less-than-optimal health. Addressing those areas and improving energy with techniques that are not difficult to understand or institute, usually leads to significant progress.

3. Ultimately, autism really IS ‘rocket science’. There are multiple causes and a variety of presentations that even experienced practitioners are hard-pressed to understand and treat. By understanding the basics, parents can lead a team of professionals to get their affected offspring on the right track towards an optimal outcome.

Other Lectures
For 3 days, there was a full roster of presentations covering cause, effects and treatments. In addition to Dr. Theoharides, world-renowned researchers and practitioners, such as Drs. Dan Rossignol, Richard Frye, Jerry Kartzinel, and Anju Usman, gave their learned and extensive points-of-view about ASD.

It is my belief that sometimes the lectures were too demanding. Although the audience was quite intelligent and knowledgable, they seemed to expect more in the way of treatment options for their child, than basic science.

Jenny Group

Ryan Blair, Jenny, Jodi Gomes, Ryan&Dawn Neufeld, Jacqueline&Chris Laurita

Jenny McCarthy
Cue the music, lights, cameras, video screens and action! To this crowd, the lady is a rock-star. She definitely delivered a great message, filled with personal anecdotes, humor, empathy and hope. A panel discussion followed, consisting of famous, and not-so-famous, warrior moms and dads. This was certainly one of the conference highlights.

Conclusion
When I announced on Facebook that I was attending this conference, one of my ‘followers’ wrote, “I think I’m going to unlike this page now,” presumably because of the ‘misguided’ position of Generation Rescue regarding the issue of vaccine injury.  Talk about the polarized world of autism diagnosis and treatment.

Bottom line – I would definitely recommend this yearly conference to parents who have the time and resources.

Docs, Glocks and Autism

Thursday, July 30th, 2015

gunMiami Herald
July 28, 2015
Appeals court upholds doctor-patient gun law

According to the article, “The law subjects healthcare providers to possible sanctions, including fines and loss of license, if they discuss or record information in a patient’s chart about firearms safety that a medical board later determined was not “relevant” or was “unnecessarily harassing.” The law did not define these terms.”

The law did not define these terms
It has been reported that U.S. Circuit Judge Gerald Tjoflat, the author of the majority opinion, understands that, in a patient at-risk for suicide, this might be a valid medical concern.

How about this case?

A fifteen year-old male who suffers from moderate-to-severe autism (or any other medical – psychiatric condition), takes Zoloft for aggressive behaviors, perseverates on violent video games, and doesn’t seem to grasp the line between fantasy and reality.

Would it be fair to say that a discussion by the physician with the parents about weapons in the home is appropriate?

The risk factors

  • The patient’s sex.
  • The person’s age.
  • Medication(s) use. There is even a ‘Black Box’ warning on SSRIs about the increased possibility of suicide.
  • The predilection for violent video games related to behaviors.
  • The teen’s inability to discern reality vs. fantasy. When asked, “Who is your best friend,” for example, one patient responded with the name of person who he had never met.
  • Constant bickering with parents over school.
  • A loaded gun in the house.

Discussion
Such a situation might be equally as valid when a patient experiences conditions other than ASD. Indeed, people ‘on the spectrum’ are probably less likely to act with outward aggression. Certainly, a discussion about elopement is absolutely a necessity in the face of autism, as are questions about a pool safety and the ability to swim.

Surely, there are a gaggle of gun-toting attorneys who can poke holes in my case. After all, I’m just a healthcare provider.

The lawyers representing the doctors got it wrong. This is not about the first amendment rights of physicians to discuss the issue of guns. This is about public safety. And, let’s face it, when it comes to vaccinations-for-all, as an example, there’s no problem protecting the herd.

Perhaps just as certain, is the possibility that, should a shooting death occur in this scenario, a lineup of litigators would appear on the radar screen, accusing the (ir)responsible doctor of not taking the obvious and necessary steps to prevent such a tragedy. “An Accident Waiting to Happen,” might be the headline.

Conclusion
This is an insane law that supports the NRA’s unyielding position about the rights of gun ownership. It is proof of how corrupted our system has become, due the superabundance of lobbying money.

Gun control is what we need, in the face all the senseless shooting deaths by too many young men, who obviously have mental challenges. However bizarre, it is a standing law that has now been upheld by the Florida Court of Appeals.

More information will be required to illuminate the holes that are created by this imprecise lawyer-speak.

The Media and Autism

Saturday, July 11th, 2015

Emily Willingham, Forbes blogger and self-appointed autism expert, couldn’t let the story about the death of Dr. Jeffrey Bradstreet pass without injecting her two cents.

Dr. W commenced her comments with a 2,000 by 1000 pixel, scary picture of a syringe and needle. I never saw that photo at the beginning of one of her ‘Vaccination is Perfectly Safe‘ stories. She went on to detail the nefarious activities of a doctor administering a dangerous serum to unsuspecting patients. Em, have you ever heard of botox?

Conjecture, innuendo and professional jealousy notwithstanding, Dr. Bradstreet was the parent of an autistic son, and an early adopter, researcher, and lecturer of biomedical treatment for the disorder. He popularized medical evaluation and protocols to address metabolic variations at a time when the generally accepted cause of ASD was considered to be bad parenting.

All but the most conventional treatments are presented as kooky at best, harmful to patients at worst, and a waste of time and money. Some of the latest national news headlines regarding autism will illustrate:

  • ABC – Jim Carrey Apologizes for Posting Photo of Autistic Boy
  • CBS – Authorities: Anti-vaccine doctor dead in apparent suicide
  • CNN – Another study finds no link between MMR vaccine and autism
  • NBC – ‘You Don’t Outgrow Autism’
  • Fox – Woman says diet is healing son’s autism

Perhaps this situation, more than any other circumstance, hinders further worthwhile (i.e. causes and treatments) autism research. Headlines are made when a researcher is proven incorrect, statistics are questioned, and even a teen’s murderous rampage is presaged with possible links to Asperger’s Syndrome.

Regardless of the manner in which autism as a medical condition got so far off track, a new attitude needs to accompany the message that academics, practitioners, parents and charities project. Even skeptics who questioned the HIV/AIDS situation abandoned the ‘it’s their own fault’ line of thinking.

What can be done?

Autism foundations need to work together. Autism Speaks, The Autism Foundation, Autism Societies, and Local chapters have to find a way to advance positive publicity and useful information. There is little room for discord at this time. An unpopular stance, perhaps, but it can only help in the search for effective treatments.

Researchers need to get out in front of the media so that the epidemic proportions are clear, and that real work is being done to further study. Disagreements, such as increased incidence only being a perception, have already been addressed by the CDC.

Knowledgeable parents are doing the most effective job of finding professionals and insisting on protocols to help their affected offspring. Doctors need to join in this effort and announce the remarkable improvements that occur when biomedical and conventional treatments are combined.

Neurologists need to get on board. Frequently, parents are admonished that, “Nothing more can be done.” Improvements following biomedical protocols are either dismissed as coincidence, imagination, or magic.

Other specialists need to get on board. This means that allergists, pediatric psychiatrists, immunologists, dermatologists, gastroenterologists, and pulmonologists, have to broaden their knowledge base and focus on the patient, not their particular subspecialty. Too often, parents are only informed that the problem does not lie in their domain.

Pediatricians and family practitioners need to get on board. This is the childhood epidemic of our time, doctors; embrace it, learn about it, and take the time to talk to your families.

Autism heroes, such as Temple Grandin, Drs. Martha Herbert, Susan Swedo, Robert Naviaux, Richard Frye, and Jill James are modern medical role models for the next generation. The media, including Forbes, needs to highlight these personalities, rather than obfuscating this important issue with titillating stories and dogmatic posturing.

Conclusion
People who have Parkinson’s disease are not Parkinson’s experts, nor are people with cancer oncology specialists. Lorenzo’s oil is the exception, not the rule. Insiders and outsiders alike, need to embrace those who are doing real work to solve this problem.

The autism community includes a large, diverse population of well-meaning, knowledgeable and competent people. Together, we will understand and conquer this devastating scourge on our youngest constituents.

Wouldn’t it be nice if the media extended a helping hand?

What Pediatricians Can Do About the Autism Epidemic

Saturday, June 27th, 2015

Pediatricians are the first line of defense against childhood conditions that have lifelong effects. Traditionally, that has included the Denver Developmental Exam, frequent doctor visits in the first few years, and vaccinations to prevent childhood diseases.

News Flash
There is an epidemic of childhood conditions that include ADHD and ASD, conflicting opinions notwithstanding. That means that pediatricians ‘stand at the door’, and are responsible for prevention and treatment, no matter how much they resist this reality.

Stay up to date on pertinent literature. As the HIV epidemic began to emerge, medical science experienced a quantum leap in our knowledge about the immune system. Similarly, the increasing volume of parents who are concerned about their children’s delayed speech, lack of focus, and hyperactivity, demands more research and knowledge and less kindly reassurance, which is based on the experience of the previous century.

Carry a high index of suspicion. Five or ten minutes spent with a parent and child is not enough time to perform a thorough physical examination and elicit pertinent clinical information. The visit should include a documented nutritional summary.

Make a presumptive (if not definitive) diagnosis. Parents need information, and the child’s pediatrician is the expert. It’s fairly simple – delay in communication, repetitive behaviors and lack of socialization demand an explanation and exploration. Loss of language, lack of eye contact, and poor tone are red flags to be explored, not ignored.

Do a proper workup. At least check the blood count, thyroid, liver and kidney function. What is over-kill about exploring vitamin and mineral deficiencies in a picky eater? Then, the doctor could evaluate whether appropriate intervention makes a difference in the signs and symptoms that concern parents.

Make appropriate consultations as early as possible. In a recent UC Davis study, six of seven high-risk children who received therapy alone lost the presumptive diagnosis. Parents will be more upset with the pediatrician who says, “Let’s wait,” and improvement does not occur, than one who advises, “Let’s err on the side of caution,” even if symptoms could have abated without intervention.

 Advise parents to try the gluten free – casein free diet for a few months. What is there to be afraid of? Uneasiness about creating a nutritional deficiency can be easily checked with laboratory evaluation and documentation of proper growth.

Perform an appropriate evaluation for associated signs and symptoms. Explore the cause of frequent infections, rather than responding with the knee-jerk reaction of prescribing antibiotics. Miralax® should only be given for brief periods and for occasional constipation, and isn’t even approved in children. GERD that is treated with antacid preparations can lead to vitamin deficiencies. Steroids may reduce skin rashes, but do not address to the root cause.

When a child has the diagnosis of ASD, the doctor should explore safety issues. Elopement is not uncommon, so family plans should be devised. Although learning to swim is no insurance against a tragedy, acquiring that skill helps provide some peace of mind. Incongruous laws notwithstanding, discussing gun security is a must.

Provide parents with a reading list. TheAutismDoctor.com is a good start, where discussions are presented to address the polarized world of autism diagnosis and treatment. When possible, the essays have hyperlinks to the original research. The Newsworthy tab includes the most recent and pertinent literature.

Become knowledgeable about the variety of protocols. The doctor who has read the literature (both pro and con) about alternative treatments is the only one qualified to give advice. Practitioners who assert, “I’m not aware of this or that treatment,” may be highlighting their ignorance, rather than providing up-to-date info. Therefore, unless the pediatrician knows about a therapy, the patient will surf the ‘net, and listen to the professional who does.

Understanding Autism Better

Sunday, May 17th, 2015

A growing number of children with tiny genetic differences, known as copy number variations, have accompanied the steady increase of patients who visit The Child Development Center.

Often, the conventional advice is that 1) such anomalies are probably not significant, and/or 2) no information is available about ‘that’ particular abnormality.
Do not believe it if your doctor has only told you that, “The chromosomes were normal.”
Take a moment to read the results yourself.

Chromosomes are structures inside our cells, mostly made of DNA. Genes, the basic building blocks of life, are located there. Suspected errors are sometimes only 1/1000 of an inch long! There seems to be a controversy about how different professionals understand the ‘not enough – too much – transposed’ pieces of DNA. How difficult is it then, for parents evaluate?

The basics about genetic results have been previously discussed here.
A specific description about copy number variation is described here.

Results are already available in children who have had a genetic testing, since they are included in the ‘Fragile X test’ (one of the known genetic causes of ASD).

Why perform a chromosomal test?
It should be required in all children who have a Spectrum diagnosis. It’s much more likely to be positive than an anesthesia-requiring MRI or EEG (especially in the absence of seizures).
The argument that testing is not necessary because, “The mom is not having any more children,” is specious. Such information can be quite important for the patient. If there are other people who have the same small chromosomal variations, they can add a great deal more knowledge about your child than merely Googling the cause and treatment of autism.
Additionally, as the future brings more and more information about the performance of those particular pieces of the chromosome – and the genes residing therein – there is added hope that it will lead to specific treatments, or regimens that might be avoided (such as, say, vaccinations) in affected individuals.

Which is the best chromosomal test?
For ninety-nine bucks, 23andme is not the best bet. A saliva sample yields information about ancestry, predisposition to certain traits (e.g., digestion, taste, metabolism, even HIV resistance). However, the SNPs (tiny genetic variations) that are tested are not indicative of ASD.

According to a formal consensus statement of genetic experts, chromosomal microarray (CMA) testing of the blood, “…offers a much higher diagnostic yield (15%–20%) for genetic testing of individuals with unexplained developmental delay, intellectual disability, ASD or multiple congenital anomalies…”
This is a >$1500 blood test (listed here) .

Lineagen advertises that their buccal smear test (a swab from inside the cheek) identifies the most number of changes that are related to autism diagnoses, and is superior to those offered by other labs.
The cost exceeds $5,000. Without insurance, that amount is often prohibitive. As data accumulates, so will the knowledge about the value and validity of this method.

How to read the results of chromosomal microarray testing?
Unless the microarray contains the text, “XX Normal Female,” or “XY Normal Male, no abnormalities reported,” continue reading and ask the lab or a trusted professional to interpret.

How to use the results of chromosomal microarray testing?
Go to the database SFARI gene,
Click on the Copy Number Variant button,
Click on the gene(s) with variation, and follow the table to the letter that best matches your child’s findings.

Conclusions:
Parents often exclaim, “I don’t care what the exact diagnosis is, just make my child improve!” However, the more precise the analysis, the more likely it is that treatment will better target each individual’s physiology.

Knowing this information about your child is valuable – not only in the future, but adds to understanding and treatment for the present situation, as well.

Addendum:

(New York Times 5.14.15)
U.S. Introduces New DNA Standard for Ensuring Accuracy of Genetic Tests

(Journal American Medical Association (6.15)
Copy Number Variations and Cognitive Phenotypes in Unselected Populations

Chromosome 7 flaws alter chemical tags throughout genome

 

Ten Reasons Why There Is No Autism Pill

Saturday, April 18th, 2015

“If you have seen one child with autism, you have seen one child with autism,” is an often-used aphorism. An important corollary: so far, there are only patterns to follow, and a single ‘cure’ may not be the cure.

There isn’t one kind of autism.
It’s like saying we’re going to find a cancer pill.

Controversies have existed from the first time the diagnosis was proposed; beginning with the ‘Refrigerator Mom’ theory, to the contribution of genetic influences, and the role of environmental factors (including the vaccination issues). The enigma has slowed research, while these matters are being sorted out.

Multiple systems are involved, including gastrointestinal, neurologic, muscular, and immunologic. That makes the documentation of recovery a moving target, reducing the likelihood that there is one pill.

There are multiple levels of system involvement, including genetics, proteins (proteome), metabolism (metabolome), body flora (microbiome) and those interactions.

Autism is freakin’ complicated.

The cost of researching, producing, testing and bringing a brand-new pharmaceutical exceeds 2.5 Billion dollars. Market size is important, and apparently 1/68 children does not meet that target. Unless it’s your kid.

Autism is freakin’ expensive.

There are no specific biomarkers, which are key laboratory or other diagnostic findings that identify a specific condition. That means there are few ‘levels’ to follow that identify severity or response to treatment.

The spectrum contains a variety of signs and symptoms that change over time and vary among individuals, including identical twins. There are various presentations, from mostly apraxia to mostly social isolation, and lots of combinations in between. That makes the evaluation and documentation of response to therapies problematic.

Since environmental factors have been implicated as an issue, it’s clear that pollution and toxins have been getting worse, not better. That has resulted in increasing numbers of affected people with more complicated problems. The light at the end of the tunnel seems to be moving farther away.

Conventional medicine isn’t leading the way, and falters even in the pursuit of assistance. Simply advising more therapy is frequently inadequate. Stimulant and other central nervous system medications can be a nightmare. The belief that ‘alternative’ therapies are kooky, or even harmful, polarizes – and little progress emerges.

There is an audible silence by way of a national voice towards solving this epidemic. When John Kennedy said we could get to the moon and back, America found a way. Autism needs more heroes, role models, and spokespeople.

All of that being said, it doesn’t mean that physicians cannot do appropriate testing to discover variances and abnormalities that are clues to downstream signs and symptoms to treat, and upstream interventions to alter the course.

In the absence of a pill, early detection and intervention successfully addresses many of the most debilitating and costly complications.

Autism Conference Spring 2015

Sunday, March 15th, 2015

The Medical Academy of Pediatric Special Needs provides this semiannual standard-of-care meeting, which is dedicated to teaching physicians and other practitioners who care for patients with ASD.

Various educational courses were offered, covering a variety of interests and experience. This being the 7th conference, an entire day was reserved for difficult clinical cases, discussed among ~30 doctors, who had previously passed the basic science courses.

Mitochondrial functioning played a significant role in this year’s presentations. The myriad of functions involved with these cellular power-plants was explored. This is a complicated topic that includes genetics (mitochondria even have their own chromosomes), over- under- and malfunctioning, environmental effects, cell-to-cell, cell-to-system and cell-to-environment interactions.

Impressions:
Prior to one of the lectures, there was a wonderful moment when Dr. Bob Sears, Dr. Jerry Kartzinel, Dr. James Neubrander, and Dr. Dan Rossignol were among those discussing the recent measles epidemic and what their practice was doing to address the situation. That conversation would have made a well-hit youtube video!

Another time I found myself eating lunch with Dr. Michael Elice, Dr. Stuart Freedenfeld, and other popular autism practitioners. There was a great sense of camaraderie and common purpose. This is one the few social experiences when doctors, such as myself, are not derided for our unpopular opinions.

Any new treatments?
Dr. Sid Baker, a true pioneer in the practice of the biomedical treatment for ASD, presented a wonderful historical perspective. Because of an earlier focus on autism as a genetic disorder, Dr. Baker opined that, “The last ten years have shown very little progress in the way of understanding and treatment of autism.”

One frequently discussed off-topic topic was the lack of research and safety of chlorine dioxide (ClO2), which is touted on the web as a helpful treatment. It is supposed to work by ridding the body of parasites. Ironically, however, one of the more popular new treatments involves helminth therapy (giving parasites to patients) to re-invigorate the immune system.

Conclusion:
It would be preferable if participants could return from such an educational experience with a list of novel therapies for our most challenging patients.

For now, learning key tricks and tips that address negative behaviors, or gut health, for example, are the order of the day. We learned about more precise lab tests, key findings that could point to more specific therapies, and important metabolic pathways that will help our patients, if not today, soon.

We consider what avenues to pursue, and those that need further evaluation. This organization is dedicated to providing well-researched medical solutions.

Because autism is so widespread, misunderstood, variable and mysterious, the ability to network with international experts and ‘pick the brain’ of those in the trenches is the most valuable feature that the conference provides.

“It’s supposed to be hard. If it were easy, everyone would do it”
Tom Hanks in A League of Their Own

To Vaccinate or Not to Vaccinate?

Saturday, February 7th, 2015

The measles outbreak that started in Disneyland has generated a fair amount of activity at The Child Development Center lately.

Many of our patients are either un- or under- vaccinated, according to the Vaccine Gods, so an increase in a preventable childhood disease in the U.S. is a very important healthcare issue.

In response to the media stories, and with the intention of addressing parents’ concerns, The Center emailed our patients.

The advice that was offered:
a. If the child has never had a vaccination, it is best to “bite the bullet” and go ahead with an MMR. We’re in the middle of an outbreak and it’s a very small world.

b. If the child has been previously vaccinated for MMR, you could get  “measles-mumps-rubella titers”. This is a blood test to determine if the child is still immune to the diseases, so it may be OK to hold off for now.

There were a variety of interesting responses.
Parent: “Thanks, Dr. Udell, for the heads up.”
Dr. U: You’re welcome. I’m just a messenger. Parents are the ones who have to make the final decision.

Parent: “What if the child has antibodies to eggs (allergy)?”
Dr. U: That is a big problem. I would look over the most recent laboratory tests and, depending on the child’s present state of health, and other findings, possibly still have to recommend. For what it’s worth, two of the products are actually grown on chick embryo, and almost all of our yolk-and/or-white-positive patients are negative to chicken. The German measles strain is grown on lung tissue derived from human fetus. We don’t test for that.

Parent: “Can’t you break up the shots?
Dr. U: No, the company that used to produce separates stopped years ago.

Parent: “My child was severely damaged by that shot. I’m surprised that you made this recommendation.”
Dr. U: It’s situational ethics, in a medical setting. I sympathize with your plight. Not only is there conflicting research; cases, such as yours, are completely ignored. Nevertheless, measles carries a 1/1000 chance of encephalitis (brain infection). 

Discussion:
After listening to so many complaints of proximate injury to an inoculation, it seemed that the best advice was to hold off vaccinating until the child improved, and/or the cause(s) of inflammation was discovered. There was little evidence of a rise in disease, so I felt less concern for the ‘herd’ than the family sitting in my office. The plan was to vaccinate a healthier child in 1-2 years, utilizing a judicious make-up protocol, if the parents agreed.

Each family will address this news differently, and act on their decision based upon what they consider as their child’s best interest. Questions and concerns persist. An epidemiologist just published a York Times editorial suggesting that there would be increased compliance if it were more difficult to obtain an exemption.

The line between the ‘good of the many’ and the ‘good of the one’ has shifted. Once the seal is broken, so to speak, and fewer than ~90% of the susceptible population is protected, there can be no accurate prediction of whether/where/when/how severe another outbreak will occur. The choice returns to the ‘good of the one’, so prevention is paramount.

The reality is that, if the AMA, AAP, FDA and CDC would express less dogma, become more sympathetic to those who claim injury, make fewer errors, and perform prospective studies to demonstrate efficacy and universal safety, parents wouldn’t be forced to make such a crucial decision on their own.

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Brian D. Udell MD
6974 Griffin Road
Davie
FL 33314
Office phone – 954-873-8413
Fax – 954-792-2424

Email bdumd@childdev.org
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