Synthesis of Blue Emissive Quaternary 9,9-Disubstituted -Methyl-7-azaindole-Appended (Phenylethynyl)-fluorene Derivatives.

A highly functionalized 9,9-disubstituted (phenylethynyl)-fluorene-appended -methyl-7-azaindole derivatives has been synthesized from various fluorene propargylic alcohols and substituted-7-azaindoles using BFOEt as a catalyst. The scope of the reaction was demonstrated by selecting a range of fluorene propargylic alcohols and substituting 7-azaindoles. A plausible reaction mechanism for forming title compounds via propargylic carbocation is postulated.

DMSO-allyl bromide: a mild and efficient reagent for atom economic one-pot -allylation and bromination of 2°-aryl amines, 2-aryl aminoamides, indoles and 7-aza indoles.

A mixture DMSO-allyl bromide has been developed as a reagent for an atom economic one-pot -allylation and aryl bromination under basic conditions. Utilizing this reagent, -allylation-bromination of a number of 2°-aryl amines, aryl aminoamides, indoles, and 7-aza indoles has been achieved. The scope of the substrates and limitations, the synthetic utility of the products, and a plausible reaction mechanism have been proposed.

A time to act: Anti-racist paediatric research.

Research offers the potential for new treatments, programs and services, and underlies decisions about funding that can have profound implications for people's lives. When racism in research is not addressed, children and their families will be unjustly impacted by systemic discrimination, exclusion, and inequity. With a growing acknowledgement that racism is a social determinant of health, and as COVID-19 reveals staggering racial disparities, we believe now is the time for intentional anti-racism initiatives throughout the research ecosystem to prevent further harms in patient care and the lives and futures of children.

Intestinal permeability correlates with behavioural severity in very young children with ASD: A preliminary study.

Systemic inflammation is known to alter behaviour, and since it has been reported that individuals with autism spectrum disorder (ASD) have higher levels of circulating cytokines, it has been hypothesized that systemic inflammation may exacerbate behaviours characteristic of ASD. The acute phase proteins α-2-macroglobulin, C-reactive protein, haptoglobin, serum amyloid P, serum amyloid A, ferritin and tissue plasminogen activator, as well as markers of intestinal permeability (intestinal fatty acid binding protein and lipopolysaccharide) were quantitated in the plasma of very young children with ASD. Behaviour severity was measured using the Autism Diagnostic Interview-Revised (ADI-R), the Autism Diagnostic Observation Schedule (ADOS) and the Vineland Adaptive Behaviour Scale (VABS).

Re-imagining the physicians' role in the assessment of feeding challenges in children with autism spectrum disorder.

While feeding challenges in autism spectrum disorder (ASD) are prevalent, they continue to pose a significant diagnostic challenge, leading to misdiagnosis and under diagnosis of factors, both contextual and inherent, that may lead to negative health outcomes. Early identification of feeding difficulties in ASD is necessary to minimize negative health outcomes and strained parent-child relationships. Family physicians and paediatricians are positioned to reduce the impact of such disordered feeding behaviours on the child, family, and health care system.

General paediatric practice in autism spectrum disorder screening in Ontario, Canada: Opportunities for improvement.

Background: Screening is important for early identification of children with autism spectrum disorder (ASD), potentially leading to earlier intervention. Research has identified some barriers to early identification of ASD, however, information about ASD screening in Canadian general paediatric practice is lacking.

Objectives: The aim of the study is to better understand ASD screening practice patterns by examining the use of ASD and general developmental screening tools by general paediatricians.

Prospective cohort study of vitamin D and autism spectrum disorder diagnoses in early childhood.

Several studies have suggested an association between vitamin D in childhood and autism spectrum disorder. No prospective studies have evaluated whether lower vitamin D levels precede ASD diagnoses - a necessary condition for causality. The objective of this study was to prospectively evaluate whether vitamin D serum levels in early childhood was associated with incident physician diagnosed ASD.

A pilot dose finding study of pioglitazone in autistic children.

Background: Pioglitazone is a promising compound for treatment of core autism spectrum disorder (ASD) symptoms as it targets multiple relevant pathways, including immune system alterations.

Objective: This pilot study aimed to elucidate the maximum tolerated dose, safety, preliminary evidence of efficacy, and appropriate outcome measures in autistic children ages 5-12 years old.

Methods: We conducted a 16-week prospective cohort, single blind, single arm, 2-week placebo run-in, dose-finding study of pioglitazone.

Large ganglioneuroma presenting as presacral mass.

Ganglioneuromas are benign tumours of the sympathetic nervous system that originate from neural crest cells. They are extremely rare in the presacral region. Here, we report a case of a presacral mass in a 14-year-old female who presented with complaints of pelvic discomfort, difficulty with micturition and constipation.

A randomized, placebo controlled trial of omega-3 fatty acids in the treatment of young children with autism.

Background: Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting more than 1% of children. It is characterized by social communication deficits and repetitive behaviors/restricted interests. In the absence of any medications known to improve core symptom domains, parents often use complementary alternative treatments, including omega-3 fatty acid supplements.

Cognitive and Neurobehavioral Profile in Boys With Duchenne Muscular Dystrophy.

Duchenne muscular dystrophy is a progressive neuromuscular condition that has a high rate of cognitive and learning disabilities as well as neurobehavioral disorders, some of which have been associated with disruption of dystrophin isoforms. Retrospective cohort of 59 boys investigated the cognitive and neurobehavioral profile of boys with Duchenne muscular dystrophy. Full-scale IQ of < 70 was seen in 27%; learning disability in 44%, intellectual disability in 19%; attention-deficit/hyperactivity disorder in 32%; autism spectrum disorders in 15%; and anxiety in 27%.

Intranasal oxytocin in the treatment of autism spectrum disorders: a review of literature and early safety and efficacy data in youth.

Background: There is a paucity of treatments targeting core symptom domains in Autism Spectrum Disorder (ASD). Several animal models and research in typically developing volunteers suggests that manipulation of the oxytocin system may have therapeutic potential for the treatment of social deficits. We review the literature for oxytocin and ASD and report on early dosing, safety and efficacy data of multi-dose oxytocin on aspects of social cognition/function, as well as repetitive behaviors and co-occurring anxiety within ASD.

Incidental thyroid carcinoma.

Objective: to find out the frequency of incidental thyroid carcinoma (ITC) in patients presumably operated for benign thyroid diseases.

Methods: a total of 187 patients undergoing surgery for benign thyroid diseases were included in the study. All the patients underwent fine needle aspiration cytology (FNAC).

New models for considering the role of medication in the treatment and elucidation of the etiology of autism.

Autism spectrum disorder (ASD) is a lifelong neurodevelopmental disorder. Over the past decades, much research has been conducted to elucidate a single etiological factor and effective pharmacotherapuetics to address the core symptom domains of ASD with limited success. Research has changed focus from behavioral observations of ASD to translating findings from animal models, genomic manipulation studies and basic science studies to pharmacological agents with the aim to lessen or reverse core symptoms of ASD.

Informing evidence-based clinical practice guidelines for children with cerebral palsy at risk of osteoporosis: a systematic review.

Aim: The aim of this systematic review was to inform evidence-based clinical practice guidelines for children with cerebral palsy (CP) and low bone mineral density (BMD).

Method: A computer-assisted literature search was focused on low BMD in children with CP, and was limited to the following interventions: weight-bearing activities, bisphosphonate use, and vitamin D or calcium supplementation. Articles were classified according to American Academy of Neurology guidelines and recommendation classifications were given based on the evidence for the intervention increasing BMD and decreasing fragility fractures.

Anterior or posterior gastro-jejunostomy with truncal vagotomy for duodenal ulcer--are they functionally different?

Truncal vagotomy with gastrojejunostomy (GJ) is the standard treatment for chronic cicatrizing duodenal ulcer with gastric outlet obstruction. We tried to determine if a significant functional difference exists in the early and late outcomes following anterior and posterior types of GJ to treat this condition. The case records of 106 patients who underwent truncal vagotomy and GJ at our institute from 1 January 1995 to 31 December 1999 were studied retrospectively.

Risk factors predicting operative mortality in perforated peptic ulcer disease.

Following the introduction of H2-blockers and proton pump inhibitors, there has been a sharp decrease in elective peptic ulcer surgery. However, emergency operations for complications such as perforation are on the rise. This study was undertaken to review the factors which determine mortality following emergency surgery for peptic ulcer perforation.

Value of core needle biopsy in the diagnosis of soft tissue tumours.

We performed a prospective study to determine the accuracy of core needle biopsy in the diagnosis and grading of soft tissue tumours and to study the morbidity of core needle biopsy. Forty one cases of soft tissue tumours, 24 of them malignant and 17 benign, were biopsied with an 18G core needle. Core needle biopsy reports were compared with the final histopathological report after definitive procedure or incisional biopsy.

Recurrent gastric trichobezoar.

Trichobezoars are concretions of ingested hair that are found in the stomach. Recurrence of this condition has not been reported. We report an 18-year-old girl with recurrent trichobezoar; this emphasizes the need for counseling in these patients.