Children with autism spectrum disorders (ASD) experience high rates of anxiety, sensory processing problems, and gastrointestinal (GI) problems; however, the associations among these symptoms in children with ASD have not been previously examined. The current study examined bivariate and multivariate relations among anxiety, sensory over-responsivity, and chronic GI problems in a sample of 2,973 children with ASD enrolled in the Autism Treatment Network (ages 2-17 years, 81.6 % male). Twenty-four percent of the sample experienced at least one type of chronic GI problem (constipation, abdominal pain, bloating, diarrhea, and/or nausea lasting three or more months). Children with each type of GI problem had significantly higher rates of both anxiety and sensory over-responsivity. Sensory over-responsivity and anxiety were highly associated, and each provided unique contributions to the prediction of chronic GI problems in logistic regression analyses. The results indicate that anxiety, sensory over-responsivity and GI problems are possibly interrelated phenomenon for children with ASD, and may have common underlying mechanisms.

The purpose of the current study was to evaluate the frequency of co-occurring attention-deficit/hyperactivity disorder (ADHD) symptoms in a well-defined cohort of children with autism spectrum disorders (ASDs) and to examine the relationship between ADHD symptoms and both adaptive functioning and health-related quality of life as reported by parents or other primary caregivers. METHODS:T scores on 2 ADHD-related scales from the Child Behavior Checklist were used to indicate the presence of ADHD symptoms. Participants were divided into groups based on whether their parents/ caregivers rated them as having clinically significant T scores on the Attention Problem and Attention Deficit Hyperactivity Problem subscales. Standard scores from the Vineland Adaptive Behavior Scales, Second Edition and raw scores from the Pediatric Quality of Life Inventory were then compared between groups with the use of multivariate analyses.RESULTS: Approximately 40% of participants had 1 elevated T score, and 19% had both ADHD-related T scores elevated on the Child Behavior Checklist. The ASD + ADHD group had lower scores on the Vineland Adaptive Behavior Scales, Second Edition and the Pediatric Quality of Life Inventory in comparison with the ASD alone group. CONCLUSIONS:Results suggest greater impairment in adaptive functioning and a poorer health-related quality of life for children with ASDs and clinically significant ADHD symptoms in comparison with children with ASDs and fewer ADHD symptoms. Physicians are encouraged to evaluate for the presence of ADHD symptoms in their patients with ASDs and, if present, include symptom treatment in the overall care plan. Pediatrics 2012;130:S91-S97 AUTHORS:

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Black men with low risk prostate cancer should be advised that the risk of progression on active surveillance may be higher than that in the available literature. Integral prognostic tools incorporating race and prostate specific antigen density may be useful to accurately assess the individual risk of progression in patients on active surveillance.

Based on clinical experience, we hypothesized that rigid-compulsive behaviors are associated with severe constipation and co-occuring diarrhea or underwear staining in children with autism spectrum disorder. Using data from the Autism Treatment Network, we evaluated the association between these gastrointestinal (GI) symptoms and measures of rigid compulsive behavior in children ages 2-17. Following statistical correction, four of five primary measures were significantly associated with constipation and diarrhea or underwear staining, including parental report of repetitive behavior, parental report of compulsive behavior, clinician diagnosis of OCD, and report of rituals observed on the Autism Diagnostic Observation Schedule. This association could point to a causal connection between these symptoms or to a common biological pathway that impacts both gut and brain.

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What's known on the subject? and What does the study add? A significant proportion of patients diagnosed with prostate cancer do not require immediate treatment and could be managed by active surveillance, which usually includes serial measurements of prostate‐specific antigen (PSA) levels and regular biopsies. The rate of rise in PSA levels, which could be calculated as PSA velocity or PSA doubling time, was previously suggested to be associated with the biological aggressiveness of prostate cancer. Although these parameters are obvious candidates for predicting tumour progression in active surveillance patients, earlier studies that examined this topic provided conflicting results. Our analysis showed that PSA velocity and PSA doubling time calculated at different time‐points, by different methods, over different intervals, and in different sub‐groups of active surveillance patients provide little if any prognostic information. Although we found some significant associations between PSA velocity and the risk of progression as determined by biopsy, the actual clinical significance of this association was small. Furthermore, PSA velocity did not add to the predictive accuracy of total PSA. Objective To study whether prostate‐specific antigen (PSA) velocity (PSAV) and PSA doubling time (PSADT) are associated with biopsy progression in patients managed by active surveillance. Patients and Methods Our inclusion criteria for active surveillance are biopsy Gleason sum <7, two or fewer positive biopsy cores, ≤20% tumour present in any core, and clinical stage T1–T2a. Changes in any of these parameters during the follow‐up that went beyond these limits are considered to be progression. This study included 250 patients who had at least one surveillance biopsy, an available PSA measured no earlier than 3 months before diagnosis, and at least one PSA measurement before each surveillance biopsy. We evaluated the association between PSA kinetics and progression at successive surveillance biopsies in different sub‐groups of patients by calculating the area under the curve (AUC) as well as sensitivity and specificity of different thresholds. Results Over a median follow‐up of 3.0 years, the disease of 64 (26%) patients progressed. PSADT was not associated with biopsy progression, whereas PSAV was only weakly associated with progression in certain sub‐groups. However, incorporation of PSAV in models including total PSA resulted in a moderate increase in AUC only when the entire cohort was analysed. In other sub‐groups the predictive accuracy of total PSA was not significantly improved by adding PSAV. Conclusions Our findings confirm that PSA kinetics should not be used in decision‐making in patients with low‐risk prostate cancer managed by active surveillance. Regular surveillance biopsies should remain as the principal method of monitoring cancer progression in these men.