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Biomedical subjects

L Wing

Publications and source records attributed to L Wing.

At least 37 records · Page 2Linked to original sources
PubMed1995

The recognition of autism in children with Down syndrome--implications for intervention and some speculations about pathology.

Although autism can occur in conjunction with a range of other conditions, the association with Down syndrome is generally considered to be relatively rare. Four young boys with Down syndrome are described who were also autistic. All children clearly fulfilled the diagnostic criteria for autism required by the ICD-10 or DSM-III-R, but in each case the parents had faced considerable difficulties in obtaining this diagnosis. Instead, the children's problems had been attributed to their cognitive delays, despite the fact that their behaviour and general progress differed from other children with Down syndrome in many important aspects. The implications, for both families and children, of the failure to diagnose autism when it co-occurs with other conditions such as Down syndrome are discussed. Some speculations about possible pathological associations are also presented.

Age Factors↗
PubMed1992

Pervasive developmental disorders: from DSM-III to DSM-III-R.

The present paper provides a brief history of the development of the DSM-III-R (American Psychiatric Association [APA], 1987) section on Pervasive Developmental Disorders. It describes the process by which the contents of the text and criteria for Autistic Disorder and Pervasive Developmental Disorder Not Otherwise Specified were decided and gives the reasons for the changes from DSM-III (APA, 1980) categories and criteria. The paper concludes with a short discussion of critical diagnostic issues.

Autistic Disorder↗
PubMed1992

Aging and susceptibility to drug-induced orthostatic hypotension.

OBJECTIVE: To test the hypothesis that the short-term effect of transbuccal nitroglycerin (glyceryl trinitrate, 0.0625 to 1.5 mg) on orthostatic cardiovascular responses would predict the effect of a diuretic (5 mg bendroflumethiazide daily for 1 week), particularly in elderly subjects who may be at higher risk for orthostatic hypotension. METHODS: This was a randomized crossover study. Participants were 17 elderly (age range, 63 to 84 years) and 15 younger (age range, 19 to 35 years) healthy ambulant volunteers. Interventions and measures of outcome included blood pressure (BP; in millimeters of mercury) and heart rate (HR; in beats per minute) changes with standing, which were measured before administration of medication and after each drug treatment. RESULTS: Subjects in the elderly and younger groups had different BP and HR changes (mean percentage change) at 1 minute after standing in all three study phases (unmedicated, elderly: BP, -4%/+1%; HR, +12%; young: BP, +2%/+12%; HR, +27%; p = 0.06 for BP, p less than 0.01 for HR; bendroflumethiazide, elderly: BP, -9%/-3%; HR, +17%; young: BP, +1%/+11%; HR, +33%; p less than 0.05 for all; nitroglycerin (0.25 mg), elderly: BP, -15%/-12%; HR, +21%; young: BP, -6%/+7%; HR, +38%; p less than 0.05 for all). The incremental orthostatic effects of the two drugs were similar in the two age groups and were positively correlated (r = 0.65, p less than 0.001) in individual subjects. CONCLUSIONS: Individual susceptibility to drug-induced orthostatic hypotension depends on a combination of the age-related unmedicated orthostatic response and the additional drug effect, which is independent of age. The BP response to standing after administration of nitroglycerin may be useful in predicting the effect of other drugs known to influence orthostatic BP control.

Administration, Oral↗
PubMed1990

Analysis of time trends, individual subject responses and background variation in crossover factorial studies with antihypertensive drugs.

In studying patients with mild hypertension, we used a double-blind, randomly allocated crossover, 2 x 2 factorial design to obtain more precise estimates of the effectiveness of individual hypertensive drugs and of the interactions when used in combination. In the present study, we reanalysed data from our own previously completed crossover factorial studies in order to determine the optimal length of phases and to try to exploit patient heterogeneity by comparing blood pressure responses within each patient to the two different drugs in each study. An analysis of the 'weeks within phases' variation (analysis of variance) applied to all phases, to the placebo phases alone and to the active treatment phases alone, of the individual factorial studies and of pooled data from studies of similar design, only revealed differences in the first week of our 4-week phases. Accordingly, we suggest that 4 weeks is an optimal phase length, since only the values from the third and fourth weeks showed the full expression of a drug's antihypertensive effect, avoiding the problem of a carryover effect and the need for a more complex intervening washout placebo phase. Comparing the blood pressure reductions shown by individual patients in response to different antihypertensive drugs using arbitrary criteria of greater than or equal to 5, 10 and 15 mmHg for diastolic and greater than or equal to 5, 10 and 20 mmHg for systolic pressure, we were unable to distinguish between the two separate drugs in each factorial study, due to the magnitude of the background variation which had a coefficient of variation of 5-7%.(ABSTRACT TRUNCATED AT 250 WORDS)

Antihypertensive Agents↗
PubMed1989

Neuropeptide Y in the sympathetic control of blood pressure in hypertensive subjects.

Neuropeptide Y (NPY) coexists with noradrenaline in postganglionic sympathetic neurons and with noradrenaline and adrenaline in the central nervous system. The possibility that NPY is released into the circulation during activation of the sympathoadrenal system was investigated in ten moderately hypertensive volunteers using three different stimuli. In healthy moderately hypertensive volunteers cold pressor test, head up tilt and graded bicycle exercise resulted in increased blood pressure, heart rate and plasma catecholamine concentrations. While there was a trend for plasma NPY-like immunoreactivity (NPY-LI) to increase during cold pressor test and head up tilt, NPY-LI concentration only increased significantly during bicycle exercise, the stimulus of greatest duration. These results suggest that plasma NPY-LI can be released into the circulation on sympathoadrenal activation in moderately hypertensive subjects and demonstrate that the pattern of release is similar to that previously observed in normotensive subjects.

Adrenal Glands↗
PubMed1987

Felodipine compared to prazosin as additional therapy to a beta-blocking drug.

Felodipine was compared with prazosin in patients with essential hypertension whose blood pressure was not controlled by a beta-blocking drug. One hundred patients with a supine diastolic blood pressure greater than or equal to mm Hg after 4 weeks or more on a beta-blocking drug and placebo were randomly assigned to felodipine or prazosin tablets. The drugs were titrated at 2-week intervals if diastolic BP was greater than or equal to 90 mm Hg. Titration steps of felodipine were 5, 10, 20 mg b.i.d. and of prazosin were 1, 2, 4 mg b.i.d. The fall in blood pressure with felodipine 32/21 mm Hg was greater than the fall with prazosin 16/12 mm Hg (p less than 0.001); 36 patients achieved a diastolic blood pressure of less than 90 mm Hg with felodipine, which was a significantly greater number than the 20 patients who obtained such a level with prazosin (p less than 0.01). Both drugs were well tolerated, but more patients complained of vascular type side effects (flushing, peripheral edema) with felodipine than with prazosin. There was significant weight gain with prazosin but not with felodipine. Felodipine was shown to be a well-tolerated, effective antihypertensive agent when used with a beta-blocking drug and to be suitable for people with hypertension who fail to be controlled with a beta-blocking drug.

Adrenergic beta-Antagonists↗
PubMed1986

Sleep problems in handicapped children: a preliminary study.

Data are reported from an exploratory study looking at the prevalence of sleep problems (broken sleep and limited hours of sleep) in a population of handicapped children. Some degree of difficulty occurred in over a third of the population. There were strong associations with age, a range of serious daytime behavioural difficulties and indices of family stress. Some support for distinct subgroups (night waking, limited hours) was obtained. The implications of these findings are discussed.

Adolescent↗
PubMed1983

Identical triplets with Asperger's syndrome.

The case histories are presented of three 17 year old identical male triplets with Asperger's syndrome. They show the impairments affecting social interaction, non-verbal communication and imagination, the motor clumsiness, and the circumscribed interests characteristic of that condition. They also have some features in their history and present behaviour more typical of childhood autism. Despite marked overall similarities, the three differ in the severity with which their problems are manifested. A relationship can be found between the amount of peri- and post-natal trauma, degree of intellectual impairment and number of autistic features. The findings support the hypothesis that autism and Asperger's syndrome are on the same continuum of pathology.

Adolescent↗
PubMed1982

Prevalence of autism and related conditions in adults in a mental handicap hospital.

The proportions of subjects with severe social impairment and those retaining the features of childhood autism were investigated in a population of mentally retarded adults in a long-stay hospital. The results confirmed the findings of an earlier study of mentally retarded children (Wing & Gould, 1979) that the administrative category of mental retardation includes a substantial minority of people with severe impairment of two-way social interaction. Such social impairment occurred in 38% of the adult population and was very significantly associated with abnormalities of communication and imaginative activities. Muteness, repetitive stereotyped behaviour, including repetitive speech, and a range of behaviour problems also occurred more frequently in the socially impaired group. Two methods of sub-classifying the socially impaired were compared. Classification based on the severity of social impairment gave more statistically significant associations with behavioural and psychological variables than did a method based on the presence or absence of typical autism. The implications of these findings and their relevance for management and planning of services for the mentally retarded were briefly discussed.

Adolescent↗
PubMed1981

Language, social, and cognitive impairments in autism and severe mental retardation.

An epidemiological study is outlined that shows that Kanner's syndrome is one group among a wider range of children, all with impairment of social interaction, communication, and imagination. Most, but not all, children with this triad of impairments are severely mentally retarded, although severe retardation also occurs in those who are sociable and communicative. It is hypothesized that the socially impaired lack certain abilities that are inborn in normal children and the sociable mentally retarded: namely, the capacity to produce and monitor the normal species-specific preverbal sounds, the drive to explore the environment and form concepts to explain experiences, and the ability to recognize that other human beings are of special interest and importance. A possible neurological basis for these problems is briefly considered.

Adolescent↗
PubMed1981

Sex ratios in early childhood autism and related conditions.

Children aged 0-14 on a specified census day, with impairments of verbal and nonverbal communication, social interaction and imaginative play, and with repetitive, stereotyped activities, were identified in an epidemiological study carried out in an area of southeast London. Sociable moderately, severely, and profoundly retarded children were included for comparison. An overall male:female ratio of 2.6:1 was found in those with language and social impairments, but, in the children of this group who were moderately, severely, or profoundly retarded, the ratio was 2.1:1, closely similar to that found in children in the same IQ range with Down's syndrome or cerebral palsy. The excess of males was much more marked in language and socially impaired children who were of higher ability, or who had a history of typical early childhood autism. The findings were linked to hypotheses of genetically greater variability in males, and to male-female differences in visuo-spatial and language skills.

Adolescent↗