Disparities in Care: Do Children with Autism Spectrum Disorder Experience Differential Medication Receipt In The Emergency Department?

ABSTRACT: Objective: The primary objective of this study was to describe analgesia administration between neurotypical (NT) individuals and those with autism spectrum disorder (ASD) diagnosed with appendicitis or long bone fractures in the emergency department (ED). A secondary objective was to compare the rates of complicated appendicitis as a proxy for delayed diagnosis between the groups. Methods: This is a retrospective cohort study using the Pediatric Health Information System database. Study participants were children aged 6 to 18 years with ASD and with an ED visit for appendicitis or fracture between 2004 and 2015 who were matched to demographically similar NT children. Children with a developmental disorder and/or complex chronic condition were excluded. Coarsened exact matching and logistic regression were used to investigate the association between ASD status and opioid and non-opioid medication receipt. Comparison of the rates of complicated appendicitis in children with ASD and NT children was conducted before matching. Results: From 2004 to 2015, 126,412 children with appendicitis and 392,151 children with long bone fractures were identified. Of these, 889 children had a diagnosis of ASD and were matched to 35,672 NT controls with appendicitis. In addition, 2117 children with ASD were matched to 200,635 NT controls with long bone fractures. Receipt of opioids or nonsteroidal anti-inflammatory drugs was not found to be significantly different between th...
Source: Journal of Developmental and Behavioral Pediatrics - Category: Child Development Tags: Original Articles Source Type: research

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Federico Altieri1, Tommy V. Hansen2 and Fabio Vandin1* 1Department of Information Engineering, University of Padova, Padova, Italy 2Department of Mathematics and Computer Science, University of Southern Denmark, Odense, Denmark Next-generation sequencing technologies allow to measure somatic mutations in a large number of patients from the same cancer type: one of the main goals in their analysis is the identification of mutations associated with clinical parameters. The identification of such relationships is hindered by extensive genetic heterogeneity in tumors, with different genes mutated in different patien...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Conclusions: Almost one-third of ASD patients in our sample had at least one fGID. The presence of fGID was associated with ID, sleep problems and with behavioral problems (as measured by the prescription of psychotropic drugs). This subsample of ASD patients with fGID deserves particular attention in future research projects, focusing on specific phenotypic characteristics and overlapping biological markers that may underlie both pathologies. Introduction Autism spectrum disorder (ASD) is a pervasive neurodevelopmental disorder characterized by impairments in social communication and restricted, repetitive patterns ...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
This report would examine developments at the state and federal-level, court cases, and current views from stakeholders. Policy Questions Which states have PAS laws and what do those laws provide? What protections against abuse of PAS?What have the Supreme Court and lower courts held regarding individuals’ rights under PAS laws? The laws themselves?Is there evidence that persons with disabilities are being denied treatment by insurance companies but offered PAS instead, as NCD predicted?How is PAS viewed by disability organizations? Has this evolved in the past 13 years? If so why? If not, why?Are persons with disabi...
Source: blog.bioethics.net - Category: Medical Ethics Authors: Tags: Health Care syndicated Source Type: blogs
PMID: 29336738 [PubMed - in process]
Source: The American Surgeon - Category: Surgery Authors: Tags: Am Surg Source Type: research
Author Affiliations open 1Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, Scotland, UK 2Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, Scotland, UK 3Adolphe Merkle Institute, University of Fribourg, Fribourg, Switzerland 4Swansea University Medical School, Swansea, Wales, UK 5University of Rochester Medical Center, Rochester, New York 6Department of Public Health, University of Copenhagen, Copenhagen, Denmark 7IUF Leibniz-Institut für Umweltmedizinische Forschung, Düsseldorf, Germany 8National Research Centre for the Working Environment...
Source: EHP Research - Category: Environmental Health Authors: Tags: Review Source Type: research
Conclusion: We concluded there was sufficient evidence supporting an association between developmental PBDE exposure and reduced IQ. Preventing developmental exposure to PBDEs could help prevent loss of human intelligence. https://doi.org/10.1289/EHP1632 Received: 16 January 2017 Revised: 28 April 2017 Accepted: 28 April 2017 Published: 03 August 2017 Address correspondence to J. Lam, Program on Reproductive Health and the Environment, University of California, San Francisco, Mail Stop 0132, 550 16th St., 7th floor, San Francisco, CA 94143 USA. Telephone: (415) 476-3219. Email: Juleen.Lam@ucsf.edu Supplemental Materi...
Source: EHP Research - Category: Environmental Health Authors: Tags: Review Source Type: research
Yes it ’s a big story in more ways than one – a team of Harvard scientists say that scientists say they are on thebrink of being able to create a hybrid elephant-mammoth embryo. There are lots of technical and ethical concerns to address before we actually have real, live mammoths (or mammophants, as they ’re being called by some) but the idea of “de-extinctifying” something that’s been gone for 4,000 years is pretty exciting. This isn’t the only genetic engineering story in town this week, though, as amajor US report out this week has prepared ground for genetic modification of hu...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Science Source Type: news
In this study published in the journal Neuroscience, the performance of mice on various tests of mental and physical function began to drop just four weeks after being fed a diet high in fat and sugar. Monosaccharides, the simplest carbohydrates containing a single molecule of glucose and fructose (a piece of Wonder bread), disrupt a healthy microbial balance because they are digested very easily by us and absorbed into our small intestine without any help from our microbes. That leaves our gut bugs hungry, with nothing to munch on, so they begin nibbling on the mucus lining of our intestines, which is meant to b...
Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: Alternative and Nutritional Supplements Books Depression Mental Health and Wellness Personal Research Alcohol Caffeine Diet gut bacteria Gut flora Lactobacillus leaky gut Monosaccharides Probiotic sugar Source Type: blogs
A 15-year-old boy with a history of autism spectrum disorder was admitted with abdominal pain. He originally had presented 2 weeks earlier with abdominal pain but was discharged after ruling out appendicitis by an ultrasound. He returned with ongoing pain in the right upper quadrant (RUQ) with postprandial vomiting and fever. Vitals were as follows: blood pressure, 101/57 mm Hg; pulse rate, 104/min; temperature, 99.1 °F; and body mass index, 18.3 kg/m2. Abdominal examination showed a firm and tender RUQ with negative Murphy’s sign.
Source: Clinical Gastroenterology and Hepatology - Category: Gastroenterology Authors: Tags: Electronic Image of the Month Source Type: research
Editor’s note: “Narrative Matters: On Our Reading List” is a monthly roundup where we share some of the most compelling health care narratives driving the news and conversation in recent weeks. Stunting The Growth Of Children With Disabilities Parents of children with severe disabilities concerned about being able to physically care for their children as they grow up are finding hope in a treatment known as “growth-attenuation therapy,” but questions about the ethics of the therapy, and a lack of long-term outcomes data, mire the treatment in controversy. In The New York Times Magazine, G...
Source: Health Affairs Blog - Category: Health Management Authors: Tags: Elsewhere@ Health Affairs Featured Narrative Matters autism heart disease On Our Reading List Source Type: blogs
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