Women

A first-ever study from a large Canadian centre found that kidney transplant recipients lived longer and had better treatment success than patients on intensive home haemodialysis, but also had an increased risk of being hospitalised within the first year.
These findings were reported in a study entitled, ‘Survival and hospitalization for intensive home hemodialysis and kidney transplantation’, by lead author Dr. Karthik Tennankore, nephrologist at Dalhousie University, and Drs. Chris Chan and Joseph Kim, nephrologists at Toronto General Hospital, University Health Network.
The research reaffirms the need to encourage patients receiving intensive home haemodialysis to pursue kidney transplantation as a definitive treatment option for end-stage kidney disease. However, the study also found that the outcomes for these specific dialysis patients were generally positive, especially when compared to patients on in-centre haemodialysis (intensive home haemodialysis patient survival was 94% and 80% at one and five years).
‘For patients with end-stage kidney disease, a kidney transplant is still the best treatment option,’ says Dr. Chris Chan, Deputy Director, Division of Nephrology, University Health Network, R. Fraser Elliott Chair in Home Dialysis and Associate Professor of Medicine, University of Toronto. ‘But not everyone is a candidate for a transplant and we are facing a shortage of organs for these patients. We must continue to study and develop new and better ways to bridge the gap, and that includes developing better dialysis treatments.’
Dialysis will continue to be an important treatment option for many patients, points out Dr. Karthik Tennankore, Division of Nephrology, Dalhousie University. ‘This study also tells us that patients who are receiving this type of dialysis still have very good health outcomes.’
Due to long waiting times for kidney transplants

Researchers in France have hit on a novel method to help kidney stone sufferers ensure they receive the correct and most effective treatment possible.
Kidney stones represent a major medical problem in the western and developing world. If left untreated, apart from being particularly painful, they can lead to renal failure and other complications. In many patients treated successfully, stone recurrence is also a major problem. Clearly a more effective pathological approach to diagnosis and treatment needs to be identified to ensure successful eradication of stones.
Worldwide approximately 1:7000 births are affected by cystinuria, the most frequent cause of stone formation among genetic diseases. Whilst stones are treatable many therapies exist with varying results depending on the type of stone and severity of the incidence.
Cystine stones, of which there are two forms, are composed of tiny micrometre-size crystallites, which are made up of a collection of nanocrystals. Both forms of cystine stone behave in a particular way under different chemical conditions induced by the drug or drugs administered.
By crystallographic techniques Dominique Bazin, Director of Research at Universit

Improving diagnosis and treatment for individuals with autism has been the focus of a growing body of research. New information from these studies led the American Academy of Child and Adolescent Psychiatry to revise key parameters for evaluating and treating autism. Researchers led by Yale Child Study Center director Dr. Fred Volkmar have published the new practice parameters.
‘Early diagnosis of children with autism spectrum disorders means treatments will be introduced that lead to more positive outcomes for children,’ said Volkmar the Irving B. Harris Professor of Psychiatry, Pediatrics, and Psychology at the Yale School of Medicine.
According to the parameters, clinicians should routinely look for symptoms of autism spectrum disorder in young children undergoing developmental assessments, and in all psychiatric evaluations. If significant symptoms are detected, clinicians should then co-ordinate a careful medical, psychological, and communication evaluation. These evaluations should differentiate between autism and a variety of developmental and other disorders, as well as intellectual and behavioural disabilities.
‘Our goal was advocacy for individuals with autism and their families, and to ensure that services are co-ordinated across clinical care,’ said Volkmar. ‘Our field is changing rapidly, and these parameters are meant to promote effective care and move professional medical methods closer to current practices.’
Volkmar and his co-authors reviewed abstracts from 9,481 research articles on autism that were published between 1991 and 2013. They then fully studied 186 of those articles based on their quality and ability to be applied more generally.
‘Treatment should involve a team approach,’ said Volkmar, who notes that under these treatment parameters, psychiatrists will closely co-ordinate diagnosis and treatment with teachers, behavioural psychologists, and speech and language pathologists, and look for commonly occurring conditions.
A key addition to the new parameters is a focus on how clinicians should address the use of non-traditional therapies, like chelation and secretin. Clinicians are urged to ask families if they are using alternative/complementary treatments and to discuss the therapies