Cecilia Pessoa Gingerich

A pilot study has found that a video game designed to treat autism spectrum disorder (ASD) and co-occurring attention/deficit-hyperactivity disorder (ADHD) is acceptable to kids and parents and feasible. While not statistically significant, investigators did report an improvement in measures of attention for children who played with the multi-tasking game.

, but without co-occurring ASD. Investigators led by Benjamin Yerys, PhD, a child psychologist at the Center for Autism Research at Children’s Hospital of Philadelphia, wanted to test the digital medicine tool with this unique population of children with both diagnoses.

The Project Evo game requires children to multi-task by switching between a memory-based task and a visuomotor task. The first requires players to tap the screen to choose a target from a few options, for example, a blue fish as the target with red and yellow fish as distractions, according to the paper. The second task consists of steering a hovercraft along a river. The game’s difficulty increases as the child progresses.

The educational game that children in the control group were given tasked them with generating ever-longer words from a pool of letters.

Children assigned to either group demonstrated high engagement with the games, indicating feasibility of the treatment. Despite the study’s small sample size&#151;just 19 children—the CHOP team also measured promising trends in attention scores for the patients assigned to the multi-tasking game compared to those in the control group.

A version of the article was originally published by Md Magazine. Visit

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A pilot study has found that a video gameÂ designed to treat autism spectrum disorder and co-occurringÂ attention/deficit-hyperactivity disorder (ADHD)Â is acceptable to kids and parents, and feasible. 

Video Game Shows Promise as Treatment for ADHD, Autism

The US Food and Drug Administration (FDA) has approved Dextenza, a dexamethasone ophthalmic insert, for intracanalicular use for the treatment of ocular pain following ophthalmic surgery.

Dextenza is inserted in the lower lacrimal punctum and into the canaliculus. Once in place, the ophthalmic insert releases .4mg dexamethasone to reduce post-surgical pain for up to 30 days with a single administration. The device could replace current standard of care regimens that include up to 70 topical steroid-containing eye drops.

The FDA’s approval decision was supported by data from 2 randomized, vehicle-controlled phase 3 studies, which showed that a statistically significantly higher percentage of patients were pain free 8 days after cataract surgery with Dextenza than with the vehicle control.

In study 1, 80% of patients treated with Dextenza (n = 164) were pain free at day 8, compared to 43% of patients in the vehicle arm (n = 83) (

<.0001). In the second study, 77% (n=161) and 59% (n=80) of patients treated with Dextenza and vehicle were pain free after 8 days (

Safety data came from both phase 3 studies as well as a phase 2 study of Dextenza, which together totaled 351 patients. The most common ocular adverse reactions were anterior chamber inflammation including iritis and iridocyclitis (9%), increased intraocular pressure (5%), reduced visual acuity (2%), eye pain (1%), cystoid macular edema (1%), corneal edema (1%), and conjunctival hyperemia (1%). The most common non-ocular adverse event was headache (1%).

FDA Approves Dextenza for Ocular Pain Following Surgery

Most children with overweight or obesity who have high blood pressure (BP) do not receive information from their pediatrician about the elevated BP at well-child visits, according to a study to be presented at the

American Heart Association Scientific Sessions 2018 in Chicago, IL

Investigators found that communication from pediatric providers about high blood pressure was direct in 16.6%, unclear in 16.6%, minimized in 13%, and absent in 66.7% of recorded visits.

“High blood pressure (BP) in children is under recognized by pediatric providers,” wrote the authors, Nora Bismar, BS, University of Texas Southwestern, Dallas, TX; Tammy M Brady, MD, PhD, Johns Hopkins School of Medicine, Baltimore, MD; and Christy B Turer, MD, University of Texas Southwestern, Dallas, TX. “Our aim was to describe and determine factors associated with provider communication of high BP during visits with a child with an elevated BP.”

The study was a cross-sectional analysis of 30 video- or audio-recorded well-child visits with 23 providers for children ages 6-12 who were overweight or obese. Investigators determined elevated blood pressure and hypertension by applying pediatric hypertension thresholds to blood pressure data stored in electronic health records.

Study: Pediatricians Often Miss Opportunities to Address High Blood Pressure in Children

A 14-year case-control study of older adults reports that elevated blood glucose was the only cardiometabolic risk factor with consistently higher values among participants with future dementia up to 14 years before diagnosis. The study was presented at the Alzheimer's Association International Conference on July 24, 2018 in Chicago, Illinois.

The study noted that in cases, body mass index (BMI) declined and systolic blood pressure (BP) increased more slowly in the 14 years before diagnosis, compared to controls. Study authors, led by Maude Wagner, MPH, Bordeaux Population Health Research Center, University of Bordeaux, suggested that the lower BP in prodromal dementia could be a “consequence and a contributing factor” while higher blood glucose levels may be a risk factor for dementia among older adults.

“Overall, these findings suggest that elevated glycemia, low BP, and weight loss may be primary targets for the management of cardiometabolic health for primary and secondary prevention of dementia in the older age range,” said Wagner et al.

This study is nested within an ongoing, prospective cohort study of adults aged 65 and older, the Three-City (3C) study, that began in 1999. The present study matched dementia cases (n = 841) with 4 controls each and compared the trajectories for major cardiometabolic risk factors up to 14 years preceding dementia diagnoses for the cases.

Specifically, the researchers examined BMI, systolic BP, diastolic BP, HDL cholesterol, LDL cholesterol, triglycerides, and glycemia levels between 1999 and 2014. Measurements were taken at baseline (T

) and at 5 follow up visits to participants in Dijon every 2-3 years (T

) and 6 visits to participants in Bordeaux and Montpellier (including the additional T

A study matched dementia cases (n = 841) with 4 controls each and compared the trajectories for major cardiometabolic risk factors up to 14 years preceding dementia diagnoses for the cases.

Researchers: BMI, Blood Pressure, Glycemia Linked to Dementia

Early preterm birth—delivery at gestational age 22-33 weeks&mdash;is associated with a higher level of ADHD symptoms in preschool-age children, according to a decade-long prospective cohort study of siblings in Norway. Children who were born early preterm scored an average of 0.24 SD (95% CI, 0.14-0.34) higher on ADHD symptoms at age 5 compared with children born at 40 weeks gestational age.

“The findings illustrate potential gains of reducing preterm birth and the importance

of providing custom support to children born preterm to prevent neurodevelopmental problems,” said the study authors Helga Ask, PhD, Kristin Gustavson, PhD, Eivind Ystrom, PhD, et al.

the study also found that early premature birth was associated with inattentive, but not hyperactive ADHD symptoms in children at 8 years of age. Compared to siblings born at 40 weeks, children born early preterm scored 0.32 SD D (95% CI, 0.02-0.62) higher on ADHD at 5 years of age, 0.31 SD (95% CI, 0.05-0.57) higher on inattention at 8 years of age, and 0.03 (95% CI, −0.32 to 0.26) lower on hyperactivity at 8 years of age.

“To our knowledge, this is the first study to investigate the association between preterm birth and symptoms of ADHD using a sibling-comparison design,” said the authors.

In addition, results showed a sex by gestational week interaction effect on ADHD symptoms when children were 5 years old. Girls born at gestational age 22-33 weeks scored a mean of 0.8 SD higher compared to their sisters born at full term (95% CI, 0.12-1.46;

= .02). This association between gestational age and ADHD symptoms at 5 years of age was not observed in boys when compared to their brothers.

“Our results suggest that the negative consequences of being born preterm are most pronounced in girls (at 5 years of age), although the power of the sex-stratified analyses is limited,” said study authors.

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