Papers by Carlos G . Aguirre Velázquez
International Journal of Neurology Sciences, 2019
Introduction: Early diagnosis of autistic spectrum disorder is difficult. The use of an observati... more Introduction: Early diagnosis of autistic spectrum disorder is difficult. The use of an observational test that focuses on the "core" clinical features of autism spectrum disorder with good sensitivity and specificity and that is within the reach of the first contact physician, pediatricians or even non-medical staff would help to detect the disorder and initiate the process of diagnosis and early therapeutic measures. Objectives: To determine the sensitivity and specificity of a 3-item direct observation test (TOD3) for the detection of autism in preschool children. Methods: Two groups were formed by convenience: Group 1, formed by 25 subjects with autism by DSM-5 or by ADOS-2. And Group 2, 25 healthy subjects with no history related to ASD and absence of neurological symptoms. MCHAT-ES, 3-items test (TOD3) and ADOS-2 were applied. Results: The direct observation test of 3 items obtained a sensitivity of 92% and specificity of 100% with a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 88%. The positive likelihood ratio (+ LR) was tending to infinity and the negative (-LR) was 0.08. Conclusions: The 3-items direct observation test has good sensitivity and highly specific specificity for easy access and application detection of autism. It can be a useful clinical instrument for the pediatrician or first contact physician.
Revista Mexicana de Neurociencia
Journal of Advances in Medicine and Medical Research
International Journal of Neurology Sciences, 2019
Introduction: Early diagnosis of autistic spectrum disorder is difficult. The use of an observati... more Introduction: Early diagnosis of autistic spectrum disorder is difficult. The use of an observational test that focuses on the "core" clinical features of autism spectrum disorder with good sensitivity and specificity and that is within the reach of the first contact physician, pediatricians or even non-medical staff would help to detect the disorder and initiate the process of diagnosis and early therapeutic measures. Objectives: To determine the sensitivity and specificity of a 3-item direct observation test (TOD3) for the detection of autism in preschool children. Methods: Two groups were formed by convenience: Group 1, formed by 25 subjects with autism by DSM-5 or by ADOS-2. And Group 2, 25 healthy subjects with no history related to ASD and absence of neurological symptoms. MCHAT-ES, 3-items test (TOD3) and ADOS-2 were applied. Results: The direct observation test of 3 items obtained a sensitivity of 92% and specificity of 100% with a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 88%. The positive likelihood ratio (+ LR) was tending to infinity and the negative (-LR) was 0.08. Conclusions: The 3-items direct observation test has good sensitivity and highly specific specificity for easy access and application detection of autism. It can be a useful clinical instrument for the pediatrician or first contact physician.
Revista Mexicana de Neurociencias, 2016
Introducción: El trastorno del espectro autista (TEA) presenta
síntomas en la interacción social,... more Introducción: El trastorno del espectro autista (TEA) presenta
síntomas en la interacción social, comunicación, intereses restringidos
y conductas repetitivas. Se ha propuesto una hipótesis de alteraciones
en el glutamato para explicar la variada sintomatología del TEA.
La memantina es un bloqueador intermitente de los receptores
N-metyl-D-aspartato (NMDA) del glutamato que puede tener efectos
terapéuticos en el TEA.
Objetivo: Demostrar que la memantina tiene efectos terapéuticos
sobre las conductas anormales y las habilidades de atención conjunta
(AC) en un grupo de niños con TEA.
Métodos: Ensayo clínico abierto a 15 niños con TEA tratados con
memantina por dos meses. Se cuantificaron los síntomas conductuales
anormales, efectos secundarios, mejorías y empeoramientos, así
como la atención conjunta por video clínico pre y post memantina.
Resultados: Grupo de 15 pacientes con TEA, 11 niños y 4 niñas.
Edades de 2.6 a 9 años (media de 5.8 años). El 93% de los padres
reportaron mejoría; en atención (60%), comunicación y lenguaje
(53%) y comprensión (40%). Los efectos secundarios reportados
fueron leves en el 86%. En la escala ABC-C se observó mejoría en el
57%. Las calificaciones de atención conjunta demostraron una mejoría
promedio de 0.75 puntos con valor de p no significativos (p=0.40).
Conclusiones: La memantina tiene efectos terapéuticos sobre
las conductas anormales en la escala ABC-C. En la tarea de AC pre y
postratamiento, la diferencia positiva no tuvo significancia estadística.
La memantina es bien tolerada por los pacientes pediátricos con TEA.
ECronicon Neurology, 2019
Keywords: Resistant Epilepsy; Seizures; Pediatric Epilepsy; Cannabidiol Purpose: To describe the ... more Keywords: Resistant Epilepsy; Seizures; Pediatric Epilepsy; Cannabidiol Purpose: To describe the experience of a private neuropediatric clinic on using standardized cannabidiol (CBD) product (RSHO-X™. Medical Marijuana Inc. San Diego, CA, USA), to treat pediatric patients diagnosed with drug-resistant epilepsy (RE) in México. Methods: Forty-six (46) pediatric patients (age: 1-17 years) with severe, drug-resistant epilepsy, who were receiving stable doses of antiepileptic drugs (AED) before study entry. 37 patients were evaluable based on protocol compliance (adherence to treatment and completed control follow-ups at 3, 6, 9 and 12 months). The selected formula contained 5000 mg CBD in 236 mL MCT coconut oil and was free of THC. The initial CBD doses treatment was (1-2 mg/kg/day) and progressively titrate the dose up to 5 mg/kg/day during the first 4 weeks to reduce the seizure frequency by 50% or more. The primary efficacy endpoint was the median percentage change in the mean monthly seizure frequency at the end of the study period. The tolerability was evaluated base on the record of the side effects. Results: The treatment yielded a positive effect on seizure reduction after 3 months. Most of the children 25/37 (67.5%) reported a reduction in seizure frequency; a 100% reduction in 1 (2.2%), more than 80% reduction in 11 (25%), 50% or more in 25 (67.5%) and less than 50% reduction was reported in 12 (27.2%) patients, respectively. Two patients reported an increase in seizures (4.3%), two no improvement (4.3%) and three (6.5%) abandoned with adverse effects dropped out of follow-up before 3 months are not included in this analysis. Adverse reactions occurred in 11/37 (29.7%) patients, with a mild grade in 10 subjects and moderate in 1 subject respectively. Conclusion: The results of this study on the treatment of CBD (RSHO-X™) oil for drug-resistant epilepsy in children and adolescents are promising with good efficacy and tolerability. Abbreviations
JAMMR, 2017
A descriptive observational study using a structured survey was circulated through Facebook netwo... more A descriptive observational study using a structured survey was circulated through Facebook networks that comprised of parents of children and patients with tuberous sclerosis complex and epilepsy on conventional or medicinal cannabis/cannabidiol (CBD) treatment. Of 105 surveys, 58 were obtained by self-selection and 10 from patients treated with CBD. Forty-seven children and 11 adults, 52% male, 48% female, were included. Epileptic syndromes were present in 70.6% of the cases of which Lennox-Gastaut Syndrome (LGS) was in 20, West syndrome (WS) in 20, and epilepsy with myoclonic-astatic crises (MAE) in 6. Refractory epilepsy (RE) was present in 22 (38%) cases. Ten patients (17.2%) underwent CBD treatment; seizures decreased for 7 patients, with significant decreases in 6 and minor decreases in 1. No effect was seen in 3 patients and there were no seizure-free cases or cases where the seizure worsened. Improvement in quality of Original Research Article Aguirre-Velázquez et al.; JAMMR, 23(12): 1-8, 2017; Article no.JAMMR.36585 2 life parameters were observed. Mild adverse events were observed in 4 cases (40%). Monthly treatment costs ranged from $300 pesos with CBD to $35,000 pesos with everolimus. Average monthly costs with CBD were $4,039 ± 2,530 pesos. Patient and parent reports suggest medicinal cannabis is a therapeutic option offering improvement in seizures and quality of life at a moderate cost.
International Journal of Neurology Sciences, 2019
Introduction: Early diagnosis of autistic spectrum disorder is difficult. The use of an observati... more Introduction: Early diagnosis of autistic spectrum disorder is difficult. The use of an observational test that focuses on the "core" clinical features of autism spectrum disorder with good sensitivity and specificity and that is within the reach of the first contact physician, pediatricians or even non-medical staff would help to detect the disorder and initiate the process of diagnosis and early therapeutic measures. Objectives: To determine the sensitivity and specificity of a 3-item direct observation test (TOD3) for the detection of autism in preschool children. Methods: Two groups were formed by convenience: Group 1, formed by 25 subjects with autism by DSM-5 or by ADOS-2. And Group 2, 25 healthy subjects with no history related to ASD and absence of neurological symptoms. MCHAT-ES, 3-items test (TOD3) and ADOS-2 were applied. Results: The direct observation test of 3 items obtained a sensitivity of 92% and specificity of 100% with a positive predictive value (PPV) of 100% and a negative predictive value (NPV) of 88%. The positive likelihood ratio (+ LR) was tending to infinity and the negative (-LR) was 0.08. Conclusions: The 3-items direct observation test has good sensitivity and highly specific specificity for easy access and application detection of autism. It can be a useful clinical instrument for the pediatrician or first contact physician.
Neurology Research International Volume 2017, Article ID 2985729, 5 pages , 2017
Structured online surveys were used to explore the experiences of the parents of children with re... more Structured online surveys were used to explore the experiences of the parents of children with refractory epilepsy using medicinal cannabis in Mexico during September 2016. The surveys, which were completed in full, were reviewed, and 53 cases of children aged between 9 months and 18 years were identified. Of these, 43 cases (82%) were from Mexico and 10 (18%) were from Latin American countries. Of the 43 Mexican cases, the diagnoses were as follows: 20 cases (47%) had Lennox-Gastaut syndrome (LGS); 13 cases (30%) had unspecified refractory epilepsy (URE); 8 cases (19%) had West syndrome (WS); 1 case (2%) had Doose syndrome (DS); and 1 case (2%) had Ohtahara syndrome (OS). In total, 47.1% of cases had previously been treated with 9 or more anticonvulsant therapies. The parents reported a decrease in convulsions when cannabidiol was used in 81.3% of the cases; a moderate to significant decrease occurred in 51% of cases, and 16% of cases were free from seizure. The number of antiepileptic drugs being used was reduced in 9/43 (20.9%) cases. No serious adverse effects were reported, with only some mild adverse effects, such as increased appetite or changes in sleep patterns, reported in 42% of cases.
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Papers by Carlos G . Aguirre Velázquez
síntomas en la interacción social, comunicación, intereses restringidos
y conductas repetitivas. Se ha propuesto una hipótesis de alteraciones
en el glutamato para explicar la variada sintomatología del TEA.
La memantina es un bloqueador intermitente de los receptores
N-metyl-D-aspartato (NMDA) del glutamato que puede tener efectos
terapéuticos en el TEA.
Objetivo: Demostrar que la memantina tiene efectos terapéuticos
sobre las conductas anormales y las habilidades de atención conjunta
(AC) en un grupo de niños con TEA.
Métodos: Ensayo clínico abierto a 15 niños con TEA tratados con
memantina por dos meses. Se cuantificaron los síntomas conductuales
anormales, efectos secundarios, mejorías y empeoramientos, así
como la atención conjunta por video clínico pre y post memantina.
Resultados: Grupo de 15 pacientes con TEA, 11 niños y 4 niñas.
Edades de 2.6 a 9 años (media de 5.8 años). El 93% de los padres
reportaron mejoría; en atención (60%), comunicación y lenguaje
(53%) y comprensión (40%). Los efectos secundarios reportados
fueron leves en el 86%. En la escala ABC-C se observó mejoría en el
57%. Las calificaciones de atención conjunta demostraron una mejoría
promedio de 0.75 puntos con valor de p no significativos (p=0.40).
Conclusiones: La memantina tiene efectos terapéuticos sobre
las conductas anormales en la escala ABC-C. En la tarea de AC pre y
postratamiento, la diferencia positiva no tuvo significancia estadística.
La memantina es bien tolerada por los pacientes pediátricos con TEA.
síntomas en la interacción social, comunicación, intereses restringidos
y conductas repetitivas. Se ha propuesto una hipótesis de alteraciones
en el glutamato para explicar la variada sintomatología del TEA.
La memantina es un bloqueador intermitente de los receptores
N-metyl-D-aspartato (NMDA) del glutamato que puede tener efectos
terapéuticos en el TEA.
Objetivo: Demostrar que la memantina tiene efectos terapéuticos
sobre las conductas anormales y las habilidades de atención conjunta
(AC) en un grupo de niños con TEA.
Métodos: Ensayo clínico abierto a 15 niños con TEA tratados con
memantina por dos meses. Se cuantificaron los síntomas conductuales
anormales, efectos secundarios, mejorías y empeoramientos, así
como la atención conjunta por video clínico pre y post memantina.
Resultados: Grupo de 15 pacientes con TEA, 11 niños y 4 niñas.
Edades de 2.6 a 9 años (media de 5.8 años). El 93% de los padres
reportaron mejoría; en atención (60%), comunicación y lenguaje
(53%) y comprensión (40%). Los efectos secundarios reportados
fueron leves en el 86%. En la escala ABC-C se observó mejoría en el
57%. Las calificaciones de atención conjunta demostraron una mejoría
promedio de 0.75 puntos con valor de p no significativos (p=0.40).
Conclusiones: La memantina tiene efectos terapéuticos sobre
las conductas anormales en la escala ABC-C. En la tarea de AC pre y
postratamiento, la diferencia positiva no tuvo significancia estadística.
La memantina es bien tolerada por los pacientes pediátricos con TEA.