Shafallah Center

An increasing body of evidence supports the role of altered sensory processing in autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This exploratory study undertook corneal confocal microscopy (CCM) to assess for differences in corneal nerve fiber density (CNFD), branch density (CNBD) and fiber length (CNFL) in relation to ASD severity in children with ASD+ADHD (n = 21), ASD (n = 6) and healthy controls (HC) (n = 15). CNBD was significantly lower in children with ASD+ADHD (P = 0.002) and ASD (P < 0.001) and CNFL was significantly lower in children with ASD (P = 0.02) compared to HC. However, CNFD (mean difference = 2.28, 95% CI [-5.84, 10.40], P > 0.99) CNBD (mean difference = 14.1, 95% CI [-8.22, 36.4], p = 0.37) and CNFL (mean difference = 2.46, 95% CI [-2.28, 7.20], p = 0.61) did not differ between ASD+ADHD and ASD. CNFD (P = 0.876), CNBD (P = 0.405) and CNFL (P = 0.606) did not correlate with the severity of ASD. Corneal confocal microscopy reveals sensory nerve degeneration in children with ASD+ADHD and ASD alone compared to controls. Larger studies integrating CCM with sensory and cognitive assessment are required to determine the utility of CCM as a clinical screening strategy for neurodegneration in ASD, ADHD and ASD-ADHD combined.

The role of noninvasive positive pressure ventilation (NIPPV) in adult respiratory distress syndrome (ARDS) is controversial, in contrast to its well established benefits in other types of respiratory failure, especially acute exacerbations of chronic obstructive pulmonary disease and cardiogenic pulmonary oedema. We report a case of ARDS caused by <i>Mycoplasma pneumoniae</i> in a 70 year old man, treated with NIPPV in addition to standard medical therapy and analyse current evidence regarding the role of NIPPV in patients with ARDS.