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Date:         Fri, 12 Oct 2001 11:39:46 -0700

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From:         FEAT News <featnews@feat.org>

Subject:      Pediatrician Org's Spin on IOM Report on Thimerosal in Vax

              Blasted * Excess of Twins Among Affected Sibling Pairs with

              Autism * Open Trial Of Risperidone In 24 Young Children with PDD

              * Clozapine and Adult Autism * Autism in Tuberous Sclerosis

              Complex * M

FEAT DAILY NEWSLETTER      Sacramento, California      http://www.feat.org

          "Healing Autism: No Finer a Cause on the Planet"

______________________________________________________

October 12, 2001        News Morgue Search  www.feat.org/search/news.asp

    PUBLIC HEALTH

   * Pediatrician Org’s Spin on IOM Report on Thimerosal in Vax Blasted

    RESEARCH (ABSTRACTS)

   * Excess of Twins Among Affected Sibling Pairs with Autism

   * Open Trial Of Risperidone In 24 Young Children with PDD

   * Clozapine and Adult Autism

   * Autism in Tuberous Sclerosis Complex

   * Medical Treatment Of Pervasive Developmental Disorders

   * Reader’s Posts

Pediatrician Org’s Spin on IOM Report on Thimerosal in Vaccines Blasted

“Shame on you AAP!”

      [This letter to Louis Z. Cooper, MD, President - Elect American

Academy of Pediatrics comes from Lyn Redwood of SAFE MINDS.  Redwood is

credited for championing the movement to remove mercury from vaccines.]

      The American Academy of Pediatrics stance on the Institute of Medicine

review of thimerosal containing vaccines and neurodevelopmental outcomes

(AAP press release of October 1, 2001) left me wondering if we had read the

same report. Pediatricians pay sizeable dues to be members of the American

Academy of Pediatrics and rely on your organization to keep them up to date

on research and policy that impact their practice. In my opinion, the 55,000

members of AAP deserve a refund.

      I find the views expressed in the AAP press release to be directly

misleading to pediatricians, other physicians, and to the American public.

The highlights of the IOM report were (a) there is insufficient evidence to

support or refute the safety of thimerosal in vaccines; (b) the association

between thimerosal and neurodevelopmental disorders is biologically

plausible; (c) thimerosal should be removed from medical products; and (d)

further research is necessary. Instead of relaying these balanced set of

facts, your press release focused on these misleading statements:

      It quotes only one line from the IOM report: “No evidence currently

exists that proves a link between thimerosal-containing vaccines and autism,

attention deficit hyperactivity disorder and speech and language delay”; and

then takes that quote out of the context in which it appeared by concluding

that: “’Parents should be reassured about the safety of vaccines’, according

to AAP President Elect Louis Z. Cooper, MD. ‘Children should be immunized

according to the recommended age-appropriate schedule.’”

      In actuality, the IOM report states in the Executive Summary (page 3):

“The committee concludes that although the hypothesis that exposure to

thimerosl containing vaccines could be associated with neurodevelopmental

disorders is not established, and rests on indirect or incomplete

information, primarily from analogies with methyl mercury and levels of

maximum mercury exposure from vaccines given in children, the hypothesis is

biologically plausible.”  As you well know, acknowledging biological

plausibility is the first step necessary in establishing a causal

relationship.

      The report goes on to state (page 4): “The evidence is inadequate to

accept or reject a causal relationship between exposure to thimerosal from

vaccines and the neurodevelopmental disorders of autism, ADHD, and speech

and language delay.”  It is not surprising that the large case controlled

studies that are necessary, according to IOM standards, to either prove or

disprove causality have not yet been done.  This issue surfaced two years

ago at FDA and none of the logical funding agencies have allocated the time

or resources to complete the required investigations. The IOM strongly

recommended that such studies be undertaken. Toxicokinetic and treatment

studies were also recommended - details not touched on in your media

release.

      The comment made by AAP that “children should be immunized according

to the age-appropriate schedule” was not even an issue addressed by the

report. The question was if children should be receiving mercury in their

vaccines and the answer was a resounding no.  “The committee recommends the

use of thimerosal-free DTaP, Hib and Hepatitis B vaccines in the United

States, despite the fact that there might be remaining supplies of

thimerosal-containing vaccine available.” (page 7)

      The American public, partially due to advances on the Internet, is now

able to access documents like the IOM report and read the findings

themselves.  They will no longer tolerate “cherry picking” of reports to

portray a false sense of security.  The AAP may fear that if parents are

given the truth about the safety of thimerosal, some may opt to forgo

vaccination.  What AAP does not seem to understand is that the real risk to

long term immunization levels lies in misleading the public by not correctly

portraying the facts - it is the systematic distortion of the truth by

official, “prestigious” organizations which erodes the publics trust in our

vaccine program and puts our children’s health in jeopardy.

      The AAP portrayal of the IOM findings is inconsistent with the

widespread media coverage of the report.  Your statement may thus create an

even greater rift between parents and their physicians, since parents are

reading the news articles and pediatricians are relying on AAP to keep them

informed.  Additionally, you risk undermining your credibility among many of

your own members, since physicians also read the newspapers and they can

read the IOM report themselves on the IOM website.  A study conducted over a

year ago and mentioned in the IOM report (Freed, 2000) found that 24% of

family physicians and 13% of pediatricians agreed that “I am more concerned

about vaccine safety as a result of thimerosal issues.” You can now count on

those numbers rising even higher as organizations such as yours conduct spin

campaigns to hide the facts.

      Thimerosal in vaccines is a serious issue which must be addressed with

good science and accurate reporting of the facts. With estimates that 17% of

children today under the age of 18 suffer with one or more learning,

developmental or behavioral disabilities, the last thing a parent should

feel is reassured - especially those parents whose children received

multiple thimerosal containing vaccines and now suffer with a broad range of

learning disabilities.

      Shame on you AAP!

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* * *

Excess of Twins Among Affected Sibling Pairs with Autism

Implications for the Etiology of Autism

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui

ds=11590546&dopt=Abstract <-- Address ends here.

1: Am J Hum Genet 2001 Nov;69(5):1062-7

Greenberg DA, Hodge SE, Sowinski J, Nicoll D.

Division of Statistical Genetics, Department of Biostatistics, Columbia

University, and New York State Psychiatric Institute, New York, NY, USA.

dag@shallot.salad.mssm.edu

      It is widely accepted that genes play a role in the etiology of

autism. Evidence for this derives, in part, from twin data. However, despite

converging evidence from gene-mapping studies, aspects of the genetic

contribution remain obscure.

      In a sample of families selected because each had exactly two affected

sibs, we observed a remarkably high proportion of affected twin pairs, both

MZ and DZ. Of 166 affected sib pairs, 30 (12 MZ, 17 DZ, and 1 of unknown

zygosity) were twin pairs. Deviation from expected values was statistically

significant (P<10-6 for all twins); in a similarly ascertained sample of

individuals with type I diabetes, there was no deviation from expected

values.

      We demonstrate that to ascribe the excess of twins with autism solely

to ascertainment bias would require very large ascertainment factors; for

example, affected twin pairs would need to be, on average, approximately 10

times more likely to be ascertained than affected nontwin sib pairs (or 7

times more likely if "stoppage" plays a role).

      Either risk factors (related to twinning or to fetal development) or

other factors (genetic or nongenetic) in the parents may contribute to

autism.

* * *

Open Trial Of Risperidone In 24 Young Children with PDD

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui

ds=11589534&dopt=Abstract <-- Address ends here.

1: J Am Acad Child Adolesc Psychiatry 2001 Oct;40(10):1206-14

Masi G, Cosenza A, Mucci M, Brovedani P.  Division of Child Neurology and

Psychiatry, University of Pisa, and IRCCS Stella Maris, Calambrone, Italy.

masi@inpe.unipi.it

      OBJECTIVE: To describe tolerability and efficacy of risperidone in

very young children with pervasive developmental disorders.

      METHOD: Twenty-four children aged 3.6 to 6.6 years (mean 4.6 years +/-

8 months) enrolled during 1999 and 2000 participated in a 16-week open-label

trial with risperidone monotherapy. Outcome measures included the Children's

Psychiatric Rating Scale (CPRS), Childhood Autism Rating Scale (CARS),

Clinical Global Impression-Improvement (CGI-I), and Children's Global

Assessment Scale (C-GAS).

      RESULTS: Two subjects did not complete the trial because of side

effects. The optimal dose was 0.5 mg/day. After the treatment a 21%

improvement in CPRS and a 14% improvement in CARS total scores was found.

Items related to behavioral control (hyperactivity, fidgetiness, rhythmic

motions) and affect regulation (lability of affect, angry affect) improved

more than 25%. Based on improvement of at least 25% on the CPRS and a score

of 1 or 2 on the CGI-I, eight subjects were considered responders.

Functional impairment (C-GAS) improved more than 25%. Thirteen subjects

(54%) were free of any side effects; in the other participants risperidone

was well tolerated. Only three subjects had a weight gain greater than 10%.

      CONCLUSIONS: Low-dose risperidone may positively affect symptoms in

young autistic children, improving disruptive/hyperactive behavior and

affective dysregulation. Further controlled studies in this age group are

warranted.

      PMID: 11589534 [PubMed - in process]

* * *

Clozapine and Adult Autism

Long-term treatment with clozapine in an adult with autistic disorder

accompanied by aggressive behaviour.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui

ds=11590976&dopt=Abstract <-- Address ends here.

1 : J Psychiatry Neurosci 2001 Sep;26(4):340-1 Related Articles, Books,

LinkOut

Gobbi G, Pulvirenti L.

Publication Types: Letter

PMID: 11590976 [PubMed - in process]

* * *

Autism in Tuberous Sclerosis Complex

Autism in tuberous sclerosis complex is related to both cortical and

subcortical dysfunction.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui

ds=11591847&dopt=Abstract <-- Address ends here.

1: Neurology 2001 Oct 9;57(7):1269-1277 Related Articles, Books, LinkOut

Asano E, Chugani DC, Muzik O, Behen M, Janisse J, Rothermel R, Mangner TJ,

Chakraborty PK, Chugani HT. Departments of Pediatrics (Drs. Asano, D.C.

Chugani, and H.T. Chugani), Neurology (Drs. Asano and H.T. Chugani),

Radiology (Drs. D.C. Chugani, Mangner, and H. T. Chugani), Psychiatry (M.

Behen and Dr. Rothermel), and the Center for Health Effectiveness Research

(J. Janisse), Children's Hospital of Michigan, Wayne State University,

Detroit.

      OBJECTIVE: To examine the relationship between autism and epilepsy in

relation to structural and functional brain abnormalities in children with

tuberous sclerosis complex (TSC).

      METHODS: Children with TSC and intractable epilepsy underwent MRI as

well as PET scans with 2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) and

alpha-[(11)C]methyl-L-tryptophan (AMT). Based on the results of Autism

Diagnostic Interview-Revised, Gilliam Autism Rating Scale, and overall

adaptive behavioral composite (OABC) from Vineland Adaptive Behavior Scale,

subjects were divided into three groups: autistic (OABC < 70; n = 9),

mentally-retarded nonautistic (OABC < 70; n = 9), and relatively normal

intelligence (OABC >/= 70; n = 8).

      RESULTS: PET studies showed that the autistic group had decreased

glucose metabolism in the lateral temporal gyri bilaterally, increased

glucose metabolism in the deep cerebellar nuclei bilaterally, and increased

AMT uptake in the caudate nuclei bilaterally, compared to the

mentally-retarded nonautistic group. In addition, a history of infantile

spasms and glucose hypometabolism in the lateral temporal gyri were both

significantly associated with communication disturbance. Glucose

hypermetabolism in the deep cerebellar nuclei and increased AMT uptake in

the caudate nuclei were both related to stereotypical behaviors and impaired

social interaction, as well as communication disturbance.

      CONCLUSIONS: These results suggest that generalized epilepsy in early

life and functional deficits in the temporal neocortices may be associated

with communication delays, and that functional imbalance in subcortical

circuits may be associated with stereotypical behaviors and impaired social

interaction in children with TSC.

      PMID: 11591847 [PubMed - as supplied by publisher]

* * *

Medical Treatment Of Pervasive Developmental Disorders

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_ui

ds=11588711&dopt=Abstract <-- Address ends here.

1: Rev Neurol 2001 Aug 1;33(3):208-10 [Article in Spanish]

Fuentes J, Gallano I.

Servicio de Psiquiatria Infanto-Juvenil; Policlinica Guipuzcoa. GAUTENA, San

Sebastian, 20011, Espana. jfuentes@servitel.es

      OBJECTIVE. Pervasive developmental disorders, exemplified by autism,

constitute clinical entities which require the attention of child

neurologists.

      DEVELOPMENT. The increasing frequency with which these disorders are

diagnosed supports the need to review and bring up to date the available

data, so as to achieve good practice.

      CONCLUSIONS. There are many studies and initiatives to orient the

child neurologist as to the steps to be taken regarding aspects such as

early identification, association with known syndromes, genetic counselling

and medical advice in general, neuroimaging techniques, treatment of

possible associated epilepsy and use of psychotropic drugs. All these

elements have to be incorporated into an overall individualized program

which, at the present time, has to be basically educational and

rehabilitation, so as to attain maximum self sufficiency and social

participation.

      PMID: 11588711 [PubMed - in process]

* * *

Reader’s Posts

I need help finding the company Food Science Laboratories who produces DMG

(dimethylglycine) for autism. Would appreciate if anyone can advise

information of this company preferably URL address, e-mail or fax number as

we live in Indonesia. Adi TAN winwintr@indosat.net.id

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