Thursday, October 31, 2013
The new ARISk test for autism

By Dr. Anthony Policastro
I recently received an e-mail from a laboratory. They were talking about a new test - the ARISk test. The e-mail said: The ARISk Test was developed to help physicians identify younger siblings of children with autism who are at increased susceptibility for ASD in order to allow for earlier diagnosis and intervention options. The suggestion is that they now have a test to diagnose autism. That is likely the way people will read this. However, that is not true. We know that approximately 20% of children with autism have genetic abnormalities. There are many kinds of abnormalities that they have. This new test looks for the most common of those abnormalities. It then makes a suggestion as to the likelihood of a child having autism based upon those results. As the advertisement says, it is only used for younger siblings of patients who already have autism. The reason for that is simple. These children are at higher risk than the general population for having autism. Even with that being the case, the studies that were done showed that the test still did not make the diagnosis. They found that a positive test makes a male younger sibling of a child with autism twice as likely to have autism. We already know that they are at higher risk. Telling us that the risk is twice what we expected really does not add anything. For female siblings with a positive test, the risk in a positive test is four times the normal population. While that is higher than for males, it does not make the diagnosis. It only tells us that the risk is very high. When I make a diagnosis of autism, I order genetic studies. These will tell me if the child is one of the 20% who has a genetic cause for their autism. If we do find that there is a genetic cause, then we can look for that specifically when the next child is born. Therefore, a screening test like this one will not be useful. If the child is one of the 80% with normal genetic studies, then there is not a specific cause of autism present. For that group of patients, this new test can then be done. It will identify which children are at higher risk. However, it will not make a diagnosis of autism. I suspect that it will not be too long before I have parents coming to the office asking for the autism test. Most of them will be parents of children who do not have older siblings with autism. Thus this test is not meant for them. Some of them will have older siblings with autism, however, their child is not young enough to show symptoms. We know the child is at higher risk for autism. Doing this test will only tell them if the risk is higher than we expect or not. It will not make the diagnosis. It also will not guarantee that their child does not have autism. It is important to diagnose autism early to do the kinds of interventions that help these children. That part of the advertisement is true. However, careful evaluation of the siblings of patients with autism is probably the most important approach to making a diagnosis.

Spina Bifida Awareness Month

By Julleanna Seely
Every October the color pink becomes popular. From NFL players sporting it to pink windshield wipers available at the local service center, the campaign for breast cancer awareness is widely publicized. Let's face it, saving the tatas is a popular cause. However, a much lesser known cause also shares this month. October is Spina Bifida awareness month. The term spina bifida literally means split spine in Latin where the spinal column or neural tube does not close all the way while a baby is growing inside her mother. This occurs early in pregnancy, usually before mom even knows she's expecting. The cause is unknown and there are many different types and levels of severity when it comes to spina bifida, but the facts are that it is the most common permanently disabling birth defect. Spina bifida is estimated to occur in one out of every 1,000 births worldwide, with a slightly lower incidence rate in the U.S. The Spina Bifida Association claims that every day about eight babies born in the U.S. have spina bifida or a similar birth defect of the brain and spine. The types of spina bifida have such a broad range that those with the more mild forms may not even know they have it, while others with the most severe are completely wheelchair bound and paralyzed, often below the waist. Unfortunately, the most severe type is also the most common type of spina bifida - myelomeningocele. With this type of spina bifida, the baby's spinal cord literally protrudes from her back in a sac. This sac can protrude anywhere from the lower spine, which is most typical, to one of the vertebrae at the top of the spine. The higher the lesion is on the spine, the worse the permanent damage. A child's function can vary significantly even if it's just one vertebrae higher on the spine. Children and adults with spina bifida typically lead active and fulfilling lives, but there are many ways that this birth defect impacts them. Spina bifida can cause paralysis, fluid on the brain, lack of bladder/bowel control, weaker leg muscles and more. Fortunately, individuals living with spina bifida often learn to prosper in the face of challenges and go on to become doctors, compete in marathons and record music. The most important awareness to spread about spina bifida is how to prevent it. It's not a guarantee, but the one factor that studies can prove reduces the likelihood of spina bifida occurring in pregnancy is folic acid. Women of child-bearing age should take a daily vitamin with at least 400 mcg of folic acid, more if possible. With increased awareness and the many recent improvements in medicine, the opportunities for these individuals can grow while the occurrence of spina bifida declines.

About the author Julleanna Seely was born in Greenwood and resides in Bridgeville with her husband and two young daughters. Her five-year-old daughter was born with spina bifida, but enjoys a full and happy life with all of her family and friends, especially from preschool.

Seasonal flu shots offered at Mears Health Campus Nanticoke Memorial Hospital will offer seasonal flu shots to individuals 18 and older at Nanticoke Memorial Hospital's Mears Health Campus (300 Rawlins Dr., Seaford, Rehabilitation Services Building) on the following dates: Thursday, Oct. 31 - 10 a.m. to 2 p.m. There is no charge for this year's flu shots. A donation of $10 per vaccination is appreciated. Pre-registration is not required.

Free balance screenings offered Suffering from dizziness or loss of balance? In honor of National PT Month, Seaford Physical Therapy of Aquacare will offer free screenings during the month of October to see if you would benefit from physical therapy.

Licensed physical therapists will provide an assessment of your balance and give tips on strategies to improve your balance. Vertigo is the sensation of spinning. Even when being still, you may feel like you are moving, or that the room is moving around you. You may also experience nausea, vomiting, sweating, and abnormal eye movements. Physical therapy for balance, vertigo, or dizziness is covered by most insurances. For more information or to schedule a free screening, call 536-1774.

Diabetes education program offered Nanticoke Memorial Hospital, Seaford, will hold a four-session diabetes education program on Oct. 30, Nov. 6, 13 and 20, from 5 to 7 p.m., at the hospital. Registration is required. The cost of the program may be reimbursable by insurance. This four-session program includes weekly education sessions and individualized meal planning for diabetes self-management. Family members/significant others are welcome to attend the weekly sessions. Pre-registration is required. For more information and to register, contact Nanticoke Memorial Hospital's Diabetes Education department at 629-6611, ext. 2446.

Mini-Walk for Alzheimer's The 4th Annual Mini-Walk for the Alzheimer's Association along with a yard sale will take place on Saturday, Nov. 2. The yard sale will run from 8 a.m. to noon and the mini-walk begins at 10:30 a.m. at Lofland Park Center at Genesis in Seaford. All proceeds benefit the Alzheimer's Association. For details call 628-3000.

Padilla joins Nanticoke Wound Care Nanticoke Health Services announces that Francisco Padilla, MD, medical director of the Diabetes and Endocrinology Center at Nanticoke, has also joined the Wound Care and Hyperbaric Center team to support the supervision of hyperbaric oxygen therapy. Dr. Padilla completed his residency and fellowship through the University of Connecticut's Primary Care Internal Medicine Residency Program in New Britain, Connecticut and is a board certified internist. Dr. Padilla specializes in the treatment of patients with diabetes or with disorders of the endocrine system. He is also credentialed in hyperbaric medicine, having received extensive training through Comprehensive Healthcare Solutions in Naperville, Ill. For an appointment, call the center at 628-8322.

Jockeys support nutrition program Delaware jockeys are continuing their support of a nutrition program to help improve jockey health and safety on the state's racetracks with a recent donation. The Delaware Jockeys Health and Welfare Fund recently presented $1,000 to the University of Delaware Cooperative Extension to continue an initiative begun in 2009 to improve jockey nutrition. The donation will provide new jockeys with information to make healthy choices in their daily diets. With jockeys facing strict weight limits to participate in races and not impede their horses, many riders can develop eating disorders or practice other unhealthy behaviors to get their weight down before races. Such practices can hinder their riding abilities and safety on the horse. Healthy riders are safer riders, said Wayne. This program helps educate jockeys and their spouses about the risks to their health.

Nanticoke offers first aid classes Nanticoke Memorial Hospital will offer community First Aid classes to anyone interested in learning first aid from 6:30 to 9:30 p.m., at the Nanticoke Training Center located on Water Street in Seaford. Participants will learn basic first aid that will enable them to administer help during the first few moments until emergency responders arrive. Classes are open to participants ages 13 and up. The course covers cognitive learning, role-playing, and skill practice. Cost is $35. Payment and registration is required by no later than five business days prior to the class. To register, or for more information, contact the Nanticoke Memorial Hospital's Training Center office at 629-6611, ext. 8919. Pre-registration is required.

Hospice plans Lunch Bunch lecture Delaware Hospice's Family Support Center will hold a Lunch Bunch Lecture on Friday, Nov. 1, where Dr. Judy Pierson, clinical psychologist, will discuss When a Family Member Struggles with Mental Illness, at the Delaware Hospice Center, 100 Patriots Way, Milford, from noon to 1:30 p.m. Registration is required as seating is limited, and the cost of lunch is $5 per person. For more information, contact Michele August at 302-478-5707 or

Stroke and osteoporosis screenings Residents living in and around Bridgeville may be screened by Life Line Screening to reduce their risk of having a stroke or bone fracture at Union United Methodist Church in Bridgeville on Monday, Nov. 11. The event is sponsored by Bayhealth Medical Center. Screenings identify potential cardiovascular conditions such as blocked arteries and irregular heart rhythm, abdominal aortic aneurysms, and hardening of the arteries in the legs, which is a strong predictor of heart disease. A bone density screening to assess osteoporosis risk is also offered and is appropriate for both men and women. Packages start at $159. All five screenings take 60 to 90 minutes to complete. For more information or to schedule an appointment, call 877-237-1287 or visit Pre-registration is required.

Steuer joins Delaware Hospice Delaware Hospice announces the appointment of Heather Steuer, LPN, of Dover, as community education coordinator statewide. Heather will be responsible for all community outreach to local senior centers, churches, clubs and associations on behalf of Delaware Hospice. She will be the contact throughout Delaware for anyone seeking a speaker on hospice, grief or end-of-life issues for meetings, workshops or conferences. Heather brings to the organization a diverse background including several years of comprehensive nursing experience as well as administrative and communications experience with home health agencies. To schedule a speaker for your organization, or to learn more about Delaware Hospice's community outreach, contact Heather Steuer at 302-678-4444 or