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1.
Infect Immun ; 91(5): e0055822, 2023 05 16.
Artículo en Inglés | MEDLINE | ID: mdl-37039653

RESUMEN

Pre-existing HIV infection increases tuberculosis (TB) risk in children. Antiretroviral therapy (ART) reduces, but does not abolish, this risk in children with HIV. The immunologic mechanisms involved in TB progression in both HIV-naive and HIV-infected children have not been explored. Much of our current understanding is based on human studies in adults and adult animal models. In this study, we sought to model childhood HIV/Mycobacterium tuberculosis (Mtb) coinfection in the setting of ART and characterize T cells during TB progression. Macaques equivalent to 4 to 8 year-old children were intravenously infected with SIVmac239M, treated with ART 3 months later, and coinfected with Mtb 3 months after initiating ART. SIV-naive macaques were similarly infected with Mtb alone. TB pathology and total Mtb burden did not differ between SIV-infected, ART-treated and SIV-naive macaques, although lung Mtb burden was lower in SIV-infected, ART-treated macaques. No major differences in frequencies of CD4+ and CD8+ T cells and unconventional T cell subsets (Vγ9+ γδ T cells, MAIT cells, and NKT cells) in airways were observed between SIV-infected, ART-treated and SIV-naive macaques over the course of Mtb infection, with the exception of CCR5+ CD4+ and CD8+ T cells which were slightly lower. CD4+ and CD8+ T cell frequencies did not differ in the lung granulomas. Immune checkpoint marker levels were similar, although ki-67 levels in CD8+ T cells were elevated. Thus, ART treatment of juvenile macaques, 3 months after SIV infection, resulted in similar progression of Mtb and T cell responses compared to Mtb in SIV-naive macaques.


Asunto(s)
Antirretrovirales , Modelos Animales de Enfermedad , Macaca , Mycobacterium tuberculosis , Virus de la Inmunodeficiencia de los Simios , Tuberculosis , Humanos , Preescolar , Niño , Animales , Tuberculosis/complicaciones , Tuberculosis/inmunología , Infecciones por VIH/complicaciones , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/inmunología , Virus de la Inmunodeficiencia de los Simios/fisiología , Síndrome de Inmunodeficiencia Adquirida del Simio/complicaciones , Síndrome de Inmunodeficiencia Adquirida del Simio/inmunología , Linfocitos T/inmunología , Antirretrovirales/administración & dosificación , Mycobacterium tuberculosis/fisiología
2.
Am J Geriatr Psychiatry ; 31(10): 833-843, 2023 10.
Artículo en Inglés | MEDLINE | ID: mdl-37217371

RESUMEN

OBJECTIVE: This study compared sexual abuse histories and depressive symptoms between younger, middle-aged, and older sexual and gender minority (SGM) male survivors. DESIGN: Participants completed a brief, online screener as part of a large comparative effectiveness psychotherapy trial. SETTING: SGM males 18 years or older, residing in the U.S. or Canada, were recruited online. PARTICIPANTS: This study included younger (aged 18-39; n = 1,435), middle-aged (aged 40-59; n = 546), and older (aged 60+; n = 40) SGM men who reported a history of sexual abuse/assault. MEASUREMENTS: Participants were asked about their sexual abuse history, experience of other traumas, symptoms of depression, and past 60-day mental health treatment engagement. RESULTS: Older SGM men reported a lower rate of occurrence of adult sexual assault, exposure to other traumas, and depression. However, older and younger groups did not differ on any childhood sexual assault variable, the frequency of or number of attackers for adult sexual assault, the frequency of accidents and other injury traumas, or the occurrence or frequency of mental health treatment. Trauma load, including childhood and adult sexual assault, were more strongly related to current depressive symptoms than age group. CONCLUSION: While there were some age-based or cohort differences in the rates of sexual trauma, the clinical response of both groups was similar. Implications for working clinically with middle-aged and older SGM men with untreated sexual assault-related mental health difficulties are discussed, including outreach and availability of gender- and older-inclusive survivor treatment and resources.


Asunto(s)
Delitos Sexuales , Minorías Sexuales y de Género , Anciano , Niño , Humanos , Masculino , Persona de Mediana Edad , Identidad de Género , Salud Mental , Conducta Sexual , Sobrevivientes , Factores de Edad
3.
South Med J ; 116(3): 286-289, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36863049

RESUMEN

OBJECTIVES: Eating disorders affect the physical and mental health of millions of Americans. Body composition trends in relation to heart rate in adolescents with eating disorders remain understudied. The aim of the present study was to determine whether body composition parameters (percent body fat, percent skeletal muscle mass) are correlated with heart rate in a sample of adolescents with anorexia nervosa. METHODS: This study included patients 11 to 19 years old who presented to an outpatient eating disorder clinic (N = 49). Patients underwent bioelectrical impedance analysis to estimate body composition parameters. Descriptive statistics, linear regression, and paired t tests were used to evaluate the data. RESULTS: Heart rate was inversely associated with percent skeletal muscle mass (P < 0.001) and positively associated with percent body fat (P = 0.001). Patients demonstrated significant improvements in weight, body mass index percentile, skeletal muscle mass, percent body fat, and heart rate when comparing results at the first and last visits (P < 0.01). CONCLUSIONS: Overall, there was an inverse relation between percent skeletal muscle mass and heart rate and a positive association between body fat and heart rate. Our study demonstrates the importance of assessing percent body fat and skeletal muscle mass rather than weight or body mass index alone in adolescents with eating disorders.


Asunto(s)
Anorexia Nerviosa , Humanos , Adolescente , Niño , Adulto Joven , Adulto , Anorexia Nerviosa/complicaciones , Frecuencia Cardíaca , Composición Corporal , Instituciones de Atención Ambulatoria , Índice de Masa Corporal
4.
J Child Sex Abus ; 32(4): 494-512, 2023 May.
Artículo en Inglés | MEDLINE | ID: mdl-37080178

RESUMEN

This paper provides a description and evaluation of training male sexual abuse survivors to deliver Motivational Interviewing (MI) and Motivational Interviewing with Trauma-Informed Affirmative Care (MI-AC) online to sexual and gender minority (SGM) men with sexual assault histories and depression. After a search and selection process, 26 men with lived experience of sexual abuse received MI training that included the use of role-playing, video demonstrations, and practice followed by weekly supervision while co-leading groups. Peer leaders completed several measures pre and post training, including beliefs about MI and self-reported learning of MI and satisfaction with the training. A sample of MI and MI-AC audio sessions were independently rated for adherence and competence. Peer leaders' beliefs about MI changed over time, while self-rated skill level stayed consistent. Peer leaders demonstrated good adherence to the MI and MI-AC conditions. Results suggest that men with lived experience of sexual trauma effectively learned to deliver MI and/or MI-AC to SGM male survivors in online groups. These interventions have the potential to expand the reach of limited services for this population as well as reduce their depression and assist in SGM men with histories of sexual abuse entering into formal mental health services.


Asunto(s)
Abuso Sexual Infantil , Entrevista Motivacional , Niño , Humanos , Masculino , Entrevista Motivacional/métodos , Grupo Paritario , Conducta Sexual , Sobrevivientes
5.
PLoS Pathog ; 16(5): e1008585, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32433713

RESUMEN

Mucosal-associated invariant T (MAIT) cells can recognize and respond to some bacterially infected cells. Several in vitro and in vivo models of Mycobacterium tuberculosis (Mtb) infection suggest that MAIT cells can contribute to control of Mtb, but these studies are often cross-sectional and use peripheral blood cells. Whether MAIT cells are recruited to Mtb-affected granulomas and lymph nodes (LNs) during early Mtb infection and what purpose they might serve there is less well understood. Furthermore, whether HIV/SIV infection impairs MAIT cell frequency or function at the sites of Mtb replication has not been determined. Using Mauritian cynomolgus macaques (MCM), we phenotyped MAIT cells in the peripheral blood and bronchoalveolar lavage (BAL) before and during infection with SIVmac239. To test the hypothesis that SIV co-infection impairs MAIT cell frequency and function within granulomas, SIV+ and -naïve MCM were infected with a low dose of Mtb Erdman, and necropsied at 6 weeks post Mtb-challenge. MAIT cell frequency and function were examined within the peripheral blood, BAL, and Mtb-affected lymph nodes (LN) and granulomas. MAIT cells did not express markers indicative of T cell activation in response to Mtb in vivo within granulomas in animals infected with Mtb alone. SIV and Mtb co-infection led to increased expression of the activation/exhaustion markers PD-1 and TIGIT, and decreased ability to secrete TNFα when compared to SIV-naïve MCM. Our study provides evidence that SIV infection does not prohibit the recruitment of MAIT cells to sites of Mtb infection, but does functionally impair those MAIT cells. Their impaired function could have impacts, either direct or indirect, on the long-term containment of TB disease.


Asunto(s)
Coinfección/inmunología , Células T Invariantes Asociadas a Mucosa/inmunología , Mycobacterium tuberculosis/inmunología , Síndrome de Inmunodeficiencia Adquirida del Simio/inmunología , Virus de la Inmunodeficiencia de los Simios/inmunología , Tuberculosis Pulmonar/inmunología , Animales , Coinfección/patología , Granuloma/inmunología , Granuloma/patología , Ganglios Linfáticos/inmunología , Ganglios Linfáticos/patología , Macaca fascicularis , Células T Invariantes Asociadas a Mucosa/patología , Receptor de Muerte Celular Programada 1/inmunología , Receptores Inmunológicos/inmunología , Síndrome de Inmunodeficiencia Adquirida del Simio/patología , Tuberculosis Pulmonar/patología
6.
Public Health Nutr ; : 1-29, 2022 Mar 23.
Artículo en Inglés | MEDLINE | ID: mdl-35318906

RESUMEN

OBJECTIVE: As older adults are at higher risk for severe illness and mortality from SARS-CoV-2 infection, social distancing has been a primary means of mitigating risk. However, this lifestyle change may impact eating habits and food choices. The aim of this study was to explore individual and interpersonal factors affecting the eating behaviors and dietary intake of community-dwelling older adults during the COVID-19 pandemic. DESIGN: Semi-structured individual interviews were conducted. All interviews were audio-recorded and transcribed verbatim. Qualitative data were analyzed using a deductive content analysis approach to identify themes. SETTING: Southeastern United States. PARTICIPANTS: Twenty-three men and women, 60 years of age and older (mean age 71.9 ± 7.7, 22% male) completed both the interview and questionnaire. RESULTS: Themes that emerged at the individual level included changes in eating habits and foods eaten, with most participants reporting healthier food choices during the pandemic. Participants also reported more frequent cooking, improved cooking skills, and cooking as a form of stress relief. Although some older adults described increased snacking and consumption of "comfort foods", others noted no influence of mood on food choices. At the interpersonal level, an increased use of technology for social interaction and the importance of social support were identified as influencing factors. CONCLUSIONS: Findings provide insight on how to help older adults maintain good nutrition amidst lifestyle changes imposed by social distancing. Nutrition educators may capitalize on positive behavior changes that occurred during the pandemic such as increased cooking and increased use of technology for social interaction.

7.
Nutr Metab Cardiovasc Dis ; 31(10): 2959-2968, 2021 09 22.
Artículo en Inglés | MEDLINE | ID: mdl-34344546

RESUMEN

BACKGROUND AND AIMS: Watermelon juice is a rich food source of cardioprotective compounds such as arginine, citrulline, and lycopene. Preventative interventions are warranted as risk of cardiovascular disease increases among women after menopause, and age alone is an independent risk factor for vascular dysfunction. Thus, this study evaluated the effects of 100% watermelon juice on measures of vascular function. METHODS AND RESULTS: In this randomized, double-blind, placebo-controlled, crossover trial, 21 healthy postmenopausal women were randomized to consume two 360 mL servings of 100% watermelon juice per day or an isocaloric placebo for four weeks. Following a two-week washout period, they consumed the other beverage for an additional four weeks. Before and after each treatment arm, a fasting blood sample was taken for measurement of serum arginine, citrulline, lycopene, glucose, and insulin. Assessments of vascular function included pulse pressure, pulse wave velocity, 24-h ambulatory blood pressure, and flow-mediated dilation. General linear mixed models with intent-to-treat analyses were used to examine the effects of the intervention. Despite a significant treatment effect for circulating lycopene (p = 0.002), no changes in arginine, citrulline, or any vascular measures were observed. Although the juice intervention resulted in a slight but significant increase in fasting serum glucose (p = 0.001), changes in glucose homeostasis were not clinically significant. CONCLUSION: In contrast to findings from previous studies in younger adults and those with pre-existing hypertension, measures of vascular function in this cohort of healthy postmenopausal women were not impacted by supplemental watermelon juice. CLINICALTRIALS. GOV IDENTIFIER: NCT03626168.


Asunto(s)
Glucemia/metabolismo , Presión Sanguínea/efectos de los fármacos , Citrullus , Jugos de Frutas y Vegetales , Posmenopausia/sangre , Rigidez Vascular/efectos de los fármacos , Anciano , Alabama , Biomarcadores/sangre , Estudios Cruzados , Método Doble Ciego , Femenino , Homeostasis , Humanos , Licopeno/sangre , Persona de Mediana Edad , Factores de Tiempo
8.
J Am Coll Nutr ; 38(7): 640-647, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31145045

RESUMEN

Objectives: This study explores relationships between cardiometabolic measures of antioxidant capacity or inflammation and diet quality assessed by the Healthy Eating Index (HEI)-2010 which measures conformity to Dietary Guidelines for Americans. This cross-sectional study was an ancillary analysis of baseline data for a randomized controlled trial with older adults at risk for cardiometabolic disease (ClinicalTrials.gov #NCT00955903). Methods: Community-dwelling older adults (n = 133, 49% male, 70.4 ± 4.8 years) with a body mass index of 30-40 kg/m2 provided a fasted blood sample for measurement of antioxidant capacity, high-sensitivity C-reactive protein, tumor necrosis factor-alpha, and interleukin-6. Dietary data were generated from the mean of three 24-hour recalls. Results: After adjustment for potential confounders, HEI-2010 composite scores were not significantly associated with decreased inflammation or greater antioxidant capacity. In analysis of the 12 components composing the HEI-2010, significant positive association was observed between total dairy and total serum antioxidant capacity (0.043; 95% CI, 0.008-0.069). Significant associations observed in inflammatory markers were between total vegetable and tumor necrosis factor-alpha (-0.078; 95% CI, -0.151 to -0.005), sodium and interleukin-6 (0.091; 95% CI, 0.023-0.158), and scores for combined calories from solid fats, alcoholic beverages, and added sugars and interleukin-6 (0.139; 95% CI, 0.027-0.252). In models adjusting for HEI-2010 composite score when significant associations were observed between component scores and biomarkers, two of six associations were strengthened by adding the composite score as a potential confounder. Conclusions: Largely null findings along with those inconsistent with scientific expectations suggest caution in extrapolating adherence to the HEI-2010 with an individual's inflammatory or antioxidant status. Results merit additional investigation with other biomarkers of chronic disease and emphasis on dietary patterns given potential synergy within food combinations.


Asunto(s)
Antioxidantes , Dieta Saludable , Dieta/normas , Anciano , Biomarcadores , Estudios Transversales , Femenino , Humanos , Inflamación/etiología , Inflamación/metabolismo , Masculino , Estados Unidos
9.
South Med J ; 112(12): 621-625, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31796973

RESUMEN

OBJECTIVES: To assess the present use of dietary supplements among the Parkinson disease (PD) population and to determine which dietary supplements are most commonly taken. METHODS: This cross-sectional study used an online questionnaire that was administered to individuals with PD via support group Web sites. Dietary supplement users also were asked whether they spoke with a healthcare professional about their supplement use. RESULTS: Of the 205 respondents, 83.4% reported taking at least 1 dietary supplement. Although 94 different types of dietary supplements were identified, >50% of participants taking dietary supplements took multivitamins, vitamin D, and vitamin B12 (52.6%, 74.3%, and 56.1%, respectively). Respondents reported taking coenzyme Q10, Mucuna pruriens, folate, vitamin B12, vitamin B6, melatonin, and N-acetylcysteine most commonly for PD. Among supplement users, 29.2% did not discuss their supplement use with a healthcare practitioner. CONCLUSIONS: The results of this study demonstrate a high prevalence of dietary supplement use among individuals with PD, in addition to a wide variety of supplements being taken. This study's findings also indicate the need for better dialog between patients and healthcare practitioners regarding the use of dietary supplements.


Asunto(s)
Suplementos Dietéticos/estadística & datos numéricos , Enfermedad de Parkinson/epidemiología , Automedicación/estadística & datos numéricos , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Estados Unidos/epidemiología , Vitaminas/administración & dosificación
10.
J Am Pharm Assoc (2003) ; 59(4S): S52-S56, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31010784

RESUMEN

OBJECTIVES: To perform a needs assessment with the use of evidence-based core indicators developed by the Preconception Health and Heath Care (PCHHC) Initiative Clinical Workgroup and Centers for Disease Control and Prevention (CDC) to describe the preconception care needs among female patients of a community pharmacy. METHODS: Women of childbearing age received a paper survey in either English or Spanish containing questions about patient demographics, health status, and pregnancy considerations. On completion of the survey, patient medication history data were retrospectively gathered from the medication profile and vaccination status on select vaccines was determined using the Michigan vaccination reporting system. RESULTS: Ninety-nine surveys were completed. The median age was 30 years (range 18-44). Of survey participants, 77.8% indicated that they were sexually active, 70.7% had an abnormal body mass index, 78.8% were missing documentation of one or more recommended vaccinations, 66.7% were not taking any form of daily folic acid supplementation, and 49.5% were using at least 1 medication with potential teratogenic effects. CONCLUSION: A preconception health needs assessment conducted in a community pharmacy with female patients of childbearing age found multiple opportunities for intervention such as improving daily folic acid supplementation and ensuring appropriate management of medications with potential teratogenic effects. Each of the preconception care needs assessed can be addressed through services provided by community pharmacists.


Asunto(s)
Atención a la Salud/estadística & datos numéricos , Farmacias/estadística & datos numéricos , Farmacéuticos/estadística & datos numéricos , Atención Preconceptiva/estadística & datos numéricos , Adolescente , Adulto , Estudios Transversales , Femenino , Estado de Salud , Humanos , Masculino , Michigan , Persona de Mediana Edad , Estudios Retrospectivos , Encuestas y Cuestionarios/estadística & datos numéricos , Adulto Joven
11.
Plant Foods Hum Nutr ; 74(2): 200-203, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30756297

RESUMEN

Because of accruing oxidative stress with advancing age, older adults may benefit from increased dietary intake of lycopene, a lipophilic carotenoid with potent antioxidant properties. Yet, intake of dietary lycopene as well as circulating lycopene levels are known to decrease with aging. Watermelon is one of the few food sources of dietary lycopene. Because heat treatment increases lycopene bioavailability, ingestion of watermelon in pasteurized juice form may be an optimal delivery vehicle to increase lycopene levels in older adults. However, due to its lipophilic nature, there are concerns that co-ingestion of dietary fat may be necessary for efficient intestinal absorption of lycopene. Thus, this feasibility study aimed to examine the effects of a one-time dose of 100% pasteurized watermelon juice on circulating lycopene concentrations of postmenopausal women after a 10-h overnight fast. Blood was sampled from eight women before and 2 h after ingestion of 360 ml of juice, and serum lycopene was measured by ultra-high performance liquid chromatography. Circulating lycopene levels increased by three-fold (p < 0.001) with increases observed for every participant. Results demonstrate that 100% watermelon juice is a palatable, effective means of increasing serum lycopene in older adult women, a group at risk for low carotenoid intake. Trial registration: Clinicaltrials.gov identifier: NCT03608254 .


Asunto(s)
Antioxidantes/farmacocinética , Citrullus/química , Jugos de Frutas y Vegetales , Alimentos Funcionales , Licopeno/farmacocinética , Anciano , Antioxidantes/análisis , Disponibilidad Biológica , Cromatografía Líquida de Alta Presión , Ingestión de Alimentos/efectos de los fármacos , Estudios de Factibilidad , Femenino , Humanos , Absorción Intestinal/efectos de los fármacos , Licopeno/sangre , Persona de Mediana Edad , Estrés Oxidativo/efectos de los fármacos , Posmenopausia
12.
J Trauma Dissociation ; 19(2): 185-213, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-28509624

RESUMEN

OBJECTIVE: The purpose of this paper was to systematically review and synthesize the empirical literature on the effects of evidence-based therapy relationship (EBR) variables in the psychological treatment for adults who experienced trauma-related distress. METHOD: Studies were identified using comprehensive searches of PsycINFO, Medline, Published International Literature on Traumatic Stress, and Cumulative Index to Nursing and Allied Health Literature databases. Included in the review were articles published between 1980 and 2015, in English that reported on the impact of EBRs on treatment outcome in clinical samples of adult trauma survivors. RESULTS: Nineteen unique studies met inclusion criteria. The bulk of the studies were on therapeutic alliance and the vast majority found that alliance was predictive of or associated with a reduction in various symptomotology. Methodological concerns included the use of small sample sizes, little information on EBRs beyond alliance as well as variability in its measurement, and non-randomized assignment to treatment conditions or the lack of a comparison group. CONCLUSIONS: More research is needed on the roles of client feedback, managing countertransference, and other therapist characteristics on treatment outcome with trauma survivors. Understanding the role of EBRs in the treatment of trauma survivors may assist researchers, clinicians, and psychotherapy educators to improve therapist training as well as client engagement and retention in treatment.


Asunto(s)
Procesos Psicoterapéuticos , Trastornos por Estrés Postraumático/psicología , Trastornos por Estrés Postraumático/terapia , Adulto , Medicina Basada en la Evidencia , Humanos , Resultado del Tratamiento
13.
Infect Immun ; 85(4)2017 04.
Artículo en Inglés | MEDLINE | ID: mdl-28115506

RESUMEN

Nonhuman primates can be used to study host immune responses to Mycobacterium tuberculosis Mauritian cynomolgus macaques (MCMs) are a unique group of animals that have limited major histocompatibility complex (MHC) genetic diversity, such that MHC-identical animals can be infected with M. tuberculosis Two MCMs homozygous for the relatively common M1 MHC haplotype were bronchoscopically infected with 41 CFU of the M. tuberculosis Erdman strain. Four other MCMs, which had at least one copy of the M1 MHC haplotype, were infected with a lower dose of 3 CFU M. tuberculosis All animals mounted similar T-cell responses to CFP-10 and ESAT-6. Two epitopes in CFP-10 were characterized, and the MHC class II alleles restricting them were determined. A third epitope in CFP-10 was identified but exhibited promiscuous restriction. The CFP-10 and ESAT-6 antigenic regions targeted by T cells in MCMs were comparable to those seen in cases of human M. tuberculosis infection. Our data lay the foundation for generating tetrameric molecules to study epitope-specific CD4 T cells in M. tuberculosis-infected MCMs, which may guide future testing of tuberculosis vaccines in nonhuman primates.


Asunto(s)
Antígenos Bacterianos/inmunología , Proteínas Bacterianas/inmunología , Epítopos de Linfocito T/inmunología , Mycobacterium tuberculosis/inmunología , Linfocitos T/inmunología , Tuberculosis/inmunología , Animales , Antígenos Bacterianos/química , Antígenos Bacterianos/genética , Proteínas Bacterianas/química , Proteínas Bacterianas/genética , Modelos Animales de Enfermedad , Epítopos de Linfocito T/química , Antígenos de Histocompatibilidad/genética , Antígenos de Histocompatibilidad/inmunología , Antígenos de Histocompatibilidad Clase II/química , Antígenos de Histocompatibilidad Clase II/genética , Antígenos de Histocompatibilidad Clase II/inmunología , Humanos , Interferón gamma/biosíntesis , Macaca fascicularis , Péptidos/química , Péptidos/inmunología , Tomografía Computarizada por Tomografía de Emisión de Positrones , Linfocitos T/metabolismo , Tomografía Computarizada por Rayos X , Tuberculosis/diagnóstico , Tuberculosis/metabolismo , Tuberculosis/microbiología
14.
J Am Chem Soc ; 137(34): 11095-104, 2015 Sep 02.
Artículo en Inglés | MEDLINE | ID: mdl-26244445

RESUMEN

Mandelic acids are prototypic chiral molecules where the sensitivity of crystallized forms (enantiopure/racemic compound/polymorphs) to both conditions and substituents provides a new insight into the factors that may allow chiral separation by crystallization. The determination of a significant number of single crystal structures allows the analysis of 13 enantiopure and 30 racemic crystal structures of 21 (F/Cl/Br/CH3/CH3O) substituted mandelic acid derivatives. There are some common phenyl packing motifs between some groups of racemic and enantiopure structures, although they show very different hydrogen-bonding motifs. The computed crystal energy landscape of 3-chloromandelic acid, which has at least two enantiopure and three racemic crystal polymorphs, reveals that there are many more possible structures, some of which are predicted to be thermodynamically more favorable as well as slightly denser than the known forms. Simulations of mandelic acid dimers in isolation, water, and toluene do not differentiate between racemic and enantiopure dimers and also suggest that the phenyl ring interactions play a major role in the crystallization mechanism. The observed crystallization behavior of mandelic acids does not correspond to any simple "crystal engineering rules" as there is a range of thermodynamically feasible structures with no distinction between the enantiopure and racemic forms. Nucleation and crystallization appear to be determined by the kinetics of crystal growth with a statistical bias, but the diversity of the mandelic acid crystallization behavior demonstrates that the factors that influence the kinetics of crystal nucleation and growth are not yet adequately understood.


Asunto(s)
Ácidos Mandélicos/química , Termodinámica , Cinética , Modelos Moleculares , Estructura Molecular , Estereoisomerismo
15.
Appetite ; 80: 236-41, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24819342

RESUMEN

The aim of this study is to test the hypothesis that a breakfast meal with high carbohydrate/low fat results in an earlier increase in postprandial glucose and insulin, a greater decrease below baseline in postprandial glucose, and an earlier return of appetite, compared with a low carbohydrate/high fat meal. Overweight but otherwise healthy adults (n = 64) were maintained on one of two eucaloric diets: high carbohydrate/low fat (HC/LF; 55:27:18% kcals from carbohydrate:fat:protein) versus low carbohydrate/high fat (LC/HF; 43:39:18% kcals from carbohydrate:fat:protein). After 4 weeks of acclimation to the diets, participants underwent a meal test during which circulating glucose and insulin and self-reported hunger and fullness, were measured before and after consumption of breakfast from their assigned diets. The LC/HF meal resulted in a later time at the highest and lowest recorded glucose, higher glucose concentrations at 3 and 4 hours post meal, and lower insulin incremental area under the curve. Participants consuming the LC/HF meal reported lower appetite 3 and 4 hours following the meal, a response that was associated with the timing of the highest and lowest recorded glucose. Modest increases in meal carbohydrate content at the expense of fat content may facilitate weight gain over the long-term by contributing to an earlier rise and fall of postprandial glucose concentrations and an earlier return of appetite.


Asunto(s)
Glucemia/metabolismo , Desayuno , Carbohidratos de la Dieta/administración & dosificación , Grasas de la Dieta/administración & dosificación , Hambre/fisiología , Adulto , Apetito/fisiología , Dieta , Carbohidratos de la Dieta/análisis , Grasas de la Dieta/análisis , Proteínas en la Dieta/administración & dosificación , Ingestión de Energía , Ácidos Grasos/administración & dosificación , Ácidos Grasos Monoinsaturados/administración & dosificación , Ácidos Grasos Insaturados/administración & dosificación , Femenino , Voluntarios Sanos , Humanos , Insulina/sangre , Modelos Lineales , Masculino , Persona de Mediana Edad , Periodo Posprandial , Adulto Joven
16.
Autism ; : 13623613241262151, 2024 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-38907717

RESUMEN

LAY ABSTRACT: What is already known?Moving the body in 'stereotyped', 'repetitive', 'ritualised' or 'unusual' ways is part of the criteria for receiving a diagnosis of autism. However, the reasons for these movements and their personal value are not well understood. Certain ways of moving have become part of a disorder, and have received negative judgements, whereas other movements have not.What this paper adds?We searched online blogs for descriptions of movement written by autistic adults, using their preferred language and definitions. The blog authors said that many types of movement attracted negative judgement, including mis-coordination shown during sports, dancing in unusual places or moving repetitively, such as when stimming. However, movement provided personal benefits, and could enhance thinking and focus, provide meaningful routine, contribute to sensory regulation, release energy, increase body awareness, emotion regulation and strengthen self-identity.Implications for practice and policyMovement could be a well-being resource, used to reduce distraction, overwhelm, confusion and distress for autistic people. This should be considered within personal coping strategies and psychological therapies. The examples provided in this study could inform autism assessments, to ensure that the meanings of movements are considered alongside the appearances of movement. Some movements such as stimming have the same functions as many other ways of moving, including dancing and exercising, which could help to reduce stigma around being autistic if reflected in policy and practice. Improving understanding is important for informing how autism is assessed, and how personal experiences of being autistic are heard.

17.
Artículo en Inglés | MEDLINE | ID: mdl-38567391

RESUMEN

BACKGROUND: Anticholinergic and sedative medications affect cognition among older adults. The Drug Burden Index (DBI) is a validated measure of exposure to these medications, with higher DBI scores indicating higher drug burden. This ancillary analysis investigated the association between DBI and cognition assessed by the Modified Mini-Mental State Examination (3MS) and the Digit Symbol Substitution Test (DSST). METHODS: The Health, Aging, and Body Composition Study was a prospective study of community-dwelling adults aged 70-79 years at enrollment. Using data from years 1, 5, and 10, DBI was calculated using medication data per participant. Linear mixed modeling was used to assess cross-sectional and longitudinal effects of DBI on 3MS and DSST. Adjusted models included biological sex, race, education level, APOE status, and death. Sensitivity analyses included testing the strength of the associations for each year and testing attrition due to death as a possible confounding factor via Cox-Proportional Hazard models. RESULTS: After adjustment, DBI was inversely associated with 3MS and DSST scores. These associations became stronger in each subsequent year. Neither DBI at year 1 nor within-person change in DBI were predictive of longitudinal declines in either cognitive measure. Sensitivity analyses indicated that DBI, 3MS, and DSST were associated with a greater risk of attrition due to death. CONCLUSIONS: Results suggest that in years when older adults had a higher DBI scores, they had significantly lower global cognition and slower processing speed. These findings further substantiate the DBI as a useful pharmacological tool for assessing the effect of medication exposure.


Asunto(s)
Composición Corporal , Cognición , Humanos , Anciano , Masculino , Femenino , Cognición/efectos de los fármacos , Estudios Prospectivos , Antagonistas Colinérgicos/efectos adversos , Hipnóticos y Sedantes/efectos adversos , Pruebas de Estado Mental y Demencia , Estudios Transversales , Envejecimiento/fisiología , Vida Independiente , Estudios Longitudinales
18.
J Biosoc Sci ; 45(6): 743-59, 2013 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23601075

RESUMEN

Malaria is a major cause of under-five mortality in Mali and many other developing countries. Malaria control programmes rely on households to identify sick children and either care for them in the home or seek treatment at a health facility in the case of severe illness. This study examines the involvement of mothers and other household members in identifying and treating severely ill children through case studies of 25 rural Malian households. A wide range of intra-household responses to severe illness were observed among household members, both exemplifying and contravening stated social norms about household roles. Given their close contact with children, mothers were frequently the first to identify illness symptoms. However, decisions about care-seeking were often taken by fathers and senior members of the household. As stewards of the family resources, fathers usually paid for care and thus significantly determined when and where treatment was sought. Grandparents were frequently involved in diagnosing illnesses and directing care towards traditional healers or health facilities. Relationships between household members during the illness episode were found to vary from highly collaborative to highly conflictive, with critical effects on how quickly and from where treatment for sick children was sought. These findings have implications for the design and targeting of malaria and child survival programming in the greater West African region.


Asunto(s)
Centros Comunitarios de Salud , Países en Desarrollo , Identidad de Género , Atención Domiciliaria de Salud/psicología , Malaria/etnología , Malaria/enfermería , Aceptación de la Atención de Salud/etnología , Aceptación de la Atención de Salud/psicología , Población Rural , Adulto , Anciano , Preescolar , Familia/etnología , Familia/psicología , Conflicto Familiar/etnología , Conflicto Familiar/psicología , Padre/psicología , Femenino , Humanos , Lactante , Malaria/psicología , Masculino , Malí , Medicina Tradicional/psicología , Persona de Mediana Edad , Madres/psicología , Valores Sociales , Factores Socioeconómicos
19.
J Environ Health ; 76(3): 52-7, 2013 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-24288852

RESUMEN

The NEHA Government Affairs program has a long and productive association with the National Conference of State Legislatures (NCSL). The organizations have worked together on any number of legislative and policy areas that directly impact the environmental health profession. One of the keys to the successes of the NEHA/NCSL collaboration has been the recognition of the fact that often some of the most significant legislation and policy initiatives related to environmental public health occur in state legislatures. The states have, in a very real sense, been the innovators in developing new programs and practices. In recognition of this fact, we have asked NCSL to provide occasional overviews of state environmental public health legislative activity, covering topics that are of the most pressing public concern. Doug Farquhar, program director for NCSI's Environmental Health Program, has worked with NCSL since 1990. Mr. Farquhar directs development, management, and research for the Environmental Health Program. These projects encompass consultation and policy analysis of state and federal policies and statutes, regulations, and programs regarding environmental and related topics for state legislatures and administrative programs. Amy Ellis is a law clerk for NCSL within the Environment, Energy, and Transportation Group. As a law clerk she has researched a wide variety of environmental health policies. She is expected to obtain her JD from the University of Colorado Law School in 2015.


Asunto(s)
Exposición a Riesgos Ambientales/legislación & jurisprudencia , Salud Ambiental/legislación & jurisprudencia , Política de Salud/legislación & jurisprudencia , Servicios de Salud Escolar/legislación & jurisprudencia , Contaminación del Aire Interior/legislación & jurisprudencia , Contaminación del Aire Interior/prevención & control , Amianto , Asma/tratamiento farmacológico , Asma/prevención & control , Modificación del Cuerpo no Terapéutica/legislación & jurisprudencia , Agua Potable/normas , Exposición a Riesgos Ambientales/prevención & control , Salud Ambiental/organización & administración , Monitoreo del Ambiente/legislación & jurisprudencia , Epinefrina/uso terapéutico , Inocuidad de los Alimentos , Sustancias Peligrosas/normas , Humanos , Gobierno Estatal , Piscinas/legislación & jurisprudencia , Estados Unidos
20.
J Med Food ; 26(7): 436-444, 2023 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-37405739

RESUMEN

Cerebral ischemia, a condition with insufficient blood flow in the brain, is associated with cognitive and behavioral changes. The underlying cellular mechanisms of ischemia-induced brain damage include oxidative stress and inflammation. Cerebral ischemia is a major cause of death and long-term disability; thus, investigating novel dietary sources and their therapeutic potentials have gained interest. Seaweed contains various functional phytochemicals with antioxidant and anti-inflammatory effects. Studies have reported that consumption of seaweed is negatively associated with the risk of cardiovascular disease and stroke in humans, but the cellular mechanisms of seaweed's effects are less known. In this review, we discuss the neuroprotective roles of seaweed phytochemicals in various models of cerebral ischemia. We further describe the potential cellular mechanisms such as the effect of seaweed phytochemicals in ischemia-mediated oxidative stress and inflammation. Additional preclinical studies are needed to develop effective dietary interventions for the prevention of ischemia-associated brain damage in humans.


Asunto(s)
Isquemia Encefálica , Fármacos Neuroprotectores , Algas Marinas , Animales , Humanos , Roedores , Fármacos Neuroprotectores/uso terapéutico , Fármacos Neuroprotectores/farmacología , Isquemia Encefálica/tratamiento farmacológico , Estrés Oxidativo , Fitoquímicos/farmacología , Fitoquímicos/uso terapéutico , Inflamación/tratamiento farmacológico , Verduras
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