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1.
Cell Rep ; 43(3): 113900, 2024 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-38460132

RESUMO

Iron overload is closely associated with metabolic dysfunction. However, the role of iron in the hypothalamus remains unclear. Here, we find that hypothalamic iron levels are increased, particularly in agouti-related peptide (AgRP)-expressing neurons in high-fat-diet-fed mice. Using pharmacological or genetic approaches, we reduce iron overload in AgRP neurons by central deferoxamine administration or transferrin receptor 1 (Tfrc) deletion, ameliorating diet-induced obesity and related metabolic dysfunction. Conversely, Tfrc-mediated iron overload in AgRP neurons leads to overeating and adiposity. Mechanistically, the reduction of iron overload in AgRP neurons inhibits AgRP neuron activity; improves insulin and leptin sensitivity; and inhibits iron-induced oxidative stress, endoplasmic reticulum stress, nuclear factor κB signaling, and suppression of cytokine signaling 3 expression. These results highlight the critical role of hypothalamic iron in obesity development and suggest targets for treating obesity and related metabolic disorders.


Assuntos
Sobrecarga de Ferro , Doenças Metabólicas , Camundongos , Animais , Proteína Relacionada com Agouti/metabolismo , Obesidade/metabolismo , Hipotálamo/metabolismo , Leptina/metabolismo , Neurônios/metabolismo , Dieta Hiperlipídica/efeitos adversos , Doenças Metabólicas/metabolismo , Ferro/metabolismo , Camundongos Endogâmicos C57BL
3.
Adv Sci (Weinh) ; 10(16): e2204824, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-37060105

RESUMO

Neuregulin 4 (Nrg4) is an adipose tissue-enriched secreted factor that modulates glucose and lipid metabolism. Nrg4 is closely associated with obesity and preserves diet-induced metabolic disorders. However, the specific mechanisms via which Nrg4 regulates metabolic homeostasis remain incompletely understood. Here, this work finds that the Nrg4 receptor, ErbB4, is highly expressed in the hypothalamus, and the phosphorylation of hypothalamic ErbB4 is reduced in diet-induced obesity (DIO) mice. Peripheral Nrg4 can act on ErbB4 via blood circulation and excite neurons in the paraventricular nucleus of hypothalamus (PVN). Central administration of recombinant Nrg4 protein (rNrg4) reduces obesity and related metabolic disorders by influencing energy expenditure and intake. Overexpression of ErbB4 in the PVN protects against obesity, whereas its knock down in oxytocin (Oxt) neuron accelerates obesity. Furthermore, Nrg4-ErbB4 signaling excites Oxt release, and ablation of Oxt neuron considerably attenuates the effect of Nrg4 on energy balance. These data suggest that the hypothalamus is a key target of Nrg4, which partially explains the multifaceted roles of Nrg4 in metabolism.


Assuntos
Obesidade , Ocitocina , Animais , Camundongos , Homeostase , Hipotálamo/metabolismo , Neurônios/metabolismo , Obesidade/metabolismo , Receptor ErbB-4/metabolismo
4.
Int J Mol Sci ; 24(2)2023 Jan 14.
Artigo em Inglês | MEDLINE | ID: mdl-36675198

RESUMO

Sorafenib is currently a targeted agent widely used in the treatment of advanced hepatocellular carcinoma (aHCC). However, to date there is still a lack of a reliable marker capable of predicting sorafenib therapeutic responses. Here, we conducted a genome-wide association study (GWAS) to identify candidate single-nucleotide polymorphism outcome predictors in aHCC patients. A total of 74 real-world sorafenib-treated aHCC patients were enrolled for GWAS and outcome analysis. GWAS showed that rs1010816 (p = 2.2 × 10-7) was associated with sorafenib therapeutic response in aHCC patients. Kaplan-Meier analysis indicated that the "TT" genotype was significantly associated with a favorable therapeutic response but not significantly associated with overall survival (OS). Univariate followed by multivariate Cox proportional hazard analysis showed that ascites, main portal vein thrombosis, lower platelet count, lower total sorafenib doses, higher PALBI score in model A and higher ALBI grade in model B were significantly associated with a shorter OS. Subgroup analysis showed that only in alcoholic aHCC patients treated by sorafenib, rs1010816 "TT" genotype was significantly associated with longer OS (p = 0.021). Sorafenib had a favorable therapeutic outcome in alcoholic aHCC patients carrying rs1010816 "TT" genotype.


Assuntos
Antineoplásicos , Carcinoma Hepatocelular , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/genética , Carcinoma Hepatocelular/patologia , Sorafenibe/uso terapêutico , Polimorfismo de Nucleotídeo Único , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/genética , Neoplasias Hepáticas/patologia , Estudo de Associação Genômica Ampla , Antineoplásicos/uso terapêutico , Resultado do Tratamento , Estudos Retrospectivos , Compostos de Fenilureia/uso terapêutico , Niacinamida/uso terapêutico
5.
Mar Pollut Bull ; 186: 114473, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36512859

RESUMO

The marine coast is an important ecological transitional boundary but easily suffers from human intervention. Total petroleum hydrocarbons (TPHs) are ubiquitous along the coast. However, the influence of anthropogenic and natural factors on TPHs distribution remains unclear. This study sampled surficial sediment (N = 243) from the coasts of the largest peninsula-Leizhou Peninsula, in Southern China. We found that land-based discharge, sea traffic, and sediment type significantly (p < 0.05) drive the accumulation of TPHs. We observed that TPHs increased by 1.036 µg · g-1 (exp[αi] = exp. [0.0355]) of its original value with the addition of one more boat on the wharf. Although the average TPHs were at a moderate level (124.68, ND-1536.14, µg · g-1) and risk, 'Blue Carbon' ecosystems, i.e., mangroves (224.84, ND - 1441.13, µg · g-1, p < 0.001) were more severely polluted. Cleaner production policy should be applied to mitigate TPHs discharging trend from coastal areas.


Assuntos
Petróleo , Poluentes Químicos da Água , Humanos , Ecossistema , Petróleo/análise , Hidrocarbonetos/análise , Atividades Humanas , China , Sedimentos Geológicos , Monitoramento Ambiental , Poluentes Químicos da Água/análise
6.
Public Health Nutr ; 26(5): 1014-1021, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36093642

RESUMO

OBJECTIVE: To investigate the association between folate levels and the risk of gestational diabetes mellitus (GDM) risk during the whole pregnancy. DESIGN: In this retrospective cohort study of pregnant women, serum folate levels were measured before 24 gestational weeks (GW). GDM was diagnosed between 24th and 28th GW based on the criteria of the International Association of Diabetes and Pregnancy Study Groups. General linear models were performed to examine the association of serum folate with plasma glucose (i.e. linear regressions) and risk of GDM (i.e. log-binomial regressions) after controlling for confounders. Restricted cubic spline regression was conducted to test the dosage-response relationship between serum folate and the risk of GDM. SETTING: A sigle, urban hospital in Shanghai, China. PARTICIPANTS: A total of 42 478 women who received antenatal care from April 2013 to March 2017 were included. RESULTS: Consistent positive associations were observed between serum folate and plasma glucose levels (fasting, 1-h, 2-h). The adjusted relative risks (RR) and 95 % CI of GDM across serum folate quartiles were 1·00 (reference), 1·15 (95 % CI (1·04, 1·26)), 1·40 (95 % CI (1·27, 1·54)) and 1·54 (95 % CI (1·40, 1·69)), respectively (P-for-trend < 0·001). The positive association between serum folate and GDM remained when stratified by vitamin B12 (adequate v. deficient groups) and the GW of serum folate measurement (≤13 GW v. >13 GWs). CONCLUSIONS: The findings of this study may provide important evidence for the public health and clinical guidelines of pregnancy folate supplementation in terms of GDM prevention.


Assuntos
Diabetes Gestacional , Gravidez , Feminino , Humanos , Diabetes Gestacional/epidemiologia , Glicemia , Estudos Retrospectivos , População do Leste Asiático , China/epidemiologia , Ácido Fólico
7.
Zhongguo Zhong Yao Za Zhi ; 48(24): 6682-6692, 2023 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-38212028

RESUMO

This study explored the effect and mechanism of Maiwei Yangfei Decoction(MWYF) on pulmonary fibrosis(PF) mice. MWYF was prepared, and its main components were detected by ultra-high-performance liquid chromatography-triple quadrupole tandem mass spectrometry(UPLC-MS/MS). Male C57BL/6J mice were randomly divided into a control group, a model group, a pirfenidone(PFD) group, and low-, medium-, and high-dose MWYF groups, with 10 mice in each group. The PF model was induced in mice except for those in the control group by intratracheal instillation of bleomycin(BLM), and model mice were treated with saline or MWYF or PFD by gavage the next day. The water consumption, food intake, hair, and activity of mice were observed daily. The pathological changes in lung tissues were observed by hematoxylin-eosin(HE) staining, Masson staining, and CT scanning. The level of hydroxyproline(HYP) in lung tissues was detected by alkaline hydrolysis. Immunohistochemistry was used to observe the expression of collagen type Ⅲ(COL3) and fibronectin. The mRNA expression levels of α-smooth muscle actin(α-SMA), type Ⅰ collagen α1(COL1α1), COL3, and vimentin were detected by reverse transcription real-time fluorescence quantitative polymerase chain reaction(RT-qPCR). Superoxide dismutase(SOD) and malondialdehyde(MDA) kits were used to detect oxidative stress indicators in lung tissues and serum. The nuclear translocation of nuclear factor E2-related factor 2(Nrf2) protein was detected by immunofluorescence. The protein and mRNA expression levels of Nrf2, catalase(CAT), and heme oxygenase 1(HO-1) in lung tissues were detected by Western blot and RT-qPCR. Twelve chemical components were detected by UPLC-MS/MS. Animal experiments showed that MWYF could improve alveolar inflammation, collagen deposition, and fibrosis in PF mice, increase body weight of mice, and down-regulate the expression of fibrosis indexes such as HYP, α-SMA, COL1α1, COL3, fibronectin, and vimentin in lung tissues. In addition, MWYF could potentiate the activity of SOD in lung tissues and serum of PF mice, up-regulate the expression level of Nrf2, and promote its transfer to the nucleus, up-regulate the levels of downstream antioxidant target genes CAT and HO-1, and then reduce the accumulation of lipid metabolite MDA. In summary, MWYF can significantly improve the pathological damage and fibrosis of lung tissues in PF mice, and its mechanism may be related to the activation of the Nrf2 pathway to regulate oxidative stress.


Assuntos
Fibrose Pulmonar , Camundongos , Masculino , Animais , Fibrose Pulmonar/tratamento farmacológico , Fibrose Pulmonar/genética , Fibrose Pulmonar/induzido quimicamente , Fator 2 Relacionado a NF-E2/genética , Fator 2 Relacionado a NF-E2/metabolismo , Fibronectinas/metabolismo , Vimentina/metabolismo , Cromatografia Líquida , Camundongos Endogâmicos C57BL , Espectrometria de Massas em Tandem , Estresse Oxidativo , Superóxido Dismutase/genética , Superóxido Dismutase/metabolismo , RNA Mensageiro/metabolismo
8.
Mindfulness (N Y) ; 13(10): 2359-2378, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36061089

RESUMO

Objectives: This study includes a systematic review of cost-effectiveness analyses (CEAs) and cost-benefit analyses (CBAs) of mindfulness-based interventions (MBIs). Methods: A literature search was conducted using PubMed, Web of Science, JSTOR, and CINAHL for studies published between January 1985 and September 2021, including an original cost-related evaluation of an MBI. A qualitative assessment of bias was performed using the Drummond checklist. Results: Twenty-eight mindfulness-based intervention studies (18 CEAs and 10 CBAs) were included in this review. Mindfulness-based stress reduction (MBSR) was less costly and more effective when compared with the usual care of cognitive behavioral therapy among patients with chronic lower back pain, fibromyalgia, and breast cancer. MBSR among patients with various physical/mental conditions was associated with reductions in healthcare costs. Mindfulness-based cognitive therapy (MBCT) was also less costly and more effective than the comparison group among patients with depression, medically unexplained symptoms, and multiple sclerosis. MBCT's cost-effectiveness advantage was also identified among breast cancer patients with persistent pain, non-depressed adults with a history of major depressive disorder episodes, adults diagnosed with ADHD, and all cancer patients. From a societal perspective, the cost-saving property of mindfulness training was evident when used as the treatment of aggressive behaviors among persons with intellectual/developmental disabilities in mental health facilities. Conclusions: Based on this review, more standardized MBI protocols such as MBSR and MBCT compare favorably with usual care in terms of health outcomes and cost-effectiveness. Other MBIs may result in cost savings from both healthcare and societal perspectives among high-risk patient populations.

9.
Complement Ther Med ; 65: 102810, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35093511

RESUMO

OBJECTIVES: To investigate the feasibility of delivering a low-dose mindfulness-based stress reduction (MBSR) intervention among prediabetes/diabetes patients in a clinical setting. DESIGN AND SETTING: This was a single-arm, mixed methods, feasibility study among prediabetes/diabetes patients at a healthcare center in United States. INTERVENTION: The low-dose MBSR intervention was delivered in group format over 4 waves and each wave comprised 8-10 h of 8 sessions over 6-8 weeks. MAIN OUTCOME MEASURES: We evaluated recruitment, adherence, and attrition rates, participants' satisfaction, motivation and barriers of low-dose MBSR. Psychological, behavioral, and physical measures were compared between pre- and post-intervention. RESULTS: We enrolled 19 participants of 34 eligible individuals with a recruitment rate of 55.9%. Among 19 enrolled participants, 4 dropped out after baseline data collection and did not attend any session and 1 attended one session but did not finish post-intervention data collection, resulting in an attrition rate of 26.3%. Among 15 participants attending at least one session, 46.7% attended all sessions and 80.0% attended at least 5 sessions. Qualitative analysis among 11 participants indicated that 90.9% had positive overall experience with the intervention. Compared to pre-intervention, there was a significant reduction in depression score (mean reduction = 5.04, SD = 7.66, p = 0.02), a higher proportion of engaging in flexibility exercises (42.86% vs. 85.71%, p = 0.01) and a lower level of glycosylated hemoglobin (HbA1c) (mean reduction = 1.43%, SD = 2.54%, p = 0.03) at post-intervention. CONCLUSIONS: Delivering a low-dose MBSR intervention to prediabetes/diabetes patients in a primary care setting is feasible. Future studies with randomized controlled design and larger sample are warranted.


Assuntos
Atenção Plena , Estado Pré-Diabético , Estudos de Viabilidade , Hemoglobinas Glicadas , Humanos , Atenção Plena/métodos , Estado Pré-Diabético/terapia , Estresse Psicológico/terapia
10.
Medicine (Baltimore) ; 100(6): e24564, 2021 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-33578552

RESUMO

BACKGROUND: Among discharged COVID-19 patients, the health-related quality of life is poor, and patients suffer from significant physical and psychological impairment. This study was designed to investigate the effects of Liuzijue exercise on the rehabilitation of COVID-19 patients. METHODS: Thirty three eligible patients with COVID-19 were enrolled in the study after discharge. All the participants practiced Liuzijue exercise once per day for 20 minutes over 4 weeks. Data were collected at baseline and the end of the intervention. Primary outcomes involved functional capacity and secondary outcomes involved quality of life. RESULTS: The maximal inspiratory pressure (MIP), peak inspiratory flow (PIF), and diaphragm movement in deep breathing (DM-DB) of patients increased significantly after 4 weeks of intervention. The dyspnea was also alleviated and exercise capacity was significantly improved. In terms of quality of life, physical functioning and role-physical scores were significantly increased. Moreover, Liuzijue could significantly alleviate the depression and anxiety status of the patients. CONCLUSION: Liuzijue exercise is a viable alternative home exercise program that produced better functional capacity and quality of life in discharged patients with COVID-19. These findings also showed the necessity of rehabilitation intervention for cured COVID-19 patients.


Assuntos
COVID-19/reabilitação , Qigong/métodos , Adulto , COVID-19/fisiopatologia , COVID-19/psicologia , Diafragma/fisiopatologia , Tolerância ao Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Mecânica Respiratória
11.
Complement Ther Med ; 57: 102640, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33388390

RESUMO

BACKGROUND: Mindful walking (MW) interventions employ mindfulness training combined with physical activity. Wearable mobile devices have been increasingly used to measure outcomes of physical activity interventions. The purpose of this study was to understand MW participants' attitudes towards MW and the use of mobile devices in health promotion interventions, including barriers and facilitators of intervention engagement and adherence. Few qualitative studies have documented participant experience with these two types of interventions. METHOD: The pilot study involved a randomized MW intervention including 38 participants with self-reported inadequate physical activity. Half of them were randomized to receive MW intervention plus a FitBit device and the other received the FitBit device only. We used a qualitative thematic analysis of the narrative data collected through open-ended survey questions at three time points. Participants in the MW intervention were asked to describe their experiences with MW, while all participants were asked to describe their experience with wearing the FitBit to track their step counts. RESULTS: Participants reported a broad range of perceived benefits and challenges related to adopting the MW intervention and using the mobile device. Participants were generally willing to try to adopt the recommended MW practice and to see value of MW in increasing physical activity and improving overall health. Participants reported using a variety of additional device features beyond goal setting and step counts, indicating using the devices may have been effective in providing additional motivation for participants in meeting physical activity goals in both the control and intervention groups. While most of the feedback about MW (in the intervention group) and the device (all participants) was overwhelmingly positive, a minority of participants reported barriers such as lack of patience with meditation and discomfort with wearing the device. CONCLUSION: Most participants in the MW intervention see the health benefits of this program and most participants using the wearable physical activity tracking device reported the motivational benefits of this device. Issues with the MW intervention (e.g., lack of patience) and the wearable device (e.g., discomfort with wearing) need to be addressed in future interventions.


Assuntos
Atenção Plena , Caminhada , Computadores de Mão , Humanos , Motivação , Projetos Piloto
12.
Contemp Clin Trials ; 99: 106182, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33080378

RESUMO

The opioid misuse epidemic has reached a crisis level in the United States. Though mindfulness-based relapse prevention (MBRP) has been shown as effective in treating substance use disorders, there is limited research on its application to opioid use disorders specifically, and there is a need to understand the underlying mechanisms. This paper outlines a protocol for a randomized controlled trial of MBRP for opioid use disorders. MBRP is a group aftercare program that integrates mindfulness skills training with cognitive-behavioral relapse prevention strategies. We will recruit 240 participants who have completed opioid use disorder treatment, and randomize them to an 8-week MBRP group intervention or treatment as usual (TAU) control group. The TAU control group will complete the intervention after 8 weeks. Assessments will take place at baseline, 8 weeks, and 16 weeks. The primary outcome is frequency of opioid use. The secondary outcomes include craving and withdrawal symptoms, time to first opioid use, adherence to medication-assisted treatment plans, perceived stress, quality of life, posttraumatic stress symptoms, and chronic pain. We will also examine the following potential moderators and correlates of intervention outcomes: comorbid diagnoses, life events history, and MBRP intervention adherence. In addition, we will examine the following mediators of intervention outcome: mindfulness skills, emotion regulation skills, executive functioning skills, savoring, and positive and negative affect. This study will contribute to the evidence base regarding MBRP's efficacy in reducing opioid use, as well as contribute to the understanding of the causal mechanisms and factors that modify treatment outcome for MBRP for substance use disorders.


Assuntos
Atenção Plena , Transtornos Relacionados ao Uso de Opioides , Transtornos Relacionados ao Uso de Substâncias , Humanos , Recidiva Local de Neoplasia , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Prevenção Secundária , Transtornos Relacionados ao Uso de Substâncias/prevenção & controle
13.
Bioprocess Biosyst Eng ; 43(11): 1999-2007, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32524279

RESUMO

Organosolv pretreatment with two ethanol concentrations (25% and 50%, v/v) was performed to improve enzymatic saccharification of poplar sawdust. It was found that lower ethanol concentration (25%, v/v) pretreatment resulted in a higher enzymatic digestibility of poplar (38.1%) due to its higher xylan removal and similar lignin removal ratios, compared to that pretreated with 50% (v/v) ethanol pretreatment (27.5%). However, the residual lignin still exhibited a strong inhibition on enzymatic hydrolysis of organosolv-pretreated poplar (OP). Bio-surfactant preparations including tea saponin (TS), TS crude extract, and tea seed waste were applied in enzymatic hydrolysis of OP, due to their potential ability of reducing enzyme non-productive binding on lignin. Their optimal loadings in enzymatic hydrolysis of OP were optimized, which indicated that adding 0.075 g/g glucan of TS improved the 72-h glucose yield of OP by 48.3%. Moreover, adding TS crude extract and tea seed waste exhibited the better performance than TS for improving enzymatic hydrolysis of OP. It was verified that the presence of protein in TS crude extract and tea seed waste accounted for the higher improvement. More importantly, the directly application of tea seed waste in enzymatic hydrolysis could achieve the similar improvement on enzymatic hydrolysis of OP, where chemosynthetic surfactant (PEG6000) was added. The residual enzyme activities in supernatant of enzymatic hydrolysis were also determined to reveal the changes on enzyme adsorption after adding surfactants. Generally, tea seed waste could be directly applied as an alternative to chemosynthetic surfactants to promote enzymatic hydrolysis of lignocelluloses.


Assuntos
Biotecnologia/métodos , Celulase/química , Glucose/química , Lignina/química , Saponinas/química , Solventes/química , Chá , Adsorção , Biomassa , Celulose/metabolismo , Etanol/metabolismo , Hidrólise , Resíduos Industriais , Tensoativos/química , Árvores , Água/química , Madeira
14.
J Oncol Pharm Pract ; 26(1): 36-42, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30885081

RESUMO

PURPOSE: The objective of this study is to determine demographic, clinical, and pharmaceutical factors that are associated with longer endocrine therapy usage duration. METHODS: South Carolina Central Cancer Registry incidence data linked with South Carolina Medicaid prescription claims and administrative data were used. The study included a sample (N = 1399) of female South Carolina Medicaid recipients with hormone receptor-positive breast cancer diagnosed between 2000 and 2012 who filled at least one ET prescription. A series of multiple regression models were built to explore the association of demographic, clinical, and pharmaceutical factors with the endocrine therapy usage duration. RESULTS: Multiple linear regression analysis showed that none of the demographic or clinical factors tested were significantly associated with the endocrine therapy usage duration. However, the type of endocrine therapy taken as well as receipt of the prescriptions that could have been used to alleviate side-effects (adrenals, nonsteroidal anti-inflammatory agents, anti-inflammatory agents, and vitamins) were significantly associated. CONCLUSION: Our study highlights the potential value of concurrent prescriptions for improving the endocrine therapy usage duration, with an optimal intervention point before 14 months post ET initiation. This work informs further research needed to test pharmacologic interventions that may significantly increase the endocrine therapy duration as well as other nonpharmacologic strategies for side-effect management.


Assuntos
Antineoplásicos Hormonais/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Medicaid/tendências , Sobreviventes , Adulto , Inibidores da Aromatase/uso terapêutico , Neoplasias da Mama/diagnóstico , Quimioterapia Adjuvante/tendências , Esquema de Medicação , Feminino , Humanos , Pessoa de Meia-Idade , South Carolina/epidemiologia , Tamoxifeno/uso terapêutico , Estados Unidos/epidemiologia , Adulto Jovem
15.
Postgrad Med ; 131(8): 612-618, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31524033

RESUMO

Objectives: The objective of this study was to assess the diagnosis and management of anemic patients in free clinics around the Tampa Bay area.Methods: In this retrospective study we extracted data including demographics, chronic diseases, and laboratory values from medical charts of uninsured patients seen in 9 free clinics from January 2016 through December 2017 in the Tampa Bay area, FL, USA. Multiple logistic regression analysis was used to assess relationships between socioeconomic variables and a documented history of anemia.Results: From two years of documented data, 6971 patients were included, of which 367 (5%) had a documented diagnosis of anemia. Most were women (315, 86%), and the median age was 41 years (6-91). Among the 367 patients with anemia,191 (52%) patients had an unspecified type of anemia, 144 (39%) were diagnosed with IDA, 16 (4%) with anemia of chronic disease, and the remaining were other uncommon causes. Only 67% (97/144) of IDA patients had documented iron replacement. Colonoscopies were documented in only 32 (9%) of all patients with anemia, and in 23 (16%) IDA patients. Several chronic diseases were statistically associated and comorbid with a diagnosis of anemia.Conclusions: Uninsured patients with IDA are prescribed iron and undergo colonoscopies at sub-optimal rates. Increasing resources, awareness, and education of providers in these settings could lead to improved treatment practices and decrease the risk of morbidity and mortality.


Assuntos
Anemia/epidemiologia , Doença Crônica/epidemiologia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Provedores de Redes de Segurança/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anemia Ferropriva/tratamento farmacológico , Anemia Ferropriva/epidemiologia , Criança , Colonoscopia/estatística & dados numéricos , Feminino , Florida/epidemiologia , Comportamentos Relacionados com a Saúde , Disparidades nos Níveis de Saúde , Humanos , Ferro/uso terapêutico , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Socioeconômicos , Adulto Jovem
16.
Complement Ther Med ; 46: 131-135, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31519269

RESUMO

OBJECTIVES: Mindfulness-based interventions (MBIs) have been used as an intervention to support recovery from alcohol use disorder (AUD) and opioid use disorder (OUD). We sought to identify attitudes and experiences toward standardized MBIs among individuals recovering from these substance abuse disorders (SUD) through a qualitative approach. DESIGN: We conducted three 60-minute focus groups among people with history of SUD (6-months to 3 years in recovery): two groups with those with alcohol use disorder (AUD) history and one with individuals with history of opioid use disorder (OUD). Each group had eight participants. RESULTS: Most participants of the OUD focus group had tried some variations on mindfulness training or meditation-like therapies during treatment. Participants expressed perceived benefits for MBIs' non-pharmacological property, while expressing concerns related to perceived barriers of cost, scheduling conflicts with work and child/family care needs, and possible lack of provider empathy. Gift cards and other rewards were recognized as useful participation and retention incentives for completing the described program; the training itself was perceived as an "incentive" if able to deliver significant benefits related to supporting continued recovery from SUD. An overarching theme across all groups was that participants reported their own altruistic behavior and social connectedness as important motivators to help them maintain recovery. CONCLUSION: The importance of perceived provider empathy and the patient's social connectedness in SUD interventions was underscored as incentives for participation and retention, providing valuable information for the implementation of MBIs among patients recovering from SUD.


Assuntos
Alcoolismo/psicologia , Analgésicos Opioides/efeitos adversos , Transtornos Relacionados ao Uso de Substâncias/psicologia , Feminino , Grupos Focais , Humanos , Masculino , Meditação/psicologia , Atenção Plena/métodos , Motivação/fisiologia
17.
Complement Ther Med ; 44: 116-122, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31126543

RESUMO

INTRODUCTION: Mindful walking is a meditation practice that combines physical activity and mindfulness practice. Some mindful walking interventions expect four weeks of attendance (as compared with the traditional 8-week models of mindfulness-based interventions, or MBIs), a practice that could make MBIs more accessible to working-age adults. This study examined whether a 4-week mindful walking intervention increased physical activity and improved mental health outcomes. METHODS: We conducted a randomized experiment among adults with inadequate physical activity (N = 38), whereby the intervention group received a four-week, one-hour-per-week mindful walking intervention and the control group received instructions to increase physical activity. Everyone in both groups received a wrist-worn step count device as participation incentive. Physical activity (as measured by the Rapid Assessment of Physical Activity questionnaire, RAPA) and other health outcomes were assessed with online surveys at baseline (T1), post-intervention (T2), and one month after the intervention (T3). Those mental health outcomes included perceived stress (Perceived Stress Scale), depression (Brief Edinburgh Depression Scale), and Mental Health Inventory (MHI). The primary outcome of device-measured step count was recorded at T1 and T2. Independent two-sample t-tests were used to compare the primary outcomes at T1. Generalized linear mixed models (GLMM) with a random intercept for each subject were used to compare the two groups on the primary outcomes at all time points. The independent variables in the model included a binary variable for group assignment (intervention vs. control), a 3-level categorical variable for time, and their interaction. Age, gender and race/ethnicity are used as covariates in the model. Estimated changes (either differences or ratios between outcomes at time points T1 and T2/T3) are reported to assess change within groups. RESULTS: Both groups exhibited significant improvements in the RAPA measures of physical activity and depression. However, between-group differences were not statistically significant. There was no within-group or between-group difference on device-measured step count, though both groups yielded an average daily step count close to the recommended level of 8,000 steps per day for older adults. The intervention group exhibited a significant reduction in perceived stress, and this reduction was significantly greater than that of the control group at T2 (p = .025) although the difference was insignificant at T3. No significant difference in MHI was found. DISCUSSION: While these adults with inadequate physical activity increased their physical activity, no significant between-group differences in physical activity were identified. Potential reasons for the lack of significant findings could be due to the ceiling effect (the step count device for everyone in both groups might have encouraged more activity in both groups), limited sample size and low-dose 4-week intervention used in this study. On the other hand, it is encouraging to see that this low-dose, short-duration 4-week intervention (as compared with those popular 8-week MBIs) achieved significantly greater stress reduction among the intervention group than among the control group, even though the between-group difference at one-month follow-up was statistically insignificant. Further studies with larger sample sizes and longer follow-up are needed to assess the possible benefits of these short-duration mindful walking interventions.


Assuntos
Terapia por Exercício/psicologia , Exercício Físico/fisiologia , Exercício Físico/psicologia , Meditação/psicologia , Adulto , Feminino , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Atenção Plena/métodos , Motivação , Projetos Piloto , Escalas de Graduação Psiquiátrica , Qualidade de Vida , Inquéritos e Questionários , Resultado do Tratamento
18.
Food Chem ; 285: 77-85, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-30797378

RESUMO

Based on QuEChERS dispersed purification, Fe3O4 nanoparticle decoloration and UHPLC-MS/MS, a robust and sensitive method was established for simultaneous analysis of 14 heterocyclic aromatic amines (HAAs) and acrylamide (AA) in coffee products. Sample was extracted by 90% acetonitrile water (v/v), dispersed with primary secondary amine (PSA) and further purified with Fe3O4 nanoparticle. Then, 15 analytes were detected using ESI positive ion under MRM mode. Good linearity was observed for all analytes in the range of 0.2-100 µg/L with the determination coefficients being above 0.996. Limits of detection (S/N ≥ 3) and limits of quantification (S/N ≥ 10) were in the range of 0.02-0.15 µg/L and 0.2-0.7 µg/L, respectively. The intra-day average recoveries were between 81.6% and 100%, and the intra-day precisions ranged from 4.3% to 9.0%. The inter-day average recoveries were in the range of 81.0-101% with precisions ranging from 5.0% to 7.8%. Results indicated that the combination of PSA and Fe3O4 exhibited superior purification and adsorption effects for removing pigments and acid compounds. Real samples analysis indicated that coffee products were widely contaminated with AA, harman and norharman.


Assuntos
Acrilamida/análise , Aminas/análise , Óxido Ferroso-Férrico/química , Nanopartículas Metálicas/química , Espectrometria de Massas em Tandem , Acrilamida/normas , Aminas/normas , Cromatografia Líquida de Alta Pressão/normas , Café/química , Café/metabolismo , Compostos Heterocíclicos/química , Limite de Detecção , Padrões de Referência , Espectrometria de Massas em Tandem/normas
19.
Nutrients ; 10(11)2018 Nov 02.
Artigo em Inglês | MEDLINE | ID: mdl-30400155

RESUMO

Findings on maternal 25-hydroxyvitamin D (25[OH]D) and neonatal anthropometry are inconsistent, and may at least be partly due to variations in gestational week (GW) of 25(OH)D measurement and the lack of longitudinal 25(OH)D measurements across gestation. The aim of the current study was to examine the associations of longitudinal measures of maternal 25(OH)D and neonatal anthropometry at birth. This study included 321 mother⁻offspring pairs enrolled in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies⁻Singletons. This study was a prospective cohort design without supplementation and without data on dietary supplementation. Nevertheless, measurement of plasma 25(OH)D reflects vitamin D from different sources, including supplementation. Maternal concentrations of total 25(OH)D were measured at 10⁻14, 15⁻26, 23⁻31, and 33⁻39 GW and categorized as <50 nmol/L, 50⁻75 nmol/L, and >75 nmol/L. Generalized linear models were used to examine associations of 25(OH)D at each time-point with neonate birthweight z-score, length, and sum of skinfolds at birth. At 10⁻14 GW, 16.8% and 49.2% of women had 25(OH)D <50 nmol/L and between 50⁻75 nmol/L, respectively. The association of maternal 25(OH)D with neonatal anthropometry differed by GW and women's prepregnancy BMI (normal (<25.0 kg/m²), overweight/obese (25.0⁻44.9 kg/m²)). All analyses were stratified by prepregnancy BMI status. Among women with an overweight/obese BMI, 25(OH)D <50 nmol/L at 10⁻14 GW was associated with lower birthweight z-score (0.56; 95% CI: -0.99, -0.13) and length (-1.56 cm; 95% CI: -3.07, -0.06), and at 23⁻31 GW was associated with shorter length (-2.77 cm; 95% CI: -13.38, -4.98) and lower sum of skinfolds (-9.18 mm; 95% CI: -13.38, -4.98). Among women with a normal BMI, 25(OH)D <50 nmol/L at 10⁻14 GW was associated with lower sum of skinfolds (-2.64 mm; 95% CI: -5.03, -0.24), at 23⁻31 GW was associated with larger birthweight z-scores (0.64; 95% CI: 0.03, 1.25), and at 33-39 GW with both higher birthweight z-score (1.22; 95% CI: 0.71, 1.73) and longer length (1.94 cm; 95% CI: 0.37, 3.52). Maternal 25(OH)D status during pregnancy was associated with neonatal anthropometric measures, and the associations were specific to GW of 25(OH)D measurement and prepregnancy BMI.


Assuntos
Peso ao Nascer , Fenômenos Fisiológicos da Nutrição Pré-Natal , Deficiência de Vitamina D/sangue , Vitamina D/sangue , Antropometria , Estudos de Casos e Controles , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Gravidez
20.
Environ Geochem Health ; 40(4): 1657-1665, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29492804

RESUMO

Coalbed methane (CBM) is an important unconventional energy source and accounts for a substantial portion of the overall natural gas production in the USA. The extraction of CBM generates significant amounts of produced water, where the withdrawal of groundwater may disturb the subsurface environment and aquifers. The release of toxic recalcitrant compounds from the coal seam is of great concern for those who use groundwater for irrigation and potable water sources. Experiments were conducted that determined a small fraction of coal carbon can be extracted and solubilized in water during the CBM formation and production. These soluble components included long-chain alkanes, aromatic hydrocarbons, and humic compounds. Biometer flask assays demonstrated that these compounds are bioamenable and can be potentially degraded by microorganisms to produce methane and carbon dioxide, where these biodegradation processes may further impact groundwater quality in the coal seam.


Assuntos
Carvão Mineral , Água Subterrânea/análise , Metano/química , Gás Natural/análise , Poluentes Químicos da Água/análise , Carbono/análise , Cromatografia Gasosa-Espectrometria de Massas , Espectrometria de Fluorescência
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