Coats Disease in 9 Patients: A Hispanic Case Series.

BACKGROUND/AIM: To describe demographic and clinical characteristics, treatment, and visual prognosis of Coats disease in Hispanic patients. METHODS: A retrospective chart review was performed on nine patients (ten eyes) diagnosed with Coats disease in our two clinical centrers from 2004 - 2017. RESULTS: Mean age at diagnosis was 5.5 years (range 1 - 12 years) and mean follow-up time was 48 months (range 9 - 108 months). Eight patients (89%) were male and had unilateral disease and one (11%) female patient had bilateral disease. In 40% of the cases, patients were asymptomatic. Visual acuity at first presentation was worse than hand motion in 60% of the eyes. Half of the eyes (5/10 eyes, 50%) had exudative retinal detachment (≥ stage IIIA). Vascular ablation with cryotherapy combined with retinal photocoagulation was the most frequent therapeutic approach (40%). Despite anatomical success at 6 months in 100% of the treated eyes, visual outcome at 1 year of treatment was poor (worse than 20/200) in 70% of the cases. CONCLUSIONS: In our case series, patients were mostly asymptomatic on presentation, with severe stages of Coats disease. Even with anatomical success after surgical treatment in all treated cases, long-term visual prognosis remained very limited.

Alcohol-Focused Behavioral Couple Therapy.

Alcohol Behavioral Couple Therapy (ABCT) has emerged over the last 30 years as a highly efficacious treatment for those with alcohol use disorders. This review highlights the historical and conceptual underpinnings of ABCT, as well as the specific treatment elements and structure. Proposed active ingredients, moderators, and mediators of treatment outcome are discussed. Efficacy is evaluated for reductions in identified patient drinking, improved relationship functioning, and reductions in intimate partner violence. Adaptations of ABCT for substances other than alcohol are described. Other adaptations, including brief interventions, interventions addressing PTSD and TBI along with alcohol use, and interventions deliverable via technology platforms are described. Additional cost-benefit and cost-effectiveness findings supporting the economic value of ABCT are noted. Future directions for research in this area include possible adaptations for female identified patients, nontraditional couples, LGBT partners and dyads involving nonintimate partner relationships. The development of more flexible models and enhanced dissemination strategies may improve clinical uptake and utility as well as increasing the feasibility of this treatment for integrated healthcare settings.

Assessing Treatment Integrity in Alcohol Behavioral Couple Therapy.

OBJECTIVES: Alcohol Behavioral Couple Therapy (ABCT) is an efficacious treatment for alcohol use disorders. Coding treatment integrity can shed light on the active ingredients of ABCT, but there are no published studies of treatment integrity instruments for ABCT. The present study describes the development and initial reliability of the Treatment Integrity Rating System - Couples Version (C-TIRS) for ABCT. METHODS: The C-TIRS was used to rate 284 first- and mid-treatment ABCT sessions of 188 couples in four randomized clinical trials. RESULTS: Average inter-rater reliability for distinguishing ratings between C-TIRS items was fair-to-good for quantity items (intraclass correlation [ICC] = 0.64) and poor-to-fair for quality items (ICC = 0.41). Five C-TIRS subscales were defined a priori to measure treatment components involving cognitive-behavioral therapy, spouse involvement, couple therapy, common therapeutic factors, and overall adherence to the treatment protocol and had adequate internal reliability (α = 0.74-0.89). Inter-rater reliability was fair to good on seven of ten scales but poor on three scales (ICC range = 0.17-0.72). CONCLUSIONS: The C-TIRS was designed to provide information about quantity and quality of the delivery of ABCT components; however, further refinement of the C-TIRS is warranted before it should be used in frontline practice. Clinical implications and recommendations for future research are discussed.

Absolute configuration of (13R)- and (13S)-labdane diterpenes coexisting in Ageratina jocotepecana.

Chemical investigation of the hexanes extracts of Ageratina jocotepecana afforded (-)-(5S,9S,10S,13S)-labd-7-en-15-oic acid (1), methyl (-)-(5S,9S,10S,13S)-labd-7-en-15-oate (2), (+)-(5S,8R,9R,10S,13R)-8-hydroxylabdan-15-oic acid (3), and (-)-(5S,9S,10S,13Z)-labda-7,13-dien-15-oic acid (5). The coexistence of (13R)- and (13S)-labdanes in this member of the Asteraceae family was demonstrated by vibration circular dichroism measurements of ester 2 and methyl (+)-(5S,8R,9R,10S,13R)-8-hydroxylabdan-15-oate (4) in comparison to the DFT B3LYP/DGDZVP-calculated spectra. In addition, transformation of 1 and 3 with HClO4 in MeOH yielded epimeric methyl (+)-(5S,10S,13S)-labd-8-en-15-oate (6) and methyl (+)-(5S,10S,13R)-labd-8-en-15-oate (7), respectively, confirming the presence of C-13 epimers in this plant. Diterpene 1 showed remarkable antibacterial activity against Bacillus subtilis (MIC 0.15 mg/mL) and Staphylococcus aureus (MIC 0.78 mg/mL), while diterpene 3 exhibited moderate activities against the same organisms.

D-(+)-pinitol, a component of the heartwood of Enterolobium cyclocarpum (Jacq.) Griseb.

D-(+)-Pinitol, a natural product of the group of cyclitols, was purified for the first time from an aqueous extract of the heartwood of Enterolobium cyclocarpum, and its chemical structure was determined.

Alcoholics Anonymous-Related Benefit for Urban Native Americans: Does Urban Native American Gender Moderate AA Engagement and Outcomes?

Alcoholics Anonymous (AA) is one of the most commonly accessed resources for individuals seeking to reduce their drinking. How urban Native Americans fare in AA is only beginning to be investigated in spite of circumstantial evidence suggesting that a majority of treatment-seeking urban Native Americans will receive 12-step treatment. Even less is known about Native American gender differences with regard to AA-related benefit. The current study addressed this gap by investigating urban Native American gender differences in AA attendance rates and outcomes. To this end, as part of two larger NIH-funded studies we recruited 63 Native American men and women and followed them for 9 months in this naturalistic study (n= 35 males, n = 28 females). Urban Native Americans significantly reduced their drinking over the study period, and AA attendance explained, in part, increased abstinence of study participants. No significant differences in AA attendance and drinking outcomes were observed between Native American men and women; however, descriptively men reported greater reductions in hazardous drinking relative to women. Clinical implications and future directions are discussed.

"It Might Actually Work This Time": Benefits and Barriers to Adapted 12-Step Facilitation Therapy and Mutual-Help Group Attendance From the Perspective of Dually Diagnosed Individuals.

Most U.S. healthcare professionals encourage mutual-help group involvement as an adjunct to treatment or aftercare for individuals with substance use disorders, yet there are multiple challenges in engaging in these community groups. Dually diagnosed individuals (DDIs) may face additional challenges in affiliating with mutual-help groups. Twelve-step facilitation for DDIs (TSF-DD), a manualized treatment to facilitate mutual-help group involvement, was developed to help patients engage in Double Trouble in Recovery (DTR), a mutual-help group tailored to DDIs. Given the promising role that TSF-DD and DTR may have for increasing abstinence while managing psychiatric symptoms, the aim of the current study was to systematically examine reasons for TSF-DD and DTR attendance from the perspective of DDIs using focus group data. Participants were a subset (n = 15) of individuals diagnosed with an alcohol use disorder as well as a major depressive, bipolar, or psychotic disorder who participated in a parent study testing the efficacy of TSF-DD for increasing mutual-help group involvement and reducing alcohol use. Analyses of focus group data revealed that participants construed DTR and TSF-DD as helpful tools in the understanding and management of their disorders. Relative to other mutual-help groups in which participants reported feeling ostracized because of their dual diagnoses, participants reported that it was beneficial to learn about dual disorders in a safe and accepting environment. Participants also expressed aspects that they disliked. Results from this study yield helpful empirical recommendations to healthcare professionals seeking to increase DDIs' participation in DTR or other mutual-help groups.

Chemical composition of the essential oil from Ageratina jocotepecana and its repellent effect on drywood termite incisitermes marginipennis / Composición química del aceite esencial de Ageratina jocotepecana y su efecto repelente en termitas de madera seca incisitermes marginipennis

Essential oils obtained from new plant species with metabolomes unexplored or poorly known are a natural resource to find molecules with deterrent (irritant) effect. The aim of this study was to evaluate the chemical composition and the termite repellent activity of the essential oils from Ageratina jocotepecana. The repellent effect was determined by the pine drywood termite Incisitermes marginipennis behavior of to sense the contact of the tunnel wall in the wooden colony in the presence of an irritant obstacle caused by essential oils. Gas chromatographic analysis of the essential oils from flower, leaf, and stem showed quantitative and qualitative differences in components. Twenty-eight volatile components were identified by their mass spectra (MS). beta-caryophyllene, carvacrol, spathulenol, and terpinen-4-ol were the four major components, of them in relation 0.1 M citronellol, the 0.1 M carvacrol was the best repellent of the termite. Essential oils from A. jocotepecana exhibited a termite repellent effect due to their major components. Additionally, more research about the termite repellent action of carvacrol is still needed.

Los aceites esenciales obtenidos de nuevas especies de plantas con metabolomas inexplorados o poco conocidos son un recurso natural para encontrar moléculas con efecto disuasivo (irritante). El propósito del estudio fue evaluar la composición química de los aceites esenciales de Ageratina jocotepecana y su actividad repelente de termitas. El efecto repelente fue determinado por el comportamiento de las termitas de la madera seca de pino Incisitermes marginipennis de sentir el contacto de la pared del túnel en la colonia de madera en la presencia de un obstáculo irritante causado por los aceites esenciales. El análisis de cromatografía de gases de los aceites esenciales de flores, hojas y tallo mostró diferencias cuantitativas y cualitativas en componentes. Veintiocho componentes volátiles fueron identificados por sus espectros de masas (MS). beta-cariofileno, carvacrol, spathulenol y terpinen-4-ol fueron los cuatro componentes mayoritarios, de ellos en relación con 0,1 M citronelol el control positivo, el carvacrol 0,1 M fue el mejor repelente de la termita. Además, más investigación sobre la acción repelente de termitas de carvacrol se necesita realizar.