RESUMO
This commentary argues that the anomalies suffered by the population behavior genetics paradigm are more widespread than suggested by Charney, including many made in the field of developmental science. Further, it is argued that, according to the criteria established by Kuhn, there is and has been available an alternative scientific paradigm that provides the formative context for Charney's postgenomic view. This is the relational developmental systems paradigm.
Assuntos
Genética Comportamental , Genômica , Feminino , Humanos , GravidezRESUMO
In 2017, the American College of Cardiology and American Heart Association released its updated blood pressure guidelines, redefining hypertension to be any systolic blood pressure ≥130 mm Hg or diastolic blood pressure ≥80 mm Hg. Among United States adults, these new parameters increased the prevalence of hypertension from 72.2 million (31.9%) to 103.3 million (45.6%) adults and decreased the rate of medication-controlled hypertension from 53.4% to 39% with the prevalence of resistant hypertension ranging from 12% to 18%. Results of the pivotal SPRINT trial showed that more intensive blood pressure control in diabetic patients decreased both cardiovascular events and all-cause mortality. However, even with ideal goals in mind, compliance remains an issue due to multiple causes, and approximately half of study participants had stopped taking their antihypertensive drug within a year. Renal sympathetic denervation is a process in which catheter-based techniques are used to ablate specific portions of the renal artery nerves with the goal of decreasing sympathetic nerve activity and reducing blood pressure. Several studies using renal artery denervation have already shown benefit in patients with resistant hypertension, and now newer trials are beginning to focus on those with stage II hypertension as an additional potential treatment population. This review will seek to summarize the current evidence surrounding renal artery denervation and discuss some of its future trials, current issues, and potential roles both in hypertension and other comorbidities.
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Rim/inervação , Simpatectomia , Adulto , Anti-Hipertensivos/administração & dosagem , Pressão Sanguínea , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/terapia , Rim/cirurgia , Artéria Renal/cirurgia , Resultado do Tratamento , Estados UnidosRESUMO
Two studies were conducted to examine the dimensionality and hierarchical organization of a measure of recursive thinking. In Study 1, Rasch analysis supported the claim that the recursive thinking task measures a single underlying dimension. Item difficulty, however, appeared to be influenced not only by level of embeddedness but also by syntactic features. In Study 2, this hypothesis was tested by adding new items to the recursive thinking measure. Rasch analysis of the modified recursive thinking task produced evidence for the undimensionality and segmentation. However, Study 2 did not support the idea that syntactic features influence item difficulty.
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Modelos Estatísticos , Psicometria/métodos , Pensamento , Feminino , Humanos , MasculinoRESUMO
BACKGROUND: Adhesive Capsulitis (AC) affects patient of all ages, and stretching protocols are commonly prescribed for this condition. Dynamic splinting has been shown effective in contracture reduction from pathologies including Trismus to plantar fasciitis. The purpose of this study was to examine the efficacy of dynamic splinting on patients with AC. METHODS: This controlled, cohort study, was conducted at four physical therapy, sports medicine clinics in Texas and California. Sixty-two patients diagnosed with Stage II Adhesive Capsulitis were grouped by intervention. The intervention categories were as follows: Group I (Control); Group II (Physical Therapy exclusively with standardized protocols); Group III; (Shoulder Dynasplint system exclusively); Group IV (Combined treatment with Shoulder Dynasplint and standardized Physical Therapy). The duration of this study was 90 days for all groups, and the main outcome measures were change in active, external rotation. RESULTS: Significant difference was found for all treatment groups (p < 0.001) following a one-way ANOVA. The greatest change with the smallest standard deviation was for the combined treatment group IV, (mean change of 29 degrees ). CONCLUSION: The difference for the combined treatment group was attributed to patients' receiving the best PT combined with structured "home therapy" that contributed an additional 90 hours of end-range stretching. This adjunct should be included in the standard of care for adhesive Capsulitis. TRIAL NUMBER: NCT00873158.
Assuntos
Bursite/terapia , Manipulação Ortopédica/instrumentação , Manipulação Ortopédica/métodos , Contenções , Adulto , Idoso , Bursite/fisiopatologia , Estudos de Coortes , Humanos , Pessoa de Meia-Idade , Manipulações Musculoesqueléticas/instrumentação , Manipulações Musculoesqueléticas/métodosRESUMO
The purpose of this study is to examine the changes in body fat mass of previously sedentary, deconditioned subjects who began following the U.S. Surgeon General's recommendation in frequency of exercise. Ninety subjects of both sexes were recruited; ages ranged from 22 to 74 (mean 37.5 +/- 13) years. Subjects were prescribed exercise of 4 times a week, 30 minutes of continuous exercise, for 8 weeks. Eighty subjects completed the 8-week study and were categorized based on voluntary compliance: control (no exercise); exercise less than 2 times/week; exercise 3 to 4 times/week; exercise 4 or more times/week. Body fat mass was the dependent variable in this study, as measured by air displacement plethysmography, and data analysis was accomplished with a repeated measures analysis of variance. There was a significant change in body fat mass in this study, but the only significant difference between groups was for the group that exercised 4 or more times/week, (p = 0.004). Adherence to the U.S. Surgeon General's Guidelines for frequency of exercising 4 times per week for 30 minutes was effective in reducing subjects' body fat mass in this study.
Assuntos
Tecido Adiposo , Exercício Físico/fisiologia , Redução de Peso , Adulto , Idoso , Análise de Variância , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pletismografia/métodosRESUMO
We present a case report of runner's hallux limitus and the effect of dynamic splinting in reducing contracture as measured by gait analysis. After 4 months of treatment with dynamic splinting, the patient regained 45 degrees in active range of motion, and the gait analysis showed significant and beneficial changes.
Assuntos
Contratura/prevenção & controle , Hallux Limitus/terapia , Fibrose , Marcha , Hallux/patologia , Hallux/fisiopatologia , Hallux Limitus/patologia , Hallux Limitus/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Amplitude de Movimento Articular , ContençõesRESUMO
Information on the knowledge and ways of using food and medicinal plants by traditional populations, family farmers and Brazilian native population in the Amazon is essential to guarantee the food sovereignty of these groups. This study was conducted using semi-structured interviews applied to local respondents. A total of 269 species of both non-conventional food plants and medicinal plants were identified, distributed in 83 botanical families and 198 genera. The Arecaceae and Lamiaceae families had the highest species richness (11 and 7, respectively). The Shannon-Wiener (H') and Pielou (J') diversity indices were considered high (5.02 and 0.9, respectively) when compared to other ethnobotanical works. In the environment in which these families are found, these species become the only food and medicinal resources available.
La información sobre los saberes y formas de uso de las plantas alimenticias y medicinales por parte de las poblaciones tradicionales, agricultores familiares e indígenas brasileños en la Amazonía es fundamental para garantizar la soberanía alimentaria de estos grupos. Este estudio se realizó utilizando entrevistas semiestructuradas aplicadas a encuestados locales. Se identificaron un total de 269 especies tanto de plantas alimenticiasno convencionales como de plantas medicinales, distribuidas en 83 familias botánicas y 198 géneros. Las familias Arecaceae y Lamiaceae tuvieron la mayor riqueza de especies (11 y 7, respectivamente). Los índices de diversidad de Shannon-Wiener (H') y Pielou (J') fueron considerados altos (5,02 y 0,9, respectivamente) en comparación con otros trabajos etnobotánicos. En el ambiente en que se encuentran estas familias, estas especies se convierten en los únicos recursos alimenticios y medicinales disponibles.
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Plantas Comestíveis , Plantas Medicinais , Etnobotânica , Brasil , Inquéritos e Questionários , Abastecimento de AlimentosRESUMO
Cytokine-mobilized PBPC transplants result in rapid neutrophil and platelet engraftment following high-dose chemotherapy. A total of 61 patients with solid tumours, sensitive to carboplatin and paclitaxol, were recruited as part of a phase I/II study and randomized to receive a single dose of 6, 12 or 18 mg pegfilgrastim on day 1 of a 14-day prechemotherapy cycle or daily filgrastim (10 microg/kg) for up to 7 days. The kinetics of megakaryocyte progenitor mobilization were studied using immunohistochemical assays and flow cytometry in a subset of 31 patients. There was no significant difference among treatment groups with respect to the timing of total progenitor colony-forming units (CFUs) and megakaryocyte progenitor (CFU-MK) mobilization, with the highest median peak falling on day 4/5 in all groups. In the pegfilgrastim 18 mg group, the mean peak total CFUs and CFU-MK were statistically significantly higher than in the filgrastim group (2.031x10(4) vs 8.06x10(3) per millilitre, P=0.024 and 1.12x10(4) vs 4.56x10(3) per millilitre, P=0.024, respectively). The kinetic profiles generated using immunohistochemical assays for CFU-MK and FACS analysis for CD41a were closely correlated suggesting that CD41a can be used as a surrogate marker for megakaryocytic mobilization.
Assuntos
Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Mobilização de Células-Tronco Hematopoéticas/métodos , Megacariócitos/fisiologia , Neoplasias/tratamento farmacológico , Neoplasias/cirurgia , Adolescente , Adulto , Antineoplásicos/uso terapêutico , Carboplatina/uso terapêutico , Ensaio de Unidades Formadoras de Colônias , Terapia Combinada , Filgrastim , Citometria de Fluxo , Humanos , Megacariócitos/efeitos dos fármacos , Megacariócitos/patologia , Pessoa de Meia-Idade , Paclitaxel/uso terapêutico , Polietilenoglicóis , Proteínas Recombinantes , Células-Tronco/patologiaRESUMO
INTRODUCTION: The purpose of this study was to retrospectively evaluate the effect of the Dynasplint Trismus System (DTS; Dynasplint Systems Inc, Severna Park, Md, USA) for patients who were recently diagnosed with trismus following radiation therapy, dental treatment, oral surgery, or following a neural pathology such as a stroke. METHODS: We reviewed 48 patient histories (treated in 2006--2007), and divided into 4 cohort groups (radiation therapy for head/neck cancer, dental treatment, oral surgery, or stroke), to measure the efficacy of this treatment's modality. Patients were prescribed the DTS after diagnosis of trismus based on examination that showed < 40 mm maximal interincisal distance. The DTS uses low-load, prolonged-duration stretch with replicable, dynamic tension to achieve longer time at end range (of motion). Each patient used this device for 20-30 min, 3 times per d. RESULTS: This cohort case series showed that there was a statistically significant difference within all patient groups (P < 0.0001; t = 10.3289), but there was not a significant difference between groups (P = 0.374). CONCLUSION: The biomechanical modality of DTS with a low-load, prolonged-duration stretch was attributed to the success in reducing contracture in this study. This improved range of motion, allowing patients to regain the eating, hygiene and speaking patterns they had before developing trismus.
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Placas Oclusais , Trismo/reabilitação , HumanosRESUMO
Morality, a central dimension of culture, is crucial for research on the development of youth experiencing marginalization. In this article, we discuss two main meta-narratives as moral frameworks that provide different meaning to the past and to cultural change: liberal progress, focused on the struggle of those who have historically experienced marginalization (e.g., racial/ethnic minorities), and community lost, focused on those who are experiencing some forms of marginalization in response to cultural and economic changes (e.g., rural Whites). Because these two meta-narratives represent a false dichotomy, we use relational epistemology principles-holism, identity of opposites, opposites of identity, and synthesis of wholes-to formulate an integrated metanarrative, community progress, to overcome this polarity and promote research on the development of all youth experiencing marginalization. Acknowledging and understanding these moral meta-narratives is crucial because they influence scientific discourse, political action, and policy that impacts marginalization and youth development. (PsycINFO Database Record
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Cultura , Grupos Minoritários , Princípios Morais , Identificação Social , Adolescente , HumanosRESUMO
Background: The incidence of carpal tunnel syndrome (CTS) is 48 million patients in the United States. The purpose of this longitudinal study was to determine whether Dynasplint stretching (immediately after diagnosis) had an effect on a patient's decision to seek surgical treatment for CTS. Methods: Fifty patients (10 men, 40 women, mean age 51.2 ± 12 years) were recruited for this randomized, controlled, longitudinal trial. Patients were diagnosed with CTS by physical examination and nerve conduction studies. The intervention used was Dynasplint stretching that delivered a prolonged duration of low load stretching. Patients who were randomly chosen for the Experimental category wore the device for two 30-minute sessions per day with regular increases in splint tension for 60 days. Control patients received nonsteroidal anti-inflammatory medication plus instructions on daily home stretching. Results: The final, longitudinal outcome showed a 72% reduction in surgery chosen by the experimental group (n = 25), compared with 38% reduction for control patients (n = 25). Conclusions: Immediate treatment with Dynasplint stretching showed a 2 to 1 reduction in surgery, with abundant financial savings.
Assuntos
Síndrome do Túnel Carpal/terapia , Contenções , Adulto , Anti-Inflamatórios não Esteroides/uso terapêutico , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/tratamento farmacológico , Redução de Custos , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Exame Físico , Fatores de Tempo , Resultado do TratamentoRESUMO
BACKGROUND: Prior studies have shown that cyclooxygenase 2 (COX-2), an enzyme involved in inflammatory mechanisms and neuronal activities, is up-regulated in the brain with Alzheimer disease (AD) and may represent a therapeutic target for anti-inflammatory treatments. OBJECTIVE: To explore COX-2 expression in the brain as a function of clinical progression of early AD. DESIGN AND MAIN OUTCOME MEASURES: Using semiquantitative immunocytochemistry, we analyzed COX-2 protein content in the hippocampal formation in 54 postmortem brain specimens from patients with normal or impaired cognitive status. SETTING AND PATIENTS: Postmortem study of nursing home residents. RESULTS: The immunointensity of COX-2 signal in the CA3 and CA2 but not CA1 subdivisions of the pyramidal layers of the hippocampal formation of the AD brain increased as the disease progressed from questionable to mild clinical dementia as assessed by Clinical Dementia Rating. COX-2 signal was increased in all 3 regions examined among cases characterized by severe dementia. CONCLUSION: Neuronal COX-2 content in subsets of hippocampal pyramidal neurons may be an indicator of progression of dementia in early AD.
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Doença de Alzheimer/metabolismo , Doença de Alzheimer/patologia , Hipocampo/enzimologia , Hipocampo/patologia , Isoenzimas/biossíntese , Prostaglandina-Endoperóxido Sintases/biossíntese , Idoso , Idoso de 80 Anos ou mais , Ciclo-Oxigenase 2 , Progressão da Doença , Feminino , Humanos , Imuno-Histoquímica , Isoenzimas/análise , Masculino , Proteínas de Membrana , Prostaglandina-Endoperóxido Sintases/análiseRESUMO
CONTEXT: Imaging measurements may aid in the characterization and diagnosis of patients with Alzheimer disease (AD). Most research studies, however, have been performed on predominantly white study groups despite the fact that there may be biological differences in AD between African American and white patients. OBJECTIVE: To measure hippocampal volume in African American patients with AD and to correlate these measurements with the presence of AD and neuropsychological test performance. DESIGN: Survey study. SETTING: Academic center. PARTICIPANTS: Fifty-four healthy African American subjects and 32 African American patients with AD were studied. Hippocampal volumes were measured in all subjects from magnetic resonance images using established methods. MAIN OUTCOME MEASURE: Correlations were assessed between hippocampal volume and demographic variables, clinical group membership, and neuropsychological performance. RESULTS: The hippocampi of patients were atrophic with respect to those of healthy subjects (P<.01). Significant direct correlations were present between hippocampal volumes and performance on several different neuropsychological tests (r>0.5 and P<.01 for every test evaluated) when patients and healthy subjects were combined. CONCLUSIONS: Hippocampal atrophy is a feature of AD in African Americans as it is in white subjects. The neuropsychological-hippocampal volume correlations indicate that hippocampal volume measurements do represent a measure of the structural substrate of functional impairment in AD.
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Doença de Alzheimer/patologia , Negro ou Afro-Americano , Hipocampo/patologia , Doença de Alzheimer/diagnóstico , Atrofia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Entrevista Psiquiátrica Padronizada , Testes Neuropsicológicos , Valores de Referência , Caracteres Sexuais , Escalas de WechslerRESUMO
Three consecutive outbreaks of Salmonella enteritidis PT4 occurred in Wales in 1989 in which epidemiological and microbiological investigation established eggs as the likely source although kitchen inspection and food preparation histories suggested other vehicles of infection. This paper examines the contribution of analytical epidemiology in attributing causation, with particular reference to those limitations which are regarded as inherent in epidemiological evidence. Such evidence, implicating eggs in the three outbreaks, fulfilled 6/7 widely accepted criteria for causation; data to assess the seventh were lacking. Collaboration between different agencies and professionals in investigating outbreaks is very important.
Assuntos
Surtos de Doenças , Ovos , Microbiologia de Alimentos , Intoxicação Alimentar por Salmonella/epidemiologia , Salmonella enteritidis/isolamento & purificação , Humanos , Intoxicação Alimentar por Salmonella/etiologia , Intoxicação Alimentar por Salmonella/microbiologia , País de Gales/epidemiologiaRESUMO
AIMS: To determine and compare two urinary indices of renal tubular function, N-acetyl-glucosaminidase (NAG) and beta 2-microglobulin (beta 2 M), in healthy term neonates and babies with perinatal asphyxia. METHODS: In a prospective case-control study using asphyxiated (n = 35) and normal control (n = 55) infants, urinary NAG and beta 2 M were assayed at 24-48 hours of life, 4-6 days, and 4-6 weeks. RESULTS: NAG and beta 2 M were significantly increased at 24-48 hours and 4-6 days in the asphyxiated infants compared with the controls. Increased NAG values reflect the degree of perinatal asphyxia more than do beta 2 M. Gentamicin also increased NAG excretion, but to a lesser extent than did perinatal asphyxia. CONCLUSIONS: NAG (+/- beta 2 M) may be a useful marker of perinatal asphyxia. Urinary NAG concentrations correlate with the severity of perinatal asphyxia.
Assuntos
Acetilglucosaminidase/urina , Asfixia Neonatal/urina , Túbulos Renais/metabolismo , Microglobulina beta-2/urina , Antibacterianos/efeitos adversos , Biomarcadores/urina , Estudos de Casos e Controles , Gentamicinas/efeitos adversos , Humanos , Lactente , Recém-Nascido , Estudos ProspectivosRESUMO
Pupal density, wing length at emergence, host-seeking female abundance, and host-seeking female wing length and parity were determined monthly for a population of Aedes albopictus (Skuse) in a southwestern Louisiana tire dump from January 1988 through January 1989. Pupae and host-seeking females were first collected in April. Pupal densities were consistently high from June through September. Host-seeking female abundance was highest during July and August. Average female wing length was longest during spring, declined in midsummer, and increased slightly during fall. Average wing length was negatively correlated with average pupal density during the month of collection and with average air temperature recorded the previous month. Host-seeking females had consistently longer wings than emerging females, and parous host-seeking females had longer wings than nulliparous host-seeking females. Average wing length of the parous host-seeking females was consistently long throughout the season. Parity of host-seeking females parity was highest during July when approximately 21 parous host-seeking females were collected per hour. These results indicate that seasonal patterns in immature population density influence average body size and parity structure in Ae. albopictus.
Assuntos
Aedes/anatomia & histologia , Animais , Feminino , Louisiana , Masculino , Densidade Demográfica , Estações do Ano , Razão de MasculinidadeRESUMO
The ability of time-release formulations of larvicides and insect growth regulators (IGRs) to provide long-term control of Aedes albopictus was investigated in the field. Larvicides used in the study were Bactimos pellets (Bacillus thuringiensis var. israelensis, active ingredient) and Abate pellets (temephos, active ingredient). The IGR Altosid (methoprene, active ingredient) was used in pellet and sand formulations. Application rates were higher than label recommendations. In a preliminary test, clay flower bowls were treated with 2 g of material. Bactimos pellets failed to provide control after 60 days. Abate pellets and the Altosid formulations provided essentially 100% control for 150 days. After 360 days in the field, the Abate pellets produced 100% larval mortality, and significant levels of control were provided by the Altosid formulations and the Bactimos pellets. In a small-scale operational trial of this technique, 1 g of Altosid pellets was applied to every container that could be located in 2 urban residential neighborhoods in Lake Charles, LA. Aedes albopictus biting populations were monitored weekly in the treated areas and in an untreated control area. Biting population densities declined significantly in treated areas compared with the control area. Results suggested that long-term control of Ae. albopictus populations can be achieved economically with one application of Altosid pellets or Abate pellets in containers.
Assuntos
Aedes , Bacillus thuringiensis , Controle de Mosquitos/métodos , Temefós , Animais , Preparações de Ação Retardada , Larva , Louisiana , Controle Biológico de Vetores , Controle da PopulaçãoRESUMO
Interspecific mating between Aedes albopictus males and Ae. aegypti females was detected in the field using mark-release-recapture techniques. By 3 days after the release of virgin Ae. aegypti females into a field site containing only Ae. albopictus, 100% of the captured females were inseminated. Laboratory investigations indicated that male Ae. albopictus were very proficient at inseminating Ae. aegypti females and that Ae. aegypti males rarely inseminated Ae. albopictus females, especially if Ae. aegypti females were available. Most of the Ae. aegypti females inseminated by Ae. albopictus males contained only small amounts of dead sperm in their spermathecae, while inseminated females from the converse interspecific mating and from intraspecific matings contained only large amounts of live sperm. The results are discussed in relation to the decline in Ae. aegypti densities observed since the introduction of Ae. albopictus into the southern USA.
Assuntos
Aedes/fisiologia , Animais , Feminino , Fertilidade , Louisiana , Masculino , Comportamento Sexual AnimalRESUMO
Gender asymmetry in touch in U.S. populations is related to the age of the participants in some studies and to the relationships between the participants in others. In the present study, researchers observed dyads in public settings in the United States frequented by couples and recorded the occurrence of touch, the touch initiator, and the body areas touched. The researchers then approached the couples and asked them to complete questionnaires indicating their ages, their relationship, and their level of agreement on major issues. Age and relationship were predictive of the gender of touch initiators. Although levels of agreement were less predictive of touch initiation, the women indicated higher levels of agreement than the men did. The results were generally consistent with a model of sex differences in reproductive strategies.
Assuntos
Relações Interpessoais , Tato , Adolescente , Adulto , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Estado Civil , Pessoa de Meia-IdadeRESUMO
An observational study of pedestrians in a shopping mall in a mid-western U.S. city was replicated in shopping malls in London. The avoidance movements of 2692 shoppers were recorded as they approached other shoppers. The relationships between these movements and the shoppers' gender, age, race, group size, and other characteristics were examined. Results of both studies indicated that men were likely to be displaced by women, smaller groups by larger ones, and nonhandicapped persons by handicapped ones. The results differed, however, with respect to race, with black persons tending to displace white individuals in the Midwest regardless of group size, while lone white pedestrians tended to displace lone black pedestrians in London. In London larger groups tended to displace smaller ones regardless of race. Hypotheses regarding spatial displacement were discussed. The need for more cross-situational and cross-cultural research in social psychology was clear.