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1.
Nicotine Tob Res ; 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38642396

RESUMO

INTRODUCTION: Alaska Native and American Indian (ANAI) peoples in Alaska currently experience a disproportionate burden of morbidity and mortality from tobacco cigarette use. Financial incentives for smoking cessation are evidence-based, but a family-level incentive structure has not been evaluated. We used a community-based participatory research and qualitative approach to culturally adapt a smoking cessation intervention with ANAI families. METHODS: We conducted individual, semi-structured telephone interviews with 12 ANAI adults who smoke, 12 adult family members, and 13 Alaska Tribal Health System stakeholders statewide between November 2022-March 2023. Through content analysis, we explored intervention receptivity, incentive preferences, culturally aligned recruitment and intervention messaging, and future implementation needs. RESULTS: Participants were receptive to the intervention. Involving a family member was viewed as novel and aligned with ANAI cultural values of commitment to community and familial interdependence. Major themes included choosing a family member who is supportive and understanding, keeping materials positive and encouraging, and offering cash and non-cash incentives for family members to choose (e.g., fuel, groceries, activities). Participants indicated that messaging should emphasize family collaboration and that cessation resources and support tips should be provided. Stakeholders also reinforced that program materials should encourage the use of other existing evidence-based cessation therapies (e.g., nicotine replacement, counseling). CONCLUSIONS: Adaptations, grounded in ANAI cultural strengths were made to the intervention and recruitment materials based on participant feedback. Next steps include a beta-test for feasibility and a randomized controlled trial for efficacy. IMPLICATIONS: This is the first study to design and adapt a financial incentives intervention promoting smoking cessation among Alaska Native or American Indian (ANAI) peoples and the first to involve the family system. Feedback from this formative work was used to develop a meaningful family-level incentive structure with ANAI people who smoke and family members and ensure intervention messaging is supportive and culturally aligned. The results provide qualitative knowledge that can inform future family-based interventions with ANAI communities, including our planned randomized controlled trial of the intervention.

2.
J Pediatr ; 270: 114009, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38492915

RESUMO

OBJECTIVE: To evaluate a fast-track triage model in an integrated community specialty clinic to reduce the age of diagnosis for patients with autism spectrum disorder (ASD). STUDY DESIGN: A retrospective chart review was performed for patients seen in an integrated community specialty pediatric practice using a fast-track screening and triage model. The percentage of ASD diagnoses, age at diagnosis, and time from referral to diagnosis were evaluated. The fast-track triage model was compared with national and statewide estimates of median age of first evaluation and diagnosis. RESULTS: From January 1, 2020, through December 31, 2021, 189 children with a mean (SD) age of 32.2 (12.4) months were screened in the integrated community specialty. Of these, 82 (43.4%) children were referred through the fast-track triage for further evaluation in the developmental and behavioral pediatrics (DBP) department, where 62 (75.6%) were given a primary diagnosis of ASD. Average wait time from referral to diagnosis using the fast-track triage model was 6 months. Mean (SD) age at diagnosis was 37.7 (13.5) months. The median age of diagnosis by the fast-track triage model was 33 months compared with the national and state median ages of diagnosis at 49 and 59 months, respectively. CONCLUSIONS: With the known workforce shortage in fellowship-trained developmental behavioral pediatricians, the fast-track triage model is feasible and maintains quality of care while resulting in more timely diagnosis, and reducing burden on DBP by screening out cases who did not require further multidisciplinary DBP evaluation as they were appropriately managed by other areas.


Assuntos
Transtorno do Espectro Autista , Triagem , Humanos , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/terapia , Estudos Retrospectivos , Pré-Escolar , Masculino , Feminino , Triagem/métodos , Lactente , Encaminhamento e Consulta/estatística & dados numéricos , Criança , Fatores de Tempo , Prestação Integrada de Cuidados de Saúde/organização & administração , Serviços de Saúde Comunitária/organização & administração
3.
Fam Community Health ; 46(4): 250-258, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37703513

RESUMO

With rising childhood obesity rates, ensuring children adopt healthy habits early is imperative. Given the unique context for Alaska Native families living in rural remote communities, who are concurrently experiencing changes in traditional practices, we investigated what impacts parents' decisions as they relate to daily living before revising a preschool curriculum focused on healthy habits. The objective of this study was to explore factors influencing parents' decisions about their children's foods, beverages, and activities. In focus group discussions with AN parents of young children across 12 communities, we asked about meals, traditional foods, beverages, physical activity, and screen time. All sessions were recorded, transcribed, and analyzed using open and selective coding to allow the most important themes to emerge. As parents discussed how they make decisions, several trends emerged related to adults' and children's food and beverage preferences; the impact of adult modeling on children; and how convenience, seasonality, access, and a reluctance to engage in conflict all impact decision-making. Parents and other community members shared important perspectives on exposing children to traditional subsistence foods and activities and passing important traditional knowledge to them at an early age. These perspectives will form the basis for preschool curricula in these communities.


Assuntos
Obesidade Infantil , Adulto , Criança , Pré-Escolar , Humanos , Tempo de Tela , Obesidade Infantil/prevenção & controle , Pais , Bebidas
4.
Contemp Clin Trials Commun ; 33: 101129, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-37091507

RESUMO

Background: Alaska Native and American Indian (ANAI) communities in Alaska are disproportionately affected by commercial tobacco use. Financial incentive interventions promote cigarette smoking cessation, but family-level incentives have not been evaluated. We describe the study protocol to adapt and evaluate the effectiveness and implementation of a remotely delivered, family-based financial incentive intervention for cigarette smoking among Alaskan ANAI people. Methods: The study has 3 phases: 1) qualitative interviews with ANAI adults who smoke, family members, and stakeholders to inform the intervention, 2) beta-test of the intervention, and 3) randomized controlled trial (RCT) evaluating intervention reach and effectiveness on verified, prolonged smoking abstinence at 6- and 12-months post-treatment. In the RCT, adult dyads (ANAI person who smokes [index participant] and family member) recruited throughout Alaska will be randomized to a no-incentives control condition (n = 328 dyads) or a 6-month incentive intervention (n = 328 dyads). All dyads will receive cessation support and family wellness materials. Smoking status will be assessed weekly for four weeks and at three and six months. Intervention index participants will receive escalating incentives for verified smoking abstinence at each time point (maximum $750 total); the family member will receive rewards of equal value. Results: A community advisory committee contributed input on the study design and methods for relevance to ANAI people, particularly emphasizing the involvement of families. Conclusion: Our study aligns with the strength and value AIAN people place on family. Findings, processes, and resources will inform how Indigenous family members can support smoking cessation within incentive interventions. Clinical Trials Registry: NCT05209451.

5.
Child Obes ; 19(7): 498-506, 2023 10.
Artigo em Inglês | MEDLINE | ID: mdl-36473164

RESUMO

Background: American Indian and Alaska Native preschool-aged children experience a high prevalence of obesity, yet are under-represented in obesity prevention research. This study examined obesity prevalence and dietary risk factors among Alaska Native preschool-aged children in southwest Alaska. Methods: The study used baseline data from "Got Neqpiaq?" a culturally centered multilevel intervention focused on Yup'ik Alaska Native children, aged 3-5 years, enrolled in Head Start in 12 communities in southwest Alaska (n = 155). The primary outcomes were BMI percentile, overweight, and obesity. Dietary factors of interest were measured using biomarkers: traditional food intake (nitrogen stable isotope ratio biomarker), ultraprocessed food intake (carbon stable isotope ratio biomarker), and vegetable and fruit intake (skin carotenoid status biomarker measured by the Veggie Meter). Cardiometabolic markers (glycated hemoglobin [HbA1c] and blood cholesterol) were also measured. Results: Among the Yup'ik preschool-aged children in the study, the median BMI percentile was 91, and the prevalence of overweight or obesity was 70%. The traditional food intake biomarker was negatively associated with BMI, whereas the ultraprocessed foods and vegetable and fruit biomarkers were not associated with BMI. HbA1c and blood cholesterol were within healthy levels. Conclusions: The burden of overweight and obesity is high among Yup'ik preschool-aged children. Traditional food intake is inversely associated with BMI, which underscores the need for culturally grounded interventions that emphasize traditional values and knowledge to support the traditional food systems in Alaska Native communities in southwest Alaska. Registered with ClinicalTrials.gov #NCT03601299.


Assuntos
Obesidade Infantil , Pré-Escolar , Humanos , Biomarcadores , Colesterol , Hemoglobinas Glicadas , Isótopos de Nitrogênio , Sobrepeso , Obesidade Infantil/epidemiologia , Prevalência
6.
Int J Circumpolar Health ; 80(1): 1961393, 2021 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34350814

RESUMO

Low intake of fruits and vegetables and high intake of sugar-sweetened beverages persists as a public health concern in rural remote Alaska Native (AN) communities. Conducting key informant interviews with 22 storekeepers in 12 communities in the Yukon-Kuskokwim region of Alaska, we explored potential factors impeding or facilitating dietary change towards healthier food choices. We selected these sites as part of a multi-level intervention aimed at introducing more traditional AN subsistence foods, increasing fruit and vegetable intake, and decreasing SSB consumption among young children enrolled in Head Start (preschool) programmes (Clinicaltrials.gov #NCT03601299). Storekeepers in these communities agreed that seasonality and flight schedules were primary factors determining commercial foods' availability. Several storekeepers noted that federal food assistance programmes that specify which food items may be purchased with funds received from the programme and community policies that set limits on less healthy items promote customer purchases of healthier products. The fact that storekeepers are comfortable enforcing government assistance programme guidelines, company policies, and tribal resolutions suggests an important role storekeepers play in improving nutritional intake in their communities.


Assuntos
Frutas , Verduras , Alaska , Bebidas , Criança , Pré-Escolar , Dieta , Ingestão de Alimentos , Humanos , População Rural
7.
BMJ Open ; 11(8): e047162, 2021 08 27.
Artigo em Inglês | MEDLINE | ID: mdl-34452959

RESUMO

INTRODUCTION: Diet, shown to impact colorectal cancer (CRC) risk, is a modifiable environmental factor. Fibre foods fermented by gut microbiota produce metabolites that not only provide food for the colonic epithelium but also exert regulatory effects on colonic mucosal inflammation and proliferation. We describe methods used in a double-blinded, randomised, controlled trial with Alaska Native (AN) people to determine if dietary fibre supplementation can substantially reduce CRC risk among people with the highest reported CRC incidence worldwide. METHODS AND ANALYSES: Eligible patients undergoing routine screening colonoscopy consent to baseline assessments and specimen/data collection (blood, urine, stool, saliva, breath and colon mucosal biopsies) at the time of colonoscopy. Following an 8-week stabilisation period to re-establish normal gut microbiota post colonoscopy, study personnel randomise participants to either a high fibre supplement (resistant starch, n=30) or placebo (digestible starch, n=30) condition, repeating stool sample collection. During the 28-day supplement trial, each participant consumes their usual diet plus their supplement under direct observation. On day 29, participants undergo a flexible sigmoidoscopy to obtain mucosal biopsy samples to measure the effect of the supplement on inflammatory and proliferative biomarkers of cancer risk, with follow-up assessments and data/specimen collection similar to baseline. Secondary outcome measures include the impact of a high fibre supplement on the oral and colonic microbiome and biofluid metabolome. ETHICS AND DISSEMINATION: Approvals were obtained from the Alaska Area and University of Pittsburgh Institutional Review Boards and Alaska Native Tribal Health Consortium and Southcentral Foundation research review bodies. A data safety monitoring board, material transfer agreements and weekly study team meetings provide regular oversight throughout the study. Study findings will first be shared with AN tribal leaders, health administrators, providers and community members. Peer-reviewed journal articles and conference presentations will be forthcoming once approved by tribal review bodies. TRIAL REGISTRATION NUMBER: NCT03028831.


Assuntos
Neoplasias do Colo , Alaska , Neoplasias do Colo/prevenção & controle , Fibras na Dieta , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 970-976, May-June, 2020. ilus, tab
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1129701

RESUMO

This study aimed to establish criteria for eliminating redundant variables, to know the magnitude of the data relationship, and to provide information that helps researchers in the use of the technique to analyze and interpret production data and egg quality. The data used in this work was obtained from four successive generations of the quail lineage developed by the Department of Animal Science of the Federal University of Pelotas. The characteristics were measured from the 42nd day of age, when the egg production period began, until 126 days of production, obtaining three 28 day periods (cycles) in the four successive generations, totaling 545 females. Of the twelve original variables, only seven demonstrated potential to be maintained in future experiments, representing a 42% exclusion. The main philosophy of this study was the analysis of the studied variables and made possible the understanding of the relationship and the correlations.(AU)


O objetivo do presente trabalho foi estabelecer critérios para eliminação de variáveis redundantes, conhecer a magnitude das relações dos dados, além de fornecer informações que auxiliem pesquisadores na utilização da técnica para analisar e interpretar dados de produção e qualidade de ovos de codornas. Os dados utilizados neste trabalho são provenientes de quatro gerações sucessivas da linhagem de codornas de corte desenvolvida pelo Departamento de Zootecnia da Universidade Federal de Pelotas. As características foram mensuradas do 42º dia de idade até o 126º dia de produção, totalizando 545 fêmeas. Das 12 variáveis originais analisadas, apenas sete demonstraram potencial para serem mantidas em experimentos futuros, representando uma exclusão de 42%. A análise de componentes principais foi efetiva para a redução das variáveis estudadas e possibilitou a compreensão da relação e correlação dessas.(au)


Assuntos
Animais , Coturnix , Ovos/análise , Perfil Genético , Qualidade dos Alimentos , Análise Multivariada
9.
Dig Dis Sci ; 65(3): 723-740, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32060812

RESUMO

This review summarizes the key results of recently published studies on the effects of dietary change and nutritional intervention on the human microbiome from around the world, focusing on the USA, Canada, Europe, Asia, and Africa. It first explores mechanisms that might explain the ability of fiber-rich foods to suppress the incidence and mortality from westernized diseases, notably cancers of the colon, breast, liver, cardiovascular, infectious, and respiratory diseases, diabetes, and obesity (O'Keefe in Lancet Gastroenterol Hepatol 4(12):984-996, 2019; Am J Clin Nutr 110:265-266, 2019). It summarizes studies from Africa which suggest that disturbance of the colonic microbiome may exacerbate chronic malnutrition and growth failure in impoverished communities and highlights the importance of breast feeding. The American section discusses the role of the microbiome in the swelling population of patients with obesity and type 2 diabetes and examines the effects of race, ethnicity, geography, and climate on microbial diversity and metabolism. The studies from Europe and Asia extoll the benefits of whole foods and plant-based diets. The Asian studies examine the worrying changes from low-fat, high-carbohydrate diets to high-fat, low-carbohydrate ones and the increasing appearance of westernized diseases as in Africa and documents the ability of high-fiber traditional Chinese diets to reverse type 2 diabetes and control weight loss. In conclusion, most of the studies reviewed demonstrate clear changes in microbe abundances and in the production of fermentation products, such as short-chain fatty acids and phytochemicals following dietary change, but the significance of the microbiota changes to human health, with the possible exception of the stimulation of butyrogenic taxa by fiber-rich foods, is generally implied and not measured. Further studies are needed to determine how these changes in microbiota composition and metabolism can improve our health and be used to prevent and treat disease.


Assuntos
Dieta , Fibras na Dieta/microbiologia , Microbioma Gastrointestinal/fisiologia , Internacionalidade , Leite Humano/microbiologia , Dieta/tendências , Dieta Ocidental/efeitos adversos , Humanos , Leite Humano/fisiologia
10.
Am J Clin Nutr ; 111(2): 406-419, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-31851298

RESUMO

BACKGROUND: Alaska Native (AN) people have the world's highest recorded incidence of sporadic colorectal cancer (CRC) (∼91:100,000), whereas rural African (RA) people have the lowest risk (<5:100,000). Previous data supported the hypothesis that diet affected CRC risk through its effects on the colonic microbiota that produce tumor-suppressive or -promoting metabolites. OBJECTIVES: We investigated whether differences in these metabolites may contribute to the high risk of CRC in AN people. METHODS: A cross-sectional observational study assessed dietary intake from 32 AN and 21 RA healthy middle-aged volunteers before screening colonoscopy. Analysis of fecal microbiota composition by 16S ribosomal RNA gene sequencing and fecal/urinary metabolites by 1H-NMR spectroscopy was complemented with targeted quantification of fecal SCFAs, bile acids, and functional microbial genes. RESULTS: Adenomatous polyps were detected in 16 of 32 AN participants, but not found in RA participants. The AN diet contained higher proportions of fat and animal protein and less fiber. AN fecal microbiota showed a compositional predominance of Blautia and Lachnoclostridium, higher microbial capacity for bile acid conversion, and low abundance of some species involved in saccharolytic fermentation (e.g., Prevotellaceae, Ruminococcaceae), but no significant lack of butyrogenic bacteria. Significantly lower concentrations of tumor-suppressive butyrate (22.5 ± 3.1 compared with 47.2 ± 7.3 SEM µmol/g) coincided with significantly higher concentrations of tumor-promoting deoxycholic acid (26.7 ± 4.2 compared with 11 ± 1.9 µmol/g) in AN fecal samples. AN participants had lower quantities of fecal/urinary metabolites than RA participants and metabolite profiles correlated with the abundance of distinct microbial genera in feces. The main microbial and metabolic CRC-associated markers were not significantly altered in AN participants with adenomatous polyps. CONCLUSIONS: The low-fiber, high-fat diet of AN people and exposure to carcinogens derived from diet or environment are associated with a tumor-promoting colonic milieu as reflected by the high rates of adenomatous polyps in AN participants.


Assuntos
Bactérias/metabolismo , População Negra , Neoplasias Colorretais/microbiologia , Microbioma Gastrointestinal/fisiologia , Adulto , Bactérias/classificação , Estudos de Coortes , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/genética , Estudos Transversais , Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , RNA Bacteriano/genética , RNA Ribossômico 16S/genética , População Rural
11.
JAMA Pediatr ; 174(1): 63-70, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31790555

RESUMO

Importance: It is critical to evaluate the risk of comorbid psychiatric diagnoses to meet the needs of individuals with autism spectrum disorder (ASD). Objective: To examine whether individuals with ASD are at greater risk for comorbid diagnoses of depression, anxiety, or bipolar disorder. Design, Setting, and Participants: This cohort study used data from a population-based birth cohort of 31 220 individuals born in Olmsted County, Minnesota, from January 1, 1976, to December 31, 2000. Patients with research-identified ASD were previously identified using a multistep process that evaluated signs and symptoms abstracted from medical and educational records. For each of the 1014 patients with ASD, 2 age- and sex-matched referents who did not meet criteria for ASD were randomly selected from the birth cohort (n = 2028). Diagnosis codes for anxiety, depression, and bipolar disorders were electronically obtained using the Rochester Epidemiological Project records-linkage system. Data analysis was performed from July 1, 2018, to April 1, 2019. Main Outcomes and Measures: Cumulative incidence of clinically diagnosed depression, anxiety, and bipolar disorder through early adulthood in individuals with ASD compared with referents. Results: A total of 1014 patients with ASD (median age at last follow-up, 22.8 years [interquartile range, 18.4-28.0 years]; 747 [73.7%] male; 902 [89.0%] white) and 2028 referents (median age at last follow-up, 22.4 years [interquartile range, 18.8-26.2 years]; 1494 [73.7%] male; 1780 [87.8%] white) participated in the study. Patients with ASD were significantly more likely to have clinically diagnosed bipolar disorder (hazard ratio [HR], 9.34; 95% CI, 4.57-19.06), depression (HR, 2.81; 95% CI, 2.45-3.22), and anxiety (HR, 3.45; 95% CI, 2.96-4.01) compared with referents. Among individuals with ASD, the estimates of cumulative incidence by 30 years of age were 7.3% (95% CI, 4.8%-9.7%) for bipolar disorder, 54.1% (95% CI, 49.8%-58.0%) for depression, and 50.0% (95% CI, 46.0%-53.7%) for anxiety. Among referents, cumulative incidence estimates by 30 years of age were 0.9% (95% CI, 0.1%-1.7%) for bipolar disorder, 28.9% (95% CI, 25.7%-32.0%) for depression, and 22.2% (95% CI, 19.3%-25.0%) for anxiety. Conclusions and Relevance: The findings suggest that individuals with ASD may be at increased risk for clinically diagnosed depression, anxiety, and bipolar disorder compared with age- and sex-matched referents. This study supports the importance of early, ongoing surveillance and targeted treatments to address the psychiatric needs of individuals with ASD.


Assuntos
Transtornos de Ansiedade/epidemiologia , Transtorno do Espectro Autista/epidemiologia , Previsões , Transtornos do Humor/epidemiologia , Adolescente , Adulto , Comorbidade , Feminino , Seguimentos , Humanos , Incidência , Masculino , Minnesota/epidemiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
12.
J Ethnopharmacol ; 244: 112150, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31401320

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Aristolochia ringens Vahl. (Aristolochiaceae) is used traditionally in Nigeria for managing a number of ailments including gastrointestinal disturbances, rheumatoid arthritis, pile, insomnia, oedema, and snake bite venom. Some studies in our laboratory have demonstrated a scientific justification for some of such uses. This study aims at investigating the toxicological actions of the aqueous root extract of Aristolochia ringens (AR). MATERIALS AND METHODS: Brine shrimp lethality assay was carried out using 10, 100 and 1000 µg/ml of the extract. Oral and intraperitoneal acute toxicity tests were carried out using mice. The effect of sub-acute (30 days) repeated oral exposure to the extract at 10, 50 and 250 mg/kg in rats was also evaluated via weekly assessments of body weights and general observations as well as end of exposure haematological, biochemical and histological examinations of blood and tissue samples of treated rats. Phytochemical analyses to determine the presence of aristolochic acid I in the extract was also carried out using high performance liquid chromatography (HPLC). RESULTS: The aqueous root extract of A. ringens showed potential for biological activity and cytotoxicity with an LC50 of 175 µg/ml in brine shrimps. AR was found to be relatively safe on acute oral exposure with LD50 estimated to be greater than 10 g/kg, while its LD50 on intraperitoneal administration was 407.38 mg/kg. Upon 30 days sub-chronic exposure, AR induced significant weight loss in female rats, enlargement of male rats' stomach, oxidative stress in male and female rats' kidney and liver tissues and disruption of leukocytes level in female rats. It also showed evidence of kidney and liver injuries inducible by oxidative damage and the potential to cause male sterility. HPLC revealed the presence of 0.003 mg/1 g of aristolochic acid in AR. CONCLUSION: These results show that AR contains detectible aristolochic acid I and has potential to induce toxic responses. Caution must therefore be exercised in its medicinal application especially when required for a prolonged use.


Assuntos
Aristolochia , Extratos Vegetais/toxicidade , Administração Oral , Animais , Artemia/efeitos dos fármacos , Feminino , Injeções Intraperitoneais , Masculino , Camundongos , Raízes de Plantas , Ratos , Testes de Toxicidade Aguda , Testes de Toxicidade Subaguda
13.
Child Psychiatry Hum Dev ; 50(1): 27-34, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-29855820

RESUMO

Given the high rates of comorbid anxiety and autism spectrum disorder (ASD) in the adolescent and young adult population, effective treatment protocols to address anxiety symptoms are of importance to help promote greater independence across settings. While research supports the use of cognitive-behavioral therapy (CBT) across younger age groups with ASD, the literature is limited on interventions benefitting adolescents and young adults with comorbid anxiety disorders and ASD. Therefore, this open trial utilized a modified CBT manual for seven participants between the ages of 16 and 20 years, consisting of a 16-week modularized CBT treatment, including psychoeducation, cognitive therapy, and exposure therapy. Measures of anxiety and depression were completed at baseline and post-treatment. Findings demonstrated significant reductions on clinician-rated measures of anxiety. While findings are encouraging, additional studies examining the efficacy of CBT for this population with ASD and clinical anxiety are necessary to further identify beneficial treatment components.


Assuntos
Transtornos de Ansiedade , Ansiedade , Transtorno do Espectro Autista , Terapia Cognitivo-Comportamental/métodos , Adolescente , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/terapia , Transtornos de Ansiedade/epidemiologia , Transtornos de Ansiedade/psicologia , Transtornos de Ansiedade/terapia , Transtorno do Espectro Autista/epidemiologia , Transtorno do Espectro Autista/psicologia , Transtorno do Espectro Autista/terapia , Comorbidade , Depressão/diagnóstico , Depressão/etiologia , Depressão/terapia , Feminino , Humanos , Terapia Implosiva/métodos , Masculino , Técnicas Psicológicas , Resultado do Tratamento , Estados Unidos , Adulto Jovem
14.
J Ethnopharmacol ; 208: 174-184, 2017 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-28668647

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Aerva lanata (L.) of the family Amaranthaceae is a Nigerian medicinal plant used traditionally for the management of lithiasis, headache, renal disorder, haematemesis, bronchitis, nasal bleeding, cough, scorpion stings, fractures and spermatorrhoea. Studies that show the pharmacological basis for some of such uses have been reported. There is, however, no scientific report on its toxicity profile to the best of our knowledge. AIM OF THE STUDY: This study was therefore aimed at investigating the toxicity profile of the aqueous extract of Aerva lanata. MATERIALS AND METHODS: Acute toxicity tests for the extract administered orally at 1-30g/kg and intraperitoneally at 0.1-2g/kg were carried out in albino mice; while a sub-chronic toxicity test was done by daily oral administration of the extract at 40-1000mg/kg to albino rats for 90 days. Anthropometric, biochemical and haematological parameters' assessments as well as vital organs histological examinations were performed in the sub-chronic toxicity study. RESULTS: The LD50 of the extract for oral and intraperitoneal acute toxicity tests were 22.62g/kg and 0.432g/kg respectively. The extract produced apparent changes in body weights of both male and female rats and significantly (p < 0.05) increased the weights of lungs, brain and pancreas of female rats while reducing the weight of testes in male rats. Haematological parameters were also altered with total leukocytes significantly (p < 0.05) increased and platelets significantly (p < 0.05) reduced in female rats; while neutrophils significantly (p < 0.05) increased in male rats. The extract (40-1000mg/kg) produced significant (p < 0.05) reduction of serum alanine transaminase concentration in both male and female rats. Aspartate transaminases and albumin were also significantly (p < 0.05) reduced in both male (at 1000mg/kg) and female (at 200mg/kg) rats. Alkaline phosphatase was also significantly (p < 0.05) reduced in female rats at 200mg/kg of the extract. Substantial alterations of creatinine, urea and uric acid were also observed. Triglyceride and cholesterol concentrations were significantly increased in male rats but decreased in female rats. At 1000mg/kg, the extract significantly elevated catalase and superoxide dismutase levels with no effect on malondialdehyde levels. It also reduced sperm count and motility of male rats. Mild to moderate cellular changes in the brain, kidney, liver, lungs, spleen and testes of treated rats were observed on histological examinations. Significant changes in biochemical and haematological parameters were also noted in treated animals when compared to control animals 30 days after cessation of treatment. CONCLUSION: The overall findings of this study suggest that the aqueous extract of A. lanata is relatively safe on acute oral exposure, moderately toxic on acute intraperitoneal administration and is relatively safe with antioxidant actions on prolonged exposure. It however shows potentials for toxic effects such as cellular damage to organs, dyslipidaemia and reduction in male reproductive capacity. Caution must therefore be applied in its use on a long term basis.


Assuntos
Amaranthaceae , Extratos Vegetais/toxicidade , Administração Oral , Animais , Feminino , Injeções Intraperitoneais , Dose Letal Mediana , Masculino , Camundongos , Ratos Wistar , Solventes/química , Testes de Toxicidade Aguda , Testes de Toxicidade Subcrônica , Água/química
15.
Arq. bras. med. vet. zootec ; 69(1): 205-213, jan.-fev. 2017. tab, graf
Artigo em Português | LILACS, VETINDEX | ID: biblio-836700

RESUMO

Este estudo foi desenvolvido com o objetivo de avaliar a expressão gênica do fator de crescimento semelhante à insulina I (IGF-I) e do receptor do hormônio do crescimento (GHR) no fígado e no músculo do peito de codornas de corte, alimentadas com dietas contendo diferentes níveis de suplementação de metionina, em duas gerações sucessivas. Foram utilizadas codornas dos 22 aos 42 dias de idade, distribuídas em três e cinco tratamentos na primeira e na segunda geração, respectivamente. Ao final, as aves foram abatidas por deslocamento cervical, sendo coletados fígado e músculo do peito para extração de RNA total. O cDNA foi amplificado usando primers específicos para os genes analisados. Os resultados mostraram que a expressão dos genes GHR e IGF-I sofreu influência da suplementação. No quinto tratamento, em que apenas a primeira geração recebeu uma suplementação acima do padrão das exigências para o período, houve uma expressão significativamente maior do GHR tanto no músculo do peito como no fígado e igualmente do IGF-I no músculo, levando a concluir que o excesso de metionina na dieta torna-se tóxica para as aves. Apesar de a expressão dos genes ter sofrido influência da adição de metionina nos níveis estudados, não foi observada diferença no consumo alimentar, na conversão alimentar e no peso das aves.(AU)


This study was conducted to evaluate the gene expression of the insulin-like I growth factor (IGF-I) and growth hormone receptor (GHR), in the liver and chest muscle of slaughter quails fed with diets containing different levels of methionine supplementation, in two successive generations. Twenty-two to 42 day-old quails were used, distributed in three and five treatments in the first and second generation, respectively. At the end, the birds were killed by cervical dislocation, and their liver and chest muscle were collected for total RNA extraction. The cDNA was amplified using specific primers for the genes analyzed. The results showed that the expression of GHR gene and IGF-I were influenced by the supplementation. In the fifth treatment, where only the first generation received supplementation above the standard requirements for the period, there was a significantly higher expression of GHR both in muscle chest and in the liver, and also IGF-I on muscle, leading to the conclusion that the excess dietary methionine becomes toxic to birds. Despite the gene´s expression seeming to be influenced by the addition of methionine levels in the study, there was no difference in feed intake, feed conversion and weight of the birds.(AU)


Assuntos
Animais , Coturnix/genética , Suplementos Nutricionais/análise , Expressão Gênica , Fator de Crescimento Insulin-Like I/genética , Metionina/administração & dosagem , Receptores da Somatotropina/genética , Primers do DNA , Reação em Cadeia da Polimerase em Tempo Real/veterinária
16.
Rev. bras. farmacogn ; 24(3): 348-354, May-Jun/2014. tab, graf
Artigo em Inglês | LILACS | ID: lil-719453

RESUMO

This study analyzes the antinociceptive and anti-inflammatory properties of ethanolic leaf extract of Alafia barteri Oliv., Apocynaceae, based on its medicinal use in the treatment of toothaches, inflammation and fevers. The antinociceptive effect was assessed in mice using acetic acid-induced writhing, tail clip, tail immersion and formalin assays. Anti-inflammatory activity was evaluated on carrageenan-induced paw oedema in rats, and xylene-induced ear oedema in mice. In acetic acid-induced writhing test, the extract at different doses (50, 100 and 200 mg/kg, p.o.) significantly (p < 0.05) and dose-dependently reduced pain by 35.04, 56.49 and 84.25%, respectively. The extract also significantly inhibited both the early and late phases of formalin-induced nociception in mice. In the tail immersion test, the extract caused a significant inhibition of pain (34.43% inhibition, after 90 min) at a dose of 200 mg/kg, while the effect of the extract in the tail clip test was only significant at the 100 mg/kg dose. A. barteri caused a significant inhibition of paw oedema development in the carrageenan and xylene-induced oedema tests. There was no mortality recorded following treatment with the extract (5 g/kg, p.o.). The results support the traditional use of A. barteri in the treatment of various diseases associated with pain and inflammation.

17.
World J Surg ; 38(6): 1353-61, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24493070

RESUMO

BACKGROUND: Neuroendocrine neoplasias (NEN) of the gastroenteropancreatic (GEP) system frequently present with metastatic deposits. The proliferation marker Ki-67 is used for diagnosis and to assess the prognosis of disease. The aim of our study was to evaluate the usefulness of Ki-67 % in the assessment of NEN patients with regard to their disease stage in clinical practice. Additionally, a comparative analysis of Ki-67 levels among different sites of disease was performed. METHODS: This retrospective study included patients with GEP NEN referred to our center from 2010 to 2012. The NEN diagnosis was confirmed by standard histopathology. Ki-67 immunohistochemistry was done on paraffin-embedded sections using an automated Leica immunohistochemistry machine. NEN grading was carried out according to European Neuroendocrine Tumor Society recommendations (low grade [G1] to intermediate grade [G2], well to moderately differentiated neuroendocrine neoplasms; high-grade [G3], moderately to poorly differentiated neuroendocrine neoplasms). Results of tumor staging and grading were correlated. In a subgroup of cases, comparative analysis of Ki-67 levels in different sites of disease was carried out. RESULTS: One hundred sixty-one GEP NEN patients were included in the study. Metastatic disease was seen in 46.1 % (53/115) of G1 tumors, 77.8 % (28/36) of G2 tumors, and 100 % of (10/10) G3 tumors (p = 0.0002). When stratified according to primary tumor site, metastatic disease was documented in 42.9 % (36/84) of patients with pancreatic NEN and in 91.9 % (34/37) of those with small intestinal primary. Stage IV metastatic disease was present in 27.8 % (32/115) and 72.2 % (26/36) of the G1 and G2 tumors, respectively, and in 90 % (9/10) of the G3 tumors. Assessment of the Ki-67 index for a subset of cases at metastatic sites as well as the primary tumor site showed discrepancies in 35.3 % cases. In 7/9 (77.8 %) patients with liver metastases, Ki-67 % was higher in the liver lesions than in the primary tumor. CONCLUSIONS: Patients with GEP NEN exhibiting a high Ki-67 proliferation index present with metastatic disease in the vast majority of cases. Depending upon the primary tumor site, metastases are to be expected also in tumors with low Ki-67 %, although they are considered less aggressive. Different disease sites may express heterogeneous Ki-67 levels.


Assuntos
Biomarcadores Tumorais/metabolismo , Neoplasias do Sistema Digestório/patologia , Antígeno Ki-67/metabolismo , Linfonodos/patologia , Tumores Neuroendócrinos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais/análise , Biópsia por Agulha , Estudos de Coortes , Neoplasias do Sistema Digestório/mortalidade , Neoplasias do Sistema Digestório/cirurgia , Intervalo Livre de Doença , Feminino , Humanos , Imuno-Histoquímica , Antígeno Ki-67/análise , Masculino , Pessoa de Meia-Idade , Índice Mitótico , Gradação de Tumores , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Tumores Neuroendócrinos/mortalidade , Tumores Neuroendócrinos/cirurgia , Prognóstico , Estudos Retrospectivos , Medição de Risco , Papel (figurativo) , Sensibilidade e Especificidade , Taxa de Sobrevida , Adulto Jovem
18.
J Med Food ; 16(9): 810-6, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24044490

RESUMO

Telfairia occidentalis (Cucurbitaceae) is a leafy vegetable used in soup and folk medicine in southern Nigeria. Ethnobotanical survey revealed that preparations of the plant are used in the treatment of central nervous system-related disorders including convulsion. This study was conducted to investigate the effect of the hydroethanolic leaf extract of T. occidentalis in mouse models of convulsion, muscle relaxation, and depression. The strychnine and isoniazid convulsion, traction and climbing muscle relaxation, and forced swim and tail suspension depression tests were used in this study. The extract was administered orally (p.o.) at dose range of 25-800 mg/kg while distilled water (10 mL/kg p.o.) served as negative control. Diazepam (5 mg/kg p.o.) was used as positive control in the convulsion and muscle relaxation models while imipramine (64 mg/kg p.o.) served the same purpose in the depression tests. T. occidentalis significantly increased the onset (P<.001) and reduced the duration of convulsion (P<.05, .01) in the strychnine test and increased the time to death (P<.05, .01, .001) in the isoniazid model. The extract insignificantly increased the reaction time in the traction test while it significantly increased the time in the climbing test (P<.001). In the forced swim and tail suspension models, T. occidentalis significantly (P<.001) and dose-dependently increased the duration of immobility. The results obtained in this study suggest that the hydroethanolic leaf extract of T. occidentalis possesses anticonvulsant and muscle relaxant properties, thus justifying its folkloric use.


Assuntos
Anticonvulsivantes/administração & dosagem , Cucurbitaceae/química , Depressão/tratamento farmacológico , Fármacos Neuromusculares/administração & dosagem , Extratos Vegetais/administração & dosagem , Convulsões/tratamento farmacológico , Animais , Depressão/fisiopatologia , Modelos Animais de Doenças , Feminino , Humanos , Masculino , Camundongos , Relaxamento Muscular/efeitos dos fármacos , Nigéria , Convulsões/fisiopatologia
19.
Nig Q J Hosp Med ; 21(2): 129-34, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21913510

RESUMO

BACKGROUND: Asystasia gangetica (Linn) T. Anderson [family Acanthaceae] is used commonly in the sub-tropics and tropics for the management of inflammatory and algesic conditions. OBJECTIVE: The study was done to evaluate the analgesic and inflammatory activity of the aqueous stem and leaf extract of Asystasia gangetica. METHODS: The analgesic effect of the aqueous stem and leaf extract of Asystasia gangetica (25, 50, 100 and 200 mg/kg) was evaluated in rats and mice using the acetic acid induced writhing, cold water tail flick and hot plate models. Its anti-inflammatory effect was evaluated using carrageenan induced rat paw oedema and xylene induced mouse ear oedema models. RESULTS: The aqueous stem and leaf extract of Asystasia gangetica (25-200 mg/kg) significantly (p < 0.05) reduced the number of writhes in the acetic acid induced writhing test. At 100 mg/kg, it produced an increase in pain threshold comparable to that produced by morphine (10 mg/kg) in the tail flick test and peak analgesia at 200 mg/kg in the hot plate test. The extract (25-200 mg/kg) also produced significant (p < 0.05) inhibition of oedema comparable to indomethacin (10 mg/kg) in the carrageenan induced paw oedema model. The extract (200 mg/kg) produced a significant inhibitory effect (p < 0.05) comparable to that produced by 1 mg/kg dexamethasone in the xylene induced mouse ear oedema model. Preliminary phytochemical screening showed that the extract contains alkaloids, tannins, cardiac glycosides and flavonoids. It did not produce mortality or any visible sign of lethality 24 hours after single oral administration of 10 g/kg. CONCLUSION: The results show that the aqueous stem and feaf extract of Asystasia gangetica possesses analgesic and antiinflammatory activities.


Assuntos
Acanthaceae/química , Analgésicos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Edema/tratamento farmacológico , Inflamação/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Ácido Acético/administração & dosagem , Ácido Acético/toxicidade , Analgésicos/química , Analgésicos/isolamento & purificação , Analgésicos/farmacologia , Animais , Anti-Inflamatórios/química , Anti-Inflamatórios/isolamento & purificação , Anti-Inflamatórios/farmacologia , Carragenina/efeitos adversos , Edema/induzido quimicamente , Inflamação/induzido quimicamente , Dose Letal Mediana , Camundongos , Medição da Dor/efeitos dos fármacos , Fitoterapia , Extratos Vegetais/química , Folhas de Planta/química , Caules de Planta/química , Ratos , Ratos Wistar , Água
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