Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 72
Filtrar
1.
JCI Insight ; 9(10)2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38625743

RESUMO

Dysregulated lipid homeostasis is emerging as a potential cause of neurodegenerative disorders. However, evidence of errors in lipid homeostasis as a pathogenic mechanism of neurodegeneration remains limited. Here, we show that cerebellar neurodegeneration caused by Sorting Nexin 14 (SNX14) deficiency is associated with lipid homeostasis defects. Recent studies indicate that SNX14 is an interorganelle lipid transfer protein that regulates lipid transport, lipid droplet (LD) biogenesis, and fatty acid desaturation, suggesting that human SNX14 deficiency belongs to an expanding class of cerebellar neurodegenerative disorders caused by altered cellular lipid homeostasis. To test this hypothesis, we generated a mouse model that recapitulates human SNX14 deficiency at a genetic and phenotypic level. We demonstrate that cerebellar Purkinje cells (PCs) are selectively vulnerable to SNX14 deficiency while forebrain regions preserve their neuronal content. Ultrastructure and lipidomic studies reveal widespread lipid storage and metabolism defects in SNX14-deficient mice. However, predegenerating SNX14-deficient cerebella show a unique accumulation of acylcarnitines and depletion of triglycerides. Furthermore, defects in LD content and telolysosome enlargement in predegenerating PCs suggest lipotoxicity as a pathogenic mechanism of SNX14 deficiency. Our work shows a selective cerebellar vulnerability to altered lipid homeostasis and provides a mouse model for future therapeutic studies.


Assuntos
Homeostase , Metabolismo dos Lipídeos , Células de Purkinje , Nexinas de Classificação , Nexinas de Classificação/metabolismo , Nexinas de Classificação/genética , Animais , Camundongos , Humanos , Células de Purkinje/metabolismo , Células de Purkinje/patologia , Modelos Animais de Doenças , Doenças Neurodegenerativas/metabolismo , Doenças Neurodegenerativas/patologia , Doenças Neurodegenerativas/genética , Camundongos Knockout , Cerebelo/metabolismo , Cerebelo/patologia , Masculino , Gotículas Lipídicas/metabolismo
3.
Front Nutr ; 10: 1181436, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37360303

RESUMO

The hypocaloric Mediterranean diet (MD) mainly reduces fat mass but inevitably causes a loss of skeletal muscle mass. High-intensity interval training (HIIT) seems to have advantages in preserving muscle mass during a hypocaloric regime. Our study compares body composition and metabolic changes in overweight and obese Chilean women and men after 3 months of weight loss treatment with a Mediterranean-type hypocaloric diet, HIIT, or a combination of both. The study included 83 overweight or obese women and men between the ages of 25 and 50. The subjects were randomly assigned to one of the three intervention groups: (1) MD, (2) EX, and (3) MD + EX. Baseline and post-intervention measurements included: (a) body composition by dual-beam densitometry, muscle, and fat measurements by thigh ultrasound and computed tomography; (b) handgrip and quadriceps muscle strength; (c) exercise performance by peak oxygen consumption, peak load, work efficiency, and exercise energy expenditure; and (d) metabolic parameters. Out of 83 participants, the retention rate was 49% due to low compliance with the interventions. As expected, the MD group resulted in significantly greater weight loss (MD -7%, EX -0.6% and MD + EX -5.3%) and appendicular fat mass loss (MD -11.1%, EX -2.9, MD + EX -10.2%) but was associated with significant lean tissue loss (2.8%), which was prevented by HIIT (EX -0.1 and MD + EX -0.6%). Metabolic and glycoxidative parameters remained unchanged, irrespective of changes in body composition. Hypocaloric diets remain the most effective means to lose weight and body fat. However, it induces a loss of lean body mass when not accompanied by exercise training. This study shows that HIIT prevents the loss of muscle mass caused by a hypocaloric Mediterranean diet.

6.
Fam Process ; 62(1): 49-73, 2023 03.
Artigo em Inglês | MEDLINE | ID: mdl-36564902

RESUMO

One of the most serious psychosocial problems worldwide is substance abuse because of its repercussions not only on the physical and psychological health of the abuser but also on their relational functioning. Among the well-established therapeutic approaches for the treatment of substance abuse is family therapy, which, in addition to influencing personal variables, promotes changes in family dynamics. The main objective of this study is to review the scientific literature published from 2010 to the present on the efficacy and effectiveness shown by family-based treatment approaches for substance use problems both in adolescent and adult samples. In addition, the effect on secondary variables such as family functioning and behavioral problems is evaluated. The empirical evidence accumulated in the last decade and reviewed in the present study indicates that the incorporation of family members in the treatment of substance abuse produces benefits by diminishing consumption and improving family functioning. Limitations of this study and of the research reviewed are discussed and directions for future research are provided.


Assuntos
Terapia Familiar , Transtornos Relacionados ao Uso de Substâncias , Adulto , Adolescente , Humanos , Transtornos Relacionados ao Uso de Substâncias/terapia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Família/psicologia , Relações Familiares
7.
J Interpers Violence ; 38(3-4): 4267-4292, 2023 02.
Artigo em Inglês | MEDLINE | ID: mdl-35942946

RESUMO

Teen dating violence (TDV) refers to a wide range of partner-directed harmful behaviors among adolescents. Since it was first documented in the 1980s, there is a growing interest in TDV due to its potentially devastating mid- and long-term consequences. Aiming at the early detection of TDV onset with prevention purposes, research has focused on the detection of typologies of perpetrators and/or victims as well as on identifying risk and protective factors for its occurrence. Research with Spanish adolescents, however, is very limited. To fill this gap, we recruited a total of 2,319 adolescents from different regions in Spain, out of which, 1,079 reported having had a romantic partner during the last year. These filled out measures of TDV (perpetration and victimization), school aggression, hostile and benevolent sexism, empathy, assertiveness, psychological inflexibility (general measures), and psychological inflexibility with prejudice thoughts. A cluster analysis revealed that adolescents could be divided into two clusters as a function of their TDV profile: Cluster 1, including close to 76% of the sample (boys and girls), presented low TDV perpetration and victimization; Cluster 2, including 24% of the sample (boys and girls), presented higher TDV perpetration and victimization. Regression analyses revealed that, as compared to those in Cluster 1, adolescents in Cluster 2 were more likely to be older boys who scored high in benevolent sexism, overt and relational school aggression, and personal distress, and low in behavior regulation skills, perspective taking, and practical personal ability. We discuss the implications of these findings for the design of evidence-based TDV prevention campaigns.


Assuntos
Comportamento do Adolescente , Vítimas de Crime , Violência por Parceiro Íntimo , Masculino , Feminino , Humanos , Adolescente , Espanha , Comportamento do Adolescente/psicologia , Violência por Parceiro Íntimo/psicologia , Vítimas de Crime/psicologia , Fatores de Risco
9.
Arq. bras. cardiol ; 119(5): 705-713, nov. 2022. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1403381

RESUMO

Resumo Fundamento Os limiares de corte para a "relação do ciclo completo de repouso" (RFR) oscilam em diferentes séries, sugerindo que as características da população podem influenciá-los. Da mesma forma, foram documentados preditores de discordância entre a RFR e a reserva de fluxo fracionado (FFR). O Estudo RECOPA, mostrou que a capacidade diagnóstica está reduzida na "zona cinzenta" da RFR, tornando necessária a realização de FFR para descartar ou confirmar isquemia. Objetivos Determinar os preditores de discordância, integrar as informações que eles fornecem em um índice clínico-fisiológico: a "RFR Ajustada", e comparar sua concordância com o FFR. Métodos Usando dados do Estudo RECOPA, os preditores de discordância em relação à FFR foram determinados na "zona cinzenta" da RFR (0,86 a 0,92) para construir um índice ("RFR Ajustada") que pesaria a RFR juntamente com os preditores de discordância e avaliar sua concordância com a FFR. Resultados Foram avaliadas 156 lesões em 141 pacientes. Os preditores de discordância foram: doença renal crônica, cardiopatia isquêmica prévia, lesões não envolvendo a artéria descendente anterior esquerda e síndrome coronariana aguda. Embora limitada, a "RFR Ajustada" melhorou a capacidade diagnóstica em comparação com a RFR na "zona cinzenta" (AUC-RFR = 0,651 versus AUC-"RFR Ajustada" = 0,749), mostrando também uma melhora em todos os índices diagnósticos quando foram estabelecidos limiares de corte otimizados (sensibilidade: 59% a 68%; especificidade: 62% a 75%; acurácia diagnóstica: 60% a 71%; razão de verossimilhança positiva: 1,51 a 2,34; razão de verossimilhança negativa: 0,64 a 0,37). Conclusões Ajustar a RFR integrando as informações fornecidas pelos preditores de discordância para obter a "RFR Ajustada" melhorou a capacidade diagnóstica em nossa população. Mais estudos são necessários para avaliar se os índices clínico-fisiológicos melhoram a capacidade diagnóstica da RFR ou de outros índices coronarianos.


Abstract Background Cutoff thresholds for the "resting full-cycle ratio" (RFR) oscillate in different series, suggesting that population characteristics may influence them. Likewise, predictors of discordance between the RFR and fractional flow reserve (FFR) have been documented. The RECOPA Study showed that diagnostic capacity is reduced in the RFR "grey zone", requiring the performance of FFR to rule out or confirm ischemia. Objectives To determine predictors of discordance, integrate the information they provide in a clinical-physiological index, the "Adjusted RFR", and compare its agreement with the FFR. Methods Using data from the RECOPA Study, predictors of discordance with respect to FFR were determined in the RFR "grey zone" (0.86 to 0.92) to construct an index ("Adjusted RFR") that would weigh RFR together with predictors of discordance and evaluate its agreement with FFR. Results A total of 156 lesions were evaluated in 141 patients. Predictors of discordance were: chronic kidney disease, previous ischemic heart disease, lesions not involving the anterior descending artery, and acute coronary syndrome. Though limited, the "Adjusted RFR" improved the diagnostic capacity compared to the RFR in the "grey zone" (AUC-RFR = 0.651 versus AUC-"Adjusted RFR" = 0.749), also showing an improvement in all diagnostic indices when optimal cutoff thresholds were established (sensitivity: 59% to 68%; specificity: 62% to 75%; diagnostic accuracy: 60% to 71%; positive likelihood ratio: 1.51 to 2.34; negative likelihood ratio: 0.64 to 0.37). Conclusions Adjusting the RFR by integrating the information provided by predictors of discordance to obtain the "Adjusted RFR" improved the diagnostic capacity in our population. Further studies are required to evaluate whether clinical-physiological indices improve the diagnostic capacity of RFR or other coronary indices.

10.
Obes Res Clin Pract ; 16(6): 533-535, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36283924

RESUMO

BACKGROUND: The 30″ sit to stand test is a submaximal exercise test that assesses functional capacity and it has been validated for various pathologies. Although it has been used in individuals with obesity, its reproducibility in this population has not yet been determined. The main objective of this study was to determine the reproducibility and safety of the 30″ sit to stand test in individuals with overweight or obesity and with cardiovascular risk factors. METHODS: A cross-sectional study was performed. Individuals with obesity or overweight who also presented cardiovascular risk factors were evaluated with the 30″ sit to stand test. The reproducibility and safety of the 30" sit to stand test were determined, as well as its association with other functional tests and anthropometric characteristics. RESULTS: 59 individuals (27 men, 32 women) with obesity or overweight and cardiovascular risk factors, aged 57.93 (9.62) years, were included in the study. The 30″ sit to stand test showed good overall reproducibility (0.907 ICC) and significant correlation with the 6-minute walk test, handgrip strength test, body fat percentage and waist - height index, with a similar hemodynamic response to the 6-minute walk test. CONCLUSION: The 30" sit to stand test is a highly reproducible and safe test for individuals with obesity and cardiovascular risk factors, with a significant correlation to anthropometric characteristics and other functional tests regularly used for the evaluation of individuals with obesity.


Assuntos
Doenças Cardiovasculares , Sobrepeso , Masculino , Humanos , Feminino , Sobrepeso/complicações , Força da Mão , Estudos Transversais , Reprodutibilidade dos Testes , Doenças Cardiovasculares/etiologia , Fatores de Risco , Obesidade/complicações , Fatores de Risco de Doenças Cardíacas
11.
Arq Bras Cardiol ; 119(5): 705-713, 2022 11.
Artigo em Inglês, Português | MEDLINE | ID: mdl-36074485

RESUMO

BACKGROUND: Cutoff thresholds for the "resting full-cycle ratio" (RFR) oscillate in different series, suggesting that population characteristics may influence them. Likewise, predictors of discordance between the RFR and fractional flow reserve (FFR) have been documented. The RECOPA Study showed that diagnostic capacity is reduced in the RFR "grey zone", requiring the performance of FFR to rule out or confirm ischemia. OBJECTIVES: To determine predictors of discordance, integrate the information they provide in a clinical-physiological index, the "Adjusted RFR", and compare its agreement with the FFR. METHODS: Using data from the RECOPA Study, predictors of discordance with respect to FFR were determined in the RFR "grey zone" (0.86 to 0.92) to construct an index ("Adjusted RFR") that would weigh RFR together with predictors of discordance and evaluate its agreement with FFR. RESULTS: A total of 156 lesions were evaluated in 141 patients. Predictors of discordance were: chronic kidney disease, previous ischemic heart disease, lesions not involving the anterior descending artery, and acute coronary syndrome. Though limited, the "Adjusted RFR" improved the diagnostic capacity compared to the RFR in the "grey zone" (AUC-RFR = 0.651 versus AUC-"Adjusted RFR" = 0.749), also showing an improvement in all diagnostic indices when optimal cutoff thresholds were established (sensitivity: 59% to 68%; specificity: 62% to 75%; diagnostic accuracy: 60% to 71%; positive likelihood ratio: 1.51 to 2.34; negative likelihood ratio: 0.64 to 0.37). CONCLUSIONS: Adjusting the RFR by integrating the information provided by predictors of discordance to obtain the "Adjusted RFR" improved the diagnostic capacity in our population. Further studies are required to evaluate whether clinical-physiological indices improve the diagnostic capacity of RFR or other coronary indices.


FUNDAMENTO: Os limiares de corte para a "relação do ciclo completo de repouso" (RFR) oscilam em diferentes séries, sugerindo que as características da população podem influenciá-los. Da mesma forma, foram documentados preditores de discordância entre a RFR e a reserva de fluxo fracionado (FFR). O Estudo RECOPA, mostrou que a capacidade diagnóstica está reduzida na "zona cinzenta" da RFR, tornando necessária a realização de FFR para descartar ou confirmar isquemia. OBJETIVOS: Determinar os preditores de discordância, integrar as informações que eles fornecem em um índice clínico-fisiológico: a "RFR Ajustada", e comparar sua concordância com o FFR. MÉTODOS: Usando dados do Estudo RECOPA, os preditores de discordância em relação à FFR foram determinados na "zona cinzenta" da RFR (0,86 a 0,92) para construir um índice ("RFR Ajustada") que pesaria a RFR juntamente com os preditores de discordância e avaliar sua concordância com a FFR. RESULTADOS: Foram avaliadas 156 lesões em 141 pacientes. Os preditores de discordância foram: doença renal crônica, cardiopatia isquêmica prévia, lesões não envolvendo a artéria descendente anterior esquerda e síndrome coronariana aguda. Embora limitada, a "RFR Ajustada" melhorou a capacidade diagnóstica em comparação com a RFR na "zona cinzenta" (AUC-RFR = 0,651 versus AUC-"RFR Ajustada" = 0,749), mostrando também uma melhora em todos os índices diagnósticos quando foram estabelecidos limiares de corte otimizados (sensibilidade: 59% a 68%; especificidade: 62% a 75%; acurácia diagnóstica: 60% a 71%; razão de verossimilhança positiva: 1,51 a 2,34; razão de verossimilhança negativa: 0,64 a 0,37). CONCLUSÕES: Ajustar a RFR integrando as informações fornecidas pelos preditores de discordância para obter a "RFR Ajustada" melhorou a capacidade diagnóstica em nossa população. Mais estudos são necessários para avaliar se os índices clínico-fisiológicos melhoram a capacidade diagnóstica da RFR ou de outros índices coronarianos.


Assuntos
Doença da Artéria Coronariana , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico , Humanos , Estenose Coronária/diagnóstico , Angiografia Coronária , Cateterismo Cardíaco , Valor Preditivo dos Testes , Índice de Gravidade de Doença , Vasos Coronários , Doença da Artéria Coronariana/diagnóstico
12.
Int J Mol Sci ; 23(14)2022 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-35887298

RESUMO

One of the multiple sclerosis (MS) risk polymorphisms, rs7923837, maps near the HHEX (hematopoietically-expressed homeobox) gene. This variant has also been associated with type 2 diabetes susceptibility and with triglyceride levels, suggesting its metabolic involvement. HHEX plays a relevant role as a negative regulator of inflammatory genes in microglia. A reciprocal repression was reported between HHEX and BCL6, another putative risk factor in MS. The present study evidenced statistically significant lower HHEX mRNA levels in lymphocytes of MS patients compared to those of controls, showing a similar trend in MS patients to the already described eQTL effect in blood from healthy individuals. Even though no differences were found in protein expression according to HHEX genotypes, statistically significant divergent subcellular distributions of HHEX appeared in patients and controls. The epistatic interaction detected between BCL6 and HHEX MS-risk variants in healthy individuals was absent in patients, indicative of a perturbed reciprocal regulation in the latter. Lymphocytes from MS carriers of the homozygous mutant genotype exhibited a distinctive, more energetic profile, both in resting and activated conditions, and significantly increased glycolytic rates in resting conditions when compared to controls sharing the HHEX genotype. In contrast, significantly higher mitochondrial mass was evidenced in homozygous mutant controls.


Assuntos
Diabetes Mellitus Tipo 2 , Esclerose Múltipla , Diabetes Mellitus Tipo 2/patologia , Genes Homeobox , Predisposição Genética para Doença , Genótipo , Proteínas de Homeodomínio/genética , Humanos , Esclerose Múltipla/complicações , Esclerose Múltipla/genética , Polimorfismo de Nucleotídeo Único , Fatores de Transcrição/genética
13.
Int J Mol Sci ; 23(15)2022 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-35897697

RESUMO

Deficiencies in Mannosidase ß (MANBA) are associated with neurological abnormalities and recurrent infections. The single nucleotide polymorphism located in the 3'UTR of MANBA, rs7665090, was found to be associated with multiple sclerosis (MS) susceptibility. We aimed to study the functional impact of this polymorphism in lymphocytes isolated from MS patients and healthy controls. A total of 152 MS patients and 112 controls were genotyped for rs7665090. MANBA mRNA expression was quantified through qPCR and MANBA enzymatic activity was analyzed. Upon phytohemagglutinin stimulation, immune activation was evaluated by flow cytometry detection of CD69, endocytic function, and metabolic rates with Seahorse XFp Analyzer, and results were stratified by variation in rs7665090. A significantly reduced gene expression (p < 0.0001) and enzymatic activity (p = 0.018) of MANBA were found in lymphocytes of MS patients compared to those of controls. The rs7665090*GG genotype led to a significant ß-mannosidase enzymatic deficiency correlated with lysosomal dysfunction, as well as decreased metabolic activation in lymphocytes of MS patients compared to those of rs7665090*GG controls. In contrast, lymphocytes of MS patients and controls carrying the homozygous AA genotype behaved similarly. Our work provides new evidence highlighting the impact of the MS-risk variant, rs7665090, and the role of MANBA in the immunopathology of MS.


Assuntos
Esclerose Múltipla , beta-Manosidose , Endocitose , Predisposição Genética para Doença , Genótipo , Humanos , Ativação Linfocitária/genética , Lisossomos , Esclerose Múltipla/genética , Polimorfismo de Nucleotídeo Único , beta-Manosidase/genética
14.
Cardiovasc Revasc Med ; 37: 61-67, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34238679

RESUMO

BACKGROUND: Coronary vascular function of a chronic coronary total occlusion (CTO) immediately after recanalization is known to be poor and to be partially improved by pre-treatment with loading dose of ticagrelor vs. clopidogrel. It is unknown if this vascular dysfunction is maintained at long-term follow-up and may be improved by 1-year dual antiplatelet therapy (DAPT). METHODS: The TIGER is a prospective, open-label, two parallel-group controlled clinical trial, which 1:1 randomized 50 CTO patients to pre-PCI loading dose and subsequent 1-year DAPT with ticagrelor vs. clopidogrel. Coronary blood flow (CBF) under stepwise adenosine infusion was assessed after drug loading dose and at follow-up and compared between the two drug groups, adjusting for time of follow-up. RESULTS: Out of 50 patients with index CBF evaluation, 38 (76%) patients underwent angiographic follow-up (23 and 15 at 1 and 3-year, respectively) and Doppler data was available in 35 (70%). A high CBF area under the curve (AUC), already observed after loading dose in ticagrelor vs. clopidogrel group (p = 0.027), was maintained at follow-up (AUC 34815.22 ± 24,206.06 vs. AUC 22712.47 ± 13,768.95; p = 0.071). Specifically, whereas high ticagrelor loading dose-related CBF was sustained at follow-up (p = 0.933), clopidogrel loading dose-related CBF increased at follow-up (p = 0.039). CONCLUSION: The TIGER trial showed that DAPT with ticagrelor maintained a non-significantly higher CBF in a recanalized CTO as compared to clopidogrel, whose treated patients exhibit a lower CBF immediately after PCI with a significant increase at follow-up. The clinical value of such sustained high coronary flow should be evaluated in a larger group of patients. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT02211066 (ClinicalTrials.gov number NCT02211066).


Assuntos
Síndrome Coronariana Aguda , Intervenção Coronária Percutânea , Síndrome Coronariana Aguda/terapia , Clopidogrel/uso terapêutico , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Inibidores da Agregação Plaquetária , Estudos Prospectivos , Ticagrelor/uso terapêutico , Resultado do Tratamento
15.
Sci Rep ; 11(1): 21371, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725369

RESUMO

One of the 233 polymorphisms associated with multiple sclerosis (MS) susceptibility lies within the NDFIP1 gene, and it was previously identified as eQTL in healthy controls. NDFIP1 shows interesting immune functions and is involved in the development of the central nervous system. We aimed at studying the NDFIP1 variant on activation and metabolism of immune cells. NDFIP1 mRNA and protein expression were assessed in PBMCs by qPCR and western blot in 87 MS patients and 84 healthy controls genotyped for rs4912622. Immune activation after PHA stimulation was evaluated by CD69 upregulation, and metabolic function of both basal and PHA-activated lymphocytes was studied by Seahorse Xfp-Analyzer. In minor-allele homozygous controls but not in patients, we found higher NDFIP1 expression, significantly reduced protein levels, and CD69 upregulation in B- and T-cells. PBMCs from minor-allele homozygous controls showed significantly higher basal mitochondrial respiration and ATP production compared to major-allele carriers, while minor-allele homozygous patients showed significantly lower metabolic activity than carriers of the major allele. In conclusion, we describe associations in minor-allele homozygous controls with lower levels of NDFIP1 protein, CD69 upregulation, and raised mitochondrial activity, which are not replicated in MS patients, suggesting a NDFIP1 differential effect in health and disease.


Assuntos
Proteínas de Transporte/genética , Proteínas de Membrana/genética , Esclerose Múltipla/genética , Adulto , Linfócitos B/metabolismo , Proteínas de Transporte/metabolismo , Feminino , Expressão Gênica , Variação Genética , Humanos , Masculino , Proteínas de Membrana/metabolismo , Pessoa de Meia-Idade , Esclerose Múltipla/metabolismo , Polimorfismo de Nucleotídeo Único , Linfócitos T/metabolismo
16.
J Interv Cardiol ; 2021: 5522707, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34007248

RESUMO

BACKGROUND: The resting full-cycle ratio (RFR) is a novel resting index which in contrast to the gold standard (fractional flow reserve (FFR)) does not require maximum hyperemia induction. The objectives of this study were to evaluate the agreement between RFR and FFR with the currently recommended thresholds and to design a hybrid RFR-FFR ischemia detection strategy, allowing a reduction of coronary vasodilator use. MATERIALS AND METHODS: Patients subjected to invasive physiological study in 9 Spanish centers were prospectively recruited between April 2019 and March 2020. Sensitivity and specificity studies were made to assess diagnostic accuracy between the recommended levels of RFR ≤0.89 and FFR ≤0.80 (primary objective) and to determine the RFR "grey zone" in order to define a hybrid strategy with FFR affording 95% global agreement compared with FFR alone (secondary objective). RESULTS: A total of 380 lesions were evaluated in 311 patients. Significant correlation was observed (R 2 = 0.81; P < 0.001) between the two techniques, with 79% agreement between RFR ≤ 0.89 and FFR ≤ 0.80 (positive predictive value, 68%, and negative predictive value, 80%). The hybrid RFR-FFR strategy, administering only adenosine in the "grey zone" (RFR: 0.86 to 0.92), exhibited an agreement of over 95% with FFR, with high predictive values (positive predictive value, 91%, and negative predictive value, 92%), reducing the need for vasodilators by 58%. CONCLUSIONS: Dichotomous agreement between RFR and FFR with the recommended thresholds is significant but limited. The adoption of a hybrid RFR-FFR strategy affords very high agreement, with minimization of vasodilator use.


Assuntos
Adenosina/farmacologia , Angiografia Coronária/métodos , Estenose Coronária , Reserva Fracionada de Fluxo Miocárdico/fisiologia , Hiperemia , Isquemia Miocárdica , Idoso , Circulação Coronária/efeitos dos fármacos , Estenose Coronária/diagnóstico , Estenose Coronária/epidemiologia , Estenose Coronária/fisiopatologia , Correlação de Dados , Relação Dose-Resposta a Droga , Feminino , Humanos , Hiperemia/induzido quimicamente , Hiperemia/fisiopatologia , Masculino , Isquemia Miocárdica/diagnóstico , Isquemia Miocárdica/etiologia , Isquemia Miocárdica/fisiopatologia , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Espanha/epidemiologia , Vasodilatadores/farmacologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-33525687

RESUMO

School violence is a serious social and public health problem prevalent worldwide. Although the relevance of teacher and classroom factors is well established in the literature, few studies have focused on the role of teacher perceptions in school violence and victimisation and the potential mediational role of classroom climate in this relationship. A total of 2399 adolescents (50% girls), aged between 11 and 18 years (M = 14.65, SD = 1.78) and enrolled in five Spanish Secondary Compulsory Education schools completed measures of classroom climate, school violence towards peers and perception of peer victimisation, and their teachers informed about their academic competence and the teacher-student relationship. Correlational analyses revealed that whereas academic competence perceived by the teacher was negatively related to overt violence and victimisation, its relationship with pure relational violence was positive. Structural equation modelling analyses showed that variables of classroom climate (involvement, affiliation, and teacher support) perceived by the students functioned as partial mediators between teacher perceptions of academic competence and of teacher-student relationship and violence and victimisation. In the mediational model, teacher perception of academic competence acted as a direct protective factor against violence and victimisation, and teacher perception of teacher-student relationship acted as a direct risk for violence, as well as an indirect protective factor through classroom climate for victimisation. The interpretation of these results points to the importance of the teacher's subjective perceptions in the prevention of violence and victimisation problems and their practical implications for the classroom climate perceived by students.


Assuntos
Bullying , Vítimas de Crime , Adolescente , Criança , Feminino , Humanos , Instituições Acadêmicas , Estudantes , Violência
18.
Artigo em Inglês | MEDLINE | ID: mdl-33430506

RESUMO

This study examines the reciprocal effects between two school-based relationships within the classroom-namely, perceived teacher support and relatedness with classmates-and school aggression (overt and relational) across two courses of secondary education. Participants were 654 adolescents (48% boys), who were assessed in three waves: first, at the beginning of the academic year (T0), second, at the end of the same academic year (T1), and third, at the beginning of the next academic year (T2) (Mage wave 1 = 13.98 years). Autoregressive cross-lagged modeling was applied. Results show a protective effect of relatedness against relational aggression in both genders. Moreover, we observed a protective effect of perceived teacher support at the beginning of the course for later school aggression as well as a risk effect if this perceived teacher support is maintained throughout the course. These effects were observed in relation with gender-atypical forms of aggression (overt in girls and relational in boys). Finally, aggression had negative consequences for relatedness in girls and for teacher support through the mediation of relatedness in boys. Gender differences and practical implications of these findings are discussed.


Assuntos
Agressão , Grupo Associado , Adolescente , Feminino , Humanos , Relações Interpessoais , Estudos Longitudinais , Masculino , Instituições Acadêmicas
19.
Artigo em Inglês | MEDLINE | ID: mdl-33406621

RESUMO

School violence towards peers and teen dating violence are two of the most relevant behaviour problems in adolescents. Although the relationship between the two types of violence is well established in the literature, few studies have focused on mediators that could explain this empirical relationship. We departed from the evidence that relates anger, emotional distress and impaired empathy to teen dating violence and juvenile sexual offending, to explore the role of personal distress, i.e., a self-focused, aversive affective reaction to another's emotion associated with the desire to alleviate one's own, but not the other's distress; as a possible mechanism linking school violence towards peers and teen dating violence in a sample of Spanish adolescents. We also explored the prevalence of emotional and physical teen dating violence, both occasional and frequent, and the differences between boys and girls. A total of 1055 adolescents (49.2% boys and 50.8% girls) aged between 11 and 17 years (M = 14.06, SD = 1.34) who had had at least one romantic relationship within the last year, completed measures of school violence towards peers, teen dating violence, and personal distress. Statistical analyses revealed that occasional and frequent teen dating violence (both physical and emotional) was more frequent in girls than in boys, and that personal distress functioned as a partial mediator, with an overall model fit higher for boys than girls: in boys, partial mediation occurred for both physical and emotional teen dating violence; in girls, partial mediation occurred only for physical violence. The interpretation of the results is tentative given the novel nature of the study, and points to the evidence of the emotional costs of school violence and the importance of emotion and behavior regulation to undermine the social costs of personal distress.


Assuntos
Comportamento do Adolescente , Violência por Parceiro Íntimo , Grupo Associado , Angústia Psicológica , Violência , Adolescente , Criança , Feminino , Humanos , Masculino , Instituições Acadêmicas
20.
Front Psychol ; 11: 576178, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33304295

RESUMO

The aim of this study was to carry out a psychosocial analysis of child-to-parent violence (CPV) in a sample of school adolescents, considering a set of individual variables (psychological distress, problematic use of social networking sites, and perceived non-conformist social reputation) and family variables (open and problematic communication with parents) according to sex. The sample consisted of 3,731 adolescents (54% boys), aged between 14 and 16 years (M = 14.6 years, SD = 0.567), from the state of Nuevo León, Mexico. The scores of the boys and girls were analyzed to check for differences. Also, correlations between all the study variables were calculated. Finally, a multiple stepwise regression analysis was carried out for the total sample and also for boys and girls separately. Results confirmed the important role of individual variables as predictors of CPV in boys and girls. The main difference between boys and girls was observed in the predictive weight of problematic use of social networking sites, which was higher in girls than in boys. Open communication with the father was a significant factor for predicting the decrease of CPV levels in the case of boys, while open communication with the mother predicted the decrease of CPV in girls. Problematic communication with the mother showed similar values in boys and girls when predicting CPV, however, the predictive weight of problematic communication with the father was higher in girls than in boys. These results are interesting and have important implications for the prevention of CPV.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...