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1.
Br J Haematol ; 204(5): 1888-1893, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38501389

RESUMO

Over 50% of patients with systemic LCH are not cured with front-line therapies, and data to guide salvage options are limited. We describe 58 patients with LCH who were treated with clofarabine. Clofarabine monotherapy was active against LCH in this cohort, including heavily pretreated patients with a systemic objective response rate of 92.6%, higher in children (93.8%) than adults (83.3%). BRAFV600E+ variant allele frequency in peripheral blood is correlated with clinical responses. Prospective multicentre trials are warranted to determine optimal dosing, long-term efficacy, late toxicities, relative cost and patient-reported outcomes of clofarabine compared to alternative LCH salvage therapy strategies.


Assuntos
Clofarabina , Histiocitose de Células de Langerhans , Humanos , Clofarabina/uso terapêutico , Clofarabina/administração & dosagem , Histiocitose de Células de Langerhans/tratamento farmacológico , Masculino , Feminino , Adulto , Adolescente , Criança , Pessoa de Meia-Idade , Pré-Escolar , Adulto Jovem , Idoso , Recidiva , Proteínas Proto-Oncogênicas B-raf/genética , Lactente , Resultado do Tratamento , Terapia de Salvação , Nucleotídeos de Adenina/uso terapêutico , Nucleotídeos de Adenina/administração & dosagem , Nucleotídeos de Adenina/efeitos adversos , Arabinonucleosídeos/uso terapêutico , Arabinonucleosídeos/administração & dosagem , Arabinonucleosídeos/efeitos adversos
2.
Am J Public Health ; 114(3): 309-318, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38382019

RESUMO

Objectives. To examine whether a previously reported association between airborne lead exposure and children's cognitive function replicates across a geographically diverse sample of the United States. Methods. Residential addresses of children (< 5 years) were spatially joined to the Risk-Screening Environmental Indicators model of relative airborne lead toxicity. Cognitive outcomes for children younger than 8 years were available for 1629 children with IQ data and 1476 with measures of executive function (EF; inhibitory control, cognitive flexibility). We used generalized linear models using generalized estimating equations to examine the associations of lead, scaled by interquartile range (IQR), accounting for individual- and area-level confounders. Results. An IQR increase in airborne lead was associated with a 0.74-point lower mean IQ score (b = -0.74; 95% confidence interval = -1.00, -0.48). The association between lead and EF was nonlinear and was modeled with a knot at the 97.5th percentile of lead in our sample. Lead was significantly associated with lower mean inhibitory control but not with cognitive flexibility. This effect was stronger among males for both IQ and inhibitory control. Conclusions. Early-life exposure to airborne lead is associated with lower cognitive functioning. (Am J Public Health. 2024;114(3):309-318. https://doi.org/10.2105/AJPH.2023.307519).


Assuntos
Cognição , Chumbo , Masculino , Criança , Humanos , Estados Unidos/epidemiologia , Chumbo/toxicidade , Estudos Prospectivos , Modelos Lineares , Avaliação de Resultados em Cuidados de Saúde , Exposição Ambiental/efeitos adversos
3.
Psychophysiology ; 61(3): e14499, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38084752

RESUMO

Research utilizing event-related potential (ERP) methods is generally biased with regard to sample representativeness. Among the myriad of factors that contribute to sample bias are researchers' assumptions about the extent to which racial differences in hair texture, volume, and style impact electrode placement, and subsequently, study eligibility. The current study examines these impacts using data collected from n = 213 individuals ages 17-19 years, and offers guidance on collection of ERP data across the full spectrum of hair types. Individual differences were quantified for hair texture using a visual scale, and for hair volume by measuring the amount of gel used in cap preparation. Electroencephalography data quality was assessed with multiple metrics at the preprocessing, post-processing, and variable generation stages. Results indicate that hair volume is associated with small, but systematic differences in signal quality and signal amplitude. Such differences are highly problematic as they could be misattributed to cognitive differences among groups. However, inclusion of gel volume as a covariate to account for individual differences in hair volume significantly reduced, and in most cases eliminated, group differences. We discuss strategies for overcoming real and perceived technical barriers for researchers seeking to achieve greater inclusivity and representativeness in ERP research.


Assuntos
Confiabilidade dos Dados , Potenciais Evocados , Humanos , Eletroencefalografia/métodos , Cabelo , Grupos Raciais
4.
Dev Psychopathol ; : 1-16, 2023 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-37545381

RESUMO

This study examined how temporal associations between parents' physiological and behavioral responses may reflect underlying regulatory difficulties in at-risk parenting. Time-series data of cardiac indices (second-by-second estimates of inter-beat intervals - IBI, and respiratory sinus arrhythmia - RSA) and parenting behaviors were obtained from 204 child welfare-involved parents (88% mothers, Mage = 32.32 years) during child-led play with their 3- to 7-year-old children (45.1% female; Mage = 4.76 years). Known risk factors for maltreatment, including parents' negative social cognitions, mental health symptoms, and inhibitory control problems, were examined as moderators of intra-individual physiology-behavior associations. Results of ordinary differential equations suggested increases in parents' cardiac arousal at moments when they showed positive parenting behaviors. In turn, higher arousal was associated with momentary decreases in both positive and negative parenting behaviors. Individual differences in these dynamic processes were identified in association with parental risk factors. In contrast, no sample-wide RSA-behavior associations were evident, but a pattern of increased positive parenting at moments of parasympathetic withdrawal emerged among parents showing more total positive parenting behaviors. This study illustrated an innovative and ecologically-valid approach to examining regulatory patterns that may shape parenting in real-time and identified mechanisms that should be addressed in interventions.

5.
J Expo Sci Environ Epidemiol ; 33(6): 903-910, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37147431

RESUMO

BACKGROUND: Exposure to environmental tobacco smoke (ETS) has been associated with detectable levels of cotinine (a nicotine metabolite) in children's saliva. However, tobacco smoke also contains toxic and essential trace metals, including chromium (Cr), copper (Cu), lead (Pb), manganese (Mn), nickel (Ni) and zinc (Zn). OBJECTIVE: The current study examines whether there is a relationship between ETS exposure, as gauged by salivary cotinine, and salivary levels of these metals in a subset (n = 238) of children from the Family Life Project. METHODS: Using inductively-coupled-plasma optical emission spectrophotometry, we measured levels of metals in saliva from children at ~90 months of age. Salivary cotinine was measured using a commercial immunoassay. RESULTS: We found that Cr, Cu, Mn, and Zn were detected in most samples (85-99%) with lower levels of detection for Pb and Ni (9.3% and 13.9% respectively). There were no significant differences in any of the metal concentrations between males and females, nor were levels associated with body mass index, although significant differences in salivary Cr and Mn by race, state and income-to-needs ratio were observed. Children with cotinine levels >1 ng/ml had higher levels of Zn (b = 0.401, 95% CI: 0.183 to 0.619; p = 0.0003) and Cu (b = 0.655, 95% CI: 0.206 to 1.104; p = 0.004) compared to children with levels <1 ng/ml, after controlling for multiple confounders, including sex, race, BMI and income-to-needs ratio. Further, we show that children whose cotinine levels were >1 µg/L were more likely to have detectable levels of Pb in their saliva (b = 1.40, 95% CI: 0.424 to 2.459; p = 0.006) compared to children with cotinine levels <1 ng/ml, also considering confounders. IMPACT STATEMENT: This is the first study to demonstrate significant associations between salivary cotinine and salivary levels of Cu, Zn and Pb, suggesting that environmental tobacco smoke exposure my be one source of increased children's exposure to heavy metals. This study also demonstrates that saliva samples can be used to measure heavy metal exposure, and thus serve as a non-invasive tool for assessing a broader range of risk indicators.


Assuntos
Metais Pesados , Poluição por Fumaça de Tabaco , Masculino , Criança , Feminino , Humanos , Poluição por Fumaça de Tabaco/análise , Cotinina , Saliva/metabolismo , Chumbo , Nicotina/análise , Zinco , Manganês , Cromo , Níquel , Exposição Ambiental
7.
J Clin Oncol ; 41(12): 2248-2257, 2023 04 20.
Artigo em Inglês | MEDLINE | ID: mdl-36669148

RESUMO

PURPOSE: For survivors of childhood cancer treated with doxorubicin, dexrazoxane is cardioprotective for at least 5 years. However, longer-term data are lacking. METHODS: Within the Children's Oncology Group and the Dana Farber Cancer Institute's Childhood Acute Lymphoblastic Leukemia Consortium, we evaluated four randomized trials of children with acute lymphoblastic leukemia or Hodgkin lymphoma, who received doxorubicin with or without dexrazoxane, and a nonrandomized trial of patients with osteosarcoma who all received doxorubicin with dexrazoxane. Cumulative doxorubicin doses ranged from 100 to 600 mg/m2 across these five trials, and dexrazoxane was administered uniformly (10:1 mg/m2 ratio) as an intravenous bolus before doxorubicin. Cardiac function was prospectively assessed in survivors from these trials, plus a matched group of survivors of osteosarcoma treated with doxorubicin without dexrazoxane. Two-dimensional echocardiograms and blood biomarkers were analyzed centrally in blinded fashion. Multivariate analyses adjusted for demographic characteristics, cumulative doxorubicin dose, and chest radiotherapy determined the differences and associations by dexrazoxane status. RESULTS: From 49 participating institutions, 195 participants were assessed at 18.1 ± 2.7 years since cancer diagnosis (51% dexrazoxane-exposed; cumulative doxorubicin dose 297 ± 91 mg/m2). Dexrazoxane administration was associated with superior left ventricular fractional shortening (absolute difference, +1.4% [95% CI, 0.3 to 2.5]) and ejection fraction (absolute difference, +1.6% [95% CI, 0.0 to 3.2]), and lower myocardial stress per B-type natriuretic peptide (-6.7 pg/mL [95% CI, -10.6 to -2.8]). Dexrazoxane was associated with a reduced risk of having lower left ventricular function (fractional shortening < 30% or ejection fraction < 50%; odds ratio, 0.24 [95% CI, 0.07 to 0.81]). This protective association was primarily seen in those treated with cumulative doxorubicin doses ≥ 250 mg/m2. CONCLUSION: Among young adult-aged survivors of childhood cancer, dexrazoxane was associated with a cardioprotective effect nearly 20 years after initial anthracycline exposure.


Assuntos
Neoplasias Ósseas , Sobreviventes de Câncer , Dexrazoxano , Osteossarcoma , Leucemia-Linfoma Linfoblástico de Células Precursoras , Adulto Jovem , Criança , Humanos , Idoso , Dexrazoxano/efeitos adversos , Doxorrubicina , Antibióticos Antineoplásicos/uso terapêutico , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Osteossarcoma/tratamento farmacológico , Neoplasias Ósseas/tratamento farmacológico
8.
J Fam Psychol ; 37(1): 110-120, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35862081

RESUMO

Research has recognized that parental emotion regulation influences whether parents respond sensitively to their children in challenging parenting situations. However, parental emotion regulation is usually assessed using questionnaires that are not about parenting, rather than through examining parents' reaction to specific parenting situations that might evoke negative emotions. This study investigates individual differences in mothers' emotion regulation during parenting, specifically examining the relation between their subjective negative emotions and observed parenting behaviors and whether this relation is moderated by cognitive (strategies to manage negative emotions) and physiological (resting baseline and reactivity of respiratory sinus arrhythmia; RSA) processes. Data of 157 mothers' self-reported negative emotions and strategy-use, their RSA, observed maternal responsiveness, and their preschool-age children's (30-60 months, 49.7% female) challenging behaviors were collected during a Wait Task, in which mothers told children to wait before opening an appealing gift. Regression analysis indicated that, after controlling for how challenging children were, mothers' level of negative emotion was not associated with observed level of maternal responsiveness. In line with hypotheses, the association was moderated by mothers' resting RSA and the extent to which they suppressed negative emotions. However, contrary to hypotheses, the association was not moderated by use of reappraisal, distraction, or rumination, or RSA reactivity. The significant findings suggest that, although mothers' subjective experiences of negative emotions are not necessarily related to less responsive parenting behaviors, the link between maternal emotions and parenting behavior may indicate differences in how mothers engage cognitive strategies as well as their physiological regulation capacity. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Assuntos
Regulação Emocional , Criança , Pré-Escolar , Humanos , Feminino , Masculino , Emoções/fisiologia , Mães/psicologia , Poder Familiar/psicologia , Pais
9.
Child Dev ; 93(5): e501-e514, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35635069

RESUMO

To advance the understanding of how parental self-regulation contributes to their role in supporting children's development, this study proposes a model of the dynamic processes involved in parental self-regulation. Based on time-series data from 157 mothers and their 30- to 60-month-old children (49.7% female; 96% White; data collected June 2017-December 2019 in central Pennsylvania, U.S.) during a challenging wait task, the model was tested by examining the temporal relations among challenging child behavior, maternal physiology, and maternal responsiveness. Results were consistent with the hypothesized dynamic negative feedback processes and revealed their associations with the overall quality of parenting behaviors and experiences. Findings elucidate how parents adapt to competing external (attending to child) and internal (restoring parents' equilibrium) demands during parenting challenges.


Assuntos
Mães/psicologia , Relações Pais-Filho , Poder Familiar , Autocontrole , Criança , Comportamento Infantil , Pré-Escolar , Feminino , Humanos , Masculino , Pais
10.
Int J Psychophysiol ; 177: 220-229, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35640857

RESUMO

Although impulsivity is associated with an increased willingness to make risky decisions, uncertainty intolerance may also contribute to maladaptive decision-making behavior, where individuals neglect to pursue potential rewards even when probabilities for success are in their favor. Several theories have sought to explain the neural systems that guide decision-making in this context, with evidence supporting a role for increased sympathetic activation. However, it remains unclear whether the sympathetic system is associated with greater apprehension in response to uncertain outcomes, or whether it serves to guide behavioral decisions in the context of this uncertainty. Furthermore, although postulated as a within-person process, most research has examined the association between decision behavior and sympathetic activation at the between-person level. We hypothesize that in the context of uncertainty between-person differences in skin conductance will be associated with longer deliberation times; whereas within-person trial-level increases in skin conductance will be associated with a tendency to reject uncertain options. Data were collected from n = 56 children aged 7-11 years, using a computerized card game in which children chose to accept or reject cards of varying point value at varying levels of probability. Skin conductance level (SCL) was recorded throughout the task. No significant between-person associations emerged. However, within-person analyses indicated that momentary deliberation time moderated the association between momentary skin-conductance and decision outcome. This moderation was such that for trials during which the individual deliberated longer (i.e., was more indecisive), a concurrent increase in skin conductance was associated with a significantly higher likelihood of rejecting the card. The within-person nature of these results suggests that skin conductance may help in resolving indecision in the context of uncertainty.


Assuntos
Tomada de Decisões , Recompensa , Biomarcadores , Criança , Tomada de Decisões/fisiologia , Humanos , Comportamento Impulsivo , Probabilidade , Incerteza
11.
Psychophysiology ; 59(10): e14073, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35460527

RESUMO

Conceptual work on interpersonal physiology suggests that the dynamic concordance between two person's physiological arousal may transpire on multiple timescales, and the timescale on which it unfolds may determine its psychological significance. The current study tested this hypothesis in the context of parent-child interaction by examining whether the concordance in their cardiac arousal on two timescales was differentially associated with parental characteristics. Using data from 98 fathers and their 3- to 5-year-old children during a task designed to frustrate young children, results indicated that the associations between cardiac concordance and fathers' self-reported parenting hassles emerged for the slower timescale (concordant increasing trends in arousal), whereas concordance on the faster timescale (concordant second-by-second reactivity) was associated with fathers' emotional clarity. Findings suggest that there may be multiple layers of concordant patterns in the dynamic associations between fathers' and children's cardiac arousal, which unfold on different timescales and bear different psychological significance.


Assuntos
Relações Pai-Filho , Pai , Pré-Escolar , Emoções , Pai/psicologia , Humanos , Masculino , Relações Pais-Filho , Poder Familiar/psicologia
12.
J Interpers Violence ; 37(9-10): NP6988-NP7013, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-33096968

RESUMO

Exposure to child-directed parental aggression in early life has been found to increase the risk of later psychopathological symptoms among children and adolescents. However, little is known about intermediate phenotypes and the developmental progression of symptoms, especially across the transition to grade school. Using prospectively collected longitudinal data from a large sample of children enrolled in the Family Life Project (n = 1,166, 49.7% female), the current study examined the mediating role of early dissociative symptoms in the relations between parental aggression and children's psychopathological symptoms. Children's exposure to parental aggression and their dissociative symptoms before school entry were assessed based on primary caregivers' reports. Teacher ratings of children's internalizing and externalizing symptoms were collected in pre-kindergarten as well as in the 1st, 3rd, and 5th grades. Results showed that dissociative symptoms before school entry partially mediated the association between parental aggression and persistent externalizing symptoms in school years. However, no significant associations were found between parental aggression or dissociative symptoms and internalizing symptoms. Findings suggest that dissociative symptoms manifested early in life serve as a mediating mechanism and indicator of risk for persistent impulsivity and behavioral problems. Thus, these symptoms could be an important target of preventive services provided to children with adverse experiences in their families.


Assuntos
Transtornos Mentais , Comportamento Problema , Adolescente , Agressão , Pré-Escolar , Feminino , Humanos , Estudos Longitudinais , Masculino , Pais , Psicopatologia
13.
Cancer ; 128(4): 788-796, 2022 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-34644414

RESUMO

BACKGROUND: The objective of this study was to examine long-term outcomes among children newly diagnosed with cancer who were treated in dexrazoxane-containing clinical trials. METHODS: P9404 (acute lymphoblastic leukemia/lymphoma [ALL]), P9425 and P9426 (Hodgkin lymphoma), P9754 (osteosarcoma), and Dana-Farber Cancer Institute 95-01 (ALL) enrolled 1308 patients between 1996 and 2001: 1066 were randomized (1:1) to doxorubicin with or without dexrazoxane, and 242 (from P9754) were nonrandomly assigned to receive dexrazoxane. Trial data were linked with the National Death Index, the Organ Procurement and Transplantation Network, the Pediatric Health Information System (PHIS), and Medicaid. Osteosarcoma survivors from the Childhood Cancer Survivor Study (CCSS; n = 495; no dexrazoxane) served as comparators in subanalyses. Follow-up events were assessed with cumulative incidence, Cox regression, and Fine-Gray methods. RESULTS: In randomized trials (cumulative prescribed doxorubicin dose, 100-360 mg/m2 ; median follow-up, 18.6 years), dexrazoxane was not associated with relapse (hazard ratio [HR], 0.84; 95% confidence interval [CI], 0.63-1.13), second cancers (HR, 1.19; 95% CI, 0.62-2.30), all-cause mortality (HR, 1.07; 95% CI, 0.78-1.47), or cardiovascular mortality (HR, 1.45; 95% CI, 0.41-5.16). Among P9754 patients (all exposed to dexrazoxane; cumulative doxorubicin, 450-600 mg/m2 ; median follow-up, 16.6-18.4 years), no cardiovascular deaths or heart transplantation occurred. The 20-year heart transplantation rate among CCSS osteosarcoma survivors (mean doxorubicin, 377 ± 145 mg/m2 ) was 1.6% (vs 0% in P9754; P = .13). Among randomized patients, serious cardiovascular outcomes (cardiomyopathy, ischemic heart disease, and stroke) ascertained by PHIS/Medicaid occurred less commonly with dexrazoxane (5.6%) than without it (17.6%; P = .02), although cardiomyopathy rates alone did not differ (4.4% vs 8.1%; P = .35). CONCLUSIONS: Dexrazoxane did not appear to adversely affect long-term mortality, event-free survival, or second cancer risk.


Assuntos
Dexrazoxano , Doença de Hodgkin , Leucemia-Linfoma Linfoblástico de Células Precursoras , Criança , Dexrazoxano/efeitos adversos , Dexrazoxano/uso terapêutico , Doxorrubicina/uso terapêutico , Seguimentos , Doença de Hodgkin/tratamento farmacológico , Humanos , Avaliação de Resultados em Cuidados de Saúde , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico
14.
J Adolesc Young Adult Oncol ; 11(3): 328-332, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34515544

RESUMO

ARST1321, a trial of patients with advanced soft tissue sarcoma, was the first National Clinical Trials Network study codeveloped by pediatric and adult consortia with two treatment cohorts. We report on the findings of a survey to identify barriers to enrolling adolescent and young adult patients (15-39 years) onto the nonchemotherapy arm. The survey response rate was 31% with a 70% completion rate. Common identified reasons for low accrual in order of decreasing frequency included insufficient funding, lack of study awareness or interest, competing trials, toxicity concerns, philosophical differences in the therapy backbone, and regulatory and infrastructure barriers. Clinical Trials.gov ID: NCT02180867.


Assuntos
Ensaios Clínicos como Assunto , Participação do Paciente , Sarcoma , Neoplasias de Tecidos Moles , Adolescente , Adulto , Humanos , Sarcoma/patologia , Sarcoma/terapia , Neoplasias de Tecidos Moles/patologia , Neoplasias de Tecidos Moles/terapia , Inquéritos e Questionários , Adulto Jovem
15.
J Adolesc Young Adult Oncol ; 11(3): 259-267, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-34357819

RESUMO

Purpose: The aim of this study was to describe diet and physical activity (PA) behaviors and health beliefs among cancer survivors and identify potential differences between adolescent and young adult (AYA) and adult/older cancer survivors. Methods: Cancer survivors (n = 1864) participating in the Health Information National Trends Survey (HINTS) provided responses regarding diet and PA and selected health beliefs related to general health and cancer (self-efficacy, attitudinal belief, normative belief, risk belief, intention, and self-regulation). Health belief associations with diet and PA were assessed using adjusted logistic regression models, and multiple linear regression was used for a computed Modified American Cancer Society Adherence score (0-10, higher score indicates higher adherence to recommendations); age at diagnosis was evaluated as a potential effect modifier. Results: Health behaviors between AYA and adult/older were not significantly different; a greater percent of AYA met fruit and resistance PA recommendations. Higher health self-efficacy was associated with meeting aerobic PA recommendations (odds ratio [OR]: 1.71; confidence interval [95% CI]: 1.13-2.60; p = 0.01). Higher intention was inversely related to meeting vegetable recommendation (OR: 0.58; 95% CI: 0.35-0.97; p = 0.04). Self-regulation was associated with higher odds of meeting each recommendation. Self-efficacy and self-regulation were associated with greater adherence (ß = 0.52 ± 0.16, p = 0.001; ß = 1.21 ± 0.24, p < 0.0001, respectively). Age at diagnosis was not an effect modifier. Conclusion: Health behaviors and beliefs among AYA and adult/older are similar. Self-efficacy and self-regulation through engagement with a mobile app support adoption of diet and PA recommendations among HINTS respondents. Future interventions should consider mechanisms to promote self-efficacy and self-regulation to maximize diet and PA behaviors in cancer survivors.


Assuntos
Sobreviventes de Câncer , Dieta , Exercício Físico , Conhecimentos, Atitudes e Prática em Saúde , Adolescente , Adulto , Fatores Etários , Sobreviventes de Câncer/psicologia , Sobreviventes de Câncer/estatística & dados numéricos , Dieta/psicologia , Dieta/estatística & dados numéricos , Exercício Físico/psicologia , Frutas , Humanos , Inquéritos e Questionários , Estados Unidos , Verduras , Adulto Jovem
16.
Cancer Epidemiol Biomarkers Prev ; 31(3): 536-542, 2022 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-34810210

RESUMO

BACKGROUND: Childhood cancer survivors are at risk for cardiovascular disease. We assessed the burden of potentially modifiable cardiometabolic risk factors (CRF) among survivors compared with population-matched controls. METHODS: Survivors previously enrolled on Pediatric Oncology Group protocols 9404, 9425, 9426, 9754, and Dana-Farber Cancer Institute 95-01 from 1996 to 2001 with acute lymphoblastic leukemia/lymphoma, Hodgkin lymphoma, or osteosarcoma were prospectively assessed for the prevalence of CRFs and compared with an age, sex, and race/ethnicity-matched 2013 National Health and Nutrition Examination Survey (NHANES) population. We estimated future predicted cardiovascular risk based on general population (e.g., Framingham) and Childhood Cancer Survivor Study (CCSS) models. RESULTS: Compared with NHANES (n = 584), survivors [n = 164; 44.5% female, median age 28 years (range, 16-38 years); median 17.4 years (range, 13-22 years) since cancer diagnosis; median doxorubicin dose 300 mg/m2; 30.5% chest radiation] had similar rates of obesity, diabetes, and dyslipidemia, but more prehypertension/hypertension (38.4% vs. 30.1%, P = 0.044). Survivors had fewer metabolic syndrome features compared with NHANES (≥2 features: 26.7% vs. 55.9%; P < 0.001). Survivors were more physically active and smoked tobacco less (both P < 0.0001). Therefore, general population cardiovascular risk scores were lower for survivors versus NHANES. However, with CCSS models, 30.5% of survivors were at moderate risk of ischemic heart disease, and >95% at moderate/high risk for heart failure, with a 9% to 12% predicted incidence of these conditions by age 50 years. CONCLUSIONS: Childhood cancer survivors exhibited similar or better cardiometabolic and lifestyle profiles compared with NHANES, but nonetheless are at risk for future clinically significant cardiovascular disease. IMPACT: Further strategies supporting optimal CRF control are warranted in survivors. See related commentary by Mulrooney, p. 515.


Assuntos
Sobreviventes de Câncer , Doenças Cardiovasculares , Leucemia-Linfoma Linfoblástico de Células Precursoras , Adulto , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores de Risco
17.
Int J Psychophysiol ; 171: 29-37, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34906622

RESUMO

Autonomic nervous system activity flexibly shifts and modulates behavior at multiple time scales, with some work suggesting that patterns of short-term reactivity contribute to long-term developmental change. However, previous work has largely considered sympathetic and parasympathetic systems independently, even though both systems contribute dynamically to the regulation of physiological arousal. Using physiological data obtained from 313 children in kindergarten, 1st, and 2nd grade we examined whether within-person autonomic coordination during an emotion-inducing film task in kindergarten was associated with developmental change in resting autonomic activity. On average, these kindergarteners exhibited reciprocal coordination during the approach-oriented emotion (angry, happy) condition and a lack of coordination during the avoidance-oriented emotion (fear, sad) condition. Alignment with these patterns was associated with more typical autonomic development, specifically an increase in resting respiratory sinus arrhythmia (RSA) and a decrease in resting skin conductance (SCR) from kindergarten to 2nd grade; while lack of coordination during the approach condition was associated with a relatively delayed increase in resting RSA and a steeper decline in SCR, and reciprocal coordination during the avoidance condition was associated with a lack of RSA increase. Findings highlight the need for additional consideration of how moment-to-moment dynamics of autonomic coordination influence longer-term development, and suggest that early patterns of atypical arousal may portend dysregulation of developing physiological systems.


Assuntos
Sistema Nervoso Parassimpático , Arritmia Sinusal Respiratória , Nível de Alerta , Sistema Nervoso Autônomo , Criança , Emoções , Humanos
18.
Int J Psychophysiol ; 169: 20-33, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34509572

RESUMO

Performance monitoring is critical for learning and behavioral adaption and is supported by both externally and internally sourced information. Cross-sectional studies indicate an increase in internal error processing across childhood, suggesting a potential developmental transition from reliance on external information to reliance on internally developed models. However, little research has examined the association between these constructs longitudinally. Data from 339 children assessed annually from kindergarten to 2nd grade were examined to determine the developmental trajectory of ERP indices of performance monitoring, and whether the association between these indices changes across time. EEG data were recorded during an incentivized Go/No-Go task and ERP component amplitudes were extracted as peak measures at Fz. Despite small increases in magnitude, no significant changes were observed in any of the ERPs. Multi-level regression analyses indicated that in kindergarten a more negative feedback-related negativity (FRN) was associated with a more negative error-related negativity (ERN) and a more negative error positivity (Pe). Further, the association between the FRN and Pe changed over time, such that in 2nd grade the FRN and Pe decoupled from one another and were no longer associated. These results suggest that the development of performance monitoring through middle childhood may be a phasic process. More specifically, matured external feedback monitoring processes may first facilitate the development of conscious error recognition, and then the development of internal error monitoring processes. Once internal models of error monitoring are well-established, children may then reduce their utilization of external feedback.


Assuntos
Eletroencefalografia , Potenciais Evocados , Criança , Estudos Transversais , Retroalimentação , Humanos , Aprendizagem , Desempenho Psicomotor , Tempo de Reação
19.
Res Child Adolesc Psychopathol ; 49(12): 1537-1549, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34213718

RESUMO

The inability to regulate affective arousal in the context of frustration may jeopardize children's ability to form successful friendships, especially as new peer groups are formed during the transition to kindergarten. While substantial research has utilized teacher reports of children's socioemotional behavior, there is less empirical evidence on the peer perspective. The present study utilized data from n = 235 kindergarteners (54% high in disruptive behavior) recruited for a multicomponent intervention. We examined whether physiological reactivity to frustration was associated with children's social success. Peer nominations of liking or disliking to play with the child were used to compute a social preference score, where negative values reflect greater rejection than acceptance. Multilevel growth modeling was employed to capture changes in respiratory sinus arrhythmia (RSA) reactivity across a manipulated inhibitory control task administered in 3 blocks, with differing algorithms embedded to induce affect: points were earned in the 1st and 3rd blocks (reward) and lost during the 2nd block (frustration). Groups did not differ in RSA reactivity during the 1st block, but children who experience greater peer rejection showed significant decreases in RSA (increases in arousal) across frustration. This increased arousal persisted across the 3rd block despite the reinstatement of reward, indicating a greater degree of reactivity and a lack of recovery relative to peer-accepted children. Teacher screenings of disruptive behavior only partially aligned with peer ratings of acceptance, highlighting the benefits of leveraging peer report to capture regulatory functioning and identify children for intervention recruitment.


Assuntos
Frustração , Arritmia Sinusal Respiratória , Criança , Emoções , Humanos , Grupo Associado , Instituições Acadêmicas
20.
Biol Psychol ; 163: 108137, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34139311

RESUMO

Resting frontal EEG alpha asymmetry has been extensively examined as a marker of motivational disposition. Recent research has examined how this trait-level marker of motivation influences an individual's internal error monitoring (indexed by the error-related negativity; ERN), with mixed findings as to whether more negative ERNs are associated with greater left or right alpha power. Data from 339 children who completed an incentivized Go/No-Go task annually from Kindergarten through 2nd grade were examined for an association between ERN amplitude and EEG asymmetry, and for whether the association was developmentally stable. Results indicate an association between left-dominant activation and a more negative amplitude in Kindergarten, with an inversion of this association emerging by 2nd grade, such that a more negative ERNs were associated with right-dominant activation. We suggest that the association between EEG asymmetry and ERN amplitude is likely modulated by task condition (e.g., incentivization) and experience over time (e.g., habituation).


Assuntos
Eletroencefalografia , Motivação , Criança , Potenciais Evocados , Humanos , Personalidade , Descanso
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