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1.
Med Gas Res ; 13(1): 23-28, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35946219

RESUMO

Demyelination of the cerebral white matter is the most common pathological change after carbon monoxide (CO) poisoning. Notch signaling, the mechanism underlying the differentiation of astrocytes and oligodendrocytes, is critical to remyelination of the white matter after brain lesion. The purpose of this work was to determine the effects of hyperbaric oxygen (HBO) on Notch signaling pathway after CO poisoning for the explanation of the protective effects of HBO on CO-poisoning-related cerebral white matter demyelination. The male C57 BL/6 mice with severe CO poisoning were treated by HBO. And HBO therapy shortened the escape latency and improved the body mass after CO poisoning. HBO therapy also significantly suppressed protein and mRNA levels of Notch1 and Hes5 after CO poisoning. Our findings suggested that HBO could suppress the activation of Notch signaling pathway after CO poisoning, which is the mechanism underlying the neuroprotection of HBO on demyelination after severe CO poisoning.


Assuntos
Intoxicação por Monóxido de Carbono , Doenças Desmielinizantes , Oxigenoterapia Hiperbárica , Animais , Intoxicação por Monóxido de Carbono/terapia , Doenças Desmielinizantes/induzido quimicamente , Doenças Desmielinizantes/terapia , Masculino , Camundongos , Oxigênio , Transdução de Sinais
2.
Addict Behav ; 136: 107467, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36037610

RESUMO

Smoking cessation treatments that are easily accessible and deliver intervention content at vulnerable moments (e.g., high negative affect) have great potential to impact tobacco abstinence. The current study examined the feasibility and acceptability of a multi-component Just-In-Time Adaptive Intervention (JITAI) for smoking cessation. Daily smokers interested in quitting were consented to participate in a 6-week cessation study. Visit 1 occurred 4 days pre-quit, Visit 2 was on the quit day, Visit 3 occurred 3 days post-quit, Visit 4 was 10 days post-quit, and Visit 5 was 28 days post-quit. During the first 2 weeks (Visits 1-4), the JITAI delivered brief mindfulness/motivational strategies via smartphone in real-time based on negative affect or smoking behavior detected by wearable sensors. Participants also attended 5 in-person visits, where brief cessation counseling (Visits 1-4) and nicotine replacement therapy (Visits 2-5) were provided. Outcomes were feasibility and acceptability; biochemically-confirmed abstinence was also measured. Participants (N = 43) were 58.1 % female (AgeMean = 49.1, mean cigarettes per day = 15.4). Retention through follow-up was high (83.7 %). For participants with available data (n = 38), 24 (63 %) met the benchmark for sensor wearing, among whom 16 (67 %) completed at least 60 % of strategies. Perceived ease of wearing sensors (Mean = 5.1 out of 6) and treatment satisfaction (Mean = 3.6 out of 4) were high. Biochemically-confirmed abstinence was 34 % at Visit 4 and 21 % at Visit 5. Overall, the feasibility of this novel multi-component intervention for smoking cessation was mixed but acceptability was high. Future studies with improved technology will decrease participant burden and better detect key intervention moments.


Assuntos
Abandono do Hábito de Fumar , Estudos de Viabilidade , Feminino , Humanos , Masculino , Fumantes , Fumar/terapia , Abandono do Hábito de Fumar/psicologia , Dispositivos para o Abandono do Uso de Tabaco
3.
J Ethnopharmacol ; 300: 115626, 2023 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-36049653

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Moxibustion is a traditional medical intervention of traditional Chinese medicine. It refers to the direct or indirect application of ignited moxa wool made of mugwort leaves to acupuncture points or other specific parts of the body for either treating or preventing diseases. Moxibustion has been proven to be effective in treating skin lesions of psoriasis. AIM OF THE STUDY: This study was performed to elucidate molecular mechanisms underlying the effects of moxibustion treatment on imiquimod-induced psoriatic mice. MATERIALS AND METHODS: We established an imiquimod (IMQ)-induced psoriatic mice (Model) and assessed the effects of moxibustion (Moxi) treatment on skin lesions of psoriatic mice by the PASI scores and expressions of inflammation-related factors relative to normal control mice (NC). We then performed nuclear magnetic resonance (NMR)-based metabolomic analysis on the skin tissues of the NC, Model and Moxi-treated mice to address metabolic differences among the three groups. RESULTS: Moxi mice showed reduced PASI scores and decreased expressions of the pro-inflammatory cytokines IL-8, IL-17A and IL-23 relative to Model mice. Compared with the Model group, the NC and Moxi groups shared 9 characteristic metabolites and 4 significantly altered metabolic pathways except for taurine and hypotaurine metabolism uniquely identified in the NC group. To a certain extent, moxibustion treatment improved metabolic disorders of skin lesions of psoriatic mice by decreasing glucose, valine, asparagine, aspartate and alanine-mediated cell proliferation and synthesis of scaffold proteins, alleviating histidine-mediated hyperproliferation of blood vessels, and promoting triacylglycerol decomposition. CONCLUSIONS: This study reveals the molecular mechanisms underlying the effects of moxibustion treatment on the skin lesions of psoriasis, potentially improving the clinical efficacy of moxibustion.


Assuntos
Moxibustão , Psoríase , Alanina/metabolismo , Alanina/farmacologia , Alanina/uso terapêutico , Animais , Asparagina/metabolismo , Asparagina/farmacologia , Asparagina/uso terapêutico , Ácido Aspártico/metabolismo , Ácido Aspártico/farmacologia , Ácido Aspártico/uso terapêutico , Citocinas/metabolismo , Modelos Animais de Doenças , Glucose/metabolismo , Histidina/metabolismo , Histidina/farmacologia , Histidina/uso terapêutico , Imiquimode , Interleucina-17/metabolismo , Interleucina-23/metabolismo , Interleucina-23/farmacologia , Interleucina-23/uso terapêutico , Interleucina-8/metabolismo , Espectroscopia de Ressonância Magnética , Camundongos , Psoríase/tratamento farmacológico , Psoríase/terapia , Pele , Taurina/metabolismo , Triglicerídeos/metabolismo , Valina/metabolismo , Valina/farmacologia , Valina/uso terapêutico
4.
Radiographics ; 43(1): e220076, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36306220

RESUMO

Intra-arterial treatment has been identified as one of the mainstays in the management of unresectable hepatocellular carcinoma. A thorough knowledge of tumor arterial supply enables selective therapy, which improves both safety and efficacy. The inferior phrenic artery (IPA) is the most common extrahepatic collateral artery that feeds hepatocellular carcinoma. The bilateral IPAs are known to have a specific vascular anatomy. A systemic-to-pulmonary shunt and a gastric branch from the IPAs may be present and should not be confused with tumor blush. The supraceliac aorta and celiac trunk are the common origin sites of the IPAs, and their orifice may be compressed by the diaphragm. Various techniques and catheters are used for catheterization of the IPAs, depending on their origin sites. Because the IPA is normally connected with the intercostal, internal mammary, retroperitoneal, and hepatic arteries, its hemodynamics may be altered when its orifice is occluded. In general, superselective chemoembolization via the target branch of the IPA is safe and effective. When a systemic-to-pulmonary shunt from the IPA is adequately embolized with coils or particles, radioembolization through the IPA can be performed safely in most cases. The cystic artery branches into deep and superficial cystic arteries; deep cystic arteries often supply tumors near the gallbladder. Chemoembolization through the cystic artery is relatively safe, with transient embolic materials. Radioembolization through the cystic artery has been recently tried, with acceptable efficacy and toxicity results, but it requires further investigation. ©RSNA, 2022.


Assuntos
Carcinoma Hepatocelular , Quimioembolização Terapêutica , Neoplasias Hepáticas , Humanos , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/irrigação sanguínea , Quimioembolização Terapêutica/métodos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/irrigação sanguínea , Artéria Hepática/patologia , Diafragma/diagnóstico por imagem
5.
Crit Care Clin ; 39(1): 139-152, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36333028

RESUMO

Patients with severe acute brain injury are left incapacitated, critically ill, and unable to make their own medical decisions. Surrogate decision-makers must make life-or-death decisions for patients and rely on clinicians' prognostication for guidance. No guidelines currently exist to guide clinicians in how to prognosticate; hence, neuroprognostication is still considered an "art" leaving room for high variability. This review examines the current literature on prognostication in neurocritical care, identifies ongoing challenges that exist in the field, and provides suggestions for future research with the goal to ameliorate variability and focus on scientific and patient-centered, rather than artistic approaches to prognostication.


Assuntos
Estado Terminal , Tomada de Decisões , Humanos , Estado Terminal/terapia
6.
Crit Care Clin ; 39(1): 123-138, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36333027

RESUMO

Diseases of the peripheral nervous system create an additional diagnostic conundrum within the intensive care setting. Causes are vast, presentations are myriad, and symptoms are often ill-defined or misidentified. Care benefits from a multidisciplinary approach including a neuromuscular specialist, rehabilitation services, and a specialty pharmacist in addition to the neurocritical care team. In general, survivors achieve a good functional recovery relative to their preintensive care unit baseline.


Assuntos
Doenças Neuromusculares , Humanos , Doenças Neuromusculares/diagnóstico , Doenças Neuromusculares/terapia , Cuidados Críticos , Debilidade Muscular/diagnóstico , Debilidade Muscular/etiologia , Debilidade Muscular/terapia , Unidades de Terapia Intensiva , Estado Terminal
7.
Crit Care Clin ; 39(1): 153-169, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36333029

RESUMO

Neurologic conditions are often encountered in the general intensive care unit. This article will discuss some of the more common neurologic issues encountered and provide guidance in the assessment and management of these conditions.


Assuntos
Unidades de Terapia Intensiva , Doenças do Sistema Nervoso , Humanos , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/terapia , Cuidados Críticos
8.
Crit Care Clin ; 39(1): 221-233, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36333033

RESUMO

Neurocritical care management of acute brain injury (ABI) is focused on identification, prevention, and management of secondary brain injury (SBI). Physiologic monitoring of the brain and other organ systems has a role to predict patient recovery or deterioration, guide individualized therapeutic interventions, and measure response to treatment, with the goal of improving patient outcomes. In this review, we detail how specific physiologic markers of brain injury and neuromonitoring tools are integrated and used in ABI patients to develop therapeutic approaches to prevent SBI.


Assuntos
Lesões Encefálicas , Cuidados Críticos , Humanos , Monitorização Fisiológica , Lesões Encefálicas/terapia , Encéfalo
9.
Crit Care Clin ; 39(1): 103-121, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36333026

RESUMO

Although intracranial pressure (ICP) monitoring has been the mainstay of traumatic brain injury (TBI) management for decades, new understanding of TBI physiopathology calls for paradigm shifts. The complexity of TBI management precludes ICP being taken as an isolated value with a specific threshold. Multimodality monitoring is crucial to expanding our comprehension of individualized pathophysiology, allowing for a precise and tailored treatment approach. This article will review keys concepts to interpret and apply published ICP management guidelines and statements.


Assuntos
Lesões Encefálicas Traumáticas , Pressão Intracraniana , Humanos , Pressão Intracraniana/fisiologia , Lesões Encefálicas Traumáticas/diagnóstico , Lesões Encefálicas Traumáticas/terapia , Monitorização Fisiológica
10.
Crit Care Clin ; 39(1): 55-70, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36333037

RESUMO

This article reviews the care of patients with ischemic stroke in the intensive care unit, including early general critical care interventions for airway control blood pressure goals according to the type of acute stroke treatment, poststroke cerebral edema management, hemorrhagic conversion in ischemic stroke, fibrinolytic reversal, and management of carotid endarterectomy and infective endocarditis. The importance of preventing common intensive care complications is discussed, including aspiration pneumonia, deep venous thrombosis, urinary tract infections, cardiac arrhythmias, and hyperglycemia.


Assuntos
Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Humanos , Isquemia Encefálica/complicações , Isquemia Encefálica/terapia , Acidente Vascular Cerebral/terapia , Acidente Vascular Cerebral/etiologia , Terapia Trombolítica , Cuidados Críticos
11.
J Ethnopharmacol ; 301: 115834, 2023 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-36270558

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Mume Fructus (MF) is processed from the near-ripe fruit of Prunus mume (Siebold) Siebold & Zucc by drying at low temperature until the color turns black. MF is often used in Chinese medicine for the treatment of chronic diarrhea and dysentery. Previous studies have shown that the active components of MF against Crohn's disease (CD) are mainly citrate and hydroxycinnamate derivatives, which can alleviate the CD-induced inflammatory response and intestinal barrier damage. However, their molecular mechanisms on CD still need further elucidation. AIM OF THE STUDY: To investigate the protective effects and underlying mechanisms of citrate and hydroxycinnamate derivatives in MF on intestinal epithelial injury. MATERIALS AND METHODS: Network pharmacology technology was used to predict the anti-CD targets and molecular mechanisms of 4 citrate and 11 hydroxycinnamate derivative prototypes and 5 hydroxycinnamate derivative metabolites in the 40% ethanol fraction of MF (MFE40), the active anti-CD ingredient group of MF. Lipopolysaccharide (LPS)-treated IEC-6 cells were used to investigate the effects of the above components on the proliferation of damaged IEC-6 cells and to verify the molecular mechanism of their regulation on the FAK/PI3K/AKT signaling pathways for the promotion of the proliferation of IEC-6 cells. RESULTS: A "compound-target-pathway" network was constructed based on network pharmacology analysis, including 20 citrate and hydroxycinnamate derivatives that target 316 core proteins and 36 CD-related pathways, of which PI3K-AKT pathway and focal adhesion were the most enriched pathways. Further cell validation experiments showed that 1 citric acid (CA) compound and 10 hydroxycinnamate derivatives, including 3-O-caffeoylquinic acid (3CQA), 4-O-caffeoylquinic acid (4CQA), 5-O-caffeoylquinic acid (5CQA), caffeic acid (CFA), p-coumaric acid (PCMA), m-coumaric acid (MCMA), ferulic acid (FUA), isoferulic acid (IFUA), 3-hydroxyphenylpropionic acid (3HPPA) and hippuric acid (HPP), could promote the proliferation of IEC-6 cells and inhibit the damage of LPS to IEC-6 cells. Ethyl caffeate (ECFA), a hydroxycinnamic acid derivative, had no effect on promoting the proliferation of IEC-6 cells and was weak in inhibiting the damage of IEC-6 cells caused by LPS. Further mechanistic verification experiments showed that 7 citrate and hydroxycinnamate derivatives (CA, CFA, 3CQA, MCMA, FUA, 3HPPA, and HPP) could upregulate the expression of p-FAK, p-PI3K, and p-AKT proteins. Among them, CA had the better effect on activating the FAK-PI3K-AKT signaling pathway. CONCLUSIONS: Citrate and hydroxycinnamate derivatives in MF can ameliorate LPS-induced intestinal epithelial cell injury to demonstrate potential for Crohn's disease alleviation. This protective effect can be achieved by upregulating FAK/PI3K/AKT pathway.


Assuntos
Doença de Crohn , Lipopolissacarídeos , Lipopolissacarídeos/farmacologia , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Frutas/metabolismo , Ácido Cítrico , Doença de Crohn/metabolismo , Doença de Crohn/terapia , Transdução de Sinais , Células Epiteliais
12.
Behav Modif ; 47(1): 3-45, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35426318

RESUMO

Studying the usefulness of contextual and cognitive transdiagnostic therapies calls for an analysis of both their differential efficacy and their specificity when acting on the transdiagnostic conditions on which they focus. This controlled trial compares the post-treatment and 3- and 6-month follow-up effects of Behavioral Activation (BA), Acceptance and Commitment Therapy (ACT) and Cognitive-Behavioral Transdiagnostic Therapy (TD-CBT) on emotional symptomatology, and analyses the role played by Experiential Avoidance, Cognitive Fusion, Activation and Emotion Regulation in the clinical change. One hundred twenty-eight patients who fulfilled diagnostic criteria for anxiety and/or depression (intention-to-treat sample) were randomly assigned to three experimental group-treatment conditions (BA, n = 34; ACT, n = 27; TD-CBT n = 33) and one control group (WL, n = 34). Ninety-nine (77.34%) completed the treatment (per-protocol sample). In the post-treatment, all therapies reduced anxiety and depression symptomatology. In the follow-ups, the reduction in emotional symptomatology was greater in the condition which produced greater and more prolonged effects on Activation. Activation appears to be the principal condition in modifying all the transdiagnostic patterns and BA was the most efficacious and specific treatment. The trial was registered at ClinicalTrials.gov NCT04117464. Raw data are available online http://dx.doi.org/10.17632/krj3w2hfsj.1.


Assuntos
Terapia de Aceitação e Compromisso , Terapia Cognitivo-Comportamental , Humanos , Resultado do Tratamento , Terapia Cognitivo-Comportamental/métodos , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/psicologia , Ansiedade/terapia , Ansiedade/psicologia
13.
Behav Modif ; 47(1): 46-70, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35440229

RESUMO

Exposure therapy has been investigated as a treatment for eating disorders, but prior research has largely neglected core fears underlying the disorder such as rejection, abandonment, disgust, and loss of control. We tested the feasibility and acceptability of using imaginal exposure to target disordered eating related fears by randomizing participants (N = 47) with disordered eating to: imaginal exposure (IE), imaginal exposure preceded by a brief food exposure (IE + Food), or an assessment control. Participants attended two in-person visits and completed pretreatment, posttreatment, and one-month follow-up questionnaires. IE was rated more acceptable than IE + Food. Retention was high across conditions. Habituation occurred for subjective distress and believability of feared outcomes, suggesting that imaginal exposure effectively activates core fears. Distress tolerance and confidence in ability to change improved. Disordered eating symptoms, fears, preoccupations, and rituals decreased in all conditions, indicating that IE was not specifically responsible for improvement.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Terapia Implosiva , Humanos , Medo , Transtornos da Alimentação e da Ingestão de Alimentos/terapia
14.
Vet Clin North Am Small Anim Pract ; 53(1): 121-140, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36270835

RESUMO

Canine cutaneous histiocytomas originate from Langerhans cells. Multiple histiocytomas are referred to as cutaneous Langerhans cell histiocytosis. Feline pulmonary Langerhans cell histiocytosis causes respiratory failure owing to extensive lung infiltration. Localized and disseminated histiocytic sarcomas usually arise from interstitial dendritic cells. Primary sites include spleen, lung, skin, brain (meninges), lymph node, bone marrow, and synovial tissues of limbs. An initially indolent form of localized histiocytic sarcomas, progressive histiocytosis, originates in the skin of cats. Hemophagocytic histiocytic sarcomas originates in splenic red pulp macrophages. Canine reactive histiocytoses (systemic histiocytosis and cutaneous histiocytosis) are complex inflammatory diseases with underlying immune dysregulation.


Assuntos
Doenças do Gato , Doenças do Cão , Sarcoma Histiocítico , Histiocitose de Células de Langerhans , Neoplasias Cutâneas , Cães , Gatos , Animais , Sarcoma Histiocítico/diagnóstico , Sarcoma Histiocítico/veterinária , Sarcoma Histiocítico/patologia , Doenças do Cão/terapia , Doenças do Cão/patologia , Histiocitose de Células de Langerhans/diagnóstico , Histiocitose de Células de Langerhans/veterinária , Histiocitose de Células de Langerhans/patologia , Pele , Neoplasias Cutâneas/veterinária
15.
Vet Clin North Am Small Anim Pract ; 53(1): 191-206, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36270834

RESUMO

In clinical medicine, evaluation of acid-base balance can be a valuable diagnostic and monitoring tool. Blood gas machines need very small volumes of blood and provide immediate results, making them ideal for use in the emergency room and intensive care setting. This review outlines the stepwise approach to assessment of acid-base balance in dogs, common causes of acid-base abnormalities, and the general approach to treatment.


Assuntos
Desequilíbrio Ácido-Base , Alcalose , Doenças do Cão , Cães , Animais , Desequilíbrio Ácido-Base/diagnóstico , Desequilíbrio Ácido-Base/terapia , Desequilíbrio Ácido-Base/veterinária , Alcalose/diagnóstico , Alcalose/veterinária , Equilíbrio Ácido-Base , Gasometria/veterinária , Concentração de Íons de Hidrogênio , Doenças do Cão/diagnóstico , Doenças do Cão/terapia
16.
Vet Clin North Am Small Anim Pract ; 53(1): 265-278, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36270844

RESUMO

Canine and feline transfusions are life-saving procedures that have become increasingly common in veterinary medicine. Laboratory testing plays a vital role in transfusion medicine, particularly in the prevention and diagnosis of transfusion reactions. Laboratory tests should be used to screen donors for their general health and for the presence of any blood-borne pathogens. Pretransfusion blood typing and compatibility testing make immunologic reactions less likely, and commercial typing and crossmatching kits are now available. Appropriate diagnostic tests in the face of a potential transfusion reaction are important to tailor effective therapy.


Assuntos
Doenças do Gato , Doenças do Cão , Medicina Transfusional , Reação Transfusional , Gatos , Cães , Animais , Doenças do Gato/diagnóstico , Doenças do Gato/terapia , Doenças do Cão/diagnóstico , Doenças do Cão/terapia , Tipagem e Reações Cruzadas Sanguíneas/veterinária , Reação Transfusional/prevenção & controle , Reação Transfusional/veterinária
17.
Artigo em Inglês | MEDLINE | ID: mdl-36332699

RESUMO

Despite multiple available treatments for bipolar depression (BD), many patients face sub-optimal responses. Transcranial direct current stimulation (tDCS) has been advocated in the management of different conditions, including BD, especially in treatment-resistant cases. The optimal dose and timing of tDCS, the mutual influence with other concurrently administered interventions, long-term efficacy, overall safety, and biological underpinnings nonetheless deserve additional assessment. The present study appraised the existing clinical evidence about tDCS for bipolar depression, delving into the putative biological underpinnings with a special emphasis on cellular and molecular levels, with the ultimate goal of providing a translational perspective on the matter. Two separate systematic reviews across the PubMed database since inception up to August 8th 2022 were performed, with fourteen clinical and nineteen neurobiological eligible studies. The included clinical studies encompass 207 bipolar depression patients overall and consistently document the efficacy of tDCS, with a reduction in depression scores after treatment ranging from 18% to 92%. The RCT with the largest sample clearly showed a significant superiority of active stimulation over sham. Mild-to-moderate and transient adverse effects are attributed to tDCS across these studies. The review of neurobiological literature indicates that several molecular mechanisms may account for the antidepressant effect of tDCS in BD patients, including the action on calcium homeostasis in glial cells, the enhancement of LTP, the regulation of neurotrophic factors and inflammatory mediators, and the modulation of the expression of plasticity-related genes. To the best of our knowledge, this is the first study on the matter to concurrently provide a synthesis of the clinical evidence and an in-depth appraisal of the putative biological underpinnings, providing consistent support for the efficacy, safety, and tolerability of tDCS.


Assuntos
Transtorno Bipolar , Estimulação Transcraniana por Corrente Contínua , Humanos , Transtorno Bipolar/terapia , Bases de Dados Factuais , Antagonistas de Hormônios , Mediadores da Inflamação
18.
J Theor Biol ; 557: 111327, 2023 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-36341757

RESUMO

Differentiated cancer cells may regain stem cell characteristics; however, the effects of such a cellular dedifferentiation on tumoural growth and treatment are currently understudied. Thus, we here extend a mathematical model of cancer stem cell (CSC) driven tumour growth to also include dedifferentiation. We show that dedifferentiation increases the likelihood of tumorigenesis and the speed of tumoural growth, both modulated by the proliferative potential of the non-stem cancer cells (NSCCs). We demonstrate that dedifferentiation also may lead to treatment evasion, especially when a treatment solely targets CSCs. Conversely, targeting both CSCs and NSCCs in parallel is shown to be more robust to dedifferentiation. Despite dedifferentiation, perturbing CSC-related parameters continues to exert the largest relative effect on tumoural growth; however, we show the existence of synergies between specific CSC- and NSCC-directed treatments which cause superadditive reductions of tumoural growth. Overall, our study demonstrates various effects of dedifferentiation on growth and treatment of tumoural lesions, and we anticipate our results to be helpful in guiding future molecular and clinical research on limiting tumoural growth in vivo.


Assuntos
Neoplasias , Humanos , Neoplasias/terapia , Carcinogênese , Transformação Celular Neoplásica , Células-Tronco Neoplásicas , Probabilidade
19.
J Affect Disord ; 321: 182-190, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36341803

RESUMO

BACKGROUND: Repetitive transcranial magnetic stimulation (rTMS) can elicit 45-55 % response rates and may alleviate suicidality symptoms in treatment resistant depression (TRD). Blunted anticipatory reward sensitivity and negatively biased self-referential processing may predict trajectories of depressive and suicidality symptoms in rTMS for TRD and be modulated during treatment. METHODS: Fifty-five individuals with TRD received four weeks of low-frequency rTMS applied to the right dorsolateral prefrontal cortex (LFR-rTMS) and were followed until 17 weeks post-baseline. Participants completed behavioral measures of anticipatory reward sensitivity and self-referential processing at baseline and five weeks post-baseline (approximately one-week post-treatment). We examined whether baseline anticipatory reward sensitivity and self-referential processing predicted trajectories of depressive and suicidality symptoms from baseline to follow-up and whether these cognitive-affective variables showed change from baseline to week five. RESULTS: Anticipatory reward sensitivity and negative self-referential encoding at baseline were associated with higher overall depressive symptoms and suicidality from baseline to 17 weeks post-baseline. At week five, participants self-attributed a higher number of positive traits and a lower number of negative traits and had a lesser tendency to remember negative relative to positive traits they had self-attributed, compared to baseline. LIMITATIONS: The specificity of these results to LFR-rTMS is unknown in the absence of a comparison group, and our relatively small sample size precluded the interpretation of null results. CONCLUSIONS: Baseline blunted anticipatory reward sensitivity and negative biases in self-referential processing may be risk factors for higher depressive symptoms and suicidality during and after LFR-rTMS, and LFR-rTMS may modulate self-referential processing.


Assuntos
Transtorno Depressivo Resistente a Tratamento , Suicídio , Humanos , Transtorno Depressivo Resistente a Tratamento/terapia , Estimulação Magnética Transcraniana , Ideação Suicida , Cognição
20.
Fam Community Health ; 46(1): 13-27, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36383230

RESUMO

Rates of overweight and obesity are problematic among systematically marginalized youth; however, these youth and their families are a hard-to-reach research population. The purpose of our study was to identify facilitators and barriers for recruiting systematically marginalized families in youth weight-management intervention research. This study built upon existing evidence through involvement of youth, parents, community agency workers, and school nurses, and an exploration of both recruitment materials and processes. Seven focus groups were conducted with 48 participants from 4 stakeholder groups (youth, parents, school nurses, and community agency workers). A codebook approach to thematic analysis was used to identify key facilitator and barrier themes related to recruitment materials and processes across the stakeholder groups. Ecological systems theory was applied to contextualize the facilitators and barriers identified. Participants reported the need to actively recruit youth in the study through engaging, fun recruitment materials and processes. Participants reported greater interest in recruitment at community-based events, as compared to recruitment through health care providers, underscoring the depth of distrust that this sample group has for the health care system. Recommendations for recruitment materials and processes for weight-management intervention research with systematically marginalized families are proposed.


Assuntos
Sobrepeso , Pais , Adolescente , Humanos , Sobrepeso/terapia , Projetos de Pesquisa , Grupos Focais
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