Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 979.935
Filtrar
1.
Rev. bras. med. esporte ; 29(spe1): e2022_0187, 2023. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1394856

RESUMO

ABSTRACT Introduction As college basketball continues to develop, more and more college students are joining the sport, and the resulting sports injuries have also gradually increased, affecting the quality of life and academic performance. Objective Analyze the most common sports injuries and offer solutions for the safe practice of college basketball. Methods This article studies, through interviews and literature review, the basketball injuries of college students, analyze the main causes of sports injuries, and presents corresponding countermeasures to promote the safe development of sports education in colleges. Results The main injuries were during training, excessive force, and inadequate preparation. Deficient muscle work is also associated with most of these injuries. Conclusion Basketball is highly competitive and popular on college campuses. It is a sport that can exercise and enrich the extracurricular life of college students, requiring from its practitioners greater attention in the pre-training warm-up phase and parallel muscle strengthening to reduce its major injuries in college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes


RESUMO Introdução Com o desenvolvimento contínuo do basquetebol universitário, cada vez mais estudantes universitários aderem ao esporte e as lesões esportivas resultantes também tem aumentado gradualmente, afetando a qualidade de vida e o desempenho nos estudos. Objetivo Analisar as lesões esportivas mais comuns e oferecer soluções visando a prática segura do basquetebol universitário. Métodos Este artigo estuda por meio de entrevistas e revisão literária as lesões no basquetebol dos estudantes universitários, analisa as principais causas das lesões no esporte e apresenta as contramedidas correspondentes para promover o desenvolvimento seguro do ensino esportivo em faculdades. Resultados As principais lesões encontradas foram durante o treino, excesso de força e preparo inadequado. O trabalho muscular deficitário também está associado a maior parte dessas lesões. Conclusão O basquetebol é um esporte altamente competitivo, muito popular nos campi universitários. É um esporte que pode exercitar e enriquecer a vida extracurricular dos estudantes universitários, requerendo de seus praticantes uma maior atenção na fase de aquecimento pré-treino e fortalecimento muscular paralelo para redução das suas principais lesões em universitários. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.


RESUMEN Introducción Con el continuo desarrollo del baloncesto universitario, cada vez más estudiantes universitarios se incorporan a este deporte y las lesiones deportivas resultantes también han aumentado gradualmente, afectando a la calidad de vida y al rendimiento en los estudios. Objetivo Analizar las lesiones deportivas más comunes y ofrecer soluciones orientadas a la práctica segura del baloncesto universitario. Métodos Este artículo estudia, mediante entrevistas y revisión de la literatura, las lesiones de baloncesto de los estudiantes universitarios, analiza las principales causas de las lesiones deportivas y presenta las correspondientes contramedidas para promover el desarrollo seguro de la enseñanza deportiva en los colegios. Resultados Las principales lesiones encontradas fueron durante el entrenamiento, la fuerza excesiva y la preparación inadecuada. El trabajo muscular deficiente también está asociado a la mayoría de estas lesiones. Conclusión El baloncesto es un deporte altamente competitivo, muy popular en los campus universitarios. Es un deporte que puede ejercitar y enriquecer la vida extraescolar de los universitarios, requiriendo de sus practicantes una mayor atención en la fase de calentamiento previo al entrenamiento y el fortalecimiento muscular paralelo para reducir sus principales lesiones en los universitarios. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.


Assuntos
Humanos , Traumatismos em Atletas/etiologia , Basquetebol/lesões , Traumatismos em Atletas/terapia , Índice de Gravidade de Doença , Entrevistas como Assunto
2.
Int J Geriatr Psychiatry ; 38(1): e5849, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36457190

RESUMO

OBJECTIVES: A frequent late Alzheimer's Disease and Related Diseases (ADRD) identification is described and may induce erratic health resource use. We aimed to describe healthcare use patterns preceding ADRD identification. METHODS: We studied persons aged 65 or older, identified with incident ADRD in 2012 in the French health insurance database. Healthcare use covering a wide range of care in ambulatory and hospital settings during the period ranging from 18 to six months before ADRD identification was studied. The main dimensions of healthcare use patterns before ADRD identification were investigated in three age groups (65-74, 75-84, ≥85) through a multiple correspondence analysis. These dimensions were secondarily interpreted according to the 5-year healthcare trajectory following ADRD identification, qualified as favorable (or not) by experts in the field. RESULTS: This research studied 36,990 subjects. Four dimensions raised in each age group. Two dimensions' interpretations were retrieved in all age groups: intensity of healthcare use, functional dependency. However, their rank differed along with the qualification of the future healthcare trajectory. Some specificities appeared in some age group. In the 65-74 and 75-84 years groups, there were dimensions reflecting healthcare use related to psychiatric or psycho-behavioral disorders. In the ≥85 group, two dimensions reflected dependency related to other comorbidities, and organised medical follow-up. CONCLUSION: Several dimensions emerged in line with erratic trajectories before ADRD identification. They underlined the need for actions towards ADRD identification.


Assuntos
Doença de Alzheimer , Humanos , Doença de Alzheimer/diagnóstico , Doença de Alzheimer/terapia , Instituições de Assistência Ambulatorial , Recursos em Saúde , Hospitais , Bases de Dados Factuais
3.
J Cardiol ; 81(1): 42-48, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36241046

RESUMO

BACKGROUND: Understanding patient perspectives of self-care is critical for improving multidisciplinary education programs and adherence to such programs. However, perspectives of self-care for patients with heart failure (HF) as well as the association between patient perspectives and patient-physician communication remain unclear. METHODS: Confidence levels regarding self-care behaviors (eight lifestyle behaviors and four consulting behaviors) and self-monitoring were assessed using a self-administered questionnaire survey, which was directly distributed by dedicated physicians and nurses to consecutive patients hospitalized with HF in a tertiary-level hospital. Patient-physician communication was evaluated according to the quality of physician-provided information regarding "treatment and treatment choices" and "prognosis" using the Prognosis and Treatment Perception Questionnaire. Out of 202 patients, 187 (92.6 %) agreed to participate, and 176 completed the survey [valid response rate, 87.1 %; male, 67.0 %; median age, 73 (63-81) years]. Multivariate logistic regression analyses were conducted to predict low confidence in self-care (score in the lowest quartile). RESULTS: High confidence (confident or completely confident >75 % of patients) was observed for all self-care behavior categories except low-salt diet (63.1 %), regular exercise (63.1 %), and flu vaccination (65.9 %). Lower confidence in self-care behavior was associated with low quality of patient-physician communication. With regard to self-monitoring, 62.5 % of patients were not confident in distinguishing worsening symptoms of HF from other diseases; non-confidence was also associated with low quality of patient-physician communication. CONCLUSIONS: Hospitalized patients with HF had low confidence regarding regular exercise, salt restriction, and flu vaccination. The results also suggest patient-physician communication affects patient confidence.


Assuntos
Insuficiência Cardíaca , Autocuidado , Humanos , Masculino , Idoso , Autocuidado/métodos , Insuficiência Cardíaca/terapia , Insuficiência Cardíaca/diagnóstico , Hospitalização , Inquéritos e Questionários , Exercício Físico
4.
Cell Signal ; 101: 110492, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36241056

RESUMO

In recent decades, there has been a significant amount of research into breast cancer, with some important breakthroughs in the treatment of both primary and metastatic breast cancers. It's a well-known fact that treating breast cancer is still a challenging endeavour even though physicians have a fantastic toolset of the latest treatment options at their disposal. Due to limitations of current clinical treatment options, traditional chemotherapeutic drugs, and surgical options are still required to address this condition. In recent years, there have been several developments resulting in a wide range of treatment options. This review article discusses the cellular and molecular foundation of chemotherapeutic drugs, endocrine system-based treatments, biological therapies, gene therapy, and innovative techniques for treating breast cancer.


Assuntos
Neoplasias da Mama , Humanos , Feminino , Neoplasias da Mama/terapia , Neoplasias da Mama/tratamento farmacológico
5.
Cell Signal ; 101: 110491, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36241057

RESUMO

Homeodomain-interacting protein kinase 2 (HIPK2) is a serine-threonine kinase that phosphorylates and regulates a plethora of transcriptional regulators and chromatin modifiers. The heterogeneity of its interactome allows HIPK2 to modulate several cellular processes and signaling pathways, ultimately regulating cell fate and proliferation. Because of its p53-dependent pro-apoptotic activity and its downregulation in many tumor types, HIPK2 is traditionally considered a bone fide tumor suppressor gene. However, recent findings revealed that the role of HIPK2 in the pathogenesis of cancer is much more complex, ranging from tumor suppressive to oncogenic, strongly depending on the cellular context. Here, we review the very recent data emerged in the last years about the involvement of HIPK2 in cancer biology and therapy, highlighting the various alterations of this kinase (downregulation, upregulation, mutations and/or delocalization) in dependence on the cancer types. In addition, we discuss the recent advancement in the understanding the tumor suppressive and oncogenic functions of HIPK2, its role in establishing the response to cancer therapies, and its regulation by cancer-associated microRNAs. All these data strengthen the idea that HIPK2 is a key player in many types of cancer; therefore, it could represent an important prognostic marker, a factor to predict therapy response, and even a therapeutic target itself.


Assuntos
Neoplasias , Proteína Supressora de Tumor p53 , Humanos , Proteína Supressora de Tumor p53/metabolismo , Apoptose/genética , Proteínas Serina-Treonina Quinases/genética , Neoplasias/genética , Neoplasias/terapia , Biologia , Proteínas de Transporte/genética
6.
Med Educ Online ; 28(1): 2151069, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36420940

RESUMO

PURPOSE: Contact-based education, offering meaningful contact with individuals living in recovery with mental illness, reduces stigma. This study evaluated the effectiveness of the National Alliance on Mental Illness Provider Education Program (NAMI PEP) when implemented as a curricular requirement across two cohorts of third-year osteopathic medical students, comparing traditional, passive learning and active, online delivery formats. MATERIALS AND METHODS: Participants were two cohorts of third-year medical students (Cohort 1 n = 186; Cohort 2 n = 139; overall N = 325) who completed questionnaires measuring affect, beliefs, and behaviors toward patients with mental illness at pre-program, 1-week follow-up, and 6-month follow-up. For Cohort 1, the existing community-based NAMI PEP was implemented. For Cohort 2, the program was adapted to an online, active learning format tailored to medical students, and an additional 3-month follow-up assessment was added to better identify intermediate-term effects. RESULTS: The NAMI PEP was associated with longitudinal improvements in target outcomes, with enhanced effects with the adapted curriculum in Cohort 2. At 6-month follow-up, students reported less stigma, fewer stereotyping negative attitudes, and lower anxiety treating patients with mental illness. They also reported increased confidence integrating psychiatry into routine care and increased competence in principles of collaborative mental health treatment. CONCLUSIONS: This study demonstrates the longitudinal effectiveness of the NAMI PEP across two cohorts of medical students, with strengthened effects observed when the program is tailored to contemporary medical education.


Assuntos
Transtornos Mentais , Psiquiatria , Estudantes de Medicina , Humanos , Aprendizagem Baseada em Problemas , Estudantes de Medicina/psicologia , Estigma Social , Transtornos Mentais/terapia , Transtornos Mentais/psicologia , Psiquiatria/educação
7.
Cancer Nurs ; 46(1): 14-28, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35398870

RESUMO

BACKGROUND: In addition to increased survivorship in childhood leukemia, a small but significant number of survivors experience psychosocial challenges that affect their health-related quality of life (QOL) that require interventions to address these challenges. OBJECTIVE: The aim of this study was to evaluate the efficacy of the technology-based, psychosocial education and counseling program on survivors' QOL, self-efficacy, and coping skills within the scope of a health promotion model for adolescent survivors of childhood leukemia. METHODS: The randomized controlled trial was conducted with adolescent survivors of childhood leukemia who were between the ages of 12 and 18 and had completed treatment at least 2 years previously. Survivors were randomized to a technology-based intervention (n = 24) or a control group (n = 31). Survivors' QOL, self-efficacy, and coping skills were measured at 4 time points (baseline, postintervention, 1 month postintervention, and 3 months postintervention). RESULTS: The 3-month postintervention QOL total and psychosocial subscale scores in the intervention group were significantly higher than those in the control group ( P < .05). In addition, the emotional self-efficacy subscale scores and the active coping scores of the intervention group adolescents were significantly higher than those in the control group ( P < .05). Negative coping scores were lower in the intervention group than in the control group ( P < .05). CONCLUSION: Technology-based, psychosocial counseling and education positively affects the QOL, emotional self-efficacy, and coping skills of adolescent survivors of childhood leukemia. IMPLICATIONS FOR PRACTICE: This program could be integrated into follow-up care and used as one of the support methods in providing and maintaining long-term follow-up care by pediatric oncology nurses.


Assuntos
Leucemia , Qualidade de Vida , Criança , Adolescente , Humanos , Qualidade de Vida/psicologia , Sobreviventes/psicologia , Aconselhamento , Leucemia/terapia , Tecnologia
8.
Int J Cancer ; 152(2): 162-171, 2023 01 15.
Artigo em Inglês | MEDLINE | ID: mdl-35913755

RESUMO

It remains controversial whether physical activity promotes bone health in childhood cancer survivors (CCS). We aimed to assess the effect of a one-year general exercise intervention on lower body bone parameters of CCS. CCS ≥16 years at enrollment, <16 years at diagnosis and ≥5 years in remission were identified from the national Childhood Cancer Registry. Participants randomized to the intervention group were asked to perform an additional ≥2.5 hours of intense physical activity/week, controls continued exercise as usual. Bone health was assessed as a secondary trial endpoint at baseline and after 12-months. We measured tibia bone mineral density (BMD) and morphology by peripheral quantitative computed tomography and lumbar spine, hip and femoral neck BMD by dual-energy x-ray absorptiometry. We performed intention-to-treat, per protocol, and an explorative subgroup analyses looking at low BMD using multiple linear regressions. One hundred fifty-one survivors (44% females, 7.5 ± 4.9 years at diagnosis, 30.4 ± 8.6 years at baseline) were included. Intention-to-treat analysis revealed no differences in changes between the intervention and control group. Per protocol analyses showed evidence for an improvement in femoral neck and trabecular BMD between 1.5% and 1.8% more in participants being compliant with the exercise program. Trabecular BMD increased 2.8% more in survivors of the intervention group with BMD z-score ≤-1 compared to those starting at z-score >-1. A nonstandardized personalized exercise programs might not be specific enough to promote bone health in CCS, although those compliant and those most in need may benefit. Future trials should include bone stimulating exercise programs targeting risk groups with reduced bone health and motivational features to maximize compliance.


Assuntos
Sobreviventes de Câncer , Neoplasias , Humanos , Feminino , Masculino , Densidade Óssea , Neoplasias/terapia , Absorciometria de Fóton , Exercício Físico
9.
Fam Community Health ; 46(1): 79-86, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36322616

RESUMO

Congestive heart failure (CHF) readmissions are frequent and costly but preventable. The purpose of this study was to analyze socioeconomic and health-related factors of CHF readmissions by examining the relationship between 30-day readmissions of individuals with CHF and their payer status, race, ethnicity, primary language spoken, living arrangement, and comorbidities. This retrospective case-control study used secondary data from 450 CHF patients admitted to a not-for-profit Northern Virginia hospital from July 2014 to December 2017. Data were analyzed using χ 2 and logistic regression. Living arrangements and comorbid chronic renal failure (CRF) were statistically significant predictors of CHF readmissions; all other factors were nonsignificant. Patients who lived with family and those in assisted living facilities were less likely to be readmitted than those who lived alone (odds ratio [OR] = 0.2 and 0.5, respectively). Patients without CRF were less likely to be readmitted than those who had CRF (OR = 0.6). This study contributes data to inform community-based health programs tailored toward frequently readmitted individuals due to CHF exacerbation.


Assuntos
Insuficiência Cardíaca , Readmissão do Paciente , Humanos , Estudos Retrospectivos , Estudos de Casos e Controles , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapia , Fatores Socioeconômicos , Fatores de Risco
10.
Methods Mol Biol ; 2598: 123-140, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36355289

RESUMO

Extracellular vesicles (EVs) have the capacity for use in cartilage tissue engineering by stimulating tissue repair and microenvironmental reprogramming. This makes them ideal candidates for treating focal cartilage defects and cartilage degeneration in osteoarthritis (OA). Observational studies have reported beneficial biological effects of EVs, such as inhibition of inflammation, enhanced extracellular matrix deposition, and reduced cartilage degradation. Isolation of EVs derived from different source materials such as conditioned cell culture media or biofluids is essential to attribute observed biological effects to EVs as genuine effectors. This chapter presents a density- and a size-based method as well as a combination of both for isolation of EVs from conditioned cell culture media or biofluids. In addition, three methods for characterization of isolated EVs are suggested based on physical properties, protein profiling, and ultrastructural morphology.


Assuntos
Vesículas Extracelulares , Osteoartrite , Humanos , Engenharia Tecidual/métodos , Cartilagem/metabolismo , Osteoartrite/terapia , Osteoartrite/metabolismo , Vesículas Extracelulares/metabolismo , Matriz Extracelular/metabolismo , Meios de Cultivo Condicionados/metabolismo , Condrócitos/metabolismo
11.
Arch Gerontol Geriatr ; 104: 104799, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36070636

RESUMO

PURPOSE OF THE RESEARCH: Ageing entails a decrease in muscle mass and strength, known as sarcopenia, which also affects respiratory function. Physical exercise is an appropriate intervention to treat both conditions. This study aims to assess the efficacy of high-intensity resistance training (HIRT) on clinical parameters of respiratory function and health-related quality of life (QoL) in community-dwelling older women with sarcopenia. METHODS: Fifty-one sarcopenic community-dwelling women aged 70 years and older were randomized to either six months of HIRT (n = 24) or control (n = 27). At baseline and post-intervention, participants were assessed for skeletal-muscle sarcopenia; respiratory sarcopenia status; respiratory function: spirometry (FEV1, FVC, FEV1/FVC, and FEF25-75) and expiratory (MEP) and inspiratory (MIP) respiratory muscle strength parameters; and health-related QoL (EURO-QOL 5D-3 L). RESULTS: A group-by-time interaction effect for MEP (p = 0.044, È 2=0.108) was observed. CG showed a significant decrease in FEV1 (mean difference [MD] -0.12 L; 95% confidence interval [CI] -0.20, -0.05; p = 0.002); and FVC (MD -0.18 L; 95% CI -0.33, -0.03; p = 0.024) after six months, whereas the HIRT maintained respiratory function without change. Post-intervention, mean EQ-VAS increased in the HIRT and decreased in CG, resulting in a significant between-group difference (mean 73.0 standard deviation [SD] 16.99 vs 61.1 SD 18.2 points, respectively; p = 0.044). Respiratory sarcopenia status was reverted in the HIRT. CONCLUSIONS: HIRT increased muscle strength and halted age-related respiratory function decline in sarcopenic old women. A strength intervention could benefit health-related QoL and physical well-being. REGISTERED IN CLINICALTRIALS.GOV: NCT03834558.


Assuntos
Treinamento de Força , Sarcopenia , Feminino , Humanos , Idoso , Idoso de 80 Anos ou mais , Sarcopenia/terapia , Treinamento de Força/métodos , Qualidade de Vida , Força Muscular/fisiologia , Músculos Respiratórios
12.
J Subst Abuse Treat ; 144: 108920, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36334384

RESUMO

INTRODUCTION: We know very little about how the pandemic impacted outpatient alcohol use disorder (AUD) care and the role of telemedicine. METHODS: Using OptumLabs® Data Warehouse de-identified administrative claims, we identified AUD cohorts in 2018 (N = 23,204) and 2019 (N = 23,445) and examined outpatient visits the following year, focusing on week 12, corresponding to the March 2020 US COVID-19 emergency declaration, through week 52. Using multivariable logistic regression, we examined the association between patient demographic and clinical characteristics and receipt of any outpatient AUD visits in 2020 vs. 2019. RESULTS: In 2020, weekly AUD visit utilization decreased maximally at the pandemic start (week 12) by 22.5 % (2019: 3.8 %, 2020: 3.0 %, percentage point change [95 % CI] = -0.86[-1.19, -0.05]) but was similar to 2019 utilization by mid-April 2020 (week 16). Telemedicine accounted for 50.1 % of AUD visits by early July 2020 (week 27). Individual therapy returned to 2019 levels within 1 week (i.e., week 13) whereas group therapy did not consistently do so until mid-August 2020 (week 31). Further, individual therapy exceeded 2019 levels by as much as 50 % starting mid-October 2020. The study found no substantial differences in visits by patient demographic or clinical characteristics. CONCLUSIONS: Among patients with known AUD, initial outpatient care disruptions were relatively brief. However, substantial shifts occurred in care delivery-an embrace of telemedicine but also more pronounced, longer disruptions in group therapy vs. individual and an increase in individual therapy use. Further research needs to help us understand the implications of these findings for clinical outcomes.


Assuntos
Alcoolismo , COVID-19 , Telemedicina , Adulto , Estados Unidos , Humanos , Pandemias , Alcoolismo/epidemiologia , Alcoolismo/terapia , Estudos de Coortes
13.
Curr Opin Psychiatry ; 36(1): 67-74, 2023 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-36017562

RESUMO

PURPOSE OF REVIEW: Borderline personality disorder (BPD) is a severe and common psychiatric disorder and though evidence-based psychotherapies are effective, rates of treatment nonresponse are as high as 50%. Treatment studies may benefit from interdisciplinary approaches from neuroscience and genetics research that could generate novel insights into treatment mechanisms and tailoring interventions to the individual. RECENT FINDINGS: We provide a timely update to the small but growing body of literature investigating neurobiological and epigenetic changes and using biomarkers to predict outcomes from evidence-based psychotherapies for BPD. Using a rapid review methodology, we identified eight new studies, updating our earlier 2018 systematic review. Across all studies, neuroimaging ( n  = 18) and genetics studies ( n  = 4) provide data from 735 participants diagnosed with BPD (mean sample size across studies = 33.4, range 2-115). SUMMARY: We report further evidence for psychotherapy-related alterations of neural activation and connectivity in regions and networks relating to executive control, emotion regulation, and self/interpersonal functioning in BPD. Emerging evidence also shows epigenetic changes following treatment. Future large-scale multisite studies may help to delineate multilevel treatment targets to inform intervention design, selection, and monitoring for the individual patient via integration of knowledge generated through clinical, neuroscience, and genetics research.


Assuntos
Transtorno da Personalidade Borderline , Humanos , Transtorno da Personalidade Borderline/terapia , Transtorno da Personalidade Borderline/psicologia , Psicoterapia/métodos , Resultado do Tratamento , Neuroimagem , Biomarcadores
14.
Cancer Nurs ; 46(1): E21-E30, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-35583988

RESUMO

BACKGROUND: Although logotherapy has been shown to relieve other psychological symptoms of patients with cancer, no studies have specifically investigated the effect of logotherapy on anxiety about death and existential loneliness in these patients. OBJECTIVE: The aim of this study was to determine the effect of group logotherapy on anxiety about death and existential loneliness in patients with advanced cancer. METHODS: Sixty-three patients who were in the advanced stage of cancer were recruited from 2 hospital oncology services and were randomly assigned to either experimental (n = 31) or control group (n = 32). The intervention group received 10 weekly 2-hour group logotherapy. Templer's Death Anxiety Scale and ELQ were completed pre- and posttreatment. RESULTS: A 2 × 2 mixed analysis of variance was used to determine the effect of the treatment on each of the dependent variables. The analyses revealed that patients in the logotherapy group reported a significant decrease in anxiety about death and existential loneliness after (vs before) the treatment. No significant decreases were observed in the waitlist control group. CONCLUSIONS: These results have implications for treating death anxiety and feelings of existential loneliness among patients with advanced cancer. They suggest that group logotherapy is highly effective in reducing these existential concerns. Limitations and avenues for future research are discussed. IMPLICATIONS FOR PRACTICE: The study emphasizes that group logotherapy can be considered in oncology care programs by healthcare professionals and in educational curriculums and is suggested for use among caregivers and patients with advanced cancer.


Assuntos
Solidão , Neoplasias , Humanos , Solidão/psicologia , Logoterapia , Existencialismo/psicologia , Ansiedade/terapia , Ansiedade/psicologia , Neoplasias/complicações , Neoplasias/terapia , Neoplasias/psicologia
15.
J Atten Disord ; 27(2): 159-168, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36239415

RESUMO

BACKGROUND: During the COVID-19 pandemic, telehealth became widely utilized for healthcare, including psychological evaluations. However, whether telehealth has reduced or exacerbated healthcare disparities for children with Attention-Deficit/Hyperactivity Disorder (ADHD) remains unclear. METHODS: Data (race, ethnicity, age, insurance type, ADHD presentation, comorbidities, and distance to clinic) for youth with ADHD (Mage = 10.97, SDage = 3.42; 63.71% male; 51.62% White) were extracted from the medical record at an urban academic medical center. Three naturally occurring groups were compared: those evaluated in person prior to COVID-19 (n =780), in person during COVID-19 (n = 839), and via telehealth during COVID-19 (n = 638). RESULTS: Children seen via telehealth were significantly more likely to be older, White, have fewer comorbid conditions, and live farther from the clinic than those seen in person. CONCLUSIONS: The current study suggests that telehealth has not eliminated barriers to care for disadvantaged populations. Providers and institutions must take action to encourage telehealth use among these groups.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , COVID-19 , Telemedicina , Criança , Adolescente , Masculino , Humanos , Pré-Escolar , Feminino , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Transtorno do Deficit de Atenção com Hiperatividade/terapia , Pandemias , Disparidades em Assistência à Saúde
16.
Curr Opin Urol ; 33(1): 59-63, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36239402

RESUMO

PURPOSE OF REVIEW: Adrenal lesions are commonly discovered on abdominal imaging studies, whereas some patients with adrenal tumors present with symptoms of homonal excess. They are categorized as either hormone active or inactive and either as benign or malignant. This review is focused on the endocrine work up in patients with adrenal tumors. Knowledge of the use and limitations of hormonal assessment is essential for propper interpretation of the obtained test results. This article reviews which diagnostics are necessary to identify adrenal masses requiring treatment. RECENT FINDINGS: Delayed hormonal assessment is not uncommon and associated with delayed treatment. The endocrine work up is guided by data from prospective and retrospective observational studies. Adrenal tumors include a wide spectrum of diseases and as a principle, most patients require biochemical testing to select the appropriate treatment. SUMMARY: The most important factor for the outcome in the management of adrenal masses is, beside the exclusion of malignancy, a structured evaluation of the patients endocrine status.


Assuntos
Neoplasias das Glândulas Suprarrenais , Urologistas , Humanos , Estudos Retrospectivos , Estudos Prospectivos , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/terapia , Neoplasias das Glândulas Suprarrenais/patologia , Diagnóstico por Imagem
17.
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
18.
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
20.
Adv Wound Care (New Rochelle) ; 12(1): 15-27, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35196892

RESUMO

Significance: Lymphedema is a common, distressing and debilitating condition with various etiologies. Effective diagnosis, assessment, and management rely on evidence-based clinical practice guidelines ("guidelines"). This study aims to describe and compare international guidelines on lymphedema diagnosis, assessment, and management. Recent Advances: The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, and registered on the International Prospective Register of Systematic Reviews (PROSPERO). Systematic searches of electronic literature databases and the web were completed in December 2020 for lymphedema guidelines published in English since 2000. Quality was assessed using the Appraisal of Guidelines for Research and Evaluation (AGREE)-II reporting checklist. Synthesis took a narrative approach to compare guideline recommendations and associated levels of evidence. Critical Issues: This systematic review of 1,564 articles and 159 web pages yielded 14 guidelines. All guidelines were from high-income countries. Ten focused exclusively on lymphedema, and four on cancer. Most (n = 13) guidelines recommended an integrated medical, psychological assessment, and physical examination, with a limb volume measurement of >10% in the affected limb compared, confirming a lymphedema diagnosis. Recommended management involved Complex Decongestive Therapy (CDT) followed by self-management using skincare, self-lymphatic drainage massage, exercise, and compression. Future Directions: The underlying etiology of lymphedema appeared to make little difference to guideline recommendations regarding care. High-quality guidelines are available to guide lymphedema care. However, their suitability for low-resource settings is unclear.


Assuntos
Linfedema , Humanos , Linfedema/diagnóstico , Linfedema/etiologia , Linfedema/terapia , Drenagem Linfática Manual/efeitos adversos , Massagem/efeitos adversos , Exercício Físico , Higiene da Pele/efeitos adversos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...