RESUMEN
Attention Deficit Hyperactivity Disorder (ADHD) is a common developmental disorder affecting 5-7% of adults and children. We surveyed the literature to examine ADHD through three pillars: developmental characteristics, symptomatology, and treatment strategies. Firstly, in terms of developmental characterstics, early life stress may increase the risk of developing ADHD symptoms according to animal models' research. Secondly, the current core symptoms of ADHD are comprised of inattention, hyperactivity, and impulsivity. However, the up-to-date literature indicates individuals with ADHD experience emotional and sensory dysregulation as well, which early-life stress may also increase the risk of. Finally, we discuss the therapeutic benefits of methylphenidate on both the current core ADHD symptoms and the sensory and emotional dysregulation found in those with ADHD. In summation, we surveyed the recent literature to analyze (i) the potential role of early-life stress in ADHD development, (ii) the involvement of emotional and sensory dysregulation in ADHD symptomatology and finally, (iii) the therapeutic intervention with methylphenidate, aiming to reduce the potential effect of early life stress in ADHD, and mainly emotional and sensory dysregulation. The apparent but currently less recognized additional symptoms of emotional and sensory dysregulation in ADHD call for further investigation of these possible causes and thus increasing treatments efficacy in individuals with ADHD.
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The demographic history of East-Central Europe after the Neolithic period remains poorly explored, despite this region being on the confluence of various ecological zones and cultural entities. Here, the descendants of societies associated with steppe pastoralists form Early Bronze Age were followed by Middle Bronze Age populations displaying unique characteristics. Particularly, the predominance of collective burials, the scale of which, was previously seen only in the Neolithic. The extent to which this re-emergence of older traditions is a result of genetic shift or social changes in the MBA is a subject of debate. Here by analysing 91 newly generated genomes from Bronze Age individuals from present Poland and Ukraine, we discovered that Middle Bronze Age populations were formed by an additional admixture event involving a population with relatively high proportions of genetic component associated with European hunter-gatherers and that their social structure was based on, primarily patrilocal, multigenerational kin-groups.
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Genoma Humano , Migración Humana , Humanos , Historia Antigua , Genoma Humano/genética , Europa (Continente) , Polonia , Cambio SocialRESUMEN
PURPOSE OF REVIEW: The purpose of this paper is to provide an overview of the state of the science of food and nutrition security among justice-impacted populations, identify who might be most at-risk and health consequences, and to highlight areas for continued research and policy implications. RECENT FINDINGS: This population is at-risk for experiencing food and nutrition insecurity due to high rates of unemployment, parental history of incarceration, housing instability, depressive symptoms, and social isolation, which result from involvement with the corrections system. Health consequences associated with food insecurity include depressive symptoms, self-reporting lower health status, and engaging in HIV-risk behaviors. The justice-impacted population has a disproportionately higher risk of chronic and infectious diseases compared to the general population. Compounding this with food and nutrition insecurity can exacerbate these outcomes and further contribute to poor health. Structural issues related to nutrition safety net programs and employment create barriers to healthy food access. More research related to food, employment, and corrections system policies are critical to improve the well-being of this population.
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Abastecimiento de Alimentos , Justicia Social , Inseguridad Alimentaria , Estado de Salud , Humanos , Estado NutricionalRESUMEN
This cross-sectional study examined whether the probation office setting was feasible to screen adults on probation for cardiometabolic risk factors, measure risk profiles, and estimate the prevalence of obesity, hypertension, hypercholesterolemia, and diabetes. During June and August 2019, screening included blood pressure, anthropometrics, total and high-density lipoprotein (HDL) cholesterol, and glucose. A survey included demographics, medical history, and current medication. The participation rate was 36% (N = 202). The screening identified 5% had hypercholesterolemia, 38% of men and 50% of women had low HDL cholesterol, 70% had overweight/obesity, 31% of men and 55% of women had elevated waist circumferences, and 26.7% had Stage 1 hypertension. Of individuals with a history of hypertension (n = 74), 77% had elevated blood pressure. Of those with a history of diabetes (n = 27), 22% had hyperglycemia, independent of whether they reported being prescribed medication. The screening identified 11% with Stage 2 hypertension, 27% with Stage 1 hypertension, 22% with elevated blood pressure, and 5% with hyperglycemia. Our findings suggest it is feasible to identify individuals at high risk for cardiometabolic disorders during routine probation office visits. These data can then be used to provide referrals for treatment to improve long-term health outcomes.
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Enfermedades Cardiovasculares , Diabetes Mellitus , Hipercolesterolemia , Hiperglucemia , Hipertensión , Adulto , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , HDL-Colesterol/uso terapéutico , Estudios Transversales , Estudios de Factibilidad , Femenino , Humanos , Hipercolesterolemia/epidemiología , Hipertensión/epidemiología , Masculino , Obesidad/epidemiología , Prevalencia , Factores de Riesgo , Circunferencia de la CinturaRESUMEN
Time spent in jail can provide opportunities to deliver comprehensive medical care, including screening and treatment for HIV; however, engagement in HIV care postrelease is often fragmented. Identifying ways to improve the transition of care from jail to community for people with HIV (PWH) may help with engagement in HIV care postrelease. We evaluated the current HIV care transition processes of one jail in Massachusetts and identified change ideas to facilitate improving the transition of care from the jail to the community for PWH. We conducted qualitative interviews in 2018-2019 with incarcerated men with HIV (n = 17), jail staff (n = 7), and community providers (n = 6) to understand the processes of HIV care prerelease from the jail and engagement in care on release. Data from these interviews and quality improvement tools were used to identify ways to improve the release process for PWH, such as using a release planning checklist, to help ensure that a 30-day supply of HIV medication and an appointment with a community provider within 30 days of release were provided. We identified communication process inefficiencies related to knowing release dates between the HIV care team and case managers that prevented providing HIV medications on release. We worked with jail administrators to find ways to improve the prerelease planning process, which is vital to the continuity of successful HIV care. The use of quality improvement methods generated a list of testable change ideas to improve the release planning process to better align with the Centers for Disease Control and Prevention guidelines, which has implications for PWH and public health.
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Infecciones por VIH , Prisioneros , Citas y Horarios , Infecciones por VIH/tratamiento farmacológico , Humanos , Cárceles Locales , Masculino , Transferencia de Pacientes , Prisiones , Salud PúblicaRESUMEN
INTRODUCTION: The quality of tissue acquisition during endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a major determinant of the diagnostic yield of the procedure. In the tissue button (TB) technique, the retrieved cellular specimen is fixed in ethanol and subsequently scraped from slide using surgical blade into formaldehyde and processed like ordinary tissue biopsy thus potentially increasing its diagnostic value. OBJECTIVES: To retrospectively evaluate the diagnostic yield of a TB technique in patients undergoing EBUS-TBNA for various malignant and benign conditions. METHODS: The diagnostic yield of specimen obtained by two methods (TB and traditional cell-block technique) performed during the same procedure are outlined in 46 patients who underwent EBUS-TBNA (median age = 65, range 19-85 years). RESULTS: Overall, in both malignant and benign conditions, TB resulted in clear diagnostic material in 43/46 (93.4%) patients. Specifically, TB provided clear histological diagnosis of malignancy (either primary lung cancer or metastases from extra-thoracic cancer) in 30/46 (65.2%) patients and granulomatous inflammation in 11/46 (23.9%) of patients. Only in two patients TB did not provide diagnostic material. CONCLUSIONS: The newly introduced TB technique provides valuable histological diagnostic material during EBUS-TBNA both malignant and benign conditions. Given its simplicity and its high diagnostic yield, TB should be considered to be used as one of the preferred specimen acquisition modalities during EBUS-TBNA specimen processing. Direct comparison to alternative tissue processing techniques during EBUS-TBNA should be explored in further randomized prospective studies.
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Broncoscopía/métodos , Biopsia por Aspiración con Aguja Fina Guiada por Ultrasonido Endoscópico/métodos , Biopsia Guiada por Imagen/instrumentación , Pulmón/patología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Neoplasias Pulmonares/patología , Ganglios Linfáticos/patología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Sarcoidosis Pulmonar/patologíaRESUMEN
In the United States, more than ten million women use contraceptive hormones. Ethinyl estradiol and levonorgestrel have been mainstay contraceptive hormones for the last four decades. Surprisingly, there is scant information regarding their action on the central nervous system and behavior. Intact female rats received three weeks of subcutaneous ethinyl estradiol (10 or 30µg/rat/day), levonorgestrel (20 or 60µg/rat/day), a combination of both (10/20µg/rat/day and 30/60µg/rat/day), or vehicle. Subsequently, the rats were tested in three versions of the novel object recognition test to assess learning and memory, and a battery of tests for anxiety-like behavior. Serum estradiol and ovarian weights were measured. All treatment groups exhibited low endogenous 17ß-estradiol levels at the time of testing. Dose-dependent effects of drug treatment manifested in both cognitive and anxiety tests. All low dose drugs decreased anxiety-like behavior and impaired performance on novel object recognition. In contrast, the high dose ethinyl estradiol increased anxiety-like behavior and improved performance in cognitive testing. In the cell molecular analyses, low doses of all drugs induced a decrease in tyrosine hydroxylase mRNA and protein in the locus coeruleus. At the same time, low doses of ethinyl estradiol and ethinyl estradiol/levonorgestrel increased galanin protein in this structure. Consistent with the findings above, the low dose treatments of ethinyl estradiol and combination ethinyl estradiol/levonorgestrel reduced brain-derived neurotrophic factor mRNA in the hippocampus. These effects of ethinyl estradiol 10µg alone and in combination with levonorgestrel 20µg suggest a diminution of norepinephrine input into the hippocampus resulting in a decline in learning and memory.