Dog-Assisted Therapy vs Relaxation for Children and Adolescents with Fetal Alcohol Spectrum Disorder: A Randomized Controlled Study.

The rationale of this study was to evaluate the efficacy of Dog-assisted Therapy (DAT) in children and adolescents with Fetal Alcohol Spectrum Disorder (FASD). We conducted a randomized controlled trial in a cohort of 71 children and adolescents with FASD. Participants were randomly assigned either to DAT group (n = 38) or Relaxation Group (control group) (n = 33). Results revealed that participants who were assigned to the DAT group experienced significantly reduced externalizing symptoms (CBCL Externalizing Inattention: t (69) = 2.81, p = .007; d = 0.7); CBCL Opposition: t (69) = 2.54, p = .013; d = 0.6), reduced internalizing symptoms (CBCL Social problems: t (69) = 3.21, p = .002; d = 0.8) as well as improvements on social skills (SSIS-P Problem behavior: t (68) = 2.55, p = .013; d = 0.6), and quality of life (KidScreen Autonomy and Parents: t (51) = - 2.03, p = .047; d = 0.5) compared to the relaxation control group. The relaxation control group obtained significant differences between the pre- and post-treatment evaluation, diminishing withdraw symptoms (t (32) = 3.03, p = .005; d = 0.2). Results suggest that DAT and relaxation may be promising adjunctive treatments for children and adolescents with FASD.Clinical trial registration information: http://clinicaltrials.gov/ ; NCT04038164.

Dog-Assisted Therapy for Children and Adolescents With Fetal Alcohol Spectrum Disorders a Randomized Controlled Pilot Study.

OBJECTIVE: The rationale of this study was to evaluate the efficacy of dog-assisted therapy (DAT) combined with pharmacological treatment in children and adolescents with fetal alcohol spectrum disorder (FASD). METHOD: We conducted a randomized, rater-blinded, controlled pilot trial in a cohort of 33 children and adolescents with FASD. Participants were randomly assigned either to DAT group (n = 17) or Treatment as Usual (TAU control group) (n = 16). RESULTS: Of the initial 39 participants enrolled, 33 completed treatment. A mixed-effects model analysis revealed that participants who were assigned to the DAT group experienced significantly improvements on social skills (SSIS-P social skills: p = 0.02, d = 0.8), reductions on externalizing symptoms (CBCL externalizing: p = 0.03; d = 0.56), and lower scores on FASD severity (CGI-S clinician: p = 0.001, d = 0.5). CONCLUSION: DAT is a promising adjunctive treatment for children and adolescents with FASD. CLINICAL TRIAL REGISTRATION: Dog-assisted therapy for children and adolescents with fetal alcohol spectrum disorders: a randomized controlled pilot study; http://clinicaltrials.gov/, identifier NCT04038164.

Terapia Asistida con Perros en niños y adolescentes con Trastorno del Espectro Alcohólico Fetal / Dog-Assisted Therapy for children and adolescents with Fetal Alcohol Spectrum Disorders

OBJETIVO: El objetivo de este estudio fue evaluar la eficacia de la Terapia Asistida con Perros (TAP) en niños y adolescentes con Trastorno del Espectro Alcohólico Fetal (TEAF). MÉTODO: Realizamos un ensayo piloto aleatorizado y controlado, cegado por el evaluador, en una cohorte de 33 niños y adolescentes con TEAF. Los participantes fueron asignados aleatoriamente al grupo TAP (n=17) o al tratamiento habitual (n=16). RESULTADOS: De los 39 participantes iniciales inscritos, 33 completaron el tratamiento. Un análisis de modelo de efectos mixtos reveló que los participantes que fueron asignados al grupo TAP experimentaron mejoras significativas en habilidades sociales (SSIS-P Habilidades sociales: p = 0.02; d = 0.8), reducciones en los síntomas de externalización (CBCL Externalización p = 0.03; d = 0.56) y puntuaciones más bajas en la severidad del TEAF (CGI-S Clínico: p = 0.001; d = 0.5). CONCLUSIONES: La TAP parece ser un tratamiento complementario prometedor para niños y adolescentes con TEAF

OBJECTIVE: The rationale of this study was to evaluate the efficacy of Dog Assisted Therapy (DAT) in children and adolescents with Fetal Alcohol Spectrum Disorder (FASD). METHOD: We conducted a randomized, rater-blinded, controlled pilot trial in a cohort of 33 children and adolescents with FASD. Participants were randomly assigned either to DAT group (n=17) or Treatment as Usual (TAU control group) (n=16). RESULTS: Of the initial 39 participants enrolled, 33 completed treatment. A mixed-effects model analysis revealed that participants who were assigned to the DAT group experienced significantly improvements on social skills (SSIS-P Social Skills: p = 0.02, d=0.8), reductions on externalizing symptoms (CBCL Externalizing: p = 0.03; d=0.56), and lower scores on FASD severity (CGI-S Clinician: p = 0.001, d=0.5). CONCLUSIONS: DAT is a promising adjunctive treatment for children and adolescents with FASD

Diabetic Kidney Disease: A Syndrome Rather Than a Single Disease.

The term "diabetic kidney" has recently been proposed to encompass the various lesions, involving all kidney structures that characterize protean kidney damage in patients with diabetes. While glomerular diseases may follow the stepwise progression that was described several decades ago, the tenet that proteinuria identifies diabetic nephropathy is disputed today and should be limited to glomerular lesions. Improvements in glycemic control may have contributed to a decrease in the prevalence of glomerular lesions, initially described as hallmarks of diabetic nephropathy, and revealed other types of renal damage, mainly related to vasculature and interstitium, and these types usually present with little or no proteinuria. Whilst glomerular damage is the hallmark of microvascular lesions, ischemic nephropathies, renal infarction, and cholesterol emboli syndrome are the result of macrovascular involvement, and the presence of underlying renal damage sets the stage for acute infections and drug-induced kidney injuries. Impairment of the phagocytic response can cause severe and unusual forms of acute and chronic pyelonephritis. It is thus concluded that screening for albuminuria, which is useful for detecting "glomerular diabetic nephropathy", does not identify all potential nephropathies in diabetes patients. As diabetes is a risk factor for all forms of kidney disease, diagnosis in diabetic patients should include the same combination of biochemical, clinical, and imaging tests as employed in non-diabetic subjects, but with the specific consideration that chronic kidney disease (CKD) may develop more rapidly and severely in diabetic patients.