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

Identification of male cardiomyocytes of extracardiac origin in the hearts of women with male progeny: male fetal cell microchimerism of the heart.

BACKGROUND: Fetal progenitor cells may cross the placenta during pregnancy, persist for decades in the maternal bloodstream, and find a microenvironment conducive to colonization in a variety of maternal solid organs. Whether extracardiac fetal progenitors are present in the heart of women with male issue is unknown. METHODS: The hearts from 2 non-pregnant women who had given birth to 2 and 3 male children, respectively, were studied. Myocardial specimens from 2 men and 2 women (without history of pregnancies) were used as controls. Real time polymerase chain reaction was performed to amplify the SRY gene located at the Y chromosome. Fluorescence in situ hybridization (FISH) with probes specific for X and Y chromosomes was combined with alpha-actin immunohistochemistry to identify cardiac muscle cells. Histocompatibility studies were conducted in both patients and their male relatives. RESULTS: The SRY gene was amplified in the myocardium of both patients. FISH analysis showed clear evidence of male cells with the typical cardiomyocyte phenotype within the myocardium. X- and Y-chromosome bodies in the nuclei were found in 0.25% and 0.20% of cells, respectively. Increased human leukocyte antigen compatibility was observed between patients and their sons. CONCLUSIONS: This study identified male cardiomyocytes of extracardiac origin, presumably fetal, in the hearts of 2 women with male progeny. Fetal progenitor cells may colonize the heart and under appropriate microenvironmental stimuli, differentiate into cardiomyocytes.

Host cell-derived cardiomyocytes in sex-mismatch cardiac allografts.

BACKGROUND: Mesenchymal precursor cells are able to respond to tissue signals and differentiate into a phenotype characteristic of mature cells of that tissue. We sought to investigate whether adult human cardiomyocytes can be derived from recipient precursor cells in sex-mismatched cardiac allografts. METHODS: We studied four male patients who received hearts from female donors, and four female patients who received an allograft from a male donor. Four sex-matched transplant patients, two of each sex served as controls. Combined fluorescence in situ hybridization with probes specific for X- and Y-chromosomes and immunohistochemistry with alpha-actin was used to identify cardiac muscle cells 4 and 12 months after transplantation. Slides were examined with a fluorescence microscope to detect the presence of male cells with one X and one Y signal in the nucleus, and female cells containing two X signals. RESULTS: Mature cardiomyocytes from the host (1-2%) were found in five endomyocardial biopsy specimens at 4 months, and in three specimens at 12 months. In addition, recipient cells negative for cytoplasmic alpha-actin were also identified (1-21% per slide). The number of infiltrating recipient cells was not associated with the degree of rejection of the sample or with the number of prior rejection episodes. Echocardiographic evaluation showed no improvement in cardiac performance in hearts from patients with more than 10% chimeric recipient cells. CONCLUSIONS: Our data confirm the existence of mature cardiomyocytes derived from host cells, likely mesenchymal precursors, in the adult cardiac allograft in vivo.