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BACKGROUND AND AIM: The objective of the present study was to investigate the relationships among pro-brain-derived neurotrophic factor (BDNF) and mature BDNF and immune functioning during aloe polymannose multinutrient complex (APMC) treatment in persons with moderate to severe Alzheimer's dementia (AD). MATERIALS AND METHODS: An open-label trial of 12 months was used to execute the study. Thirty-four adults with AD were enrolled and consumed four teaspoons/day of APMC for 12 months. Subjects were assessed at baseline and 12 months follow-up for proBDNF and BDNF and cytokines, growth factors, T-cell and B-cell subsets, and complete blood count to measure immune functioning. All biomarkers were intercorrelated. RESULTS: Several relationships were identified between proBDNF, BDNF, and BDNF/proBDNF ratio and immune function at 12 months, particularly BDNF with vascular endothelial growth factor (VEGF) (r=0.55, P=0.03), epidermal growth factor (EGF) (r=0.74, P=0.001), and CD95+CD3+ (%) (r=-0.64, P=0.03) and proBDNF with VEGF (r=0.64, P=0.02), EGF (r=0.86, P<0.001), and CD16+56+ (%) (r=-0.78, P<0.01). Other correlations were noted for various immune function variables with BDNF, proBDNF, and/or BDNF/proBDNF ratio at baseline and 12 months. Dichotomizing subjects on BDNF above and below 5000 pg/mL revealed additional relationships with platelets and neutrophils. CONCLUSIONS: The associations between BDNF and proBDNF and various immune markers, such as VEGF, EGF, and CD95+CD3+ ratio, provide insight into the link between neurological function and the immune system. These relationships were even stronger in response to APMC treatment, which lends support to previous findings showing improved immune function after dietary supplementation. RELEVANCE FOR PATIENTS: AD patients have conventional treatment options with limited efficacy for counteracting the deleterious effects of the disease on neurological function. The link between neurological and immune function has been understudied in this population. Overall, our results showed a significant beneficial relationship between immune and neurological function, particularly in response to 12 months of treatment with an all-natural polysaccharide-based dietary supplement that is a known immunomodulator. Thus, the use of this dietary supplement may benefit these patients by simultaneously improving immune and neurological function.
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Adolescent alcohol use demonstrates distinct developmental trajectories with dissimilar times of onset and trajectories. Given the importance of brain-derived neurotrophic factor (mature BDNF) in this development stage, the current study investigated its relationship with alcohol use. It also extends the literature by assessing the role of its precursor (pro-BDNF). Therefore, over the span of 5 years, we enrolled and followed participants to define age-related changes in BDNF levels in healthy adolescents. Then, the onset and frequency of alcohol use from ages 11 to 18 were collected to determine how the relationship between alcohol, pro-BDNF, and m-BDNF unfolds over time. With respect to development, analyses demonstrated that BDNF concentration slowly increases throughout adolescence. However, despite having similar basal BDNF levels, compared to controls, adolescents that started drinking before 15 years of age always exhibited lower BDNF levels. They also had a significant decrease in pro-BDNF levels. On the other hand, levels of mature BDNF steadily increased (974.896 ± 275 pg/ml) in those starting alcohol use after the age of 15. Similar to the younger users, a significant drop in pro-BDNF levels was observed over the course of the study. Our results suggested that both pathways may participate in the complex processes of alcohol dependence. The findings highlight the relevance of assessing alcohol-associated changes across the different phases of this vulnerable developmental period. This is the first study evidencing that m-BDNF changes associated with drinking behaviors differed between young and older adolescents. It is also the first article, documenting that drinking during adolescence leads to long-term decreases in pro-BDNF. These results have important implications for policies and programs targeting alcohol use disorders.
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Desarrollo del Adolescente , Factor Neurotrófico Derivado del Encéfalo/sangre , Precursores de Proteínas/sangre , Consumo de Alcohol en Menores , Adolescente , Femenino , Humanos , Estudios Longitudinales , MasculinoRESUMEN
Background. Disparities in sleep disturbances have been described in adults; nevertheless, among adolescents, data have yielded conflicting results. Therefore, analyses of our cohort study of 500 urban, normally developed Hispanic adolescents (10-18 years), aim to determine if rates of sleep debt differ between: (a) male and female adolescents, (b) US-born Hispanics and first-generation immigrant ethnic counterparts, and (c) specific activities that these teens trade for sleep. Participants' weekday and weekend sleep patterns, along with the reasons for sleeping less than the recommended hours were recorded. Standardized surveys were used to gather information regarding sociodemographics, migration, acculturation, and medical history. Using the criteria set forth by the National Sleep Foundation, analyses indicated that sleep deprivation is a pervasive problem, with 75% in the preadolescents and 45% of the late adolescents exhibiting sleep problems. Females slept on average at least one hour less per day than their male counterparts (7 vs. 8 hours). The sleep problems were rooted in several overlapping causes, including use of technology, video games, studying, and employment. Nevertheless, reasons for sleep loss differed by gender and by immigrant status. Multivariable adjusted logistic regression analyses showed that females, US-born teens, and preadolescents had higher odds of being sleep deprived. Pediatricians and sleep experts should be aware of gender-specific causes and responses of sleep problems. Cultural ecological frameworks need to be considered, and clearly indicate that findings may not generalize to youth from other cultural backgrounds.
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BACKGROUND: Heavy alcohol use is prevalent among men who have sex with men (MSM) living with HIV and is associated with reduced antiretroviral therapy adherence, reduced HIV viral suppression, and reduced survival. We recently found that compared to HIV treatment as usual, three sessions of in-person motivational interviewing (MI) substantially reduced drinking in MSM with HIV. In an effort to enhance the effectiveness and efficiency of this intervention, the present study will test whether MI is more effective than brief intervention when delivered by videoconferencing, whether interactive text messaging (ITM) can enhance the effects of alcohol intervention, and whether extended duration of intervention is more effective than brief duration. METHODS: Using a 2â¯×â¯2â¯×â¯2 factorial design, we will randomly assign 224 heavy-drinking MSM with HIV to: MI or brief intervention (BI); ITM or no ITM; Standard or Extended intervention (EI). All participants will receive intervention immediately after baseline assessment via videoconferencing and at 1-month post baseline via telephone. Participants randomized to EI will receive additional intervention sessions at 3, 6, and 9 months. Participants randomized to ITM will receive daily interactive texts about alcohol use for 1 month, with those randomized to EI receiving weekly interactive texts through 9 months. Alcohol and HIV-related outcomes will be assessed at 6 and 12 months post baseline. CONCLUSION: By testing the combinations of interventions that can most effectively reduce alcohol use among MSM with HIV, this study will set the stage for wider-scale implementation of an optimized intervention combination.
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BACKGROUND: Alcohol consumption is associated with poor health outcomes in women living with HIV (WLWH), but whether medication can help to reduce drinking in non-treatment-seeking women or whether reduction in drinking improves HIV outcomes is unclear. We conducted a randomized clinical trial (RCT) of daily oral naltrexone (50 mg) versus placebo in WLWH who met criteria for current unhealthy alcohol use. METHODS: WLWH with current unhealthy alcohol use (>7 drinks/wk or >3 drinks/occasion) were randomly assigned to daily oral naltrexone 50 mg (n = 96) or placebo (n = 98) for 4 months. Drinking outcomes, including the proportion of women who reduced (Asunto(s)
Consumo de Bebidas Alcohólicas/tratamiento farmacológico
, Trastornos Relacionados con Alcohol/tratamiento farmacológico
, Naltrexona/uso terapéutico
, Disuasivos de Alcohol/uso terapéutico
, Trastornos Relacionados con Alcohol/complicaciones
, Antirretrovirales/uso terapéutico
, Recuento de Linfocito CD4/estadística & datos numéricos
, Femenino
, Infecciones por VIH/complicaciones
, Infecciones por VIH/tratamiento farmacológico
, Humanos
, Persona de Mediana Edad
, Resultado del Tratamiento
, Carga Viral/estadística & datos numéricos
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BACKGROUND: With increases in marijuana use and legalization efforts, it is imperative to establish its impact on the developing brain. Therefore, we investigated whether exposure to marijuana alters brain derived neurotropic-factor (BDNF), given its critical role in brain development and plasticity. We then examined whether onset age of cannabis use was associated with more severe changes. A single site, cohort study following 500 urban healthy American adolescents. Changes in plasma m-BDNF levels were longitudinally assessed, and a multi-method approach was implemented to ascertain marijuana use. Multivariate and general linear model (GLM) regression modeling were utilized to test the main hypothesis, controlling for confounders. RESULTS: Group-based trajectory modeling identified four distinct groups, characterized by naive (60% control), starters (14%), chronic users (20%), and experimenting/quitters (6%). Compared to controls, those initiating marijuana use had similar pre-existent m-BDNF (1939.2 ± 221 vs. 2640.7 ± 1309 ng/ml, p=0.4) After adjusting for confounding factors, GLM analyses revealed that, compared to controls, younger adolescents increased BDNF levels when experimenting and during moderate marijuana use. Older adolescents had a steeper increase in endogenous BDNF levels, particularly when escalating use. Multivariate analyses confirmed marijuana use as a predictor of m-BDNF (p = 0.001). CONCLUSIONS: This is the first study demonstrating BDNF alterations were not a precondition. Rather, BDNF alteration was secondary to marijuana use, serving as cautionary evidence of marijuana's deleterious effects. Findings suggest that when marijuana use escalates, the BDNF pathway becomes more deregulated. Analyses confirm that age of marijuana use onset influences the magnitude of these changes.
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BACKGROUND AND AIM: The objective of the present study was to investigate the effect of an aloe polymannose multinutrient complex (APMC) on pro brain-derived neurotrophic factor (BDNF) and mature BDNF in persons with moderate to severe Alzheimer's dementia. METHODS: A 12-month open-label trial was utilized to evaluate the effect of the APMC on proBDNF and BDNF and their relationship to cognitive functioning. Thirty-four adults were enrolled and consumed 4 teaspoons/day of APMC for 12 months. Subjects were assessed at baseline and twelve months follow-up for proBDNF and BDNF and with a neuropsychological battery to measure cognitive functioning. Cognitive functioning was correlated with proBDNF and BDNF. RESULTS: Few adverse effects were reported. While proBDNF (baseline M = 6,108.9, SD = 854.9 and 12 months M = 5,799.2, SD = 573.4; p = 0.57) and BDNF (baseline M = 5,673.8, SD = 3,342.3 and 12 months M = 6,312.9, SD = 2,830.9; p = 0.29) did not significantly change, the correlations between the ADAS-cog total score and BDNF (r = -0.53, p = 0.04) and BDNF/proBDNF ratio (r = -0.58, p = 0.05) became statistically significant after 12 months of dietary supplementation. Other correlations were noted for various cognitive functioning assessments and BDNF and/or BDNF/proBDNF ratio at both baseline and 12 months. CONCLUSIONS: These findings suggest that the relationship between cognitive functioning and BDNF and BDNF/proBDNF ratio improved in response to consumption of a dietary supplement in persons with Alzheimer's dementia, which is consistent with our previous findings on cognitive functioning. RELEVANCE FOR PATIENTS: Overall, our results showed modest improvements in clinical outcomes for a disease that otherwise has no standard conventional approach to treatment with proven efficacy.
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To determine the relationships among body mass index (BMI), and HIV-associated neurocognitive impairment and the potential mediating effects of inflammatory cytokines. Among the HIV-infected individuals (N = 90) included in this study, obesity was associated with slower processing speed (ß = -.229, standard error (SE) = 2.15, p = .033), compared to participants with a normal BMI, after controlling for psychosocial and HIV clinical factors. Serum concentrations of the interleukin-16 (IL-16) cytokine were significantly associated with slowed processing speed (ß = -.235, SE = 1.62, p = .033) but did not mediate the relationship between obesity and processing speed These findings suggest that obesity may contribute to cognitive processing speed deficits in HIV-infected adults. Elevated concentrations of IL-16 are also associated with slowing, though the results suggest that obesity and IL-16 may exert independent effects.
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Biomarcadores/sangre , Índice de Masa Corporal , Trastornos del Conocimiento , Infecciones por VIH/psicología , Interleucinas/sangre , Adulto , Citocinas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Obesidad/psicologíaRESUMEN
BACKGROUND: Although the deleterious effects of separation during early childhood have been extensively studied, little is known regarding other stress-sensitive periods in development, such as adolescence. Also unknown are the biological mechanisms explaining its deleterious effects. This study was carried out to determine how different types of separation can impact neurotrophic factors during adolescence. METHODS: A community sample of 450 Hispanic adolescents was queried in 3 separate visits about regarding four indicators of stress exposure: migration, low closeness to parents, divorce, and growing up with individuals other than their biological parents. Chronological age at the time of exposure to the stressor were documented. BDNF and Pro-BDNF levels were obtained at three time points during the length of the study. RESULTS: The expression of pro-BDNF and m-BDNF was altered by separation, both divorce and death. Of concern, near half of the sample reported their parents to be divorce as a result the majority had mothers that work full time. Exposure to recent life events such as a parent divorce resulted in a time-point dependent, differential down-regulation of m-BDNF levels. Parent-child conflict positively related to BDNF. Specifically, BDNF was affected only in those the father/male adolescent relationship. CONCLUSION: Our data confirmed that separation triggers alterations in BDNF, even after the growth spurt of the brain during early childhood. The important implication of this study is the persistent abnormal levels of BDNF. The prolonged alteration is of concern when considering that BDNF plays a critical role in the pruning process occurring during adolescence. Additional studies are needed to assess whether these alterations can lead to neuropsychological disruptions.
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INTRODUCTION: Hispanic adolescents domiciling in Florida rank second in the U.S. with respect to HIV/AIDS incidence and prevalence. Extending studies showing that risky sexual behavior is associated with limited access to information, this project surveyed knowledge about HIV etiology, prevention and treatment. METHODS: The sample consisted of 400 Hispanic youth between 11-18 years of age living in Miami, Florida. The sample is enrolled in an ongoing project Role of Brain Derived Neurotrophic Factor in Decision Making (ROBIM). The HIV Knowledge Questionnaire (HIV-KQ-18), an 18 item self-administered questionnaire was used to measure HIV knowledge, particularly transmission and prevention. RESULTS: Less than 10% of the sample had comprehensive knowledge about HIV/AIDS. Approximately 25% incorrectly answered all of the questions. Questions pertaining to transmission were incorrectly answered by more than half of the sample. The most frequent topics reflecting absence of knowledge are related to high-risk sexual behaviors (sex during the menses) and infection prevention methods (e.g. condoms). A majority of youth believed incorrectly that HIV could be cured (61%), an effective vaccine is available (61%), and antibiotics protect against HIV infection (76%). School (28%) and parents (26%) were the most frequent sources of knowledge about HIV/AIDS. However, youth receiving information from parents had significantly higher knowledge scores than peers receiving education in school (7.4 ± 4.15 vs. 6.1 ± 4.5 scores, p = 0.037). Yet, 68% of the sample had never discussed condom use with their parents. CONCLUSIONS: These findings indicate Hispanic youths, although at very high risk, are poorly informed about prevention of HIV/AIDS. Moreover, the most frequent source of information, namely schools, inculcates less knowledge than parents. Lastly, youths who discuss sex with parents do not typically dialog about condoms, the most readily available protection from HIV/AIDS. These findings identify gaps that need to be addressed for lowering the high rate of HIV infection in Hispanic youths.
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Metabolic perturbations associated with HIV and antiretroviral therapies are widespread. Unfortunately, research has predominantly focused in cardiometabolic problems, neglecting other important areas. In fact, the immune-calcium-skeletal interface has been understudied despite its potential relevance in people living with HIV (PLWH). Using a case-control methodology, 200 PLWH receiving medical care were enrolled and stratified according to hazardous vs. non-hazardous alcohol intake (HAU vs. non-HAU) and calcium (Ca) levels by analyzing baseline data. The group was chosen to represent relatively "pure" HAU with minimal drug use and no psychiatric diagnoses. With these narrow parameters in place, we found evidence that HAU significantly increases TNF-α levels compared to Non-HAU (2.8 ± 0.6 vs. 1.9 ± 0.3 pg/ml, p = 0.05) and decreases blood Ca levels (9 ± 0.6 vs. 9.4 ± 0.5, p = 0.03). Our analyses also suggest that chronic inflammation, as indicated by increased TNF-α levels, is associated with hypocalcemia (hypoCa <8.6). Despite the limited prevalence of hypoCa, these findings are clinically significant given that hypoCA PLWH exhibited decreased CD4 (253 ± 224 vs. 417.7 ± 281, p = 0.02), B cells (147 ± 58 vs. 248 ± 151, p = 0.03) and NK cells (146.8 ± 90 vs. 229 ± 148, p = 0.008) and elevated CD8 (902.5 ± 438 vs. 699 ± 510, p = 0.09) compared to those with normal calcium. Furthermore, calcium effects on viral load were also evident with hypoCA exhibiting the highest loads (140,187 ± 111 vs. 35,622 ± 7770 HIV copies, p = 0.01). Multivariate analyses confirmed the significance of hypoCa in predicting viroimmune parameters. This paper provides the first evidence that hypoCa accounts for some of the variation in viroimmune measures in HAART recipients and suggests that hypoCa may be mediating alcohol's deleterious effects.
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Consumo de Bebidas Alcohólicas/inmunología , Terapia Antirretroviral Altamente Activa/efectos adversos , Hipocalcemia/inmunología , Hipocalcemia/virología , Inmunidad Celular/inmunología , Carga Viral/inmunología , Adulto , Consumo de Bebidas Alcohólicas/efectos adversos , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/inmunología , Infecciones por VIH/virología , Humanos , Hipocalcemia/inducido químicamente , Inmunidad Celular/efectos de los fármacos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Among severely mentally ill (SMI) substance abusers, HIV rates are elevated and HIV risk reduction interventions have been shown to be less effective. An enhanced cognitive behavioral HIV risk reduction intervention (E-CB) for SMI was compared to a health promotion condition (HPC) in 222 psychiatric outpatients at 6 months postintervention. Compared to females, males in the E-CB improved on intention to practice safer sex and in condom use skills and in unprotected vaginal sex, but did not differ in HIV knowledge, perceived susceptibility, anxiety, condom attitudes, safer sex self-efficacy, unprotected vaginal sex acts, or sex partners. Across intervention groups, there were improvements in all areas except self-efficacy and number of partners. Risk reduction among SMI may be facilitated by increasing awareness of health related behaviors and HIV-targeted content. However, meaningful changes in critical risk reduction skills and intentions may require a more focused intervention and may vary by gender.
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Síndrome de Inmunodeficiencia Adquirida/psicología , Cognición , Promoción de la Salud/métodos , Trastornos Mentales/psicología , Conducta de Reducción del Riesgo , Conducta Sexual/psicología , Trastornos Relacionados con Sustancias/psicología , Síndrome de Inmunodeficiencia Adquirida/epidemiología , Síndrome de Inmunodeficiencia Adquirida/prevención & control , Adulto , Condones , Femenino , Florida , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Trastornos Mentales/epidemiología , Trastornos Mentales/terapia , Evaluación de Programas y Proyectos de Salud , Distribución por Sexo , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/terapiaRESUMEN
AIMS: Chronic inflammation has become increasingly recognized as a health threat for people living with HIV, given its associations with multiple diseases. Accordingly, the scientific community has prioritized the need to identify mechanisms triggering inflammation. PARTICIPANTS METHODS: A clinic-based case-control study was designed to elucidate the plausible effects of alcohol use on IL-6. Peripheral blood mononuclear cells for measuring IL-6 culture supernatant and plasma for HIV assessments were collected from 59 hazardous alcohol users and 66 nonhazardous alcohol users, who were matched according to their age, gender and US CDC HIV severity status. RESULTS: Stimulated peripheral blood mononuclear cells produced significantly higher amounts of IL-6 in hazardous alcohol users compared with nonhazardous alcohol users. However, racial status and receiving HAART significantly moderated this effect. Notably, in both HAART and non-HAART scenarios, IL-6 levels were associated with CD4 counts and viral burden. A distinctive IL-6 production pattern across racial/ethnic groups was also evident and showed that, when prescribed HAART, Hispanic hazardous alcohol users have a particularly high risk of morbidity compared with their Caucasian and African-American counterparts. After adjusting for confounders (e.g., sociodemographics and HIV disease status), regression analyses confirmed that chronic inflammation, as indicated by IL-6 levels (log), is associated with alcohol use, race/ethnicity and thrombocytopenia, and tended to be related to concurrent smoking. CONCLUSION: Our data confirm that, despite HAART, people living with HIV still have a persistent inflammatory response that, in our study, was associated with chronic hazardous alcohol use. The data also highlight racial/ethnic disparities in IL-6 that justify further investigations.
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Our objective is to review and summarize relevant aspects of the literature regarding human papillomavirus (HPV), the most common sexually transmitted infection in the United States, and to compare how the trajectory of HPV may differ in persons who are and who are not co-infected with HIV. This comparison is particularly important because the literature on HPV has been largely based on individuals who are not co-infected with HIV. Also, HPV findings may differ in HIV-uninfected individuals versus HIV-infected individuals. In addition, many reviews ignore gender differences, although in HIV-uninfected individuals, anal cancers are up to 4 times more prevalent in women than men. Clinical decision making may be problematic if such critical factors as HIV status and gender are neglected. Therefore, we will review existing information on how HIV status and gender may affect the manifestation of HPV, particularly focusing on epidemiology, screening, and treatment issues.
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Neoplasias del Ano/prevención & control , Infecciones por VIH/complicaciones , Factores Sexuales , Alphapapillomavirus/aislamiento & purificación , Neoplasias del Ano/complicaciones , Neoplasias del Ano/virología , Femenino , Vacuna Tetravalente Recombinante contra el Virus del Papiloma Humano Tipos 6, 11 , 16, 18 , Humanos , Masculino , Tamizaje Masivo , Infecciones por Papillomavirus/complicaciones , Infecciones por Papillomavirus/transmisión , Vacunas contra Papillomavirus/administración & dosificación , Factores de RiesgoRESUMEN
We analyzed the role of cholesterol as a potential mediator of alcohol-increased risk of respiratory infections that required hospitalization in People Living with HIV (PLWH). Using a longitudinal clinic-based design, 346 PLWH were consecutively admitted and followed at Jackson Memorial Medical Center(enrolled in the study). Following national guidelines, PLWH were stratified according to cholesterol levels: <150 mg/dl (Hypocholesterolemia= HypoCHL), 151-200, and >200 mg/dl Hypercholesterolemia =HyperCHL), and compared on the basis of clinical outcomes, lymphocyte phenotypes and behavioral risks. Analyses indicated that compared to HyperCHL participants, HypoCHL subjects were more likely to be hospitalized, particularly for lower respiratory tract infections (LRTI). Excessive admissions were associated with more deviant lymphocyte profiles, particularly limited NK cells. In logistic regression analyses, smoking (OR=1.5), HypoCHL (OR=7.7), and alcohol (OR=1.2) were predictors of LRTI. These findings warrant further investigation of the potential use of HypoCHL as a risk marker, and the cost-effectiveness of switching prevention gears towards HypoCHL, alcohol and tobacco in PLWH.
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BACKGROUND: In vitro studies suggest that reducing cholesterol inhibits HIV replication. However, this effect may not hold in vivo, where other factors, such as cholesterol's immunomodulatory properties, may interact. METHODS: Fasting blood samples were obtained on 165 people living with HIV at baseline and after 24 weeks on highly active antiretroviral therapy (HAART). Participants were classified as hypocholesterolemic (HypoCHL; <150 mg/dl) or non-HypoCHL (>150 mg/dl) and were compared on viro-immune outcomes. RESULTS: At baseline, participants with HypoCHL (40%) exhibited lower CD4 (197 +/- 181 vs. 295 +/- 191 cells/mm3, p = 0.02) and CD8 (823 +/- 448 vs. 1194 +/- 598 cells/mm3, p = 0.001) counts and were more likely to have detectable viral loads (OR = 3.5, p = 0.01) than non-HypoCHL controls. After HAART, participants with HypoCHL were twice as likely to experience a virological failure >400 copies (95% CI 1-2.6, p = 0.05) and to exhibit <200 CD4 (95% CI 1.03-2.9, p = 0.04) compared with non-HypoCHL. Low thymic output was related to poorer CD4 cell response in HypoCHL subjects. Analyses suggest a dose-response relationship with every increase of 50 mg/dl in cholesterol related to a parallel rise of 50 CD4 cells. CONCLUSIONS: The study implicates, for the first time, HypoCHL with impaired HAART effectiveness, including limited CD4 repletion by the thymus and suboptimal viral clearance.
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Terapia Antirretroviral Altamente Activa , Colesterol/sangre , Infecciones por VIH/tratamiento farmacológico , Adolescente , Adulto , Linfocitos T CD4-Positivos/inmunología , Femenino , Infecciones por VIH/sangre , Infecciones por VIH/inmunología , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto JovenRESUMEN
Se estudió el papel de labilidad emocional y afectividad negativa y de regulación emocional en la relación entre ansiedad rasgo materna y problemas de atención, sociales y sintomatología externalizante e internalizante de 275 niños de entre 6 y 11 años. Los resultados indicaron un efecto moderador directo de regulación emocional sobre la relación entre ansiedad materna y conductas externalizantes y que labilidad y afectividad negativa fue el mediador de la relación entre ansiedad materna y problemas de atención, sociales y quejas somáticas. Los vínculos de ansiedad materna con los síntomas de aislamiento y de ansiedad/depresión también fueron mediados por la labilidad y afectividad negativa. Esa mediación fue independiente de la regulación emocional en el primer caso y condicional a la misma en relación con la sintomatología ansioso/depresiva
This study examined the role of emotional lability and negative affect and emotional regulation in the relation between maternal trait anxiety and attentional and social problems, and internalizing and externalizing symptoms of 275 six- to eleven-year-old children. The results indicated a direct moderating effect of emotional regulation in the relation between maternal anxiety and externalizing behaviour and that lability and negative affect moderated the relation between maternal anxiety and attention and social problems and somatic complaints. The links between maternal anxiety and withdrawal and anxiety/depression symptoms were also mediated by lability and negative affect. This mediation was independent of emotional regulation in the first case, and it depended on emotional regulation with regard to anxiety/depression symptoms
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Humanos , Masculino , Femenino , Niño , Adulto , Relaciones Madre-Hijo , Trastornos de Ansiedad/psicología , Emociones , Refuerzo en Psicología , AfectoRESUMEN
This study examined the role of emotional lability and negative affect and emotional regulation in the relation between maternal trait anxiety and attentional and social problems, and internalizing and externalizing symptoms of 275 six- to eleven-year-old children. The results indicated a direct moderating effect of emotional regulation in the relation between maternal anxiety and externalizing behaviour and that lability and negative affect moderated the relation between maternal anxiety and attention and social problems and somatic complaints. The links between maternal anxiety and withdrawal and anxiety/depression symptoms were also mediated by lability and negative affect. This mediation was independent of emotional regulation in the first case, and it depended on emotional regulation with regard to anxiety/depression symptoms.
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Afecto , Ansiedad/psicología , Emoción Expresada , Madres/psicología , Autoeficacia , Controles Informales de la Sociedad , Adulto , Niño , HumanosRESUMEN
PURPOSE: The effectiveness of massage therapy on immune parameters was evaluated in young Dominican HIV+ children without current access to antiretroviral therapies. METHODS: Eligible children, who were followed at the Robert Reid Cabral Hospital (San Domingo, Dominican Republic), were randomized to receive either massage treatment or a control/friendly visit twice weekly for 12 weeks. Blood was drawn at baseline and following the 3-month intervention for determinations of CD4, CD8, and CD56 cell counts and percentage, along with activation markers (CD25 and CD69). RESULTS: Despite similar immune parameters at baseline in the two groups, significantly more of the control group exhibited a decline in CD4 cell count (>30%, p = 0.03), postintervention. The decrease was particularly evident in older (5-8 years) children in the control arm, who demonstrated a significant reduction in both CD4 and CD8 cell counts compared to massage-treated older children who remained stable or showed immune improvement. Additionally, a significant increase in CD4+CD25+ cells was observed over the 12-week trial in the massage-treated older children (p = 0.04) but not in the control group. In younger massage-treated children, (2-4 years old), a significant increase in natural killer cells was shown. CONCLUSION: Together these findings support the role for massage therapy in immune preservation in HIV+ children.
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Síndrome de Inmunodeficiencia Adquirida/inmunología , Síndrome de Inmunodeficiencia Adquirida/terapia , Protección a la Infancia , Masaje/métodos , Recuento de Linfocito CD4 , Relación CD4-CD8 , Niño , Preescolar , República Dominicana , Femenino , VIH-1 , Humanos , Masculino , Resultado del TratamientoRESUMEN
Se presenta una intervención, fundamentada en la hipótesis del déficit metarrepresentacional, en un sujeto con autismo y centrada en el aprendizaje de dos estrategias específicas basadas en la analogía pictórica de la representación y proceso mental de ficción. La efectividad y eficacia de la intervención se refleja en los resultados que muestran la capacidad del sujeto para generar y comprender la ficción, así como para generalizar el conocimiento a otras áreas de funcionamiento mentalistas. Se discute la posibilidad de desarrollar un conocimiento metarrepresentacional fundamentado en la interiorización de las estrategias de apoyo conceptual
Methodologically and theoretically based on metarrepresentational deficit hypothesis, we design an intervention to teach the mental state of pretense to an autistic boy. The production and comprehension of symbolic play by means of the use of two specific strategies founded on pictorial analogy of the mental representation and process, was the focus of the learning. The efficiency and efectiveness of the program is reflected in the results that indicated the subjects competence to generate and comprehend the pretense as well as to generalize the acquired knowledge into other areas of mentalistic functioning. We discuss the possibility to develop a metarrepresentational knowledge based on the internalizing of the strategies of conceptual support