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1.
Transl Psychiatry ; 11(1): 493, 2021 09 25.
Artigo em Inglês | MEDLINE | ID: mdl-34564704

RESUMO

Theory of mind (ToM) deficits are common in children with neurodevelopmental disorders (NDDs), such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), which contribute to their social and cognitive difficulties. The social attribution task (SAT) involves geometrical shapes moving in patterns that depict social interactions and is known to recruit brain regions from the classic ToM network. To better understand ToM in ASD and ADHD children, we examined the neural correlates using the SAT and functional magnetic resonance imaging (fMRI) in a cohort of 200 children: ASD (N = 76), ADHD (N = 74) and typically developing (TD; N = 50) (4-19 years). In the scanner, participants were presented with SAT videos corresponding to social help, social threat, and random conditions. Contrasting social vs. random, the ASD compared with TD children showed atypical activation in ToM brain areas-the middle temporal and anterior cingulate gyri. In the social help vs. social threat condition, atypical activation of the bilateral middle cingulate and right supramarginal and superior temporal gyri was shared across the NDD children, with between-diagnosis differences only being observed in the right fusiform. Data-driven subgrouping identified two distinct subgroups spanning all groups that differed in both their clinical characteristics and brain-behaviour relations with ToM ability.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Transtorno do Espectro Autista , Teoria da Mente , Adolescente , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico por imagem , Transtorno do Espectro Autista/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Criança , Pré-Escolar , Emoções , Humanos , Adulto Jovem
2.
Leuk Lymphoma ; 60(7): 1767-1774, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-30632841

RESUMO

Although ruxolitinib improves symptoms and splenomegaly in patients with advanced myelofibrosis, whether this agent is truly disease-modifying remains unclear. Histone deacetylase inhibitors (HDACi) downregulate JAK2 via interference with chaperone function. Pracinostat, a pan-HDACi, has modest single-agent activity in myelofibrosis. We conducted a single-institution, phase 2, investigator-initiated trial of ruxolitinib plus pracinostat (begun after 12 weeks of ruxolitinib) in 25 patients with myelofibrosis, of whom 20 received both agents. Sixteen (80%) patients had objective responses (all 'clinical improvement'). The rate of spleen response (by palpation) was 74%, and that of symptom response 80%. Most responses occurred prior to pracinostat initiation. Three patients experienced improvement in bone marrow fibrosis, and one a near-complete molecular response after two years on study treatment. All patients discontinued pracinostat and are currently off-study. Pracinostat interruptions and dose reductions were frequent, often due to worsening anemia. These findings do not support continued development of pracinostat in myelofibrosis.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Mielofibrose Primária/tratamento farmacológico , Idoso , Benzimidazóis/administração & dosagem , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Nitrilas , Mielofibrose Primária/patologia , Prognóstico , Pirazóis/administração & dosagem , Pirimidinas , Taxa de Sobrevida
3.
Acta Haematol ; 141(1): 23-27, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30463063

RESUMO

Myeloproliferative neoplasms (MPNs) are clonal disorders divided into Philadelphia (Ph) chromosome-positive chronic myeloid leukemia (CML) or Ph chromosome-negative MPNs. Co-occurrence of these disease entities is very rare and typically involves presence of common p190 or p210 BCR/ABL fusion transcript (responsible for CML) along with JAK2V617F mutation (most common driver mutation in Ph-negative MPNs). Because of the rarity of such cases, it is not clear if the outcomes are any different in these patients. In this article, we report a unique patient with polycythemia vera driven by a rare complex in-frame deletion-insertion mutation in JAK2 exon 12, and CML driven by uncommon p210 e14a3 (b3a3) BCR/ABL fusion transcript. We describe clinical and laboratory features, bone marrow pathology, treatment, and overall outcome.


Assuntos
Proteínas de Fusão bcr-abl/genética , Janus Quinase 2/genética , Transtornos Mieloproliferativos/diagnóstico , Idoso , Medula Óssea/patologia , Éxons , Humanos , Hibridização in Situ Fluorescente , Cariótipo , Masculino , Mutação , Transtornos Mieloproliferativos/genética
4.
Ann Hematol ; 96(5): 733-738, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28247057

RESUMO

New automated hematology analyzers have led to the availability of novel hematological parameters, including the immature platelet fraction (IPF) and the immature reticulocyte fraction (IRF), both of potential interest in patients with myeloproliferative neoplasms (MPNs). We performed a prospective analysis of 217 patients with MPN, including 32 (15%) with essential thrombocythemia (ET), 43 (20%) with polycythemia vera (PV), and 142 (65%) with myelofibrosis (MF); the IPF and IRF were measured by the Sysmex XN analyzer. As compared to patients with ET, both a higher IPF and IRF were observed among patients with PV and MF. Factors associated with high IPF among patients with PV/ET were male sex, thrombocytopenia, and diagnosis of PV; among patients with MF, they were elevated peripheral blasts, low platelet count, JAK2 V617F mutation, and previous therapy. Factors associated with high IRF among patients with PV/ET were low hemoglobin, high reticulocyte count, and PV diagnosis; among patients with MF, they were peripheral blasts and elevated reticulocytes. The IPF and IRF represent novel parameters in patients with MPN with potential relevant clinical implications. Comparison with healthy subjects and those with secondary polycythemia is needed to confirm our preliminary findings.


Assuntos
Contagem de Células Sanguíneas , Plaquetas/patologia , Transtornos Mieloproliferativos/sangue , Transtornos Mieloproliferativos/diagnóstico , Reticulócitos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Transformação Celular Neoplásica , Diagnóstico Diferencial , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mortalidade , Transtornos Mieloproliferativos/mortalidade , Fenótipo , Policitemia Vera/sangue , Policitemia Vera/diagnóstico , Mielofibrose Primária/sangue , Mielofibrose Primária/diagnóstico , Estudos Prospectivos , Fatores de Risco , Trombocitemia Essencial/sangue , Trombocitemia Essencial/diagnóstico , Adulto Jovem
5.
PLoS One ; 11(7): e0158189, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27380261

RESUMO

The number of highly caffeinated products has increased dramatically in the past few years. Among these products, highly caffeinated energy drinks are the most heavily advertised and purchased, which has resulted in increased incidences of co-consumption of energy drinks with alcohol. Despite the growing number of adolescents and young adults reporting caffeine-mixed alcohol use, knowledge of the potential consequences associated with co-consumption has been limited to survey-based results and in-laboratory human behavioral testing. Here, we investigate the effect of repeated adolescent (post-natal days P35-61) exposure to caffeine-mixed alcohol in C57BL/6 mice on common drug-related behaviors such as locomotor sensitivity, drug reward and cross-sensitivity, and natural reward. To determine changes in neurological activity resulting from adolescent exposure, we monitored changes in expression of the transcription factor ΔFosB in the dopaminergic reward pathway as a sign of long-term increases in neuronal activity. Repeated adolescent exposure to caffeine-mixed alcohol exposure induced significant locomotor sensitization, desensitized cocaine conditioned place preference, decreased cocaine locomotor cross-sensitivity, and increased natural reward consumption. We also observed increased accumulation of ΔFosB in the nucleus accumbens following repeated adolescent caffeine-mixed alcohol exposure compared to alcohol or caffeine alone. Using our exposure model, we found that repeated exposure to caffeine-mixed alcohol during adolescence causes unique behavioral and neurochemical effects not observed in mice exposed to caffeine or alcohol alone. Based on similar findings for different substances of abuse, it is possible that repeated exposure to caffeine-mixed alcohol during adolescence could potentially alter or escalate future substance abuse as means to compensate for these behavioral and neurochemical alterations.


Assuntos
Cafeína/farmacologia , Bebidas Energéticas , Etanol/farmacologia , Atividade Motora/efeitos dos fármacos , Adolescente , Análise de Variância , Animais , Cafeína/administração & dosagem , Depressores do Sistema Nervoso Central/administração & dosagem , Depressores do Sistema Nervoso Central/farmacologia , Estimulantes do Sistema Nervoso Central/administração & dosagem , Estimulantes do Sistema Nervoso Central/farmacologia , Condicionamento Psicológico/efeitos dos fármacos , Dopamina/metabolismo , Etanol/administração & dosagem , Feminino , Humanos , Masculino , Camundongos Endogâmicos C57BL , Atividade Motora/fisiologia , Núcleo Accumbens/efeitos dos fármacos , Núcleo Accumbens/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Recompensa , Adulto Jovem
6.
Qual Health Res ; 22(12): 1685-93, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-22923387

RESUMO

Although the rate of hypertension (HTN) is no higher for Mexican-origin clients than for non-Hispanic Whites, their rate of blood pressure (BP) control is lower. To effectively assist clients with their BP, health care providers must first understand barriers and facilitators to BP control from the clients' perspectives. The purpose of this study was to describe the experience of living with HTN for Mexican immigrants and Mexican Americans. A phenomenological method was appropriate to describe their lived experience. We conducted one-time interviews with 26 adults who self-identified as Mexican-origin. Some participants did not know what caused HTN and others believed in causes they could control. Many believed HTN was of short duration. Some participants forgot to take medication or were not able to afford it. Mexican-origin clients need more assistance with BP control, and need it in both English and Spanish.


Assuntos
Emigrantes e Imigrantes , Conhecimentos, Atitudes e Prática em Saúde , Hipertensão/etnologia , Hipertensão/psicologia , Americanos Mexicanos , Características Culturais , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade
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