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1.
J Autism Dev Disord ; 51(5): 1428-1445, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-32929662

RESUMEN

Growing interest in the pathogenesis of autism spectrum disorders (ASDs) and other intellectual and developmental disabilities (IDD) has led to emerging evidence implicating a role for oxidative stress. However, understanding the strength of this association is made challenging by the use of a variety of purported biomarkers of oxidative stress, many of which have either uncertain specificity or flawed methods of analysis. This review aims to address this issue, which is widespread in the ASD and IDD literature, by providing readers with information concerning the strengths and limitations of the choice and analysis of biomarkers of oxidative stress. We highlight that biomarkers and assays should be specific, sensitive, reproducible, precise, robust, and chosen with careful consideration. Future studies should be sufficiently powered and address sample collection, processing, and storage which are, additionally, poorly considered, sources of bad practice, and potential errors. Only with these issues considered, will the data lead to conclusions as to the precise role of oxidative stress in ASDs and IDD.


Asunto(s)
Trastorno del Espectro Autista/diagnóstico , Trastorno del Espectro Autista/metabolismo , Discapacidad Intelectual/diagnóstico , Discapacidad Intelectual/metabolismo , Estrés Oxidativo/fisiología , Antioxidantes/metabolismo , Trastorno del Espectro Autista/epidemiología , Biomarcadores/metabolismo , Femenino , Glutatión/metabolismo , Humanos , Discapacidad Intelectual/epidemiología , Masculino , Embarazo , Efectos Tardíos de la Exposición Prenatal/epidemiología , Efectos Tardíos de la Exposición Prenatal/metabolismo , Especies Reactivas de Oxígeno/metabolismo
2.
J Appl Res Intellect Disabil ; 33(2): 180-192, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31694076

RESUMEN

BACKGROUND: Transitioning to adult healthcare systems can be challenging, especially if left unaddressed for adolescents with special healthcare needs (ASHCN), such as those with autism spectrum disorder and attention-deficit/ hyperactivity disorder. While there is evidence of disparities between different demographics regarding general healthcare services, research on healthcare-specific transition planning is lacking. Thus, there is a critical need to continually investigate these disparities. METHOD: Using nationally representative data from the 2016 National Survey for Children's Health, several analyses were conducted to examine doctor-patient interactions and discussions about transitioning to adult health care. Accounting for demographic and diagnostic indicators allowed for the assessment of disparities. RESULTS: Findings revealed significant disparities between age, disability and race relative to various healthcare transition support services. CONCLUSIONS: Findings provide valuable information that can inform the development of training programmes for healthcare providers, influence policy, modify procedures and interventions and highlight the need for increased advocacy for ASHCN.


Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad/terapia , Trastorno del Espectro Autista/terapia , Discapacidades del Desarrollo/terapia , Disparidades en Atención de Salud/estadística & datos numéricos , Discapacidad Intelectual/terapia , Relaciones Médico-Paciente , Transición a la Atención de Adultos/estadística & datos numéricos , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Masculino
3.
BMC Psychiatry ; 19(1): 328, 2019 10 29.
Artículo en Inglés | MEDLINE | ID: mdl-31664964

RESUMEN

The core symptoms and co-morbidities associated with autism spectrum disorders (ASD) affect daily living and quality of life. Existing pharmacological interventions are only able to attenuate some related symptoms but are unable to address the underlying etiologies associated with ASD. Anecdotal evidence, which claims benefit from the use of cannabis to treat symptoms among this population, has been gaining popularity as families seek solutions.This paper analyzed recent peer-reviewed literature to identify the current state of evidence regarding cannabis use for the ASD population. Systematic reviews, reports, and experimental studies were assessed to understand the current extent and nature of the evidence on the risks and benefits of cannabis use for ASD. At this time, three large-scale clinical trials are currently at varying stages of progress and publication of results. Only five small studies were identified that have specifically examined cannabis use in ASD. Given the sparse state of evidence directly assessed in this population, studies which examined effects of cannabis on shared pathological symptoms of ASD such as hyperactivity, sleep disorders, self-injury, anxiety, behavioral problems, and communication were also reviewed.Studies revealed mixed and inconclusive findings of cannabis effects for all conditions, except epilepsy. Adverse outcomes were also reported, which included severe psychosis, increased agitation, somnolence, decreased appetite, and irritability. In addition, a wide range of cannabis compositions and dosage were identified within the studies, which impact generalizability.There is currently insufficient evidence for cannabis use in ASD, which creates an urgent need for additional large-scale controlled studies to increase understanding of risks and benefits and also to examine the impact of "entourage effects." This will support discussions of treatment options between health care providers and ASD patients and their families. Evidence may lead to a desired new line of treatment or prevent adverse outcomes from unsubstantiated use amongst families aiming for symptom reduction.


Asunto(s)
Trastorno del Espectro Autista/tratamiento farmacológico , Marihuana Medicinal/uso terapéutico , Humanos
4.
Artículo en Inglés | MEDLINE | ID: mdl-31341491

RESUMEN

Oxidative stress is understood to be involved in the ontology and maintenance of different developmental disabilities. Some complementary and alternative medicine (CAM) therapies have been proposed to modify this relationship by affecting oxidative stress pathways. However, it is unclear which of these CAM therapies are used among children with different developmental disabilities. This study examines the use of these therapies among 10,218 children between the ages of 4 and 17 using the 2012 Child Complementary and Alternative Medicine (CAM) Supplement of the National Health Interview Survey (NHIS) to highlight a potential avenue for intervention and prevention efforts. The results suggest that children with developmental disabilities are more likely to utilize particular CAM therapies that may alter oxidative stress pathways. Future work is needed to assess the potential moderating effect of these CAM therapies and oxidative stress levels among children with different developmental disabilities.

5.
J Intellect Disabil ; 23(1): 97-116, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28847208

RESUMEN

In Florida, the Agency for Persons with Disabilities provides waivers for adults with the following types of disabilities: intellectual disability, autism spectrum disorder, cerebral palsy, spina bifida, Down syndrome, and Prader-Willi syndrome. This review examined the peer-reviewed literature to indicate and assess the common needs for individuals with intellectual and developmental disabilities. Current models of service delivery, the efficacy of these services, and remaining gaps in the need fulfillment of individuals within the six diagnostic categorizations of interest were examined. Severity level within each diagnostic category was plotted on a matrix according to whether the needs of individuals were minimal, moderate, severe, or universal. The study found that sexual health education, socialization, and adult-focused medical care are universal needs among the six conditions. The study indicates that health-care professionals must work toward addressing the many unmet needs in comprehensive life span care services for adult individuals with neurodevelopmental disorders.


Asunto(s)
Trastorno del Espectro Autista/terapia , Parálisis Cerebral/terapia , Atención a la Salud/estadística & datos numéricos , Discapacidades del Desarrollo/terapia , Discapacidad Intelectual/terapia , Evaluación de Necesidades/estadística & datos numéricos , Disrafia Espinal/terapia , Adulto , Humanos
6.
J Natl Med Assoc ; 110(4): 314-325, 2018 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30126555

RESUMEN

Approximately 5.5 million individuals are diagnosed with Alzheimer's disease (AD) dementia, a number which includes those with mild cognitive impairment and asymptomatic individuals with biomarkers of AD. There is a higher incidence of mild cognitive impairment (MCI) in African American populations as compared to White populations, even when controlling for sociodemographic factors. The existing body of ethnically/racially targeted research on MCI has been limited by few studies with the ability to generalize to African American communities. This study sought to examine whether medical conditions which occur at a higher rate in African American individuals increase the hazard of subsequent MCI development. A secondary data analysis of the National Alzheimer's Coordinating Center Uniform Data Set was employed to examine the associations between health conditions (congestive heart failure, traumatic brain injury, diabetes, hypertension, hypercholesterolemia, B12 deficiency, thyroid disease) and their relationship to MCI. The analytic sample included 2847 participants with 9872 observations. Binary logistic generalized estimating equation modeling was used to examine repeated measures over the course of 1-11 observations. Education was associated with MCI development, specifically those with some college or college graduates (p < 0.001) and more than college (p = 0.002). Female sex was associated with development of MCI (p < 0.001). African Americans with traumatic brain injury (TBI) were more likely to develop MCI (p < 0.001) compared to those with no reports of a TBI. Inactive thyroid conditions decreased the risk of MCI development (p = 0.005) compared to those without thyroid disease. Though vascular factors are often attributed to higher mortality and neurodegeneration in African Americans, congestive heart failure, diabetes, high cholesterol, hypertension, diabetes, nor seizures were associated with an increased risk of MCI development. Findings from this study provide formative data to develop targeted interventions for subsets of the African American community, including those with higher educational levels, those with TBI, and those with a history of thyroid disease. While it may not be possible to prevent MCI development, it is possible to modify lifestyle behaviors contributing to these health conditions, such as falls that are often experienced by older adults. Practitioners can increase awareness, knowledge, and resources relevant to clients.


Asunto(s)
Negro o Afroamericano , Enfermedad Crónica/psicología , Disfunción Cognitiva/etnología , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/etnología , Disfunción Cognitiva/etiología , Conjuntos de Datos como Asunto , Femenino , Humanos , Modelos Logísticos , Masculino , Factores de Riesgo , Factores Sexuales
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