RESUMO
BACKGROUND: Electroconvulsive therapy (ECT) is an effective treatment for depression, mania, and refractory schizophrenia. Its tolerability profile is established for acute treatment, but less is known regarding the effects of longer treatment courses, particularly on cognitive performance. OBJECTIVES: To assess the effect of the long-term ECT on cognition. METHODS: We searched CINAHL, EMBASE, PsychInfo and Pubmed, for the period between January 1, 2010, and June 30, 2022, in English or French, for randomized controlled trials, prospective or retrospective studies of ECT continued for at least 2 months for the treatment of mood or schizophrenic disorders and which measured cognition before and at the end of treatment. Non-peer reviewed records were excluded. The Cochrane Risk of Bias tool was used to assess study quality. Classical meta-analyses, with heterogeneity statistics (tau2, I2) were complemented with three level-meta-analysis and Bayesian Meta-analyses. RESULTS: Nine studies were included in the narrative and quantitative review. Controlled comparison at 6 months (k = 6, n = 334) and at 12 months (k = 3, n = 56), within-subject comparisons at 6 (k = 6, n = 218) and 12 months (k = 4, n = 147) showed no detrimental effect of maintenance or continuation ECT on cognition, with little to no heterogeneity. Bayesian analysis further confirmed that data better supported the no effects hypothesis. LIMITATIONS: Insufficient data resulted in imprecision in estimates. CONCLUSIONS: Continuation and maintenance ECT do not appear detrimental for cognitive performance. However, the low number of studies limit the interpretation of the results.
Assuntos
Eletroconvulsoterapia , Teorema de Bayes , Cognição , Eletroconvulsoterapia/efeitos adversos , Eletroconvulsoterapia/métodos , Humanos , Estudos Prospectivos , Estudos Retrospectivos , Resultado do TratamentoRESUMO
According to two current definitions, the prevalence of the metabolic syndrome (MetS) among black Haitians of Montreal was <20%, 30%-36% in Algonquin Indians of Quebec, and >45% in Mexicans of Oaxaca (all aged 35-60 y). Although phenotypes were different, high triglycerides and fasting dysglycemia were good predictors of MetS in all three groups using both definitions. The international cut-offs for abdominal obesity were not predictive of MetS in the Haitian subjects.
Assuntos
Síndrome Metabólica/epidemiologia , Gordura Abdominal/fisiologia , Adulto , Glicemia/metabolismo , Pressão Sanguínea/fisiologia , Canadá/epidemiologia , HDL-Colesterol/sangue , Estudos Transversais , Etnicidade , Feminino , Haiti/epidemiologia , Haiti/etnologia , Hispânico ou Latino , Humanos , Indígenas Norte-Americanos , Resistência à Insulina/fisiologia , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Terminologia como Assunto , Triglicerídeos/sangueRESUMO
OBJECTIVES: To identify dietary transition stages based on dietary patterns of adult Haitians having lived in Montreal for various lengths of time, and to assess associated dietary quality. SUBJECTS: One hundred and eighty-one Haitians aged 25-60 years were recruited by the modified random digit dialling method. DESIGN: Socio-economic, diet and lifestyle variables were documented by questionnaire. Three non-consecutive 24-hour dietary recalls were conducted over a 3-month period. Dietary patterns were studied using cluster analysis, and their association with proportion of lifetime in Canada and with socio-economic status (SES) was examined. Diet quality criteria were micronutrient adequacy and healthfulness based on dietary recommendations of the World Health Organization. RESULTS: Four dietary phenotypes were identified which could roughly represent stages of dietary transition or acculturation (Traditional, Pre-Western, Western and Modern). Subjects in the 'Traditional' cluster were older and had lived for a significantly lower proportion of their lifetime in Canada; they also tended to be of lower SES. Diet quality was significantly higher in the 'Traditional' than the 'Western' type, particularly with respect to healthfulness. A significantly lower proportion of subjects complying with limited intake of total fat ( < 30%) and cholesterol ( < 45%) was observed in the 'Western' compared with other diet phenotypes. Less than 15% of all subjects consumed enough dietary fibre, irrespective of diet type. CONCLUSION: Dietary transition stages could be identified on the basis of food patterns of Haitians according to the proportion of their lifetime in Canada. Encouraging the youth to retain the traditional food culture in its positive aspects would appear relevant
Assuntos
Aculturação , Inquéritos sobre Dietas , Dieta/normas , Dieta/tendências , Adulto , Análise por Conglomerados , Estudos Transversais , Comportamento Alimentar , Feminino , Haiti/etnologia , Humanos , Estilo de Vida , Masculino , Rememoração Mental , Pessoa de Meia-Idade , Quebeque/epidemiologia , Classe Social , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: People of African descent may be at greater risk of metabolic syndrome (MS) compared with whites. We examined the associations among MS markers, body composition, and resting metabolic rate (RMR) in black Haitians and in white subjects living in Quebec, Canada. RESEARCH METHODS AND PROCEDURES: Forty randomly selected Haitians were matched with 40 white subjects for age, sex, and BMI. Glycemic status and insulin resistance were assessed based on a 3-hour glucose tolerance test. Blood lipids, blood pressure, abdominal fat (computed tomography), and waist circumference (WC) were measured. RMR was estimated by indirect calorimetry. RESULTS: Triglycerides were significantly correlated with blood pressure only in Haitians and with the area under the curve for insulin only in whites. Haitians had significantly (p < 0.05) lower triglycerides and higher high-density lipoprotein-cholesterol concentrations but higher blood pressure than whites at any given WC value. General linear models showed that Haitians had less visceral adipose tissue than whites for the same WC. RMR was lower among Haitians for any given value of BMI or WC than in whites. Also, WC was more strongly associated with glucose area under the curve and to log-homeostasis model assessment in white than in Haitian subjects. DISCUSSION: The MS may be ethnospecific in its features and etiology. The standard anthropometric indices of obesity may not be as effective in populations of African descent compared with whites, unless appropriate cut-off values are defined.