Efeito do polimorfismo Thr92Ala da enzima desiodase tipo 2 no comportamento adaptativo de indivíduos com Transtorno do Espectro Autista

O Thr92Ala é um polimorfismo da D2, enzima cuja principal função é converter T4 em T3, forma biologicamente ativa do hormônio tireoidiano. Esse polimorfismo tem sido relacionado a transtornos como Esquizofrenia, Depressão e Alzheimer, e foi demonstrado que em indivíduos homozigotos para o polimorfismo existe uma alteração no padrão de expressão de genes ligados aos processos neurodegenerativos e estresse oxidativo no Sistema Nervoso Central (SNC). Estudos com indivíduos com Transtorno do Espectro Autista (TEA) têm demonstrado que esses pacientes apresentam maior estresse oxidativo celular. Assim, o objetivo desse estudo foi avaliar se pacientes com TEA que apresentavam o polimorfismo teriam piores resultados nas avaliações cognitivas e comportamentais quando comparados aos pacientes que não apresentavam o polimorfismo. Foram avaliados 132 pacientes com TEA atendidos em unidade de referência e foram avaliados os resultados obtidos no Autism Behavior Checklist (ABC), Escala Vineland de Comportamento adaptativo, testes de QI e em duas avaliações de Autism Treatment Evaluation Checklist (ATEC). Foi possível observar que os pacientes que expressavam o alelo polimórfico em homozigose tiveram melhor desempenho que os pacientes com genótipo selvagem nos seguintes parâmetros: Comunicação, Comunicação Receptiva, Atividades de vida diária e Autocuidado, e pacientes com genótipo selvagem e com piores resultados no ABC obtiveram melhora significativa nas habilidades de socialização avaliadas pela ATEC após a intervenção. Portanto, a presença do polimorfismo melhora o desempenho adaptativo dos indivíduos, mas parece prejudicar a resposta do paciente à terapia proposta. Mais estudos são necessários para aumentar a compreensão acerca do papel dessa enzima e os mecanismos pelos quais o polimorfismo altera o funcionamento do SNC, tanto para indivíduos de desenvolvimento típico quanto para aqueles com algum distúrbio do desenvolvimento.Thr92Ala D2 it’s the polymorphism of a thyroid hormone enzyme responsible to convert T4 in its active form, T3. This polymorphism has been related to Schizophrenia, Depression and Alzheimer’s disease, and its been shown that in the presence of both polymorphic alleles there’s a difference in the expression of genes relates to neurodegenerative process and oxidative stress in Central Nervous System (CNS). Studies with Autism Spectrum Disorder (ASD) patients has demonstrated that in this group, cells are more likely to present oxidative stress condition. The aim of this study was to evaluate whether ASD patients expressing Thr92Ala-D2 polymorphism would have poorer results at cognitive and behavioral tests when compared with patients without the polymorphism. Were assessed 132 ASD patients and the results of Autism Behavior Checklist (ABC), Vineland Scale of Adaptative Behavior, IQ and Autism Treatment Evaluation Checklist (ATEC). The analyses showed that patients expressing the polymorphism had better performances in Communication, Receptive Communication, Daily Living and Selfcare, although patients with wild genotyping and more critical ABC results had significative improvement of their social skills after interventions. Therefore, the existence of polymorphism improves adaptative performance in ASD patients, however the polymorphism seems to impair patient’s response to therapies. More researches are necessary in order to improve the comprehension of enzyme’s role and mechanisms underlying polymorphism’s CNS fingerprint

Medication consumption in a Brazilian area covered by the Family Health Strategy: Prevalence and associated factors

Abstract Objective: The aim of the present study was to determine the prevalence and factors associated with the medication consumption among users registered in the Family Health Strategy (FHS) of Rondonópolis, Mato Grosso State, Brazil. Method: The population was constituted of all adult residents in the area covered by the FHS. The Poisson regression model with robust variance was used to the statistical analysis. Results: There were included 553 participants, of which 72% were women. The mean age was 48 years. The prevalence of medication consumption was about 74.9% (n = 414). The most consumed class medication was drugs that act on the cardiovascular system (42.2%). The factors associated with medication consumption were female gender (PR = 1.21; CI95%: 1.07 - 1.38), diagnosed morbidity (PR = 1.83; CI95%: 1.61 - 2.08) and be bedridden in the last month (PR = 1.14; 95% CI95%: 1.02 - 1.26). Moreover, 72.7% of the interviewees obtained the medicines in public pharmacies. Conclusion and implications for practice: Women, people diagnosed with morbidities and those participants who were bedridden during the last month showed the highest levels of drug consumption. Nursing professionals in promoting the rational use of medications can contribute to integral care to FHS users