EFFECTIVENESS OF SEROTONERGIC DRUGS IN THE MANAGEMENT OF PROBLEM BEHAVIORS IN PATIENTS WITH NEURODEVELOPMENTAL DISORDERS

Neurodevelopmental disorders often result in disabilities associated with auto- and / or hetero-aggressive behaviors, that can be defined as "problem behaviors" (Lacy 2007). Therapeutic interventions are mainly directed towards the use of neuroleptic drugs or benzodiazepines, to ensure a rapid and significant sedation in most of cases. These pharmacological devices exposes the patient to clinical risks and/or long-term management difficulties. The main problem of the chronic use of benzodiazepines is the development of tolerance and dependence; furthermore benzodiazepine withdrawal or their abrupt reduction may lead to rebound effect. Regarding the long-term effects of neuroleptics, it is necessary to focus on extrapyramidal effects, motor restlessness and akathisia, anticholinergic effects, as well as endocrine and metabolic alterations. Several studies have shown that the reduction of serotonergic receptor activity is associated with the appearance of aggressive behavior (Farnam et al. 2017), especially impulsive behaviors (Manchia et al. 2017, Takahashi et al. 2012). The dynamics that subtend these data are still not fully clarified, however there are evidences that the use of selective serotonin reuptake inhibitors (SSRI) is helpful in the treatment of aggressive behavior in mental disabilities (Sterke et al. 2012, Janowsky et al. 2015). In this study we observe the behavioral response to sertraline, for minors, and to vortioxetine, for adults, considering that the literature shows significant evidence of modulation of synaptic neuroplasticity (Waller et al. 2017). To support the observation we used behavioural scales to collect the data, before the administration of the drug, during the course of treatment, at 3 months from the start of the administration. We detected the improve of behavioral disorders with the less use neuroleptic drugs and benzodiazepines

EFFECTIVENESS OF SEROTONERGIC DRUGS IN THE MANAGEMENT OF PROBLEM BEHAVIORS IN PATIENTS WITH NEURODEVELOPMENTAL DISORDERS

Neurodevelopmental disorders often result in disabilities associated with auto- and / or hetero-aggressive behaviors, that can be defined as "problem behaviors" (Lacy 2007). Therapeutic interventions are mainly directed towards the use of neuroleptic drugs or benzodiazepines, to ensure a rapid and significant sedation in most of cases. These pharmacological devices exposes the patient to clinical risks and/or long-term management difficulties. The main problem of the chronic use of benzodiazepines is the development of tolerance and dependence; furthermore benzodiazepine withdrawal or their abrupt reduction may lead to rebound effect. Regarding the long-term effects of neuroleptics, it is necessary to focus on extrapyramidal effects, motor restlessness and akathisia, anticholinergic effects, as well as endocrine and metabolic alterations. Several studies have shown that the reduction of serotonergic receptor activity is associated with the appearance of aggressive behavior (Farnam et al. 2017), especially impulsive behaviors (Manchia et al. 2017, Takahashi et al. 2012). The dynamics that subtend these data are still not fully clarified, however there are evidences that the use of selective serotonin reuptake inhibitors (SSRI) is helpful in the treatment of aggressive behavior in mental disabilities (Sterke et al. 2012, Janowsky et al. 2015). In this study we observe the behavioral response to sertraline, for minors, and to vortioxetine, for adults, considering that the literature shows significant evidence of modulation of synaptic neuroplasticity (Waller et al. 2017). To support the observation we used behavioural scales to collect the data, before the administration of the drug, during the course of treatment, at 3 months from the start of the administration. We detected the improve of behavioral disorders with the less use neuroleptic drugs and benzodiazepines

Geometria através de hipertextos com animações interativas

Um dos grandes desafios da educação, provocados, sobretudo pela modalidade a distância, é o desenvolvimento de atitudes, por parte dos alunos, na direção de uma aprendizagem com a autonomia. Na área da Educação Matemática os alunos se defrontam com as dificuldades adicionais quanto ao domínio da linguagem matemática, com seus signos, símbolos e desenhos. Este artigo trata da produção e do uso de hipertextos com animações interativas para curso ofertado na modalidade a distância para professores da educação básica. Os resultados obtidos indicam interessantes possibilidades deste material digital quanto ao processo de aprendizagem da geometria, com autonomia.   

Geometry through hypertexts with interactive animations

Um dos grandes desafios da educação, provocados, sobretudo pela modalidade a distância, é o desenvolvimento de atitudes, por parte dos alunos, na direção de uma aprendizagem com a autonomia. Na área da Educação Matemática os alunos se defrontam com as dificuldades adicionais quanto ao domínio da linguagem matemática, com seus signos, símbolos e desenhos. Este artigo trata da produção e do uso de hipertextos com animações interativas para curso ofertado na modalidade a distância para professores da educação básica. Os resultados obtidos indicam interessantes possibilidades deste material digital quanto ao processo de aprendizagem da geometria, com autonomia.One of the great challenges of the education, especially in distance learning, is the development of student’s attitudes for the study with autonomy. In Mathematics Education the students are confronted with an additional difficulty from the domain of the mathematical language with their signs, symbols and drawings. This article talks about the design and the use of hypertexts integrated with interactive animations to be used in a distance learning course for mathematics teachers. The results indicate interesting possibilities of the material in a geometry learning process based on autonomy

Short-term one-lung ventilation does not influence local inflammatory cytokine response after lung resection

Background: One-lung ventilation (OLV) is a ventilation procedure used for pulmonary resection which may results in lung injury. The aim of this study was to evaluate the local inflammatory cytokine response from the dependent lung after OLV and its correlation to VT. The secondary aim was to evaluate the clinical outcome of each patient. Methods: Twenty-eight consecutive patients were enrolled. Ventilation was delivered in volume-controlled mode with a VT based on predicted body weight (PBW). 5 cmH2O positive end-expiratory pressure (PEEP) and FiO20.5 were applied. Bronchoalveolar lavage (BAL) was performed in the dependent lung before and after OLV. The levels of pro-inflammatory interleukins (IL-1α, IL-1β, IL-6, IL-8), tumor necrosis factor alpha (TNFα), vascular endothelial growth factor (VEGF), endothelial growth factor (EGF), monocyte chemoattractant protein-1 (MCP-1) and anti-inflammatory cytokines, such as interleukins (IL-2, IL-4, IL-10) and interferon (IFN-γ), were evaluated. Subgroup analysis: to analyze the VT setting during OLV, all patients were ventilated within a range of 5-10 mL/kg. Thirteen patients, classified as a conventional ventilation (CV) subgroup, received 8-10 mL/kg, while 15 patients, classified as a protective ventilation (PV) subgroup, received 5-7 mL/kg. Results: Cytokine BAL levels after surgery showed no significant increase after OLV, and no significant differences were recorded between the two subgroups. The mean duration of OLV was 64.44±21.68 minutes. No postoperative respiratory complications were recorded. The mean length of stay was for 4.00±1.41 days in the PV subgroup and 4.45±2.07 days in the CV group; no statistically significant differences were recorded between the two subgroups (P=0.511). Conclusions: Localized inflammatory cytokine response after OLV was not influenced by the use of different VT. Potentially, the application of PEEP in both ventilation strategies and the short duration of OLV could prevent postoperative complications

NEW TECHNOLOGIES FOR ART THERAPY INTERVENTIONS TAILORED TO SEVERE DISABILITIES

Individuals with multiple disabilities can have a wide range of characteristics depending on the combination and severity of the disabilities, such as intellectual disability, mobility issues, sensorial impairment, language issues and brain injury. New technologies can help therapists find an alternative way to engage and interact with clients by opening a communication window and starting to build the therapeutic relationship. The need to use more customized technological tools led us to develop the Painteraction system, an intuitive tool based on Augmented Reality that allows clients to be immersed in their own images. Just by moving their bodies individuals are able to make drawings and receive visual feedback, both from themselves and their therapists, as it appears on the screen. The pilot testing of Painteraction was performed on 21 inpatients at Istituto Serafico (Assisi, Italy) with severe/multiple disabilities in order to explore and assess reaction and responsiveness in a semi-structured art therapy setting. The sample was formed by 14 males and 7 females (N=21) between the ages of 7 and 35. All participants attended three twenty-minute individual art therapy sessions which were approximately one week apart. Through direct and indirect (video recordings) observation of the sessions, it appeared that the specific Augmented Reality tool introduced in the art therapy setting was easily accepted by most of the clients involved and generally allowed the development of an interpersonal therapist-client relationship. The present study therefore gave us the opportunity to test new digital tools in the challenging setting of severe/multiple disabilities and observe the huge potential of new media to empower clients to express themselves and their creativity, and ultimately overcome mental and physical barriers. We propose that Augmented Reality tools are particularly well-suited to art therapy and create an equally suitable therapeutic environment to address specific client needs

Medicina da noite: da Cronobiologia à prática clínica

Resenha do livro: MEDICINA DA NOITE: DA CRONOBIOLOGIA À PRÁTICA CLÍNICA. Jansen JM, Lopes AJ, Jansen U, Capone D, Maeda TY, Noronha A, Magalhães G, organizadores. Rio de Janeiro: Editora Fiocruz; 2007.Submitted by Sandra Infurna ([email protected]) on 2019-04-02T13:06:02Z No. of bitstreams: 1 Lucia_Rotenberg_etal_IOC_2008.pdf: 78624 bytes, checksum: d06303bbf029c7fba3b995edfe3b4b1b (MD5)Approved for entry into archive by Sandra Infurna ([email protected]) on 2019-04-02T13:18:15Z (GMT) No. of bitstreams: 1 Lucia_Rotenberg_etal_IOC_2008.pdf: 78624 bytes, checksum: d06303bbf029c7fba3b995edfe3b4b1b (MD5)Made available in DSpace on 2019-04-02T13:18:15Z (GMT). No. of bitstreams: 1 Lucia_Rotenberg_etal_IOC_2008.pdf: 78624 bytes, checksum: d06303bbf029c7fba3b995edfe3b4b1b (MD5) Previous issue date: 2008Universidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ. Brasil.Universidade Federal do Paraná. Setor de Ciências Biológicas. Curitiba, Paraná, Brasil.Universidade de São Paulo. Faculdade de Saúde Pública. São Paulo, SP, Brasil.Universidade de São Paulo. Escola de Artes, Ciências e Humanidades. São Paulo, SP, Brasil

MOZART\u27S MUSIC AND MULTIDRUG-RESISTANT EPILEPSY: A POTENTIAL EEG INDEX OF THERAPEUTIC EFFECTIVENESS

Multidrug-resistant epilepsy is a pathological condition that affects approximately one-third of patients with epilepsy, especially those with associated intellectual disabilities. Several non-pharmacological interventions have been proposed to improve quality of life of these patients. In particular, Mozart’s sonata for two pianos in D major, K448, has been shown to decrease interictal electroencephalography (EEG) discharges and recurrence of clinical seizures in these patients. In a previous study we observed that in institutionalized subjects with severe/profound intellectual disability and drug-resistant epilepsy, a systematic music listening protocol reduced the frequency of seizures in about 50% of cases. This study aims to assess electroencephalography as a quantitative (qEEG) predictive biomarker of effectiveness of listening to music on the frequency of epileptic discharges and on background rhythm frequency (BRF)