Pediatric prolonged-release melatonin for insomnia in children and adolescents with autism spectrum disorders

Introduction: Insomnia is common among children and adolescents with Autism spectrum disorder (ASD). The first drug licensed for insomnia in this population, a pediatric-appropriate prolonged-release melatonin (PedPRM) formulation is described. Areas covered: Literature search on PedPRM efficacy and safety profile in clinical trials, and a proposed decision-making algorithm to optimize outcome in the treatment of insomnia in children and adolescents with ASD. Expert opinion: PedPRM treatment effectively improves sleep onset, duration and consolidation, and daytime externalizing behaviors in children and adolescents with ASD and subsequently caregivers’ quality of life and satisfaction with their children’s sleep. The coated, odorless and taste-free mini-tablets are well-accepted in this population who often have sensory hypersensitivity and problems swallowing standard tablet preparations. The most frequent long-term treatment-related adverse events were fatigue (6.3%), somnolence (6.3%), and mood swings (4.2%) with no evidence of delay in height, BMI, or pubertal development, or withdrawal effects. The starting dose is 2 mg once daily independent of age or weight, escalated to 5–10 mg/day if predefined treatment success criteria are unmet. Slow melatonin metabolizers (~10% of children), may require lower doses. Given its long-term efficacy, safety and acceptance, PedPRM may ameliorate long-term consequences of insomnia in this population.publishedVersio

Avaliação da função tiroidiana na fibromialgia primária

-INTRODUÇÃO: A fibromialgia é uma entidade mórbida de elevada prevalência e o hipotireoidismo é uma das manifestações clínicas mais freqüentemente associadas à fibromialgia. A busca ativa de transtornos da função tireoidina é importante uma vez que existe superposição de sintomas entre essas doenças além de ser descrita grande freqüência da associação entre elas. OBJETIVO: O objetivo do presente estudo é avaliar a correlação existente entre os sintomas de fibromialgia e provas de função tireoidiana. MATERIAL E MÉTODOS: Foram estudados pacientes com diagnóstico de fibromialgia, acompanhados pelo Serviço de Reumatologia do Hospital Universitário da UFJF. Trata-se de um estudo transversal em que cada indivíduo foi submetido a exame clínico com ênfase na avaliação dos “tender points” (pontos dolorosos) e posterior coleta de sangue, para avaliação tireoidiana, que incluiu dosagens de TSH, T4 livre e, se necessário, dosagem de anticorpos anti-tiroperoxidase. Foi feita análise de variância para detectar a relação entre os níveis de TSH, T4 livre e número de pontos dolorosos. RESULTADOS: Foram avaliados 39 pacientes, sendo 38 do sexo feminino. Foi encontrada correlação positiva entre os níveis de TSH e o número de pontos dolorosos. Níveis de TSH abaixo de 0,5 mUI/ml se relacionaram com média de 10,0 e desvio-padrão de 2,8 pontos dolorosos; níveis de TSH entre 0,5 e 2,0 mUI/ml corresponderam a média de 8,6 com desvio-padrão de 7 pontos; níveis de TSH entre 2,0 a 5,0 mUI/ml corresponderam a média de 12,5 com desvio-padrão de 5,0 pontos e TSH acima de 5 mUI/ml se correlacionaram com média de 10,6 e desvio-padrão de 6,0 pontos. Não foi encontrada significância estatística entre esses parâmetros, mas existe tendência de que pacientes com número de pontos dolorosos acima de 11 apresentem maior mediana dos níveis de TSH, quando comparados àqueles com menor número de pontos. CONCLUSÃO: Existe a possibilidade de que, em portadores de fibromialgia, o número de pontos dolorosos guardem relação com os niveis de TSH. Estudos posteriores são necessários para confirmar esse achado

Cognitive impairment induced by delta9-tetrahydrocannabinol occurs through heteromers between cannabinoid CB1 and serotonin 5-HT2A receptors

Delta-9-tetrahydrocannabinol (THC), the main psychoactive compound of marijuana, induces numerous undesirable effects, including memory impairments, anxiety, and dependence. Conversely, THC also has potentially therapeutic effects, including analgesia, muscle relaxation, and neuroprotection. However, the mechanisms that dissociate these responses are still not known. Using mice lacking the serotonin receptor 5-HT2A, we revealed that the analgesic and amnesic effects of THC are independent of each other: while amnesia induced by THC disappears in the mutant mice, THC can still promote analgesia in these animals. In subsequent molecular studies, we showed that in specific brain regions involved in memory formation, the receptors for THC and the 5-HT2A receptors work together by physically interacting with each other. Experimentally interfering with this interaction prevented the memory deficits induced by THC, but not its analgesic properties. Our results highlight a novel mechanism by which the beneficial analgesic properties of THC can be dissociated from its cognitive side effects

International Expert Opinions and Recommendations on the Use of Melatonin in the Treatment of Insomnia and Circadian Sleep Disturbances in Adult Neuropsychiatric Disorders

Introduction: Insomnia and circadian rhythm disorders, such as the delayed sleep phase syndrome, are frequent in psychiatric disorders and their evaluation and management in early stages should be a priority. The aim of this paper was to express recommendations on the use of exogenous melatonin, which exhibits both chronobiotic and sleep-promoting actions, for the treatment of these sleep disturbances in psychiatric disorders.Methods: To this aim, we conducted a systematic review according to PRISMA on the use of melatonin for the treatment of insomnia and circadian sleep disorders in neuropsychiatry. We expressed recommendations for the use of melatonin in psychiatric clinical practice for each disorder using the RAND/UCLA appropriateness method.Results: We selected 41 studies, which included mood disorders, schizophrenia, substance use disorders, attention deficit hyperactivity disorders, autism spectrum disorders, neurocognitive disorders, and delirium; no studies were found for both anxiety and eating disorders.Conclusion: The administration of prolonged release melatonin at 2–10 mg, 1–2 h before bedtime, might be used in the treatment of insomnia symptoms or comorbid insomnia in mood disorders, schizophrenia, in adults with autism spectrum disorders, neurocognitive disorders and during sedative-hypnotics discontinuation. Immediate release melatonin at <1 mg might be useful in the treatment of circadian sleep disturbances of neuropsychiatric disorders

Significance of vascular endothelial growth factor in growth and peritoneal dissemination of ovarian cancer

Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis which drives endothelial cell survival, proliferation, and migration while increasing vascular permeability. Playing an important role in the physiology of normal ovaries, VEGF has also been implicated in the pathogenesis of ovarian cancer. Essentially by promoting tumor angiogenesis and enhancing vascular permeability, VEGF contributes to the development of peritoneal carcinomatosis associated with malignant ascites formation, the characteristic feature of advanced ovarian cancer at diagnosis. In both experimental and clinical studies, VEGF levels have been inversely correlated with survival. Moreover, VEGF inhibition has been shown to inhibit tumor growth and ascites production and to suppress tumor invasion and metastasis. These findings have laid the basis for the clinical evaluation of agents targeting VEGF signaling pathway in patients with ovarian cancer. In this review, we will focus on VEGF involvement in the pathophysiology of ovarian cancer and its contribution to the disease progression and dissemination

L'autre intelligence des enfants autistes (Une étude rétrospective comparative entre différents tests d'évaluation des capacités cognitives chez l'enfant avec trouble du spectre autistique)

STRASBOURG-Medecine (674822101) / SudocSudocFranceF

Meso-and Neoproterozoic paleoenvironments of the Mbuji-Mayi Supergroup, Democratic Republic of Congo

info:eu-repo/semantics/nonPublishe

Luminothérapie dans le syndrome des jambes sans repos : étude en double aveugle, contrôlée versus placebo.

Medications often partially alleviate the symptoms of RLS patients, emphasizing the need for finding alternative treatments. Recent studies reported an efficacy of bright light therapy (BLT) in Parkinson disease. RLS pathogenesis involves the dopaminergic system and light has been shown to influence the dopaminergic tone. Therefore, the objective of our study was to determine the therapeutic value of three weeks of BLT on RLS symptoms severity, sleep quality, daytime somnolence, circadian rhythms and mood

Pediatric prolonged-release melatonin for insomnia in children and adolescents with autism spectrum disorders

Introduction: Insomnia is common among children and adolescents with Autism spectrum disorder (ASD). The first drug licensed for insomnia in this population, a pediatric-appropriate prolonged-release melatonin (PedPRM) formulation is described. Areas covered: Literature search on PedPRM efficacy and safety profile in clinical trials, and a proposed decision-making algorithm to optimize outcome in the treatment of insomnia in children and adolescents with ASD. Expert opinion: PedPRM treatment effectively improves sleep onset, duration and consolidation, and daytime externalizing behaviors in children and adolescents with ASD and subsequently caregivers’ quality of life and satisfaction with their children’s sleep. The coated, odorless and taste-free mini-tablets are well-accepted in this population who often have sensory hypersensitivity and problems swallowing standard tablet preparations. The most frequent long-term treatment-related adverse events were fatigue (6.3%), somnolence (6.3%), and mood swings (4.2%) with no evidence of delay in height, BMI, or pubertal development, or withdrawal effects. The starting dose is 2 mg once daily independent of age or weight, escalated to 5–10 mg/day if predefined treatment success criteria are unmet. Slow melatonin metabolizers (~10% of children), may require lower doses. Given its long-term efficacy, safety and acceptance, PedPRM may ameliorate long-term consequences of insomnia in this population