Epilepsy and Psychiatric Comorbidities: Drug Selection.

Purpose of review The pharmacological treatment of patients with epilepsy and psychiatric comorbidities may sometimes represent a therapeutic challenge. This review is focused on the pharmacological management of patients with epilepsy and psychiatric problems in terms of rationalization of the antiepileptic drug (AED) treatment and the pharmacological management of the most clinically relevant psychiatric comorbidities, namely mood and anxiety disorders, psychoses, and attention deficit hyperactivity disorder (ADHD). Recent findings Up to 8% of patients with drug-resistant epilepsy develop treatment-emergent psychiatric adverse events of AED regardless of the mechanism of action of the drug and this is usually related to an underlying predisposition given by the previous psychiatric history and the involvement of mesolimbic structures. Careful history taking, periodic screening for mood and anxiety disorders, low starting doses, and slow titration schedules can reduce the possibility of AED-related problems. A pragmatic checklist for the pharmacological management of patients with epilepsy and psychiatric disorders is presented. Summary patients should be informed of potential behavioral effects of AEDs but no drugs should be excluded a priori. Any psychiatric comorbidity should be addressed in the appropriate setting and full remission and recovery should always represent the first goal of any therapeutic intervention. Neurologists should be aware of the side effects of major psychotropic drug classes in order to fully counsel their patients and other health professionals involved

Vertical distribution, segregation by size and recruitment of the yellow clam Mesodesma mactroides Deshayes, 1854 (Mollusca, Bivalvia, Mesodesmatidae) in exposed sandy beaches of the Rio Grande do Sul state, Brazil

The vertical distribution and the segregation by size of the yellow clam Mesodesma mactroides Deshayes, 1854 were investigated in the intertidal zone and its limits with the lower and upper shores at exposed sandy beaches of Rio Grande do Sul state, Brazil. The gathering was made throughout 12 months; from the Pinhal beach towards the south of the State, in six 15 km equidistant transects, determined through random selection. In these transects, the calculation of 30 consecutive waves was made in order to determine its average amplitude point (P0), from which two points were marked towards the lower shore (P-1 and P-2) and three towards the upper shore (P1, P2 and P3). A 30 by 50 cm cylinder was buried down to the depth of 40 cm, the material was separated with a 0.25 cm mesh and the specimens were quantified and measured in length. The yellow clam presented segregation by size, especially between recruit and adult individuals, with recruits occupying preferably the zones above P0 and adults from this point towards the sea. The young specimens are distributed through all zones, mixed with adult and recruit specimens, which dismisses the hypothesis of segregation by size in function of competition for space and food, once the burying depth is directly proportional to their length. However, the segregation between recruits and adults might be related to the filtering mechanism of the adults, which could ingest the larva, as well as the fact that the recruits, being small and light, are easily transported to the regions above P0. Seasonal migration was observed for adult individuals during winter and spring, probably associated to the reproduction period of the species, being that the peak of recruitment was greater in the end of the winter and the beginning of spring

Impactos socioeconômicos de uma doença emergente Socioeconomic impacts of an emerging disease

Em 1995, ocorreu uma praga de lesmas identificadas como Sarasinula linguaeformis (Semper, 1885), que prejudicou as lavouras situadas entre os municípios de Nova Itaberaba e Planalto Alegre, no oeste do estado de Santa Catarina, Brasil. Neste artigo analisamos os impactos socioeconômicos provocados pela ocorrência desta praga, que sinalizou a possibilidade, posteriormente verificada, da emergência de casos de angiostrongilíase abdominal. Os dados foram coletados através de observação do estudo soroepidemiológico realizado na região durante o período de agosto de 2000 a agosto de 2001 pela equipe de pesquisa da Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), entrevistas com técnicos da Empresa de Pesquisa Agropecuária e Extensão Rural de Santa Catarina S.A. (Epagri-SC) e com cinquenta famílias locais. Para avaliar esses impactos, elaboramos algumas categorias de análise, como: prejuízo econômico; medidas preventivas e mudança de hábitos; estigma e preconceito, que surgiram à luz das narrativas dos sujeitos entrevistados. Ficou evidente a necessidade de se procederem a estudos sobre os aspectos sociológicos dos problemas epidemiológicos, além dos estritamente médico-sanitários.<br>In 1955 a population explosion of the slug Sarasinula linguaeformis (Semper, 1885) damaged crop plantations in the municipalities of Nova Itaberaba and Planalto Alegre, western of Santa Catarina State, Brazil. In this article we analyze the socioeconomic impacts caused by the emergence of this plague, which raised the suspicion, eventually confirmed, of the occurrence of human cases of abdominal angyostrongiliasis. The data were collected through the observation of a serological study during the period of August 2000 to August 2001 by a research team from the Catholic University of Rio Grande do Sul (PUCRS) together with field technicians from the Empresa de Pesquisa Agropecuária e Extensão Rural de Santa Catarina S.A. (Epagri-SC), and with the members of 50 local families. In order to analyze these impacts, we elaborated several analytical categories as economic losses; preventive measures, habit change and social prejudice, that emerged from the narratives of the residents interviewed. It became evident the need for sociological analyses of epidemiological problems, in addition to strictly medico-sanitary considerations