EQUILÍBRIO ASSOCIADO AO RISCO DE QUEDAS EM IDOSOS NÃO INSTITUCIONALIZADOS

Realizar uma revisão integrativa da literatura sobre a relação existente entre o equilíbrio e o risco de queda da população idosa. Métodos: trata-se de uma revisão integrativa da literatura entre os anos de 2007 a 2016, que ocorreu por meio de consulta à Biblioteca Virtual em Saúde (BVS) utilizando os descritores "acidentes por quedas", "idoso" e "equilíbrio postural”, separados pelo operador boleano “AND”, sendo selecionados 7 estudos. Resultados: em relação ao equilíbrio em idosos associado ao risco de quedas e ao aumento dessa ocorrência, os 7 artigos mantiveram uma relação na abordagem quando evidenciaram que as alterações no equilíbrio geram a predisposição e aumenta o risco de quedas na população idosa. Conclusões: percebe-se que é necessária a identificação precoce dos riscos para a prevenção de quedas, e desta forma, atentar-se para a realização de ações preventivas que estimulem a responsabilidade do autocuidado, melhor qualidade de vida e o exercício da autonomia entre esses indivíduos

Effects of erythropoietin on depressive symptoms and neurocognitive deficits in depression and bipolar disorder

<p>Abstract</p> <p>Background</p> <p>Depression and bipolar disorder are associated with reduced neural plasticity and deficits in memory, attention and executive function. Drug treatments for these affective disorders have insufficient clinical effects in a large group and fail to reverse cognitive deficits. There is thus a need for more effective treatments which aid cognitive function. Erythropoietin (Epo) is involved in neuroplasticity and is a candidate for future treatment of affective disorders. The investigators have demonstrated that a single dose of Epo improves cognitive function and reduces neurocognitive processing of negative emotional information in healthy and depressed individuals similar to effects seen with conventional antidepressants. The current study adds to the previous findings by investigating whether repeated Epo administration has antidepressant effects in patients with treatment resistant depression and reverses cognitive impairments in these patients and in patients with bipolar disorder in remission.</p> <p>Methods/design</p> <p>The trial has a double-blind, placebo-controlled, parallel-group design. 40 patients with treatment-resistant major depression and 40 patients with bipolar disorder in remission are recruited and randomised to receive weekly infusions of Epo (Eprex; 40,000 IU) or saline (NaCl 0.9%) for 8 weeks. Randomisation is stratified for age and gender. The primary outcome parameters for the two studies are: depression severity measured with the Hamilton Depression Rating Scale 17 items (HDRS-17) <abbrgrp><abbr bid="B1">1</abbr></abbrgrp> in study 1 and, in study 2, verbal memory measured with the Rey Auditory Verbal Learning Test (RAVLT) <abbrgrp><abbr bid="B2">2</abbr><abbr bid="B3">3</abbr></abbrgrp>. With inclusion of 40 patients in each study we obtain 86% power to detect clinically relevant differences between intervention and placebo groups on these primary outcomes.</p> <p>Trial registration</p> <p>The trial is approved by the Local Ethics Committee: H-C-2008-092, Danish Medicines Agency: 2612-4020, EudraCT: 2008-04857-14, Danish Data Agency: 2008-41-2711 and ClinicalTrials.gov: NCT 00916552.</p

Cognitive dysfunction in bipolar disorder and schizophrenia: a systematic review of meta-analyses

Beatrice Bortolato,1 Kamilla W Miskowiak,2 Cristiano A K&ouml;hler,3 Eduard Vieta,4 Andr&eacute; F Carvalho3 1Department of Mental Health, ULSS 10 &ldquo;Veneto Orientale&rdquo;, Venice, Italy; 2Psychiatric Centre Copenhagen, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; 3Translational Psychiatry Research Group and Department of Clinical Medicine, Faculty of Medicine, Federal University of Cear&aacute;, Fortaleza, CE, Brazil; 4Bipolar Disorders Program, Institute of Neuroscience, Hospital Cl&iacute;nic Barcelona, IDIBAPS, CIBERSAM, University of Barcelona, Catalonia, Spain Abstract: Cognitive impairment is a core feature of schizophrenia (SZ) and bipolar disorder (BD). A neurocognitive profile characterized by widespread cognitive deficits across multiple domains in the context of substantial intellectual impairment, which appears to antedate illness onset, is a replicated finding in SZ. There is no specific neuropsychological signature that can facilitate the diagnostic differentiation of SZ and BD, notwithstanding, neuropsychological deficits appear more severe in SZ. The literature in this field has provided contradictory results due to methodological differences across studies. Meta-analytic techniques may offer an opportunity to synthesize findings and to control for potential sources of heterogeneity. Here, we performed a systematic review of meta-analyses of neuropsychological findings in SZ and BD. While there is no conclusive evidence for progressive cognitive deterioration in either SZ or BD, some findings point to more severe cognitive deficits in patients with early illness onset across both disorders. A compromised pattern of cognitive functioning in individuals at familiar and/or clinical risk to psychosis as well as in first-degree relatives of BD patients suggests that early neurodevelopmental factors may play a role in the emergence of cognitive deficits in both disorders. Premorbid intellectual impairment in SZ and at least in a subgroup of patients with BD may be related to a shared genetically determined influence on neurodevelopment. Keywords: schizophrenia, bipolar disorder, psychosis, neuropsychological tests, cognition, meta-analysis, psychiatr

The oldest herpetological collection in the world: the surviving amphibian and reptile specimens of the museum of Ulisse Aldrovandi

The natural history collection of the Bolognese polymath, encyclopedist, and natural philosopher Ulisse Aldrovandi (1522-1605) is regarded as the first museum in the modern sense of the term. It was intended as a resource for scholarship and a microcosm of the natural world, not simply a cabinet of curiosities. In addition to physical specimens, Aldrovandi's zoological material included a large series of paintings of animals (Tavole di Animali) that were integral to the collection. Following Aldrovandi's death, his collection was maintained by the terms of his will, but by the 19th century relatively little remained. We examined surviving herpetological components of the collection, comprising 19 specimens of ten species, as well as the corresponding paintings and associated archival material in the Museum of Palazzo Poggi, Museo di Zoologia, and Biblioteca Universitaria Bolognese in Bologna, Italy. Although the antiquity of some of these dried preparations is in question, many are documented in the Tavole di Animali and/or are mentioned in 17th century lists of the museum, verifying them as the oldest museum specimens of amphibians and reptiles in the world. Exotic species are best represented, including two specimens of Uromastyx aegyptia and several boid snakes - the first New World reptiles to be displayed in Europe. However, the Tavole di Animali suggest that the original collection was dominated by Italian taxa and that greater effort may have been made to conserve the more spectacular specimens. The Aldrovandi collection provides a tangible link to the dawn of modern herpetology in Renaissance Italy

Acute antidepressant drug administration and autobiographical memory recall: a functional magnetic resonance imaging study.

Antidepressants affect memory and neural responses to emotionally valenced stimuli in healthy volunteers. However, it is unclear whether this extends to autobiographical memory for personally experienced events. The current study investigated the effects of acute administration of the antidepressant reboxetine on emotional autobiographical retrieval in healthy volunteers (14 men, 10 women). Functional magnetic resonance imaging was used in a double-blind between-groups investigation with reboxetine (4 mg) and placebo. Consistent with previous reports using lab-based stimuli, neural activation in the processing of positive versus negative memories was reduced following reboxetine compared with placebo in the left frontal lobe (extending into the insula) and the right superior temporal gyrus. This was paired with increased memory speed in volunteers given reboxetine versus placebo. The effect of reboxetine on emotional memory extends to recall of personally experienced events. Such effects may be relevant to the cognitive improvements found with recovery from depression and with the mechanism of action of contemporary antidepressant drugs