Prevalence of brain fag syndrome and its correlation with stimulant use and socioeconomic/demographic characteristics among university undergraduate students in Nigeria

Background: Brain Fag Syndrome (BFS) is a culture-bound syndrome characterized by cognitive and somatic symptoms, commonly reported among African students. This study aimed to determine the prevalence of BFS among Nigerian university students and examine its associated factors. Methods: A cross-sectional survey was conducted among undergraduate students from a university in the northwest region of Nigeria. The study utilized a self-administered questionnaire to collect data on socio-demographic characteristics, stimulant use, course of study, and academic performance. The presence of BFS was assessed using standardized diagnostic criteria. Results:The study included a total of 625 participants, in their young adulthood. The prevalence of BFS among Nigerian university students was found to be 62.7%. The majority of affected students were aged 20-30, male, and from the Hausa ethnic group. No significant association was found between stimulant use and BFS. However, there was a significant relationship between the course of study and the occurrence of BFS. Academic performance (CGPA) showed a weak negative association with BFS. Other socio-demographic factors such as age, gender, ethnicity, relationship status, birth position, type of home, and family income did not predict the occurrence of BFS. Conclusion: The high prevalence highlights the need for attention to mental health issues among this population. The results emphasize the importance of considering the course of study and academic performance when studying BFS. Further research is warranted to explore the underlying mechanisms and develop effective interventions for students affected by BFS.

Urine Drugs of Abuse Testing at Hospital Universiti Sains Malaysia: A Review of Trends from 2009 – 2019

@#Introduction: Substance abuse is a major social and health bane worldwide, including Malaysia, inflicting extensive morbidity and mortality. Our study aims to review the request and results of urine drugs of abuse testing conducted at the Pharmacology Laboratory of Hospital Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia, over a period of 11 years. Methods: Data for urine drugs of abuse testing requested and their results performed at the Pharmacology Laboratory between January 2009 and December 2019 was retrospectively extracted. Data on patient demographics, types of drugs requested, and types of drugs tested positive were analysed. Testing was performed using the enzyme multiplied immunoassay technique. Results: The absolute number and percentage of positive cases for amphetamine type stimulant (ATS) drugs has steadily risen over the past decade making it the current drug of abuse of most concern. Opiate abuse, although still seen, remained static. The peak age range for abusing drugs falls between 25–34 years with a male predominance; an alarming finding was of positive cases observed among neonates and children below the age of 12. Majority of requests came from the Psychiatric and Emergency Departments. Conclusion: Over the past eleven years, ATS abuse has superseded opiate in being the most abused drug type, detected even at young ages. Therefore, societal awareness and education on the dangers of ATS abuse, and intensive detection of ATS use must be implemented.

Interview and treatment of idiopathic hypersomnia comorbidity tics disorder / 四川精神卫生

The purpose of this paper is to present the diagnosis and treatment of idiopathic hypersomnia comorbidity tics disorder. The client is 15 years old， female， a senior student， with frequent blinking and a crooked mouth since childhood， diagnosed with tics disorder. She previously had consistently good academic performance. Since the COVID-19 epidemic in 2020， the client has been sleeping more， averaging 12 hours per day， accompanied by increased daytime sleep with fatigue after waking up， and a significant decline in her studies. She was diagnosed with idiopathic hypersomnia comorbidity persistent （chronic） movement or tic disorder. It was suggested that she adopt a method of comprehensive biopsychosocial intervention. Biotherapy with methylphenidate can improve her arousal， enhance attention and improve drowsiness， meanwhile， changes to tic symptoms must be monitored. Cognitive behavioral therapy was used to help the client correct cognitive biases， reshape cognitive structure， and establish confidence in rehabilitation. Mindfulness therapy was adopted to help the client adjust her emotions. In terms of social resources， the client was encouraged to explore resources actively， seek social support， and build therapeutic alliances. Through coordinating multiple resources， the client reduced symptoms of sleepiness and enhanced her adaptability to continue with her studies.

Trastorno por deficit de atención/hiperactividad y uso de sustancias / Attention-deficit/hyperactivity disorder and substance abuse. Scientific evidence

El trastorno por déficit de atención con hiperactividad (TDAH) es una alteración del neurodesarrollo de base biológica que iniciado en la infancia puede persistir durante la adolescencia-juventud y, a pesar de lo que se pensaba hasta hace no muchos años, también en la edad adulta hasta en un 50-60% de los afectados, produciendo un notable deterioro clínico y psicosocial. A pesar de tratarse de un síndrome fácilmente identificable por la triada: desatención, hiperactividad e impulsividad que le caracteriza, en la práctica clínica existen diferentes circunstancias que dificultan y complican su diagnóstico y tratamiento. Una de las más significativas es la presencia, tanto en la infancia como en la edad adulta, de otros trastornos mentales comórbidos. Es a partir de la adolescencia-juventud cuando junto al TDAH podemos detectar la presencia de trastornos de la personalidad, trastornos del estado de ánimo, trastornos de ansiedad y muy especialmente trastornos por uso de sustancias. Las evidencias existentes hasta el presente muestran como la comorbilidad del TDAH y el trastorno por uso de sustancias influyen en el curso evolutivo de ambos, complicando el abordaje, el tratamiento y consecuentemente agravando el pronóstico final. Las dificultades en su abordaje y la escasez de opciones de tratamiento nos hacen subrayar la importancia del tratamiento preventivo en la etapa infantil a partir de programas de psicoeducación centrados en la vulnerabilidad de estos pacientes a las sustancias y las consecuencias asociadas al consumo.

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental alteration of biological basis that started in childhood may persist during adolescence-youth and, despite what was believed until not many years ago, also in adulthood up to 50-60% of those affected, producing a significant clinical and psychosocial deterioration. In spite of being a syndrome easily identifiable by the triad: inattention, hyperactivity and impulsivity that characterizes it, in clinical practice there are different circumstances that hinder and complicate its diagnosis and treatment. One of the most significant is the presence, both in childhood and adulthood, of other comorbid mental disorders. It is from adolescence-youth when together with ADHD we can detect the presence of personality, mood and anxiety disorders and especially the use of several substances. The evidences existing until now show how the comorbidity of ADHD and substance use disorder influence the evolutionary course of both, complicating the approach, the treatment and, therefore, aggravating the final prognosis. The difficulties in their approach and the scarcity of treatment options make us underline the importance of preventive treatment in the infantile stage, starting from psychoeducation programs focused on the vulnerability of these patients to substances and the consequences associated with consumption.

La transición del adolescente con trastorno por déficit de atención con hiperactividad: Implicaciones para el tratamiento del adulto / Transition of adolescents with attention deficit/hyperactivity disorder. Implications for treatment of adults

El trastorno por déficit de atención con hiperactividad (TDAH) es un trastorno del neurodesarrollo crónico, complejo y multifactorial asociado con elevadas tasas de concurrencia con otros trastornos psiquiátricos, junto con problemas y repercusiones en diferentes áreas del funcionamiento del individuo. El TDAH no es exclusivo de la edad infanto-juvenil, estimándose una persistencia del 40-60% en la edad adulta, de modo que entre 2.5 y 5% de adultos continúan presentando este trastorno. La adolescencia es una etapa en la que se producen grandes y continuos cambios y que se asocia con una menor adherencia al tratamiento, una mayor vulnerabilidad a la aparición de problemas académicos, más conductas de riesgo, el inicio en el consumo de sustancias y la aparición de otros trastornos comórbidos. Se produce también la transición a los servicios o unidades de adultos, siendo necesaria una mayor coordinación entre los servicios infanto-juveniles y de adultos para asegurar una continuidad de la intervención en una etapa d e la vida en la que el paciente es especialmente vulnerable. Como en el caso de los niños y adolescentes, el tratamiento recomendado en el adulto con TDAH es el abordaje multimodal y multidisciplinar, que combina la medicación con estrategias psicológicas o psicosociales, como la psicoeducación, la terapia cognitivo conductual o el coaching, adaptadas a las necesidades individuales de cada paciente. Los fármacos psicoestimulantes son considerados de primera elección en adultos por las guías clínicas.

Attention deficit hyperactivity disorder (ADHD) is a chronic, complex and multifactorial neurodevelopmental disorder associated with high rates of concurrent psychiatric disorders, along with problems and complications on different areas of individual functioning. ADHD is not exclusively a childhood disorder, 40-60% persisting into adulthood with an estimated prevalence of 2.5-5%. Adolescence is a stage where great and continuous changes occur, associated with a lower adherence to treatment, a greater vulnerability to the emergence of academic problems, more risk-behaviors, the onset of substance use and higher rates of other comorbid disorders. The transition to adult services or units also occurs at this stage, requiring greater coordination between child/adolescent and adult services to ensure continuity of care in a phase of life in which the patient is particularly vulnerable. As in the case of children and adolescents, the recommended treatment for adults with ADHD is the multimodal and multidisciplinary approach, that combines medication with psychological or psychosocial strategies, such as psycho-education, cognitive behavioral therapy or coaching, adapted to the individual needs of each patient. Clinical guidelines recommend psycho-stimulant drugs as first-line treatments for adult patients with ADHD.

Medicina supresora y medicina estimulante: una mirada penetrante de la práctica médica / Suppressive medicine and stimulant medicine: a penetrating view in medical practice

Resumen: La teoría de la medicina supresora (MS) y la medicina estimulante (ME) destaca dos formas radicalmente distintas de entender la enfermedad y de enfrentarla. Para la MS es un objeto extraño o ajeno al organismo que hay que disminuir o destruir (suprimir); para la ME es un trastorno de la armonía interna que requiere fortalecer o avivar el organismo para restablecerla (estimular). En la medicina moderna, el poder de la industria de la salud favorece el predominio de la MS, por su alta rentabilidad, y la marginación de las medicinas alternativas (MA), poco rentables que, al igual que la vacunación o las terapias sustitutivas y regenerativas, son formas de ME. El efecto placebo (EP) inherente a la práctica médica, revelador de fuerzas curativas endógenas susceptibles de estimulación, da sentido a la ME y credibilidad a las MA. La dirección del EP de lo macro (psicosocial) a lo micro (físico-químico) explica su alta especificidad y ausencia de efectos secundarios. El efecto farmacológico de lo micro a lo macro, opuesto a las fuerzas endógenas, conlleva indefectiblemente efectos secundarios que requieren ulteriores supresiones y dosis repetidas indefinidamente. Se analizan equívocos de la ciencia con respecto al EP y al imponer a las MA criterios metódicos propios de la MS, que las desvirtúa, descalifica y excluye como objetos de conocimiento. Se insiste en la necesidad de reconocer la ME y rescatar las MA para la indagación, a fin de explorar sinergias, complementos o reemplazos con relación a la MS en la búsqueda del bien vivir.

Abstract: The theory of suppressive (SuM) and stimulant (StM) medicine highlights two radically different ways of understanding and coping with diseases. For SuM it is a strange or foreign object to the organism that must be diminished or destroyed (suppressed); for StM it is a disorder of internal harmony that requires strengthening or enlivening the body to re-establish it (stimulate). In modern medicine, the power in the health industry favors the predominance of SuM, because of its high profitability, and the marginalization of low-cost alternative medicines (AM) that, like vaccination or substitutive and regenerative therapies, are forms of StM. The placebo effect (PE) inherent to medical practice, revealing of endogenous curative forces susceptible to stimulation, gives meaning to StM and credibility to AM. The direction of the PE from the macro (psychosocial) to the micro (physical-chemical) explains its high specificity and absence of side effects. The pharmacological effect of the micro to the macro, opposed to the endogenous forces, inevitably entails side effects that require further suppression and indefinite repetition of doses. Scientific assertions that misunderstand PE, and impose on the AM methodical criteria of the SuM that detract, disqualify and exclude them as objects of knowledge, are analyzed. The emphasis is on the need to recognize the StM and rescue the AM for inquiry in order to explore synergies, complements or replacements in relation to the SuM, in the quest for to live well.

Representação social de mães sobre alimentação e uso de estimulantes do apetite em crianças: satisfação, normalidade e poder / Social representation of mothers about feeding and use of appetite stimulants in children: satisfaction, normality and power

Resumo: Este estudo teve como objetivo identificar as representações sociais elaboradas por mães sobre o apetite dos filhos e os medicamentos utilizados para modificá-lo. A abordagem qualitativa desta pesquisa empregou como suporte a teoria das representações sociais. Por meio de entrevistas realizadas com 15 mães que administraram em seus filhos medicamentos para estimular o apetite, foi possível identificar uma insatisfação materna com o volume habitual e seletividade de alimentos ingeridos por seus filhos. Essas foram as principais razões para o uso de medicamentos. Outras razões que encontram espaço são o desenvolvimento da criança, com ganho de massa corpórea, além da vontade de regular as horas em que a criança deveria comer. Esses resultados apontam para a importância das representações sociais maternas sobre a percepção corporal, papel dos alimentos e medicamentos nas práticas do cuidado alimentar infantil.

Abstract: Social representation of mothers about feeding and use of appetite stimulants in children: satisfaction, normality and power This study aimed to identify the social representations elaborated by mothers about the appetite of children and the drugs used to modify this appetite. The qualitative approach used in this study employed as theoretical support the theory of social representations. Through interviews with 15 mothers who administered their children drugs to stimulate appetite, it was possible to identify a maternal dissatisfaction with the usual volume and selectivity of food eaten by their children. These were the main reasons for using drugs. Other related reasons were the growth of the children, with a body mass gain, beyond the desire to regulate the times which the child should eat. These results point to the importance of maternal social representations of body perception , and the role of food and medicine in child care practices.

Application of psychological intervention in intravenous infusion of stimulant drugs in neurology / 中国生化药物杂志

Objective To explore the application and effect of psychological intervention in stimulating intravenous infusion of drugs in neurology department. Methods In the control group, the patients in the neurology department selected appropriate stimulant drugs according to their actual conditions, and the patients in the study group received psychological intervention on the basis of stimulating drugs and intravenous treatment. Records the two groups of neurology patients treatment compliance, before and after treatment of neurological function changes, the data into the SPSS software, after statistical analysis, and draw conclusions. Results Before treatment, two groups of neurology patients were compared with the NIHSS scale score; after the treatment of nerve function improvement (NIHSS scale decline) than the control group, the study group (P<0.05). Department of neurology patients with complete compliance (82.61%) was significantly higher than the control group (50.00%, P<0.05). Conclusion On the basis of stimulating drugs intravenous infusion in the treatment of Neurology, patients with targeted psychological intervention can significantly improve the treatment compliance, and is conducive to the protection of patients with drug treatment effect.

Uncertainty Analysis of Formaldehyde Content in Food Stimulant / 中国药师

Objective: To analyze the uncertainty in the determination of formaldehyde in food stimulant.Methods: HPLC with pre-column derivation was used to determine formaldehyde in food stimulant.A calculation formula was established to identify the source of uncertainty and the combined uncertainty was evaluated.Results: The synthetic uncertainty in the determination of formaldehyde was 1.7% and the expanded uncertainty was 3.4%.The formaldehyde content in food stimulant was (1.320 ± 0.044) mg·L-1 (k =2).Conclusion: The study provides reference for the uncertainty analysis on formaldehyde content in food stimulant by HPLC with pre-column derivation.

The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (III): Pharmacological Treatment

The objective of this review is the revision of the Korean practice parameters for the pharmacological treatment of attention-deficit hyperactivity disorder (ADHD) based on the change in the diagnostic system from DSM-IV-TR to DSM-5 and psychopharmacological developments. For the evidence-based approach, the authors conducted a review of the literature, including controlled clinical trials, studies of the side effects of drugs, toxicology and meta-analyses from the United States and Europe, as well as recent research conducted in Korea. The review committee composed of Korean experts on ADHD reviewed the revised parameters. This revised version reveals how to use central nervous system psychostimulants, non-stimulants such as atomoxetine and alpha2 agonists, and other medication for ADHD, and how to manage the adverse effects of such medication. At the end of this revised version, the authors propose recommendations for the pharmacotherapy of ADHD.

Intake of stimulant foods is associated with development of parasomnias in children / Ingestão de alimentos estimulantes está associada ao desenvolvimento de parassonias em crianças

ABSTRACT Objective To verify if nighttime feeding habits can influence parasomnia in children. Method Seven private and four public Elementary Schools took part in the study. A total of 595 Sleep Disturbance Scale for Children were distributed to the parents of children aged from 7 to 8 years. Data of dietary recall, starting time to school, physical activity, and nutritional status were studied. Results Of the 226 questionnaires completed, 92 (41%) reported parasomnia. Girls had 2.3 times more the chance to parasomnia than boys. Children who consumed stimulant foods had 2.6 times more chance to have parasomnia than those of children who consumed non-stimulant foods. There were no difference between parasomnia and no-parasomnia groups in food type (p = 0.78) or timing of last meal before bedtime (p = 0.50). Conclusion Our findings suggest that intake of stimulant foods is associated with development of parasomnia in children.

RESUMO Objetivo Verificar se hábitos de alimentação noturna influenciam parassonias em crianças. Método Sete escolas privadas e quatro públicas, de Ensino Fundamental, fizeram parte do estudo. Um total de 595 Escalas de Distúrbio do Sono para Crianças foram distribuídas para os pais de crianças entre 7 e 8 anos. Dados de recordatório alimentar, período escolar, atividade física e estado nutricional foram estudados. Resultados Dos 226 questionários preenchidos, 92 (41%) relataram presença de parassonias. Meninas tiveram 2,3 vezes mais chance de parassonias e crianças que consumiram alimentos estimulantes tiveram 2,6 vezes mais chance de parassonias em relação àquelas que consumiram alimentos não estimulantes. Não houve diferença entre os grupos em relação ao tipo de alimento (p = 0,78) ou horário da última refeição antes de ir para a cama (p = 0,50). Conclusão Nossos achados sugerem que a ingestão de alimentos estimulantes está associada com o desenvolvimento de parassonias em crianças.

Randomized controlled trial of noninvasive positive pressure ventilation technology combined with respiratory stimulant in the treatment of pulmonary encephalopathy in patients with COPD / 中国基层医药

Objective To explore the efficacy of noninvasive positive pressure ventilation technology com-bined with respiratory stimulant in the treatment of pulmonary encephalopathy in patients with COPD.Methods For-ty -eight COPD patients with early pulmonary encephalopathy were included.They were randomly divided into the treatment group and control group.The treatment group was treated by not only regular treatment and noninvasive posi-tive pressure ventilation technology,but also respiratory stimulant.The control group was only treated by regular treat-ment and noninvasive positive pressure ventilation technology.The indexes were recorded,including tracheal intubation rate,clinical recovery rate,mortality,Glasgow coma score,arterial blood gas analysis and adverse reactions.Results Compared with the control group,the arterial blood gas analysis of treatment group on the 2h,24h and 72h were statis-tically significant different(P <0.05).The GCS score on the 24h and 72h were also statistically significant different [24h,(13.4 ±1.6)vs.(11.8 ±2.1),P <0.05;72h,(14.6 ±1.5)vs.(12.4 ±2.4),P <0.05].The treatment group had lower tracheal intubation rate(12% vs.56.5%,P =0.001),shorter consciousness recovery time[(3.0 ± 0.5)h vs.(5.6 ±0.7)h,P =0.023],shorter hospitalization time in ICU[(12.6 ±1.5)d vs.(19.2 ±1.8)d,P =0.004]and better clinical recovery(22 /25 vs.10 /23,P =0.001)than the control group.But the mortality rate had no significant difference between the two groups(1 /25 vs.4 /23,P =0.129).Conclusion NIPPV combined with respiratory stimulant is an effective,safe and simple method for treatment of COPD complicated with pulmonary encephalopathy.It can significantly improve the clinical symptoms and the index of arterial blood gas analysis,and it can shorten consciousness recovery time and decrease tracheal intubation rate.But close observation must be carried out,and the invasive mechanical ventilation should be promptly executed in case of emergency or exacerbation.

Appetite stimulants for older persons

Anorexia is one of the most common issues in older patients. Although there is a tendency for loss of appetite in older persons due to decreased physical activity and reduced resting metabolic rate, this physiological anorexia of aging can easily develop into progressive anorexia and weight loss. This pathologic anorexia and resultant weight loss is associated with increased morbidity and mortality, especially in the frail elderly. To prevent older persons from entering a vicious cycle of frailty, that is, anorexia-malnutrition-sarcopenia-functional impairment, routine screening for anorexia and malnutrition should be implemented in geriatric clinical practice. All anorexic elderly patients should be strongly encouraged to maintain their nutrition, and appetite stimulants can be considered if non-pharmacological interventions are not effective. Although there are no US or Korea Food and Drug Administration approved medications for geriatric-specific anorexia and weight loss, several appetite stimulants can be prescribed and are used widely. Megestrol acetate is the most widely studied and commonly used of these drugs. Cyproheptadine, dronabinol, mirtazapine, corticosteroids, anabolic steroids (e.g., testosterone or oxandrolone), and growth hormone are also effective in increasing appetite or weight. However, the use of these orexigenic agents should occur only after their benefit-to-risk ratio has been carefully considered.

Central nervous system stimulant actions of Alpinia galanga (L.) rhizome: A preliminary study.

Methanolic and ethyl acetate extract of A. galanga showed significant central nervous system (CNS) stimulant activity in mice using actophotometer and rotarod test. CNS stimulation at a dose of 500 mg/kg was comparable with standard drugs caffeine and amphetamine derivative modalart. The extracts did not shown any depressant effect in forced swim or tail suspension tests. It can be concluded that A. galanga rhizome may have stimulant activity in mice and the active constituents responsible for this effect is present both in crude methanolic extract as well as in ethyl acetate fraction of methanolic extract of this plant species.

Preliminary pharmacological investigation of the ischuretic property and safety of a hydro-ethanolic extract of Amaranthus spinosis (Fam: Amaranthaceae).

Background: Ischuria is a health and social problem, having a negative impact on sufferers. This study therefore was a preliminary investigation of the ischuretic property and safety for use of a hydro-ethanolic extract of Amaranthus spinosus used traditionally in managing ischuria. Methods: Phytochemical screening, thin layer chromatography and high performance liquid chromatography were performed on the extract to establish fingerprints for identification. Acetylcholine, Nicotine, and the extract were applied to an isolated rat urinary bladder to ascertain contractile response. The possible receptor site(s) of action was also investigated using isolated rabbit jejunum, and guinea-pig ileum preparations. In-house observation, hematological analysis, and liver and kidney function tests were performed on Sprague-Dawley rats, in acute and sub-acute toxicity studies. Results: The extract had contractile effects on the rat urinary bladder (similar to acetylcholine and nicotine) and rabbit jejunum. Its contractile effect of the guinea-pig ileum was significantly inhibited by hexamethonium (77.50 ± 8.50 %; P ≤ 0.001) and to a lesser extent by mepyramine (49.2 ± 6.80 %; P ≤ 0.001) and Atropine (22.45 ± 5.22 %; P ≤ 0.01). The extract (80-800 mg kg-1) was not lethal and a 160 and 240 mg kg-1 dose had no adverse effect on blood, liver, kidney metabolic function. Conclusions: The hydro-ethanolic extract of Amaranthus spinosus has ischuretic activity possibly mediated via nicotinic, histaminic and muscarinic receptor stimulation and is safety to use in ischuria.

Ensaio clínico randomizado, duplo-cego e controlado por placebo de ciproheptadina para estímulo do apetite na fibrose cística / A randomized, double-blind, placebo-controlled trial of cyproheptadine for appetite stimulation in cystic fibrosis

OBJETIVO: O objetivo deste estudo foi determinar se a administração de ciproheptadina é capaz de induzir ganho de peso em pacientes com fibrose cística. MÉTODOS: Foi realizado um estudo duplo-cego, controlado com placebo em dois centros no Brasil. Vinte e cinco pacientes com fibrose cística entre 5 e 18 anos completaram o estudo. Os pacientes foram randomizados em dois grupos, para receber ciproheptadina 4 mg três vezes por dia durante 12 semanas ou placebo. Todos os dados foram coletados no início e no final do período de estudo e incluíram peso, altura e espirometria. RESULTADOS: O ganho de peso médio foi de 0,67 kg e 1,61 kg nos grupos placebo e ciproheptadina, respectivamente (p = 0,036). O índice de massa corporal (IMC) diminuiu 0,07 kg/m² no grupo placebo e aumentou 0,46 kg/m² no grupo intervenção (p = 0,027). A mudança no IMC para a idade (escore z) foi de -0,19 no grupo placebo e 0,20 no grupo ciproheptadina (p = 0,003). O IMC escore z diminuiu 0,19 no grupo placebo e aumentou 0,2 no grupo ciproheptadina (p = 0,003). Alterações na função pulmonar não foram estatisticamente diferentes. CONCLUSÃO: O uso de ciproheptadina em pacientes com fibrose cística foi bem tolerado, apresentando um ganho de peso significativo e um aumento no IMC após 12 semanas. Foi encontrado um tamanho de efeito clinicamente relevante para o peso/idade (escore z) e IMC para idade (escore z). Tais achados sugerem que a prescrição de ciproheptadina pode ser uma abordagem alternativa para pacientes que precisam de suporte nutricional por um curto período de tempo.

OBJECTIVE: To determine whether the administration of cyproheptadine was able to induce weight gain in patients with cystic fibrosis. METHODS: We performed a double-blind, placebo-controlled trial in two centers in Brazil. Twenty-five patients with cystic fibrosis between 5 and 18 years completed the study. Patients were randomized into two groups, to receive either cyproheptadine 4 mg three times per day for 12 weeks or placebo. All data were collected at the beginning and at the end of the study period and included weight, height and spirometry. RESULTS: Average weight gain was 0.67 kg in the placebo group and 1.61 kg in the cyproheptadine group (p = 0.036). Body mass index (BMI) decreased 0.07 kg/m² in the placebo group and increased 0.46 kg/m² in the intervention group (p = 0,027). The change in BMI for age (z score) was -0.19 in the placebo group and +0.20 in the cyproheptadine group (p = 0.003). BMI z score decreased 0.19 in the placebo group and increased 0.2 in the cyproheptadine group (p = 0.003). Changes in pulmonary function were not statistically different. CONCLUSION: Use of cyproheptadine in cystic fibrosis patients was well tolerated, showing a significant weight gain and a significant increase in BMI after 12 weeks. A clinically relevant effect size for weight/age (z score) and body mass index for age (z score) was found. Such findings suggest that the prescription of cyproheptadine can be an alternative approach for patients who need nutritional support for a short period of time.

Effect of Methylphenidate on Learning in Normal Population

Methylphenidate is a widely used stimulant for treatment of attention-deficit hyperactivity disorder (ADHD). In addition to core symptoms of attention and behavioral symptoms, methylphenidate is even effective for executive functions. However, abuse and misuse of stimulants, including methylphenidate, for the purpose of cognitive enhancement is an issue of concern worldwide. Some prejudices and misunderstandings against methylphenidate are popular ; however, little attention has been given to the neuropsychiatric evidence of methylphenidate for enhancement of cognitive function among healthy populations. In this article, our aim was to conduct a review of previous studies investigating the effect of methylphenidate in healthy populations. Findings from several recent studies have demonstrated the effectiveness of methylphenidate for enhancement of cognitive function in healthy populations. The mechanisms of cognitive enhancement are thought to be associated with motivation and the reward circuit in the brain. However, when considering the risk to benefit, an official discussion of the use of methylphenidate among healthy members of the population would be premature. Instead, investigation of epidemiological studies of the prevalence of misuse of stimulants among healthy members of the population, particularly adolescents and college students, is needed. In addition, based on achievements reported in previous studies, investigation of the effect of an approach using non-pharmacological enhancing motivation, which will in turn result in increased cognitive function would be helpful.

Factors Affecting Adherence to Pharmacotherapy in Children with Attention-Deficit Hyperactivity Disorder:A Retrospective Study

OBJECTIVES: To identify the factors affecting long-term adherence to methylphenidate treatment in children with attention-deficit hyperactivity disorder (ADHD). METHODS: A retrospective medical record review of 239 ADHD patients (mean age 9.3+/-2.6 years, range 6.0-17.4 years) who had visited the child and adolescent psychiatry clinic at a university hospital, in Seoul, Korea from March 2005 to February 2008. Subjects were diagnosed as ADHD based on the criteria set forth in the Diagnostic and Statistical Manual of Mental Disorders 4th edition, text revision version (DSM-IV-TR) and underwent neuropsychological tests including the continuous performance test (CPT). Treatment discontinuation was defined as the last prescription date when the medication possession rate (MPR) became less than 0.80. Subjects were divided into three groups and labeled as Group I, non-adherence without pharmacotherapy, Group II, non-adherence with short-term pharmacotherapy, and Group III, adherence with long-term pharmacotherapy. RESULTS: Ninety (37.7%) patients were grouped as non-adherent (Groups I+II) and 149 (62.3%) as adherent (Group III). The adherence group exhibited lower intelligence, higher symptom severity, and a higher number of comorbid psychiatric disorders than controls. The use of stimulants was significantly associated with long-term adherence to treatment. Additionally, the duration of interval between the date of the first visit and the date of the first prescription was positively associated with long-term adherence. CONCLUSION: About two-thirds of patients diagnosed as ADHD adhered to the treatment six months after the first visit. With respect to patient evaluation and the development of treatment strategies, factors affecting early drop-out and longer follow-up must be considered.

Consumption of stimulant drinks and consequent ingestion of phenolic compounds and caffeine / Consumo de bebidas estimulantes e consequente ingestão de compostos fenólicos e cafeína

Coffee and yerba maté beverages are widely consumed by the South American population. In adition to the stimulant characteristic, due the presence os caffeine in its composition, these beverages contribute to the intake of bioactive compounds such as phenolic compounds. The content of these compounds justify the several health benefits atributed to yerba maté and coffee: antioxidant, antimutagenic, chemioprevention, antiatherogenic and hepatoprotective effects. The aim of this study was to verify the consumption of these beverages and consequent intake of bioactive compounds (caffeine and total phenolics) by the Brazilian population. A sub analysis of the BRAZOS study (a cross-sectional study) provided data about the beverages intake. The content of bioactive compounds was compiled from original articles and reviews indexed at ISI Web of Knowledge. Coffee (consumed by aproximately 75% of population) and yerba maté (most consumed in the South region) are an important source of bioactive compounds in the Brazilian diet, being chimarrão the major contributor for the intake of these compounds due the large volume ingested.

Las bebidas café y yerba maté son extensamente consumidas por la población de América del Sur. Además de su característica estimulante,debido a la presencia de cafeína en sucomposición, estas bebidas contribuyen para el consumo de compuestos bioactivos tales como los compuestos fenólicos. El contenido de fenólicos justifica los muchos beneficiospara la salud humana atribuidos a estasinfusiones: antioxidantes, anti-mutagénicos, quimiopreventivos, antiaterogénicos y hepatoprotectores. El objetivo de este estudio fue evaluar el consumo de estas bebidas y laconsiguiente ingestión de compuestos bioactivos (cafeína y fenólicos totales) por la población brasileña. Datos sobre el consumo de estas infusiones fueron retirados de un sub-análisisdel estudio BRAZOS (un estudio transversal). Los valores de la concentración de compuestosbioactivos en las infusiones fueron compilados de los artículos originales y revisiones indexadasen la base de datos ISI Web of Knowledge. El café (consumido por aproximadamente 75%de la población) y la yerba mate (consumido más en la región sur) son fuente importante de compuestos bioactivos en la dieta brasileña,siendo el chimarrão el mayor contribuyente para el consumo de estos compuestos debido al gran volumen ingerido.

Infusões de café e erva-mate são largamente consumidos pela população sul-americana. Além da propriedade estimulante, devido à presença de cafeína na composição destes, estas bebidas contribuem para a ingestão de compostos bioativos como os compostos fenólicos. A presença destes compostos biativos estão relacionados a muitos dos efeitos benéficos à saúde humana atribuídos a estes infusos: ação antioxidante, antimutagênica, quimiopreventiva, antiaterogênica e hepatoprotetora. O objetivo deste estudo foi avaliar a ingestão destas bebidas e consequente ingestão de compostos bioativos (cafeína e fenólicos totais) pela população brasileira. Dados sobre o consumo das infusões foram retirados de uma subanálise da estudo BRAZOS (um estudo transversal). Os valores do conteúdo de compostos bioativos nas infusões foram compilados de artigos originais e revisões indexados na base de dados ISI (Web of Knowledge). Café (consumido por aproximadamente 75% da população) eerva-mate (consumida principalmente na região Sul) são importantes fontes de compostos bioativos na dieta brasileira, sendo o chimarrão a infusão responsável pela maior ingestão destes compostos devido ao alto volume ingerido.

Efeito da água de criação larval na oviposição de Aedes aegypti em laboratório / Effect of larval rearing water on Aedes aegypti oviposition in the laboratory

Para avaliar a influência da água de criação larval na oviposição de Aedes aegypti, quatro tipos de águas foram oferecidos a fêmeas grávidas. Foram observados mais ovos na água de criação larval mista (2.837) do que na água de Aedes albopictus (690) e controle (938) porém, semelhante à Aedes aegypti (2.361).

To evaluate the influence of larval rearing water on Aedes aegypti oviposition, four types of water were provided for gravid females. It was observed that more eggs were laid in the mixed larval rearing water (2,837) than in the Aedes albopictus water (690) or control water (938), but that this number was similar to what was seen in the Aedes aegypti water (2,361).