RESUMO
ABSTRACTObjectives:to perform a comprehensive literature review of studies on older adults with exceptional cognitive performance. DESIGN: We performed a systematic review using two major databases (MEDLINE and Web of Science) from January 2002 to November 2017. RESULTS: Quantitative analysis included nine of 4,457 studies and revealed that high-performing older adults have global preservation of the cortex, especially the anterior cingulate region, and hippocampal volumes larger than normal agers. Histological analysis of this group also exhibited decreased amyloid burden and neurofibrillary tangles compared to cognitively normal older controls. High performers that maintained memory ability after three years showed reduced amyloid positron emission tomography at baseline compared with high performers that declined. A single study on blood plasma found a set of 12 metabolites predicting memory maintenance of this group. CONCLUSION: Structural and molecular brain preservation of older adults with high cognitive performance may be associated with brain maintenance. The operationalized definition of high-performing older adults must be carefully addressed using appropriate age cut-off and cognitive evaluation, including memory and non-memory tests. Further studies with a longitudinal approach that include a younger control group are essential.
Assuntos
Envelhecimento/fisiologia , Encéfalo/diagnóstico por imagem , Cognição/fisiologia , Imageamento por Ressonância Magnética , Memória , Tomografia por Emissão de Pósitrons , Idoso , Amiloide/metabolismo , Feminino , Humanos , Masculino , NeurobiologiaRESUMO
Introdução: Esclerose Múltipla (EM) é uma doença imunomediada do Sistema Nervoso Central (SNC) que atinge um grande número de pacientes no mundo. Estão disponíveis diversas medicações com mecanismos, vias de administração e eficácia diferentes que serão abordadas nesta revisão. Métodos: Realizamos uma busca por artigos de revisão dos últimos 5 anos na base de dados PubMed. Resultados: Nove drogas foram descritas com base nos seus mecanismos de ação, via de administração e eficácia. Conclusão: Há uma variedade de possibilidades para tratar pacientes com EM. Devem-se observar os perfis específicos de cada droga, a fim de equilibrar os riscos e benefícios junto com a preferência do paciente pela via de administração.
Introduction: Multiple Sclerosis (MS) is an immune mediated disease of the Central Nervous System (CNS) that affects a large number of patients globally. There is a variety of medications with different mechanisms, administration routes and efficacy that will be reviewed in this paper. Methods: We searched for review articles of the last 5 years at the PubMed database. Results: Nine drugs were described regarding their mechanism of action, administration routes and efficacy. Conclusion: There are several possibilities when treating a patient with MS. Patient's preference for the administration route and the specific profile of each drug should be considered to balance the risks and benefits of the treatment.
Assuntos
Esclerose Múltipla/tratamento farmacológico , Preparações FarmacêuticasRESUMO
A dor crônica (DC) é uma experiência sensorial e emocional desagradável e é definida por períodos contínuos ou persistentes de dor superior a três meses de duração. A classificação da DC, por seu mecanismo, permite um manejo mais adequado e eficiente. O presente trabalho objetiva revisar esta visão e analisar aspectos concernentes à essa questão.
Chronic pain (CP) is a multidimensional sensation with intrinsically unpleasant experiences. It is associated to uninterrupted or persistent periods of pain superior to e three months. CP is classified according to its mechanism, and this distinction is important to make the appropriate management of the condition. The goal of this assessment is to review such concept.
