Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Transtorno Obsessivo-Compulsivo/diagnóstico , Síndrome de Tourette/diagnóstico , Tricotilomania/diagnóstico , Transtorno do Deficit de Atenção com Hiperatividade/tratamento farmacológico , Criança , Clonidina/uso terapêutico , Comorbidade , Quimioterapia Combinada , Fluoxetina/uso terapêutico , Humanos , Masculino , Entrevista Psiquiátrica Padronizada , Transtorno Obsessivo-Compulsivo/tratamento farmacológico , Encaminhamento e Consulta , Sertralina/uso terapêutico , Síndrome de Tourette/tratamento farmacológico , Síndrome de Tourette/genética , Tricotilomania/tratamento farmacológicoRESUMO
Anxiety disorders in children and adolescents are highly prevalent and associated with long-term impairment. This article reviews the main diagnostic features of the most common pediatric anxiety disorders, including specific phobia, separation anxiety disorder, generalized anxiety disorder and social anxiety disorder, and highlights the state-of-the-art treatments for these diagnoses. The most recent evidence for empirically supported treatments is described, namely cognitive-behavioral therapy and selective serotonin-reuptake inhibitors. The review concludes by providing practitioners with recommendations for treating pediatric anxiety and highlighting areas for further investigation.
Assuntos
Transtornos de Ansiedade/terapia , Terapia Cognitivo-Comportamental/métodos , Pediatria/métodos , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Apoio Social , Adolescente , Criança , Terapia Cognitivo-Comportamental/tendências , Feminino , Humanos , Masculino , Pediatria/tendências , Guias de Prática Clínica como Assunto , Padrões de Prática MédicaRESUMO
In recent years, the gene defects causing many types of hereditary palmoplantar keratoderma have been discovered. These genes encode a variety of proteins involved in the terminal differentiation of keratinocytes and the formation of the cornified cell envelope. In this article, we review the molecular defects underlying various palmoplantar keratodermas with particular attention to the role of these molecules in the terminal differentiation of palmoplantar epidermis. Of the proteins involved in keratodermas, loricrin, keratins, and desmosomal proteins provide the protein structure of the cornified cell envelope. Connexins form intercellular gap junctions, which regulate ionic calcium signals necessary for the expression of the proteins that form the cornified cell envelope. Cathepsins likely mediate enzymatic processes necessary for the formation and dissolution of the cornified cell envelope. The clinical phenotypes produced by various mutations affecting these proteins are discussed vis-à-vis data from genetic, cellular, and molecular experiments.
