An overview on neurobiology and therapeutics of attention-deficit/hyperactivity disorder.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a prevalent psychiatric condition characterized by developmentally inappropriate symptoms of inattention and/or hyperactivity/impulsivity, which leads to impairments in the social, academic, and professional contexts. ADHD diagnosis relies solely on clinical assessment based on symptom evaluation and is sometimes challenging due to the substantial heterogeneity of the disorder in terms of clinical and pathophysiological aspects. Despite the difficulties imposed by the high complexity of ADHD etiology, the growing body of research and technological advances provide good perspectives for understanding the neurobiology of the disorder. Such knowledge is essential to refining diagnosis and identifying new therapeutic options to optimize treatment outcomes and associated impairments, leading to improvements in all domains of patient care. This review is intended to be an updated outline that addresses the etiological and neurobiological aspects of ADHD and its treatment, considering the impact of the "omics" era on disentangling the multifactorial architecture of ADHD.

Accuracy evaluation of 2021 Chronic Kidney Disease Epidemiology Collaboration, Full Age Spectrum and European Kidney Function Consortium equations for estimating glomerular filtration rate in type 2 diabetes mellitus and healthy adults.

BACKGROUND AND AIMS: Estimated glomerular filtration rate (eGFR) equations accuracy has been questioned in diabetes mellitus (DM). We aimed to evaluate the performance of three equations - European Kidney Function Consortium (EKFC), Full Age Spectrum (FAS), and 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) - in healthy and type 2 DM participants. MATERIAL AND METHODS: This cross-sectional studycompared eGFR equations withareference method: measured GFR (mGFR) by 51Cr-EDTA. The equations performance was assessed usingBland-Altman plot,concordance correlation coefficient (CCC), bias,P30 andP15 accuracy. RESULTS: In the 100 healthy adults included (aged 39 ± 15 years, 67% women, mean mGFR 107 ± 15, 2021 CKD-EPI 109 ± 14, FAS 107 ± 18 and EKFC 101 ± 12 mL/min/1.73 m2), all equations reached P30 accuracy above the desirable benchmark of 90%. In the 122 patients with type 2 DM (aged 61 ± 10 years, 55% women, mGFR97 ± 22, 2021 CKD-EPI 86 ± 20, FAS 83 ± 25 and EKFC 79 ± 18 mL/min/1.73 m2), the equations presented larger biases, worst agreement with mGFR and inferior accuracy, with 2021 CKD-EPI (83%) and EKFC (82%) presenting greater P30 than FAS (77%). CONCLUSION: In healthy Brazilian adults, 2021 CKD-EPI, FAS and EKFC are suitable to estimate GFR. However, all equations underperform in people with type 2 DM.

Efeitos agudos da combinação de série isométrica com dinâmica nos aspectos hemodinâmicos / Acute effects of isometric sets combination with dynamic in hemodynamic aspects

Introdução: O objetivo foi verificar as respostas hemodinâmicas durante a combinação de série isométrica com séries dinâmicas no agachamento. Métodos: Quatorze mulheres treinadas realizaram primeiramente a antropometria e identificação da carga de 1RM no agachamento. Posteriormente, foi realizado o Protocolo Isométrico+Dinâmico executando uma série isométrica máxima de 20seg e três séries dinâmicas a 80% de 1RM até a exaustão, mensurando frequência cardíaca, pressão arterial sistólica e diastólica, em repouso (pré), isometria e dinâmico (pós). Após, foi realizada apenas a execução dinâmica no Protocolo Dinâmico mensurando as mesmas variáveis, em repouso (pré) e dinâmico (pós). Resultados: Não foram encontradas diferenças significativas nas variáveis entre protocolos e na análise intragrupo do Protocolo Isométrico-Dinâmico, identificou-se aumento somativo na frequência cardíaca, pressão arterial sistólica e diastólica e duplo produto (p<0,05). Conclusão: Uma série isométrica prévia as séries dinâmicas causa aumento agudo somativo nas respostas hemodinâmicas, sem haver alterações significativas entre os dois protocolos.

Introduction: The objective was to verify the hemodynamic responses during the combination of isometric sets with dynamic sets until exhaustion in squat. Methods: Fourteen trained women was performed anthropometry and identification load of 1RM in squat. After, it was performed the Isometrico+Dynamic Protocol with one maximum isometric sets of 20 seconds and three dynamic sets 80% of 1RM until exhaustion, measuring heart rate, systolic and diastolic blood pressure, at rest (pre), isometry and dynamic (post). Then, it was performed only the dynamic execution in Dynamic Protocol, measuring the same variables at rest (pre) and dynamic (post). Results: No significant differences were found between protocols in variables and intragroup analysis of Isometrico-Dynamic Protocol identified summative acute increase in heart rate, systolic and diastolic blood pressure and product double (p<0,05). Conclusions: One isometric sets the prior dynamic sets cause summative acute increase in hemodynamic responses, without significant changes between the two protocols.