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Biomedical subjects

Helena M T Barros

Publications and source records attributed to Helena M T Barros.

13 recordsLinked to original sources
PubMed2006

Adaptation and validation of the Portuguese version of the Lithium Knowledge Test (LKT) of bipolar patients treated with lithium: cross-over study.

OBJECTIVE: Adherence problems are a common feature among bipolar patients. A recent study showed that lithium knowledge was the main difference between adherent and non adherents bipolar patients. The Lithium Knowledge Test (LKT), a brief questionnaire, was developed as a means of identifying aspects of patients' practical and pharmacological knowledge which are important if therapy is to be safe and effective. The original English version is validated in psychiatric population, but a validated Portuguese one is not yet available. METHODS: One hundred six patients selected were diagnosed with bipolar disorder (I or II) according to DSM-IV criteria and had to be on lithium treatment for at least one month. The LKT was administered on only one occasion. We analysed the internal consistency, concurrent validity, sensitivity and specificity of the LKT for the detection of the knowledge about lithium treatment of bipolar patients. RESULTS: The internal consistency, evaluated by Cronbach's alpha was 0.596. The mean of total score LKT by bipolar patients was 9.0 (SD: 0.75) for men and 8.74 (SD: 0.44) for women. Concurrent validity based on plasma lithium concentration showed a significant correlation between the total LKT score and plasma lithium (r = 0.232; p = 0.020). The sensitivity was 84% and specificity was 81%. CONCLUSION: LKT is a rapid, reliable instrument which appears to be as effective as a lengthier standard interview with a lithium clinic doctor, and which has a high level of acceptability to lithium patients. We found that the psychometric assessment of the Portuguese version of LKT showed good internal consistency, sensitivity and specificity.

Journal Article↗
PubMed2006

Validation of the Portuguese version of the Lithium Attitudes Questionnaire (LAQ) in bipolar patients treated with lithium: cross-over study.

BACKGROUND: Poor adherence to lithium is very common in bipolar patients and it is a frequent cause of recurrence during prophylactic treatment. Several reports suggest that attitudes of bipolar patients interfere with adherence to lithium. The Lithium Attitudes Questionnaire (LAQ) is a brief questionnaire developed as a means of identifying and grouping the problems patients commonly have with taking lithium regularly. The original version is validated in patients, but a validated version in Portuguese is not yet available. METHODS: One-hundred six patients with bipolar disorder (DSM-IV criteria) criteria under lithium treatment for at least one month were assessed using LAQ. LAQ is a brief questionnaire administered under interview conditions, which includes 19 items rating attitudes towards prophylactic lithium treatment. We analysed the internal consistency, concurrent validity, sensitivity and specificity of the Portuguese version of LAQ. RESULTS: The internal consistency, evaluated by Cronbach's alpha was 0.78. The mean total LAQ score was 4.1. Concurrent validity was confirmed by a negative correlation between plasma lithium concentration and total LAQ score (r = -0,198; p = 0.048). We analysed the scale's discriminative capacity revealing a sensitivity of 69% and a specificity of 71% in the identification of negative attitudes of bipolar patients. CONCLUSION: The psychometric assessment of the Portuguese version of LAQ showed good internal consistency, sensitivity and specificity. The results were similar to the original version in relation to attitudes of bipolar patients towards lithium therapy.

Journal Article↗
PubMed2006

Correlation between drug treatment adherence and lithium treatment attitudes and knowledge by bipolar patients.

BACKGROUND: Non-adherence should always be investigated when there is a failure in bipolar treatments, since it is known that reported non-adherence rates in bipolar disorder treatment for long-term prophylactic pharmacotherapy range from 18% to 52%, with a median prevalence of 44.7%. Several factors are related to the poor adherence and reduction of medication efficiency, such as the different types of bipolar disorder, the presence of side effects, medication interactions, level of patient's knowledge about the disorder and their attitude towards treatment, complexity of medical regimens and the doctor-patient relationship. METHODS: Bipolar disorder outpatients under lithium treatment from the Hospital de Clínicas and Materno Infantil Presidente Vargas of Porto Alegre were recruited. All the patients had bipolar disorder and gave informed consent to participate in a clinical interview (106), answered the Lithium Attitudes Questionnaire (LAQ), Lithium Knowledge Test (LKT), Medication Adherence Rating Scale (MARS) and had plasma and red blood cells lithium measurements to assess their medication adherence and the factors that influenced it. RESULTS: 85.6% of bipolar disorder were adherent to lithium treatment showing plasma lithium between 0.6 and 1.2 mmol/L. There was an inverted correlation between the total LAQ score with plasma and red blood cells, a positive correlation between LKT and MARS with plasma and red blood cell lithium. CONCLUSION: These results confirmed that knowledge level is directly correlated to treatment adherence and patients' attitudes, lower adherence, general opposition to prophylaxis, fear of side effects, denial of therapeutic effectiveness and illness severity.

Adolescent↗
PubMed2006

Social anxiety disorder in 300 patients hospitalized for alcoholism in Brazil: high prevalence and undertreatment.

BACKGROUND: Although the frequency of social phobia is high among alcoholic patients, this anxiety disorder is often neglected because treatment tends to be focused exclusively on alcohol dependence. METHODS: A total of 300 hospitalized alcoholic patients were interviewed using Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and Liebowitz Social Anxiety Scale as well a questionnaire to check the use of medication for social phobia among alcoholics and the relationship between social phobia and alcohol use. RESULTS: A prevalence of 30.6% was found for specific phobia, 24.7% for social phobia, 22.2% for anxiety disorder induced by alcohol, 19.3% for generalized anxiety disorder, 5% for obsessive-compulsive disorder, 4.6% for posttraumatic stress disorder, and 2% for panic disorder with agoraphobia. Social phobia preceded alcohol dependence in 90.2% of the patients. The frequency of the use of medication for social phobia among social phobic alcoholics was 20.3%. CONCLUSIONS: The study confirms the high prevalence of anxiety disorders among alcoholics, particularly of social phobia. It also suggests that social phobia precedes alcohol dependence but shows that the use of medication for social phobia is still infrequent. Further studies are required to check if the failure to identify this comorbidity can make the recovery of alcoholics even more difficult.

Adult↗
PubMed2006

Ultrasonic rat vocalizations during the formalin test: a measure of the affective dimension of pain?

The emission of ultrasonic vocalization (USV) by rats submitted to the formalin test has not yet been demonstrated. We performed two experiments to establish the formalin concentration to induce USV and the relationship of USV emission with motor behaviors and the effects of morphine and naloxone on USV during the formalin test. Male Wistar rats were used. In Experiment 1, 3 different groups of rats were subcutaneously injected with 5%, 10%, or 12.5% formalin in 1 of the anterior paws. Experiment 2 was intended to verify the effect of morphine 1, 2.5, or 5 mg/kg on USV during the 12.5% formalin test, whereas other groups of rats received naloxone 2 mg/kg with each one of the morphine doses to verify the specificity of opioid action. USV and motor behaviors were simultaneously measured in 5-min windows for 40 min, and early (0-5 min), interphase (5-20 min), and late (20-40 min) phases of the test were characterized. Vocalization was detected mostly during the interphase of the formalin test, mainly after formalin 12.5%. Morphine suppressed USV in a naloxone-reversible manner. This is a demonstration of USV during the formalin test, allowing the inclusion of an additional nonreflex behavioral measure to help characterize more clinically relevant integrated behavioral patterns in this rat model of pain.

Animals↗
PubMed2005

Early behavioral effects of lead perinatal exposure in rat pups.

Acoustic analysis of infants crying, a sensitive and selective index for measuring the effect of pre and perinatal lead exposure, may provide an early marker for central nervous system damage produced by the toxic. The present study evaluated the effects of exposure to low lead levels during perinatal and early postnatal periods on ultrasonic vocalization (USV), an early behavior of rat pups essential to their development. Non-sexually experienced females were gavaged daily with 8, 16 or 24 mg/kg of lead acetate or the control solution (1 ml/kg) for 30 days prior to breeding and until their pups were weaned. After crossover of dams, pups had been exposed to lead during pregnancy+lactation, pregnancy or lactation. The physiological variables measured on postnatal days 7 or 14 were USV, locomotion, rectal temperature, body weight and blood lead levels. Lead exposition during pregnancy+lactation, pregnancy or lactation induced a significant dose-dependent decrease of USV of 7-day-old pups. On the contrary, lead exposition during the different phases of pregnancy induced a significant dose-dependent increase of USV in 14-day-old rat pups. Blood lead levels varied from 5.7 to 36.5 microg/dl in pups. Body weight and temperature were not influenced by lead exposition. Lead-exposed 14-day-old pups were significantly more active. This study provides evidence of developmental changes in USV emission in rat pups exposed with low lead levels.

Animals↗
PubMed2005

Opposite effects of antidepressants on unstimulated and stimulated salivary flow.

In this study, effects on both stimulated and non-stimulated salivary flow as well as salivary components of different antidepressant drugs were compared. Rats received imipramine (IMI; 10mg/ml), fluoxetine (FLU; 20 mg/ml) or moclobemide (MOC; 30 mg/ml) by gavage. The drugs were administered 24, 5 and 1 h before saliva collection (sub-acute treatment) or as a once a day treatment for 14 days (chronic treatment). Animals were sedated with thiopental and saliva was collected using pre-weighed cotton balls inserted in the mouth for 1 min before and after pilocarpine stimulus. Pilocarpine-stimulated saliva was also collected for biochemical assays of total proteins, amylase, phosphate and calcium, performed through automated colorimetric methods. Non-stimulated salivary flow was decreased by sub-acute IMI 10 mg/kg treatment. Pilocarpine-stimulated salivary flow was significantly increased by acute treatments with IMI, FLU and MOC in comparison to the control group. The same opposite pattern of effects on non-stimulated and pilocarpine-stimulated salivation was seen after chronic treatment with the antidepressants. Increased levels of calcium following sub-acute treatment with IMI and after prolonged treatment with FLU and MOC were detected. In the assayed samples, phosphate was found to be increased following chronic treatment with FLU or MOC. These results may explain the discrepant effects of the antidepressants on salivation described in pre-clinical and clinical studies.

Amylases↗
PubMed2004

Ecstasy intoxication: the toxicological basis for treatment.

Youngsters are increasingly using 3,4 methylenedioxymethamphetamine, known as ecstasy, because it is wrongly believed that it does not induce harm. However, there are many reports of adverse effects, including acute intoxication, abuse potential, and possible neurotoxic effects. Therefore, health care providers need to promptly recognize the symptoms of systemic intoxication in order to initiate early treatment. The drug is used by the oral route for long hours during crowded dance parties. Acutely, ecstasy increases the release of serotonin and decreases its reuptake, leading to hypertension, hyperthermia, trismus, and vomiting. There is debate on whether recreational doses of ecstasy cause permanent damage to human serotonergic neurons. Ecstasy users showed a high risk of developing psychopathological disturbances. The prolonged use of ecstasy might induce dependence, characterized by tolerance and hangover. Acute ecstasy intoxication needs emergency-type treatment to avoid the dose-dependent increase in adverse reactions and in severity of complications. There are no specific antidotes to be used during acute intoxication. Supportive measures and medical treatment for each one of the complications should be implemented, keeping in mind that symptoms originate mainly from the central nervous system and the cardiovascular system.

Central Nervous System Stimulants↗
PubMed2004

Commercially available Hypericum perforatum extracts do not decrease immobility of rats in the forced swimming test.

There are controversial results of clinical trials on the antidepressant effects of Hypericum perforatum, while several preclinical studies describe antidepressant properties for Hypericum extracts. This study evaluates the antidepressant effect of two commercially available hydroalcoholic extracts of H. perforatum standardized to contain 0.3% hypericin in comparison to imipramine (IMI), in the forced swimming test (FST). Wistar rats were treated with different doses of two Hypericum extracts, of hypericin or of IMI and submitted to the FST. The experiments were videotape recorded to detail immobile and active behaviors of rats during the procedures. The imported extract tested and hypericin did not modify rats' behaviors in the test, while IMI, a classical antidepressant, significantly shortened immobility and prolonged climbing behavior during forced swimming. The locally produced Hypericum extract significantly increased immobility duration as compared to the controls at the same time as climbing efforts were decreased. Therefore, the two different commercially available Brazilian hydroalcoholic H. perforatum extracts did not show the expected effects in a screening test for antidepressant agents, on the contrary, one of the extracts promoted a depressant-like effect in rats. Therefore, these extracts available to the population differ from other Hypericum extracts. At which step of the production or commercialization chain these extracts probably lost their therapeutic potential remains to be evaluated.

Animals↗
PubMed2004

Carbamazepine enhances discriminative memory in a rat model of epilepsy.

PURPOSE: Seizures and antiepileptic drugs (AEDs) are the main causes for cognitive impairment in persons with epilepsy. It is still a matter of debate whether carbamazepine (CBZ) improves cognition because of its own psychotropic effects or because it is more effective to treat temporal epilepsy. Our objective was to analyze the performance of CBZ-treated or nontreated pilocarpine epileptic rats in an object-recognition test. METHODS: Twelve chronic pilocarpine-induced epileptic rats were treated with CBZ, 40 mg/kg, or saline, t.i.d. for 8 days. Twenty-one nonepileptic controls were treated with CBZ or saline. On day 8 of treatment, all rats were tested with an object-recognition paradigm. RESULTS: No locomotor impairment was detected in chronic epilepsy or CBZ treatment, as exploration during training was not affected. Exploratory behaviors during the choice session were not decreased in rats treated with CBZ; therefore CBZ does not compromise procedural memory. Epileptic rats showed a nonsignificant change in the discrimination performance, and prolonged treatment with CBZ in epileptic rats induced a significant increase in object discrimination during the choice session. CONCLUSIONS: Even though pilocarpine-induced epileptic animals do not show compromised performance in the spontaneous object-recognition test, prolonged CBZ treatment has a positive effect on a simple object-discrimination task. These results may be associated with the psychotropic effects of CBZ.

Animals↗
PubMed2003

Lower in vivo brain extracellular GABA concentration in diabetic rats during forced swimming.

Diabetic rats are more immobile during the forced-swimming test (FST) and GABAergic drugs reverse this behavior. We investigated if there is in vivo changes of GABA levels of diabetic rats during the FST. In vivo basal striatal GABA levels of streptozotocin diabetic rats are similar to non-diabetic rats. Non-diabetic rats presented a significant increase in GABA levels after the FST while the increase was delayed and lower in diabetic rats. These results suggest that diabetes may change GABA homeostasis and modify behavioral responses in an animal model of depression.

Animals↗
PubMed2003

Clonazepam increases in vivo striatal extracellular glucose in diabetic rats after glucose overload.

Hyperglycemia modulates brain function, including neuronal excitability, neurotransmitter release and behavioral changes. There may be connections between the GABAergic system, glucose sensing neurons and glucose in the neuronal environment that shed light on the mechanism by which GABA(A) agents influence depressive behavior in diabetic rats submitted to the forced swimming test. We aimed to investigate whether clonazepam (CNZ), a GABA(A) receptor positive modulator, modifies in vivo striatal extracellular glucose levels in diabetic rats under fasting condition or after oral glucose overload. Streptozotocin diabetic and nondiabetic rats were submitted to in vivo striatal microdialysis. Perfusate samples were collected at baseline, during fasting and following administration of CNZ (0.25 mg/kg) and oral glucose overload. Blood glucose and striatal extracellular glucose were measured simultaneously at several time points. Fasting striatal glucose levels were higher in diabetic than in nondiabetic rats and the differences between these animals were maintained after glucose overload. The increases in extracellular striatal glucose after glucose overload were around 40% and blood to brain transference was decreased in diabetics. CNZ treatment paradoxically increased striatal glucose after glucose overload in diabetic rats, which may mark the dysfunction in brain glucose homeostasis.

Animals↗