Cognitive, Mood, and Electroencephalographic Effects of Noninvasive Cortical Stimulation With Weak Electrical Currents

Objectives: The use of noninvasive cortical electrical stimulation with weak currents has significantly increased in basic and clinical human studies. Initial, preliminary studies with this technique have shown encouraging results; however, the safety and tolerability of this method of brain stimulation have not been sufficiently explored yet. The purpose of our study was to assess the effects of direct current (DC) and alternating current (AC) stimulation at different intensities in order to measure their effects on cognition, mood, and electroencephalogram. Methods: Eighty-two healthy, right-handed subjects received active and sham stimulation in a randomized order. We conducted 164 ninety-minute sessions of electrical stimulation in 4 different protocols to assess safety of (1) anodal DC of the dorsolateral prefrontal cortex (DLPFC); (2) cathodal DC of the DLPFC; (3) intermittent anodal DC of the DLPFC and; (4) AC on the zygomatic process. We used weak currents of 1 to 2 mA (for DC experiments) or 0.1 to 0.2 mA (for AC experiment). Results: We found no significant changes in electroencephalogram, cognition, mood, and pain between groups and a low prevalence of mild adverse effects (0.11% and 0.08% in the active and sham stimulation groups, respectively), mainly, sleepiness and mild headache that were equally distributed between groups. Conclusions: Here, we show no neurophysiological or behavioral signs that transcranial DC stimulation or AC stimulation with weak currents induce deleterious changes when comparing active and sham groups. This study provides therefore additional information for researchers and ethics committees, adding important results to the safety pool of studies assessing the effects of cortical stimulation using weak electrical currents. Further studies in patients with neuropsychiatric disorders are warranted.

Electroconvulsive Therapy in Brazil After the "Psychiatric Reform" A Public Health Problem-Example From a University Service

Objectives: The Brazilian public health system does not provide electroconvulsive therapy (ECT), which is limited to a few academic services. National mental health policies are against ECT. Our objectives were to analyze critically the public policies toward ECT and present the current situation using statistics from the Institute of Psychiatry of the University of Sao Paulo (IPq-HCFMUSP) and summary data from the other 13 ECT services identified in the country. Methods: Data regarding ECT treatment at the IPq-HCFMUSP were collected from January 2009 to June 2010 (demographical, number of sessions, and diagnoses). All the data were analyzed using SPSS 19, Epic Info 2000, and Excel. Results: During this period, 331 patients were treated at IPq-HCFMUSP: 221 (67%) were from Sao Paulo city, 50 (15.2%) from Sao Paulo's metropolitan area, 39 (11.8%) from Sao Paulo's countryside, and 20 (6.1%) from other states; 7352 ECT treatments were delivered-63.0% (4629) devoted entirely via the public health system (although not funded by the federal government); the main diagnoses were a mood disorder in 86.4% and schizophrenia in 7.3% of the cases. Conclusions: There is an important lack of public assistance for ECT, affecting mainly the poor and severely ill patients. The university services are overcrowded and cannot handle all the referrals. The authors press for changes in the mental health policies.

Nitric Oxide Synthase in Heart and Thoracic Aorta After Liver Ischemia and Reperfusion Injury: An Experimental Study in Rats

Objectives: We tested the effects of liver reperfusion in the immunohistochemical expression of nitric oxide synthase on the thoracic aorta and the heart. Materials and Methods: We randomized 24 male Wistar rats into 3 groups: (1) control; (2) R2 group, with 60 minutes of partial (70%) liver ischemia and 2 hours of global liver reperfusion; (3) and R6 group, with 60 minutes of partial liver ischemia and 6 hours of global liver reperfusion. Results: In the heart, there was little, diffuse immunohistochemical endothelial staining; immunohistochemical inducible nitric oxide synthase staining was expressed in the adventitia layer of intramyocardial vessels in both cases, with a time-dependent but not statistically significant increase. In the thoracic aorta, a time-dependent decrease in endothelial nitric oxide synthase expression in the muscular layer after reperfusion, which was statistically significant in R6 versus the control. Positive immunostaining for inducible nitric oxide synthase was seen in the muscular and endothelial layers, and this varied from moderate in the control group, to light in the endothelium in groups R2 and R6. Conclusions: We observed changes that may be implicated in heart injury and impairment of aortal tone after liver ischemia and reperfusion injury.

Electroconvulsive therapy use in adolescents: a systematic review

Abstract Background Considered as a moment of psychological vulnerability, adolescence is remarkably a risky period for the development of psychopathologies, when the choice of the correct therapeutic approach is crucial for achieving remission. One of the researched therapies in this case is electroconvulsive therapy (ECT). The present study reviews the recent and classical aspects regarding ECT use in adolescents. Methods Systematic review, performed in November 2012, conformed to the PRISMA statement. Results From the 212 retrieved articles, only 39 were included in the final sample. The reviewed studies bring indications of ECT use in adolescents, evaluate the efficiency of this therapy regarding remission, and explore the potential risks and complications of the procedure. Conclusions ECT use in adolescents is considered a highly efficient option for treating several psychiatric disorders, achieving high remission rates, and presenting few and relatively benign adverse effects. Risks can be mitigated by the correct use of the technique and are considered minimal when compared to the efficiency of ECT in treating psychopathologies.

O efeito protetor do bicarbonato de sódio na nefropatia induzida por contraste radiológico em ratos

Contrastes radiológicos iodados – CI são causa de lesão renal aguda – LRA. Avaliar o efeito renoprotetor do bicarbonato de sódio (Bic) sobre a função renal (clearance de creatinina, Jaff é, Clcr-ml/min/100g) e o perfi l oxidativo (excreção de peróxidos, PU e de malondealdeído urinários, FOX-2 e TBARs, nmol/mgCr ) em ratos com CI. Ratos machos adultos Wistar, 250-300g, tratados 1x/dia, por 5 dias, foram divididos nos grupos: Salina (solução salina 0,9%, 3ml/kg/dia, intraperitoneal-i.p.); CI (ioxitalamato de meglumina e sódio, 3ml/kg, i.p); Bic+Salina (Bic 3ml/kg, i.p, 1 hora antes e 1 hora depois da Salina); Bic+CI (Bic 3ml/ kg, i.p, 1 hora antes e 1 hora depois do CI). CI induziu LRA e o Bic confi rmou seu efeito renoprotetor antioxidante (Clcr/TBARs/PU Salina: 0,59±0,03/0,11±0,02/1,29±0,24 vs Bic+Salina 0,58±0,03/0,13±0,02/1,32±0,64 vs CI 0,22±0,02A/0,19±0,02A/4,77±0, 24A vs Bic+CI 0,51±0,04B/0,13±0,3B/1,80± 0,04B, A/B p<0,05). O Bic confi rmou efeito protetor na LRA por CI, podendo ser considerado como possibilidade terapêutica para pacientes submetidos a CI.

Variable rotational line broadening in the Be star Achernar

Aims. The main theoretical problem for the formation of a Keplerian disk around Be stars is how angular momentum is supplied from the star to the disk, even more so since Be stars probably rotate somewhat subcritically. For instance, nonradial pulsation may transport angular momentum to the stellar surface until (part of) this excess supports the disk-formation/replenishment. The nearby Be star Achernar is presently building a new disk and o ers an excellent opportunity to observe this process from relatively close-up. Methods. Spectra from various sources and epochs are scrutinized to identify the salient stellar parameters characterizing the disk life cycle as defined by H emission. The variable strength of the non-radial pulsation is confirmed, but does not a ect the other results. Results. For the first time it is demonstrated that the photospheric line width does vary in a Be star, by as much as v sin i . 35 km However, unlike assumptions in which a photospheric spin-up accumulates during the diskless phase and then is released into the disk as it is fed, the apparent photospheric spin-up is positively correlated with the appearance of H line emission. The photospheric line widths and circumstellar emission increase together, and the apparent stellar rotation declines to the value at quiescence after the H line emission becomes undetectable