Is there a role for rare variants in DRD4 gene in the susceptibility for ADHD? Searching for an effect of allelic heterogeneity.

Although several studies have demonstrated an association between the 7-repeat (7R) allele in the 48-bp variable number of tandem repeats (VNTRs) in the exon 3 at dopamine receptor D4 (DRD4) gene and attention-deficit/hyperactivity disorder (ADHD), others failed to replicate this finding. In this study, a total of 786 individuals with ADHD were genotyped for DRD4 exon 3 VNTR. All 7R homozygous subjects were selected for VNTR re-sequencing.

Initial evaluation of the Mobile Emergency Medical Services in the city of Porto Alegre, Brazil.

Background: Little is known about the immediate outcomes of the Mobile Emergency Medical Services (SAMU) in Brazil.

Objective: To evaluate clinical predictors of survival of patients in cardiorespiratory arrest (CRA) in the nonhospital environment treated by the SAMU in the city of Porto Alegre.

Methods: The present study has a prospective and observational design.

Endothelial dysfunction is related to poor glycemic control in adolescents with type 1 diabetes under 5 years of disease: evidence of metabolic memory.

Context: The relation between endothelial dysfunction (ED), glycemic control, and early type I diabetes mellitus (T1DM) is unclear.

Objective: The objective of the study was to evaluate the association of ED, glycemic control, and the duration of diabetes in T1DM.

Design: This was a cross-sectional study.

Influence of genetic, biological and pharmacological factors on warfarin dose in a Southern Brazilian population of European ancestry.

Aims: To investigate the influence of polymorphisms in CYP2C9, VKORC1, CYP4F2 and F2 genes on warfarin dose-response and develop a model including genetic and non-genetic factors for warfarin dose prediction needed for each patient.

Methods: A total of 279 patients of European ancestry on warfarin medication were investigated. Genotypes for -1639G>A, 1173C>T, and 3730G>A SNPs in the VKORC1 gene, CYP2C9*2 and CYP2C9*3, 1347C>T in the CYP4F2 gene and 494C>T in the F2 gene were determined by allelic discrimination with Taqman 5'-nuclease assays.

Polymorphisms of matrix metalloproteinases in systolic heart failure: role on disease susceptibility, phenotypic characteristics, and prognosis.

Background: The role of matrix metalloproteinases (MMPs) polymorphisms on heart failure (HF) susceptibility, phenotypic characteristics, and prognosis has been poorly explored.

Methods And Results: We studied 313 HF patients with left ventricular systolic dysfunction and 367 healthy control subjects. Genotyping of MMP-1 (-1607 1G/2G), MMP-3 (-1171 5A/6A), and MMP-9 (-1562 C/T) polymorphisms was performed by polymerase chain reaction.

Are family variables associated with ADHD, inattentive type? A case-control study in schools.

Attention-deficit/hyperactivity disorder (ADHD) seems to be associated with significant psychosocial adversity. However, few studies assessed the role of environmental, social and interpersonal factors specifically in ADHD, inattentive type (ADHD-I). Thus, this study aims to investigate whether family environment risk factors are associated with ADHD-I.

Prevalence and correlates of gambling problems among a nationally representative sample of Brazilian adolescents.

The objectives of the study are: (a) to provide the first prevalence estimates of pathological gambling among Brazilian adolescents using an age-specific instrument in a nationally representative sample; (b) to investigate the extent to which adolescents participate in gambling activities in a developing country; and (c) to correlate different levels of gambling behavior with demographic variables. Multistage cluster sampling selected 3,007 individuals over 14 years of age from Brazilian household population. A total of 661 participants were between 14 and 17 years old.

Smoking and ADHD: an evaluation of self medication and behavioral disinhibition models based on comorbidity and personality patterns.

Objective: The prevalence of smoking is significantly increased among adults with Attention-Deficit/Hyperactivity Disorder (ADHD), and this association has a significant impact in both disorders, ascribed to either self-medication or behavioral disinhibition hypotheses. However, little is known about clinical variables associated with cigarette smoking among patients with ADHD. The present study evaluates comorbidity, demographic and personality profiles of patients with ADHD in relation to smoking status.

Do hyperactive symptoms matter in ADHD-I restricted phenotype?

The objective of the current study was to evaluate a proposed restrictive inattentive type of Attention Deficit Hyperactivity Disorder (ADHD) by comparing clinical correlates among youths with ADHD inattentive type (ADHD-I) as a function of the number of hyperactivity symptoms presented (none vs. 3 or less) and controls (individuals without ADHD). The sample for this community-based study was comprised of youths aged 6 to 18 years from 12 public schools in Porto Alegre, Brazil.

What is to be the fate of ADHD subtypes? An introduction to the special section on research on the ADHD subtypes and implications for the DSM-V.

One of the major questions facing the taxonomy of attention deficit/hyperactivity disorder is how to handle its marked heterogeneity in symptom presentation and impairments. The current methods for defining subtypes have been widely criticized but it is unclear if the subtype concept is fundamentally flawed or whether it is the methods for designating subtypes in current diagnostic approaches which are flawed. The current article is an introduction to a special section in which four articles provide data illustrating the complexity of considerations involving subtyping of attention deficit/hyperactivity disorder and provide ideas for alternatives that warrant further discussion and examination.

Bone marrow derived cells decrease inflammation but not oxidative stress in an experimental model of acute myocardial infarction.

Aims: Bone marrow cell (BMC) therapy is thought to exert beneficial effects on the infarcted heart. We assessed cardiac function and its correlation with redox status and inflammation in cardiac tissue early post-AMI in rats treated with BMC.

Main Methods: Male Wistar rats (8-week-old) were randomized into four groups: Sham-operated (S); AMI; S+treatment (ST) and AMI+treatment (AMIT).

Nurses' performance in classifying heart failure patients based on physical exam: comparison with cardiologist's physical exam and levels of N-terminal pro-B-type natriuretic peptide.

Aim: The purpose of this study is to compare clinical assessment of congestion performed by a nurse to that performed by cardiologist and correlate them with NT-ProBNP levels.

Background: The nurses' role in heart failure has been strongly focused in therapeutic, educational and self-care interventions. The diagnostic performance of nurses in heart failure outpatients is not well explored.

Early determinants of attention and hyperactivity problems in adolescents: the 11-year follow-up of the 1993 Pelotas (Brazil) birth cohort study.

The aim of this study was to assess early determinants of attention and hyperactivity problems in adolescents. In 1993, all hospital births in the city of Pelotas, Rio Grande do Sul State, Brazil, were monitored and mothers were interviewed (N = 5,249). At 11 years of age, 4,423 mothers answered the Strengths and Difficulties Questionnaire (SDQ) in order to evaluate attention and hyperactivity problems in the adolescents.

The burdened life of adults with ADHD: impairment beyond comorbidity.

Since approximately 70% of adult patients with attention-deficit/hyperactivity disorder (ADHD) have at least one comorbid disorder, rating of impairment specifically attributable to ADHD is a hard task. Despite the evidence linking environmental adversities with negative outcomes in ADHD, life events measures have not been used to rate the disorder impairment. The present study tested for the first time the hypothesis that increased ADHD severity is associated with an increase in negative recent life events, independently of comorbidity status.

Cost-effectiveness of implantable cardioverter defibrillators in Brazil in the public and private sectors.

Background: Many randomized clinical trials have demonstrated the effectiveness of the implantable cardioverter-defibrillator (ICDs) in death reduction of chronic heart failure (CHF) patients. Some developed countries studies have evaluated its cost-effectiveness, but these data are not applicable to Brazil.

Objective: To evaluate the cost-effectiveness of ICD in CHF patients under two perspectives in Brazil: public and supplementary health systems.

Effects of childhood development on late-life mental disorders.

Purpose Of Review: To explore recent findings bridging childhood development and common late-life mental disorders in the elderly.

Recent Findings: We addressed aging as a part of the developmental process in central nervous system, typical and atypical neurodevelopment focusing on genetic and environmental risk factors and their interplay and links between psychopathology from childhood to the elderly, unifying theoretical perspectives and preventive intervention strategies.

Summary: Current findings suggest that childhood development is strictly connected to psychiatric phenotypes across the lifespan.

Clinical predictors of preserved left ventricular ejection fraction in decompensated heart failure.

Background: Identification and clinical impact of preserved left ventricular ejection fraction (LVEF) on in-hospital outcomes in patients with acute decompensated heart failure (HF) remain poorly defined.

Objective: To describe clinical predictors and in-hospital outcomes of acute decompensated HF patients and preserved LVEF, and to develop a clinically-based predictive rule based on data acquired on admission.

Methods: Consecutive admissions for HF (n=721) at a tertiary care hospital were followed up to discharge or death.

Fast chiral chromatographic method development and validation for the quantitation of eszopiclone in human plasma using LC/MS/MS.

Traditional chiral chromatographic separation method development is time consuming even for an experienced chromatographer. This paper describes the application of computer software ACD Lab to facilitate the development of chiral separation for the quantitation of eszopiclone using LC-MS/MS technology. Assisted by ACD/Chrom Manager and LC Simulator software, the optimal chiral chromatographic development was completed within hours.

ADHD in a representative sample of the Brazilian population: estimated prevalence and comparative adequacy of criteria between adolescents and adults according to the item response theory.

Background: Attention deficit hyperactivity disorder (ADHD) is a clinically significant disorder in adulthood, but current diagnostic criteria and instruments do not seem to adequately capture the complexity of the disorder in this developmental phase. Accordingly, there are limited data on the proportion of adults affected by the disorder, specially in developing countries.

Method: We assessed a representative household sample of the Brazilian population for ADHD with the Adult ADHD Self-report Scale (ASRS) Screener, and evaluated the instrument according to the Rasch model of item response theory.

Molecular imaging genetics of methylphenidate response in ADHD and substance use comorbidity.

Purpose: Attention-deficit/hyperactivity disorder (ADHD) and substance use disorders (SUDs) are highly comorbid and may share a genetic vulnerability. Methylphenidate (MPH), a dopamine transporter (DAT) blocker, is an effective drug for most ADHD patients. Although dopamine D4 receptor (DRD4) and dopamine transporter (DAT1) genes have a role in both disorders, little is known about how these genes influence brain response to MPH in individuals with ADHD/SUDs.

Levosimendan in acute decompensated heart failure: systematic review and meta-analysis.

Background: Congestive heart failure (CHF) is a rather prevalent condition with a high mortality rate. Levosimendan is one among the new drugs that have been tested for its management.

Objective: To undertake a systematic review and meta-analysis of the morbidity and mortality reduction associated with levosimendan in the treatment of CHF.

Mental disorders and delivery motorcycle drivers (motoboys): a dangerous association.

Objective: Low and middle-income countries experience an expressive growth in the number of circulating motorcycles, paralleled by an increasing number of traffic accidents. Delivery motorcycles drivers ("motoboys") are generally perceived as accountable for this scenario. Although traffic accidents have a multivariate etiology, mental disorders, such as substance use disorders (SUD) and attention deficit/hyperactivity disorder (ADHD), are often involved.

Does the prevalence of CD and ODD vary across cultures?

Purpose: The worldwide prevalence of conduct disorder (CD) and oppositional defiant disorder (ODD) is presented to examine the first of four criteria used in other studies to determine the validity of psychiatric disorders across cultures.

Methods: The authors searched Medline and PsycINFO from 1987 to 2008. Studies were included if they were representative of specific communities or countries and reported point prevalence of CD or ODD according to DSM-III-R or DSM-IV criteria for children 18 years or younger.

Impact of beta-2 Thr164Ile and combined beta-adrenergic receptor polymorphisms on prognosis in a cohort of heart failure outpatients.

Genetic polymorphisms of adrenergic receptors (ARs) have been associated with the development, progression, and prognosis of patients with heart failure (HF), with few data for the Brazilian population. We evaluated the role of the beta2-AR Thr164Ile polymorphism at codon 164 on prognosis in a prospective study on 315 adult Brazilian HF patients, predominantly middle-aged Caucasian men in functional class I-II, with severe left ventricular systolic dysfunction. Genomic DNA was extracted from peripheral blood and beta2-AR164 genotypes were detected by PCR followed by restriction fragment length analysis.