Eficácia e segurança de risperidona solução oral na agitação associada a demência em idosos

BACKGROUND: Behavioral and psychological symptoms in dementia (BPSD) contribute to caregiver burden and institutionalization of elderly. Neuroleptics are prescribed to control agitation. Side effects of typical neuroleptics are harmful, making atypical neuroleptics an indication. OBJECTIVES: To evaluate efficacy and tolerability of risperidone oral solution (ROS) given once daily to demented elderly outpatients with BPSD (agitation). METHOD: Patients (n=26), 76.35±8.63 years, Diagnostic and Statistical Manual of Mental Disorders 4th ed. (DSM-IV) criteria for dementia. RSO was given, starting dose of 0.25 mg and increments of 0.25 mg every week. Mini-Mental State Examination (MMSE) assessed cognitive status, Behavioral and Emotional Activities Manifested in Dementia (BEAM-D) and Clinical Global Impression (CGI) measured BPSD, Extrapiramidal Symptom Rating Scale (ESRS) evaluated extrapyramidal symptoms. Cardiovascular side effects were evaluated clinically. RESULTS: There was a 26% reduction in agitation and no cardiovascular side effects in the range from 1.0 to 1.25 mg. Side effects were more prevalent above 2.5 mg. CONCLUSION: Risperidone oral solution improved agitation with good tolerability from 0.5 to 1.25 mg. A single dose with increments of 0.25 mg may be more acceptable to patients and caregivers.FUNDAMENTOS: Sintomas psicológicos e do comportamento nas demências (BPSD) contribuem para a sobrecarga dos cuidadores e institucionalização dos idosos. Neurolépticos são prescritos para agitação. Efeitos colaterais dos típicos são prejudiciais, sendo os atípicos indicáveis. OBJETIVO: Avaliar eficácia e tolerabilidade da risperidona solução oral (RSO), dose única diária, em idosos demenciados ambulatoriais com BPSD (agitação). MÉTODO: Pacientes (n=26), 76,35±8,63 anos, critérios do Manual Diagnóstico e Estatístico de Transtornos Mentais 4.ed. (DSM-IV) para demência. RSO administrada, com dose inicial de 0,25 mg e incrementos de 0,25 mg toda semana. Foram utilizados mini-mental (MEEM) para estado cognitivo, behavioral and emotional activities manifested in dementia (BEAM-D) e clinical and global impression (CGI) para BPSD, extrapyramidal symptom rating scale (ESRS) para sintomas extrapiramidais. Efeitos colaterais cardiovasculares foram avaliados clinicamente. RESULTADOS: Houve redução de 26% na agitação, sem efeitos colaterais cardiovasculares, numa faixa de 1,0 a 1,25 mg. Efeitos colaterais foram mais prevalentes acima de 2,5 mg. CONCLUSÃO: Risperidona melhorou agitação com boa tolerabilidade entre 0,5 e 1,25 mg. Dose única diária e aumentos de 0,25 mg podem ser mais aceitáveis para pacientes e cuidadores.Federal University of Rio de Janeiro Institute of Psychiatry Psychogeriatric UnitUniversidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM)University of São Paulo Hospital das Clínicas Institute of PsychiatryUNIFESP, EPMSciEL

Physiological ripening of Anadenanthera colubrina (Vellozo) Brenan seeds

Abstract: The seed physiological maturity knowledgment is critical determine its maximum production and physiological quality. The objective of this study was to determine the ideal time to harvest by evaluating seeds physiological maturity. Seventeen weekly harvests of fruits and seeds from matrices located in the Brazilian city of Botucatu, SP, were performed from May to September 2001. Fruits size and weight, seed water content and dry matter, and germination and emission of primary root were evaluated. Seeds showed maximum dimension in the thirteenth week of collection, while the highest fruit weight was obtained in the twelfth week of collection. Water content decreased over time. Seeds dry matter showed its highest value in the sixteenth week harvest, while germination percentage showed its highest value between the fourteenth and fifteenth week harvest. The percentage of primary root emission was observed with maximum value in the tenth week harvest. Based on the results, it is concluded that the best Anadenanthera colubrina harvest season occurs between the fourteenth and fifteenth weeks