Background: Hyperprolactinemia is a common consequence of treatment with antipsychotics. It is usually defined by a sustained prolactin level above the laboratory upper level of normal in conditions other than that where physiologic hyperprolactinemia is expected. Normal prolactin levels vary significantly among different laboratories and studies. Several studies indicate that olanzapine does not significantly affect serum prolactin levels in the long term, although this statement has been challenged. Aims: Our aim is to report two olanzapine-induced hyperprolactinemia cases observed in psychiatric consultations. Methods: Medical records of the patients who developed this clinical situation observed in psychiatric consultations in the Psychiatry Department of the Prof. Dr. Fernando Fonseca Hospital during the year of 2017 were analyzed, complemented with a non-systematic review of the literature. Results: The case reports consider two women who developed prolactin-related symptoms after the initiation of olanzapine. No baseline prolactinemia was obtained, and prolactin serum levels were only evaluated after prolactin-related symptoms developed: at the time of its measurement, both patients had been taking olanzapine for more than 24 weeks. Hyperprolactinemia was found to be present in Case 2, whereas Case 1 (a 49-year-old woman) had “normal” serum prolactin levels for premenopausal and prolactin levels slightly above the maximum levels for postmenopausal women. Both patients underwent similar pharmacological adjustments, which comprised switches from olanzapine to aripiprazole. After all pharmacological changes, prolactin serum levels decreased to normal range values and prolactin-related symptoms disappeared. Discussion/Conclusions: Laboratorial and literature prolactinemia values variability and discrepancies may make the management of borderline hyperprolactinemia clinical situations difficult. Baseline prolactin levels should have been obtained, as they help in the management of patients who develop neuroleptic-induced hyperprolactinemia. Prolactin-related symptoms can occur with borderline or normal standardized prolactinemia values. Olanzapine-induced hyperprolactinemia is a rare but possible event. Aripiprazole was used as a suitable alternative for olanzapine-induced hyperprolactinemia.
O presente estudo pretende avaliar a efetividade do programa de outdoor training KidsTalentum na aprendizagem de competências sociais e emocionais em crianças do ensino básico. No programa, realizado ao ar livre, as crianças são retiradas da sua zona de conforto e estimuladas a enfrentar vários desafios. Foi adotado um desenho quase experimental com pré-teste e pós-teste, com duas turmas de cada ano de escolaridade do 1.º ciclo do ensino básico, distribuídas num grupo de controlo (n=78) e num grupo experimental (n=78). Para avaliar as competências sociais e emocionais foram utilizados tanto instrumentos de desempenho como de auto e heteroperceção. O efeito do programa foi avaliado através da análise da mudança de scores. Os alunos que participaram no programa KidsTalentum apresentaram uma melhoria nas competências de tomada de decisão e autoconhecimento. Os resultados apontam a metodologia outdoor training como uma ferramenta facilitadora da aprendizagem das competências sociais e emocionais.
BackgroundThe present study protocol is designed to assess the relationship between outdoor air pollution and low birth weight and preterm births outcomes performing a semi-ecological analysis. Semi-ecological design studies are widely used to assess effects of air pollution in humans. In this type of analysis, health outcomes and covariates are measured in individuals and exposure assignments are usually based on air quality monitor stations. Therefore, estimating individual exposures are one of the major challenges when investigating these relationships with a semi-ecologic design.Methods/DesignSemi-ecologic study consisting of a retrospective cohort study with ecologic assignment of exposure is applied. Health outcomes and covariates are collected at Primary Health Care Center. Data from pregnant registry, clinical record and specific questionnaire administered orally to the mothers of children born in period 2007-2010 in Portuguese Alentejo Litoral region, are collected by the research team. Outdoor air pollution data are collected with a lichen diversity biomonitoring program, and individual pregnancy exposures are assessed with spatial geostatistical simulation, which provides the basis for uncertainty analysis of individual exposures. Awareness of outdoor air pollution uncertainty will improve validity of individual exposures assignments for further statistical analysis with multivariate regression models.DiscussionExposure misclassification is an issue of concern in semi-ecological design. In this study, personal exposures are assigned to each pregnant using geocoded addresses data. A stochastic simulation method is applied to lichen diversity values index measured at biomonitoring survey locations, in order to assess spatial uncertainty of lichen diversity value index at each geocoded address. These methods assume a model for spatial autocorrelation of exposure and provide a distribution of exposures in each study location. We believe that variability of simulated exposure values at geocoded addresses will improve knowledge on variability of exposures, improving therefore validity of individual exposures to input in posterior statistical analysis.
Supported by a change of mentality, which coincides with the entry of the century, the investigations begin to question the intelligence quotient as a predominant factor in achieving social and professional success, going to defend the emotional quotient. Thus, we advocate its improvement in children and young people to equip them with differentiating competencies.Outdoor Training, which places individuals in natural settings outside their comfort zone, is shown as a methodology to better and faster learning than the traditional model. For this reason, it is being developed at this time a research project that aims to assess whether the methodology of outdoor training, used to work socio-emotional skills in executives, is also valid for working competences in children in basic education. For this, we chose an experimental study, which includes 162 students from two public schools in 1.º cycle of basic education Funchal Council, a group operating as an experimental group ( 83 students ) who participate in outdoor training activities during the academic year 2013/2014, and a control group (79 students). Children will be assessed at two points, at the beginning and end of the school year through the following instruments: the Bar -On Emotional Quotient Inventory test: Youth Version (Candeias & Rebocho, 2007) (Simões , 2000) and the Piers-Harris Children's Self-Concept Scale (PHCSCS -2, Veiga , 2006). By now it was made the first evaluation and are being developed outdoor training activities with the experimental group. In this paper, we present some qualitative results of the developments observed in the students who are participating in these activities.Keywords RESUMENApoyados por un cambio de mentalidad, que coincide con la entrada del siglo XXI, las investigaciones comienzan a poner en duda el coeficiente de inteligencia como factor predominante para alcanzar éxito social y profesional, pasando a defender el coeficiente emocional. Así, defendemos su perfeccionamiento en niños y jóve-nes para dotarlos de competencias diferenciadoras.El Outdoor Training, que coloca a los individuos en contextos naturales fuera de su zona de conforto, se ha mostrado como una metodología que permite mayor eficacia y rapidez de aprendizaje que el modelo tradicional. Por esta razón, está siendo desarrollado en este momento un proyecto de investigación que pretende evaluar si la metodología de outdoor training, utilizada para trabajar competencias socioemocionales en empresarios, es también válida para trabajar competencia de niños de educación básica. Para tal, optamos por un estudio experimental, que incluye 162 alumnos de dos escuelas públicas de 1.º ciclo de educación básica del Concejo de Funchal, funcionando un grupo como grupo experimental (83 alumnos (PCIS, Candeias, 2007); las matrizes progressivas coloridas de Ravem (MPCR, Simões, 2000) y el Piers-Harris Children's Self-Concept Scale (PHCSCS-2 Veiga, 2006). En este momento ya fue realizada la primera evaluación y están siendo desarrolladas las actividades de outdoo...
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