Browsing by Autor "VINICIUS COSTA"

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EVALUATING THE EFFECTIVENESS OF LAPAROSCOPIC SURGERY IN ELDERLY PATIENTS
(2024) João Pedro do Valle Varela; Bruno De Oliveira Figueiredo; VINICIUS COSTA; Natália Sobrinho Vaz; Thomas Henrique de Melo Almeida; Gabriel Bernardes; Letícia Rodrigues de Almeida; Ana Luiza Fonseca Maia Caetano
Laparoscopic surgery has established itself as a minimally invasive approach that offers several advantages over open surgery, including less post-operative pain, faster recovery and lower risks of complications. However, the effectiveness of laparoscopic surgery in elderly patients, who often have comorbidities and distinct physiological characteristics, is a growing area of interest. This abstract examines the risks, benefits and post-operative results of laparoscopic surgery in elderly patients, providing a critical overview of its applicability and effectiveness in this population. The aim of this paper is to evaluate the effectiveness of laparoscopic surgery in elderly patients, analyzing the main risks, benefits and postoperative outcomes associated with this approach. The intention is to provide a comprehensive overview that will help in clinical decision-making and in improving surgical practices for this age group. This study carries out a literature review on laparoscopic surgery in elderly patients, analyzing the benefits, risks and long-term results associated with this procedure. The aim is to provide a comprehensive overview of the positive aspects and challenges of minimally invasive surgery for the geriatric population. Laparoscopic surgery offers several advantages for elderly patients, including smaller incisions, less postoperative pain and a faster recovery. These benefits are particularly important in the elderly, who may have a slower recovery after open surgery and a higher risk of complications. However, elderly patients often have comorbidities such as cardiovascular disease, diabetes and functional impairment, which can increase the risk of complications during and after the laparoscopic procedure. Studies show that although laparoscopic surgery can reduce the length of hospitalization and improve functional recovery, these patients can still face specific challenges, such as a greater propensity to respiratory complications and difficulties in healing. As a result, the effectiveness of laparoscopic surgery in the elderly can also be influenced by the experience and skill of the surgeon, as well as the appropriateness of patient selection. Rigorous preoperative assessment and consideration of individual factors are crucial to minimizing risks and optimizing results. Studies indicate that careful patient selection and the suitability of laparoscopic techniques to meet the specific needs of the elderly are essential to maximize the benefits of this approach. Post-operative results generally include faster recovery and less pain compared to open surgery. However, long-term analysis is essential to assess ongoing efficacy and the incidence of late complications, such as adhesions or complications associated with pre-existing conditions. It is concluded that laparoscopic surgery offers significant benefits for elderly patients, such as less postoperative pain and faster recovery, compared to open surgery. However, the increased complexity due to comorbidities and the physiological characteristics of elderly patients can lead to additional risks and specific challenges. Careful patient selection, detailed preoperative assessment and the surgeon’s experience are determining factors for the success of laparoscopic surgery in this population. Although the minimally invasive approach has demonstrated overall efficacy, it is essential to continue monitoring long-term results and to adapt surgical practices to meet the unique needs of elderly patients.
IMPACT OF PROLONGED USE OF ANTIDEPRESSANTS ON NEUROPLASTICITY
(2024) João Pedro do Valle Varela; VINICIUS COSTA; Natália Sobrinho Vaz; Thomas Henrique de Melo Almeida; Gabriel Bernardes; Letícia Rodrigues de Almeida; Ana Luiza Fonseca Maia Caetano; Bárbara Figueiredo
Antidepressants are widely used in the treatment of depressive and anxiety disorders and are essential for the management of these conditions. However, the impact of prolonged use of these drugs on neuroplasticity - the brain’s ability to reorganize itself, forming new neural connections - has been a topic of growing interest and debate in the scientific community. This abstract addresses the effects of prolonged use of antidepressants on neuroplasticity, considering their implications for long-term mental health. The aim of this paper is to examine and synthesize the scientific evidence on the impact of long-term use of antidepressants on neuroplasticity, with a focus on how these changes can influence the effectiveness of treatment and the long-term prognosis of patients. This study conducts a literature review on the long-term effects of antidepressants on neuroplasticity, investigating both the therapeutic potentials and the associated risks. The review focuses on how neuroplasticity can influence treatment outcomes, tolerance to antidepressants, and the impacts on specific populations, such as the elderly and individuals with hormonal variations. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenaline reuptake inhibitors (SNRIs), have been shown to influence neuroplasticity in several ways. Pre-clinical and clinical studies suggest that prolonged use of these drugs can promote neurogenesis, particularly in the hippocampus, an area of the brain crucial for memory and learning. This neurogenic effect is associated with an improvement in depressive symptoms and the brain’s ability to adapt to new challenges. In addition, antidepressants appear to increase the expression of neurotrophic factors, such as brain-derived neurotrophic factor (BDNF), which plays a vital role in the survival and growth of neurons. The increase in BDNF levels may contribute to the restoration of synaptic connectivity, which is often compromised in patients with depression. However, there is controversy about the long-term effects of continuous use of these drugs on neuroplasticity. Some studies suggest that, despite the initial benefits, prolonged use can lead to a “rigidity” in brain plasticity, making it difficult to adapt to new treatments or therapeutic strategies. In addition, the impact on other areas of the brain, such as the prefrontal cortex, which is involved in decision-making and emotional control, is still poorly understood and requires further research. These findings raise questions about the optimal duration of treatment with antidepressants and the need for continuous monitoring of patients’ long-term mental health. Neuroplasticity may be a crucial factor in individual response to treatment and the possibility of relapse or development of resistance to treatment. Therefore, the prolonged use of antidepressants has a significant impact on neuroplasticity, initially promoting neurogenic effects and an increase in synaptic connectivity, which can improve depressive symptoms. However, the long-term effects still need to be better understood, especially with regard to the possible “rigidity” in brain plasticity and the implications for ongoing treatment. To maximize the benefits and minimize the risks, it is essential that treatment with antidepressants is carefully monitored, with attention to changes in neuroplasticity over time. More research is needed to elucidate the underlying mechanisms and guide clinical practice towards more effective and safer strategies for the management of depression and other related disorders.