Medicina
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Traumatic brain injury (TBI) as well as Attention Deficit Disorder with or without hyperactivity (ADHD) are very common problems that affect children. It is known that patients who suffer a traumatic brain injury may present symptoms of ADHD, which often go unnoticed in the acute period, especially when there are more serious injuries that hide them and are only evident when the patient returns to their regular cognitive activity after discharge. Symptoms can vary depending on the mechanism of injury, the location in the brain where the trauma or its effects occur, complications, and the severity of the injury. ⋯ We describe some clinical scenarios in this article in which there is an interaction between these two processes that are explained in part because both can affect similar nerve conduction pathways and neurotransmitters. The clinician must recognize attention problems in patients with TBI and other presentations and offer appropriate and timely treatment when symptoms interfere with the patient's functioning. Treatment of ADHD in patients with TBI uses accommodations and medications similar to those used in patients who only have ADHD, but depending on the severity, they can vary in duration.
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Autism or ASDs are neurodevelopmental disorders that affect socio-communicative development, interests, and a restricted and stereotyped pattern of interests and behavior. Epidemiological studies indicate that there are 3 times more boys affected with autism than girls but clinical studies indicate a much higher preponderance in favor of boys. There is an under detection of autism with a late or wrong diagnosis more frequently in girls and women with autism. ⋯ Autism in the female gender presents differential clinical, cognitive and biological characteristics associated with under detection and late diagnosis.
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Individuals with autistic spectrum disorder are often described as having communication, social, emotional, nd behavioral impairments. They are often isolated and passive, with few opportunities for positive and constructive interaction with the outside world. Moreover, they may exhibit withdrawn, stereotyped and disruptive behaviors. ⋯ Overall, 8 studies were selected, with 132 participants using 4 technological systems. Finally, the technological, clinical, psychological, and rehabilitative implications of the findings are discussed. Practical guidelines within this topic area are outlined as future research perspectives.
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In more than half of neurodevelopmental disorders, a genetic etiology is demonstrated. The detection of these pathogenic variants has a huge impact on the course of the disease of these patients. ⋯ Even in the diagnostic guides of the different scientific societies, their algorithms are outdated by the quick incorporation of new techniques. This article reviews the current techniques as well as the latest advances in them that are being incorporated into clinical practice.
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Attention-deficit/hyperactivity disorder (ADHD) has been the focus of magnetic resonance imaging studies for more than 30 years, with more than 2200 articles listed in PubMed. Nevertheless, the brain substrates of ADHD remain poorly understood. This reflects the crisis of replicability across nearly all scientific endeavors, deriving from factors such as small sample sizes combined with a proliferation in analytical approaches, yielding high rates of false positive results. ⋯ Adolescent Behavior & Cognitive Developm ent Study (ABCD). Both embrace the culture of open science, and are beginning to yield credible findings, despite being limited initially to cross-sectional analyses. As the field continues to mature, these and other ongoing longitudinal large-scale studies are poised to transform our understanding of the pathophysiology of ADHD to bring closer the day when neuroimaging can contribute to clinical utility.