Resumo O tratamento da epilepsia avançou nos últimos 30 anos com o desenvolvimento de novos medicamentos anticrise (MAC). Infelizmente, nem todos estão aprovados no Brasil e muitos ainda são subutilizados. Os novos MAC não são mais eficazes que os antigos, mas apresentam melhor tolerabilidade, menos interações e efeitos colaterais a longo prazo, especialmente para pacientes com comorbidades ou que necessitam de politerapia. A indução enzimática causada pelos MAC antigos está associada ao aumento dos níveis de colesterol, interações medicamentosas com redução do efeito das estatinas e outros medicamentos cardiovasculares, anticoagulantes, quimioterapia, imunossupressores, agentes anti-infecciosos (incluindo tratamento do HIV), antidepressivos e contraceptivos. Além disso, podem reduzir os níveis de vitamina D e hormônios sexuais, podendo afetar a massa óssea. A crescente preocupação sobre estes efeitos ao longo da vida, com a exposição prolongada, levou a maioria dos países desenvolvidos a modificar o padrão de prescrição com maior uso dos novos MAC, especialmente levetiracetam e lamotrigina. Ambos são considerados as opções mais seguras para mulheres em idade fértil. Infelizmente, as tendências de prescrição no Brasil permaneceram praticamente inalteradas ao longo do tempo. Isto pode ser parcialmente explicado pela lentidão no processo de aprovação dos MAC e à resistência dos médicos generalistas e neurologistas em adotar estes novos conceitos. Nesta revisão, destacamos as vantagens dos novos MAC e a necessidade da mudança no padrão de prescrição também no Brasil. A escolha do MAC deve ser feita de acordo com as características individuais dos pacientes e sugestões práticas são apresentadas. 3 MAC. . (MAC) Infelizmente subutilizados tolerabilidade prazo politerapia colesterol cardiovasculares anticoagulantes quimioterapia imunossupressores antiinfecciosos anti infecciosos incluindo HIV, HIV , HIV) contraceptivos disso sexuais óssea vida prolongada lamotrigina fértil tempo conceitos revisão apresentadas (MAC

Abstract The treatment of epilepsy has advanced over the past 30 years through the development of new antiseizure medications (ASMs). Unfortunately, not all of them have been approved yet in Brazil, and many are still underused. When comparing new ASMs to older ones, they are generally not more effective in treating epilepsy. However, they offer better tolerability, with fewer interactions and long-term side effects, especially for patients with comorbidities or those requiring polytherapy. Enzyme induction caused by older ASMs is associated with increased cholesterol levels, drug interactions with decreased effects of statins and other cardiovascular medications, anticoagulants, chemotherapy, immunosuppressors, anti-infective agents (including HIV treatment), antidepressants, and contraceptives. Additionally, they can reduce levels of vitamin D and sex hormones, as well as decrease bone density. The increasing concern about these effects during life, especially after prolonged exposure, has led most developed countries to change prescription patterns in favor of new ASMs, particularly levetiracetam and lamotrigine. Both are also considered the safest options for women of childbearing age. Regrettably, the prescription trends in Brazil have remained largely unchanged over time. This can be partially attributed to the slower approval process of ASM and the reluctance of general physicians and neurologists to embrace these new concepts. In this concise review, we highlight the various advantages linked to the new ASM, aiming to promote a shift in the prescription pattern for ASM. The selection of ASM should be customized according to individual characteristics, and practical suggestions for choosing ASMs are provided in this paper. 3 ASMs. . (ASMs) Unfortunately underused ones However tolerability longterm long term polytherapy anticoagulants chemotherapy immunosuppressors antiinfective anti infective including treatment, , treatment) antidepressants contraceptives Additionally hormones density life exposure lamotrigine age Regrettably time concepts review characteristics paper (ASMs

Contexto: El cáncer como factor de estudio en el escenario mundial, la transición epidemiológica y la incidencia de la enfermedad en países emergentes. Objetivo: hacer un levantamiento bibliográfico sobre los factores de riesgo asociados al cáncer de tiroides en mujeres. Material e Métodos: Fue realizada una búsqueda en el primer semestre del 2011 en la base de datos virtual Embase utilizando tres escritores en ingles thyroid cáncer, risk factors y women. La búsqueda fue reducida para artículos publicados en los años 2010 y 2011 y estudios controlados. Fueron seleccionados trece artículos y fueron incluidos diez. Resultados: Fue posible agrupar los factores de riesgo presentados en los estudios incluidos en tres grupos: factor ambiental (n = 4), fármaco o tratamiento utilizado (n = 3) y, por fin, características de los individuos y sus hábitos cotidianos (n = 3). Conclusión: Mujeres, bajo IMC, edad de inicio del cáncer, obesidad, tiroiditis de Hashimoto y hábito de alimentarse con un consumo excesivo de vegetales crucíferos, son factores de riesgo asociados al cáncer de la glándula tiroides

Background: The cancer study as a factor in the global scenario, the epidemiological transition and the incidence of disease in developing countries. Objective: To review the literature on risk factors associated with thyroid cancer in women. Methods: We performed a search in the first half of 2011 in virtual database EMBASE using three key-words in English: thyroid cancer, risk factors and women. The search was refined to articles published in the years 2010 and 2011 and controlled studies. We selected thirteen articles and ten were included. Results: Is possible cluster the risk factors presented in included studies into three groups: environmental factors (n=4), drug use or treatment (n = 3) and, finally, characteristics of individuals and their daily habits (n = 3). Conclusion: Women, low BMI, age at onset of cancer, obesity, Hashimoto’s thyroidits and eating habits with excessive consumption of cruciferous plants, are risk factors associated with thyroid cancer gland