Questões de Vestibular de Inglês

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Autism's Drug Problem 

Many people on the spectrum take multiple medications, which can lead to serious side effects and may not even be effective

Connor was diagnosed with autism early — when he was just 18 months old. His condition was already obvious by then. “He was lining things up, switching lights on and off, on and off,” says his mother, Melissa. He was bright, but he didn’t speak much until age 3, and he was easily frustrated. Once he started school, he couldn’t sit still in class, called out answers without raising his hand and got visibly upset when he couldn’t master a math concept or a handwriting task quickly enough. “One time, he rolled himself up into the carpet like a burrito and wouldn’t come out until I got there,” Melissa recalls. (All families in this story are identified by first name only, to protect their privacy.) 
Connor was prescribed his first psychiatric drug, methylphenidate (Ritalin), at age 6. That didn’t last long, but when he was 7, his parents tried again. A psychiatrist suggested a low dose of amphetamine and dextroamphetamine (Adderall), a stimulant commonly used to treat attention deficit hyperactivity disorder (ADHD). The drug seemed to improve his time at school: He was able to sit still for longer periods of time and focus on what his teachers were saying. His chicken-scratch handwriting became legible. Then, it became neat. Then perfect. And then it became something Connor began to obsess over.
“We were told that these are the gives and takes; if it’s helping him enough to get through school, you have to decide if it’s worth it,” Melissa says. It was worth it — for a while.  
But when the Adderall wore off each day, Connor had a tougher time than ever. He spent afternoons crying and refusing to do much of anything. The stimulant made it difficult for him to fall asleep at night. So after a month or two, his psychiatrist added a second medication — guanfacine (Intuniv), which is commonly prescribed for ADHD, anxiety and hypertension, but can also help with insomnia. The psychiatrist hoped it might both ease Connor’s afternoons and help him sleep. 
In some ways, it had the opposite effect. His afternoons did get slightly better, but Connor developed intense mood swings and was so irritable that every evening was a struggle. Rather than simply tossing and turning in bed, he refused to even get under the covers. “He wouldn’t go to bed because he was always angry about something,” Melissa says. “He was getting himself all wound up, carrying on, getting upset at night and crying.” 
 wound up, carrying on, getting upset at night and crying.” After seven months, his parents declared the combination unsustainable. They swapped guanfacine for over-the-counter melatonin, which helped Connor fall asleep with no noticeable side effects. But within a year, he had acquired a tolerance for Adderall. Connor’s psychiatrist increased his dosage and that, in turn, triggered tics: Connor began jerking his head and snorting. Finally, at his 9-year physical, his doctor discovered that he’d only grown a few inches since age 7. He also hadn’t gained any weight in two years; he’d dropped from the 50th percentile in weight to the 5th. That was the end of all the experiments. His parents took him off all prescription drugs, and today, at almost 13 years old, Connor is still medication-free. His tics have mostly disappeared. Although he has trouble maintaining focus in class, his mother says that the risk-benefit ratio of trying another drug doesn’t seem worth it. “Right now we’re able to handle life without it, so we do.”
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For Connor, eliminating prescription drugs was difficult, but doable. For others, multiple medications may seem indispensable. It’s not unusual for children with autism to take two, three, even four medications at once. Many adults with the condition do so, too. Data are scant in both populations, but what little information there is suggests multiple prescriptions are even more common among adults with autism than in children. Clinicians are particularly concerned about children with the condition because psychiatric medications can have long-lasting effects on their developing brains, and yet are rarely tested in children. 
In general, polypharmacy — most often defined as taking more than one prescription medication at once — is commonplace in people with autism. In one study of more than 33,000 people under age 21 with the condition, at least 35 percent had taken two psychotropic medications simultaneously; 15 percent had taken three.
“Psychotropic medications are used pretty extensively in people with autism because there aren’t a lot of treatments available,” says Lisa Croen, director of the Autism Research Program at Kaiser Permanente in Oakland, California. “Is heavy drug use bad? That’s the question. We don’t know; it hasn’t been studied.”

  Disponível em: <https://www.scientificamerican.com/article/autisms-drug-problem/>. Texto adaptado. 

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OBESITY

Is it a disease or a lifestyle problem?
Obesity is a serious health problem in the United States and increasingly around the world. Costs and associated diseases continue to increase. Recent studies into the causes of obesity indicate that the problem is more complex, and may have less to do with “willpower” and other such issues, than previously thought. Many obesity experts hope this research will help physicians and others rethink the way they understand and treat the problem. Skeptics, however, continue to blame inactivity and overeating for obesity. While the World Health Organization (WHO) and others call for a reduction in sugar consumption to combat obesity, the food industry says it is being unfairly targeted.
 The planet’s population is getting fatter. Once a problem largely confined to high-income regions, overweight and obesity are on the rise in low- and middle-income countries. According to the World Health Organization (WHO), obesity has more than doubled worldwide since 1980. In 2014 more than 1.9 billion adults (39 percent of Earth’s adult population) were overweight. That includes 600 million who were obese.
Among children, overweight and obesity are increasing more than 30 percent faster in lower-and middle-income countries than in developed countries. In 2013, 42 million children under the age of 5 worldwide were overweight or obese.

Disponível em: http://library.cqpress.com/cqresearcher/document.php?id=cqr_ht_o besity_2015. Acessado em 15 de outubro de 2015. 

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Treating Alzheimer’s Disease

Are scientists close to finding a cure?

The number of Americans suffering from Alzheimer's, a degenerative brain disease, is projected to more than double by 2050, from 5.3 million today to 13.8 million. At the same time, as Baby Boomers age and medical expenses rise, the cost of treating and caring for people with the disease is expected to rise fivefold to $1.1 trillion. No treatment can yet prevent or cure Alzheimer's. However, advances in brain science and diagnostic technologies are creating breakthroughs unimagined even a few years ago. Rapidly expanding knowledge in genetics, neuroscience, biology and computing is leading to clinical trials on potential new drug therapies, research on how to prevent the disease and new tests to help diagnose it — perhaps even before symptoms appear. Scientists are debating whether the main hypothesis of what causes the disease — a buildup of amyloid protein into plaques that kill nerve cells in the brain — is correct. Patient advocates say federal Alzheimer's research is underfunded, but Congress is clearing the way for more research funds.

Disponível em: <http://library.cqpress.com/cqresearcher/static.php?page=docnotfound> Acessado em 15 de outubro de 2015.