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Constitutive heterochromatin typically exhibits low gene density and is commonly found adjacent or close to the nuclear periphery, in contrast to transcriptionally active genes concentrated in the innermost nuclear region. In Triatoma infestans cells, conspicuous constitutive heterochromatin forms deeply stained structures named chromocenters. However, to the best of our knowledge, no information exists regarding whether these chromocenters acquire a precise topology in the cell nuclei or whether their 18S rDNA, which is important for ribosome function, faces the nuclear center preferentially. In this work, the spatial distribution of fluorescent Feulgen-stained chromocenters and the distribution of their 18S rDNA was analyzed in Malpighian tubule cells of T. infestans using confocal microscopy. The chromocenters were shown to be spatially positioned relatively close to the nuclear periphery, though not adjacent to it. The variable distance between the chromocenters and the nuclear periphery suggests mobility of these bodies within the cell nuclei. The distribution of 18S rDNA at the edge of the chromocenters was not found to face the nuclear interior exclusively. Because the genome regions containing 18S rDNA in the chromocenters also face the nuclear periphery, the proximity of the chromocenters to this nuclear region is not assumed to be associated with overall gene silencing.
In 1880, the French neurologist Jules Cotard described a specific kind of nihilistic delusion which the patient believed that she no longer existed. Since then, this rare condition known as Cotard's Syndrome or Cotard's Delusion (CD) has intrigued clinicians and investigators.
To present CD's features, including historical, clinical, etiopathological, and treatment issues.
Case report of a 49-year-old woman with fully developed CD; review of the literature.
There is still a considerable debate concerning the nature of this phenomenon - whether it should be conceptualized as a psychiatric symptom or as a syndromatic entity.
CD may appear in different severity levels, and most authors accept the idea of a spectrum of clinical presentations, ranging from the belief of loosing intellectual capacities to the extreme belief of non-existence of life and the universe.
This manifestation has been identified in patients with distinct diagnosis, mostly in severe depression, but also in schizophrenia and psycho-organic syndromes.
Treatment should be chosen according to the underlying pathology.
Over the last few years, new contributions from neuropsychological and imaging studies have brought interesting approaches to understand CD's underlying mechanisms. At the moment, CD does not fit clearly into any category of the current systems of classification. Future investigations should address the pathophysiological nature of CD and its place in the new, etiopathologically-oriented, classification systems.
PPA is characterized by progressive language dissolution, with remarkable spare of other cognitive domains for at least two years, and should be considered in the differential diagnosis of dementia.
A 56-year-old previously healthy man was seen for speech difficulties. He studied Portuguese for 4 years, and then went to live in France, where he learned French for 3 years. He returned definitely to Portugal when he was 42. Since early adolescence he was fluent on speaking, reading and writing in both languages. In the last 12 years he spoke French mainly when visiting his family. Three years ago he started showing disintegration of his second language preceding that of his native one. Upon examination he had laborious, effortful, nonfluent and agrammatic speech, with severe anomia and some repetition and complex-command comprehension difficulties. He could not name, understand or write any French word. The remaining neurological examination was near-normal to age and education level (MMSE - 25/30). Brain MRI showed left-side predominant frontotemporal cortical atrophy. PET scan revealed hypometabolism in the same area and the temporal lobe, anterior cynguli and dorsolateral frontal cortex.
Our patient has nonfluent variant of PPA. Cases like this can give further insight into the neural network subserving language acquisition and dissolution. In proficient bilinguals, the main point on language dissolution in PPA seems to be the recency of use. The best way to confirm this would be to systematically characterize PPA patients on secondary language usage, attained proficiency and disintegration sequence.
Bipolar disorder is a chronic, recurrent and debilitating mood disorder with a major impact on several aspects of everyday life. Although pharmacotherapy plays a central role in bipolar disorder treatment, psychosocial interventions are essential to a more complete and successful treatment.
To present a psychoeducation program for bipolar patients runned in a Portuguese psychiatric hospital - Hospital de Magalhães Lemos, Oporto. To review the impact of psychoeducative measures on bipolar patients.
A psychoeducative program for bipolar patients was developed and adapted, based on the Barcelona Bipolar Disorders Program"s experience. The psychoeducative program was applied to bipolar patients as an adjuvant of maintenance treatment.
Fifteen sessions were runned during 15 weeks. Twelve patients were recruited to integrate the psychoeducative group. The sessions addressed several topics including information about the illness, early detection of prodromal symptoms and symptoms management, stress management and the importance of maintaining routines.
The best treatment available for patients with bipolar disorder includes, along with the pharmacological treatment, psychosocial interventions aimed to target issues as early identification of prodromal symptoms, coping skills, medication adherence and understanding of the disorder. This broader approach of bipolar disorder treatment has proved to be efficient in reducing relapse rates, and improving patients’ feelings of self-efficacy and quality of life.
Verbal fluency (VF) involves complex processes and has been a good marker of cognitive decline. However, the literature is inconsistent concerning to witch factors are associated with VF.
Our aims are to analyze the relationship between both phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) and sociodemographic and psychopathological variables, and explore which emerge as significant predictors.
A subsample of 429 of healthy institutionalized elderly from the Aging Trajectories at Coimbra Council Project were surveyed (60 to 100 years; mean age = 80.38 ± 7.24), the majority was women (76.9%), without a partner (82.2%), without education or with less than four years of education (85.7%), manual occupation (90.1%), and attending day care centers. We evaluated VF phonetically (letters P, M, R) and semantically (animals and food), anxiety symptoms through the Geriatric Anxiety Inventory (GAI), depressive symptoms through Geriatric Depression Scale (GDS), and feelings of loneliness through Loneliness Scale (UCLA).
PVF was significantly related with education, occupation, GAI, and GDS. SVF was significantly associated with age, education, occupation, and GDS. Furthermore, SVF scores were worse in elderly men and in those living in night care center, and PVF scores were lower in those with high levels of anxiety symptomatology. In logistic regression analysis none of the variables accounted for the variance in PVF. The only predictor of SVF was sex. In conclusion, this study allowed us to elucidate the only key factor underlying verbal fluency. Being a man may affect SVF performance in institutionalized elderly.
The changing epidemiological profile of population in recent decades is related to the socio-economic conditions of contemporaneity. Diabetes mellitus (DM) is positioned in the chronic non-communicable diseases spectrum as one of the most prevalent being responsible for high rates of morbidity and mortality. Therapeutic adhere is of crucial importance because there are high risks associated with non-adherence and it impacts on quality of life.
Identifying therapeutic adherence predictors in type 2 diabetes (DM2).
188 patients attending diabetology consultations at the Department of Endocrinology, Diabetes and Metabolism, at Centro Hospitalar e Universitário de Coimbra and at Associação Protetora dos Diabéticos de Portugal participated in the study. Participants completed the following set of self-report instruments: Beck Depression Inventory (BDI), the Diabetes Health Profile (DHP), the Rosenberg Self-Esteem (RSE), and the social relations dimension of the World Health Organization Quality of Life (WHOQOL). Therapeutic adherence was established base on HbA1C clinical criteria.
Multiple regression analyses revealed that the full model was statistically significant [c 2 (4, n = 188) = 20.79, p >0.001] explaining between 20% and 29.6% of total variance and 76.3% of the cases were correctly classified. The four variables significantly contributed to the model, especially the BDI and the RSE, registering an odds ratio of 1.104 and 1.203, respectively.
In DM2 predictors of non-adherence were depression and diabetes patient health profile while self-esteem and quality of life in social relations, emerged as predictors of adherence.
Mental health literacy is an emergent research area in the fields of health promotion and mental illness prevention in communitarian environment, considered one relevant variable in the professional help-seeking behavior.
Evaluate the mental health literacy of Portuguese adolescents and youth concerning depression and schizophrenia; - Identify the contribute of the social demographic variables in mental health literacy.
Characterize the mental health literacy of adolescents and youth with the aim of create health promotion and mental illness prevention programs.
Descriptive-correlational study. Sample of 671 students, randomly selected of Portuguese schools. 294 of male gender and 323 of female gender, with an average age of 15,20 (sd = 1,84 years). The data were collected with the Mental Health Literacy Evaluate Questionnaire (Loureiro, Pedreiro and Correia, 2011). The data were analyzed using the IBM-SPSS 20.
Only 47,81% correctly identifies depression and 22,04% schizophrenia. Besides gender (p = 0,002), the familiarity with the mental illness and the socio demographic variables weren?t related to the recognition of the disorders.
The low levels of mental health literacy are a problem and a challenge, since they are associated with prejudiced and stigmatizing visions of the diseases and the ill with implications in the professional help-seeking behavior. The planning of programs should be alert since the adolescents and youth are the group with less interaction with the health system.
The aim of this study was to understand the universe of a group of Muslim women, focusing their experiences in a western society, their perception of cultural differences and the repercussion of these factors mental health. for such, we applied the qualitative method using the semidirected interview in eight Muslim women who live in Brazil. the sample was constructed using the snow-ball technique, closed according to the criterion of saturation of data. the emergent categories starting from the statements were analyzed and explained in the light of psychosocial theories. the interviewers showed great interest in bringing up visibility to the religious questions which permeate the life of the Muslim people, emphasizing the lack of knowledge of the Western world concerning these issues. They say they are discriminated in several aspects, especially in relation to their clothes; they questioned the Western idea of the subdued woman, introducing as counterpoint the submission to the rigid patterns of beauty and health which permeate the female western universe. General aspects of Islam were also dealt with, including sexuality, marriage, raising children and the relations with the people of a country with habits and traditions different from their own. the impact of September 11th on the lives of these women was evident, promoting fear and social exclusion. as these issues are closely related to mental health, the study of the religious and ethnic minorities aiming the comprehension of mental disease through a culturally sensitive medicine is urgent.
Donepezil, a centrally acting acetylcholinesterase inhibitor (AChEI), is approved for symptomatic relief of cognitive impairment in patients with Alzheimer's disease and Vascular Dementia (VD). Several adverse effects were reported and the most common are gastrointestinal disturbances. Others include bradycardia, agitation and confusion. Although epileptic seizures are listed as a side effect, there are few reports.
To present a case-report of donepezil-induced epileptic seizures and a review study regarding the theme available in Medline.
Brief literature review.
A case report is presented and literature of this theme shortly reviewed.
The case involves a 62-year-old female diagnosed with VD 6 months previously. Her medical history included a cerebrovascular accident 24 months earlier. She started the treatment with donepezil 5 mg and 48 hours later she was admitted in the Emergency with convulsions. She was unconscious for 20 minutes with urinary incontinence and bitten tongue. Normal blood analyses. A contrast brain CT showed a mild degree of cortical atrophy without new structural lesions. EEG showed mild and diffuse neuronal dysfunction with no grafoelements indicative of epilepsy. Donepezil was discontinued, no therapy was instituted and the patient has been convulsion free.
The mechanism of convulsive action of AChEIs isn’t clear. There are reports about centrally acting AChEIs inducing convulsions in patients with Dementia without any underlying neurological condition. Further research is needed to delineate the frequency of this effect and to extend our knowledge of the underlying pathophysiological mechanism in order to determinate the safety profile of AChEIs.
Depression is very common among institutionalized elders. Because of the increased risk of cognitive impairment/dementia, and mortality we want to describe the evolution of depression and analyze predictive factors.
In the Aging Trajectories Study (Instituto Superior Miguel Torga - Coimbra), we followed up a sample of 83 nondemented persons (M ± SD baseline age = 79.51 ± 6.58; men: 17; women: 66). In a 2-year prospective cohort analysis (2010-2011, and 2013), we assessed depression using the Geriatric Depressive Scale/GDS as screening tool and the Mini International Neuropsychiatric Interview to diagnose depression. We also used the UCLA Loneliness Scale, the Geriatric Anxiety Inventory/GAI, the Positive and Negative Affect Scale/PANAS. Sociodemographics, and health were control variables. We performed a multinomial logistic regression to identify predicitive factors.
Fifty participants had depression at baseline, nine developed, 49 maintained, nine remitted, and 16 maintained without depression.
Having depression was associated with worse scores in UCLA, GAI, and PANAS. Not having depression was correlated with higher positive affect.
Baseline higher GAI and UCLA, and lower positive affect and satisfaction predicted recurrent depression.
Improvement in GDS, GAI, and positive affect predicted depression remission.
Results show that depression is a concern issue for professionals working with institutionalized elderly. Anxiety, loneliness, low positive affect and satisfaction constitute a risk factor for maintaing depression in institutionalized elderly and low anxiety and depressive symptoms are a protective factors for depression. These results could be used in depression prevention programs.
Affectivity is related to cognitive impairment, but it is not known whether positive affect and negative affect increase/decrease the risk of cognitive impairment. In this study, we sought to examine the prevalence of cognitive impairment, and the potential role of positive and negative affectivity on cognitive functioning in institutionalized portuguese elderly, controlling the potential role of demographic and emotional factors.
A cross sectional investigation has been conducted with a portuguese institutionalized sample at Coimbra’s Council. We inquired 412 healthy elderly with a mean age of 80.38 years (SD = 7.24) using the Positive and Negative Affect Schedule (PANAS), the Mini-Mental State Examination (MMSE), the Geriatric Depression Scale (GDS) and the Geriatric Anxiety Inventory (GAI). Demographic (76.9% women, 14.3% > 4 years of education, 99.1% manual occupation, 82.2% without partner) and other self-reported related factors were taken into consideration (GDS mean 14.30 ± 6.31; GAI mean = 12.49 ± 5.93).
The prevalence of cognitive impairment was 66.6% (youngest-old: 1.4%; young-old: 24.7%, old-old: 36.5%, oldest-old: 3.9%). We found that only the positive affect was significantly related with the MMSE (r = 0.22). Multiple logistic regression analysis showed that positive affect predicted impairment in cognitive performance (OR = 0.96, CI 95% = 0.93-0.98; p < 0.001). These relationships were significant even after controlling for depression and anxiety status, age, education, and occupation.
These findings suggest that positive affect is a variable to attend to when evaluating cognitive functioning in institutionalized elderly.
Cognitive rehabilitation techniques, reminiscence therapy, and reality orientation therapy, have shown an impact on cognition, life satisfaction, mood, and on the progression of cognitive decline in elderly.
To test the effectiveness of a NRGP on the cognitive and emotional functioning of institutionalized elderly.
single blind randomized controlled study with paired groups.
Coimbra institutionalized elderly, aged between 64-92 (N = 88) with cognitive impairment no dementia, mostly women (75.0%).
randomization of participants to the rehabilitation group/RG (n = 41) and to the comparison/waiting-list group/CG (n = 23). NRGP involved groups of five elders, and took 90 min. per day, once a week, for 10 weeks.
Mini-Mental State Examination/MMSE, Frontal Evaluation Battery/FAB, Geriatric Depression Scale/GDS.
We used general linear model with repeated measures analysis of variance.
RG improved significantly on cognitive, and executive function (p < 0.001), and CG worsened on cognitive, executive function, and mood (p < 0.01). There was a significant effect on the MMSE, FAB, and GDS scores, after excluding pre-rehabilitation scores as covariates [F (1, 81) = 43.98, p < 0.001; η2 = 0.35; F(1, 80) = 28.37, p < 0.001; η2 = 0.26; F(1, 79) = 19.66, p < 0.001; η2 = 0.20].
A NRGP including cognitive rehabilitation, reminiscence therapy, and reality orientation proved to be effective on cognitive and executive functioning, and on depressive symptoms of institutionalized elders with cognitive impairment no dementia.
Venlafaxine is a serotonin and norepinephrine reuptake inhibitor widely used for the treatment of depression, generalized anxiety, and social anxiety disorders, as well as a number of other psychiatric conditions for which serotonergic antidepressants are often employed. Although urinary incontinence is listed as one side effect of these drugs, there are few reports in the literature.
To present a case report of venlafaxine-induced urinary incontinence and a review study regarding the theme with articles available in Medline.
A case report is presented in sequential detail and literature review of this theme shortly reviewed.
A 56-years-old caucasian man, average weight, with no prior medical or substance use history, with personality disorder and comorbid depression. This subject had his medication dosages increased from venlafaxine 150 mg/day to venlafaxine 225 mg/day; almost immediately he reported an increase in the urinary frequency, urge and incontinence. These clinical features remitted 72 hours after the dose was decreased to 150 mg/day. Animals studies suggest that incontinence secondary to serotonergic antidepressants could be mediated by the 5HT4 receptors found on the bladder. Further research is needed to delineate the frequency of this side effect and how best to treat it.
Urinary incontinence is an important medical condition with clinical and social implications. Clinicians who prescribe venlafaxine or other serotonergic antidepressants should be aware of the potential development of incontinence and need to query patients, particularly those at highest risk, with direct questions about this potential adverse effect.
Negative, cognitive and residual positive symptoms are a frequent concern in schizophrenia patients despite optimal management with current medication. Also, adverse effects induced by antipsychotics prevent them to be used in the so called high risk patients. Until new drugs specifically designed to address these symptoms are developed, several drugs used in different conditions have been tested.
To assess the evidence regarding the use of non-antipsychotic, alternative drugs, to treat or prevent schizophrenia.
To broaden available pharmaceutical options in the management of unremitting symptoms in schizophrenia patients, beyond commonly used antipsychotics.
A survey of the literature regarding alternative drugs to treat schizophrenia symptoms. Studies available in MEDLINE and published after year 2000 were surveyed. Only drugs assessed in at least one randomized and controlled clinical trial were included.
Several drugs have been studied in the management of resistant symptoms in schizophrenia, mainly negative symptoms and cognitive dysfunction. Also, the management of high risk patients is controversial and raises many ethical concerns. Such alternatives, namely those with a suitable safety profile are appealing.
Omega-3, memantine, acetylcysteine, d-cicloserine, estrogens, psychostimulants and acetylcholinesterase inhibitors have been assessed but only some of these have shown promising results, each for a specific group of symptoms, in different stages of the disease and with a diverse safety profile.
There exist a few alternative drugs with promising efficacy in the management of non-remitting symptoms in schizophrenia. Also, due to its safety profile some may be interesting options to high risk patients.
When cognitive decline (CD) is present, attention is one of the impaired mental functions. CD is also associated with anxious/depressive symptoms and with some demographic variables, particularly, age.
Investigate the associations between selective attention (Stroop Test: Stroop_Word, Stroop_Color, Difference between Stroop_Word and Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color and Difference between Stroop Ratio_Word and Stroop Ratio_ Color) and CD (Montreal Cognitive Assessment/MoCA) in institutionalized elders; explore the predictive value of Stroop variables for CD, controlling anxious/depressive symptoms and sociodemographic variables.
140 institutionalized elders (mean age, M = 78.4, SD = 7.48, range = 60-97) voluntarily answered to sociodemographic questions, the MoCA, the Geriatric Anxiety Inventory/GAI, the Geriatric Depression Scale/GDS and Stroop test.
73 elders (52, 1%) had CD. Dichotomized MoCA was associated with Stroop_Word, Stroop_Color, Stroop Ratio_Word, Stroop Ratio_Color, GDS and the sociodemographic variable schooling × profession. Age and education were not tested, since MoCA was stratified according to those variables. GDS, Stroop Ratio_Word and Stroop Ratio_Color showed to predict CD.
There was an association between Stroop_Word, Stroop_Color, Stroop Ratio_Word and Stroop Ratio_Color and CD, confirming that selective attention is smaller when the elderly reveal CD. GDS and CD were, also, associated. However, there was no association between MoCA dichotomized and differences between the correct answers (Stroop_Word and Stroop_Color) and Ratios (Stroop Ratio_Word and Stroop Ratio_Color). Selective attention and depressive symptoms predicted CD. It would be important to intervene through cognitive rehabilitation with the elders to improve their attention.
Valproic acid (VA) is an effective mood stabilizer. Although it's usually well tolerated, it may cause hyperammonemia through carnitine deficiency created by its inhibition of mitochondrial enzymes in the urea cycle. Clinical presentation of hyperammonemia usually involves lethargy and somnolence but this diagnosis is often overlooked due to a clinical presentation that may include normal liver enzyme tests and serum VA levels within therapeutic range.
To present case-reports of VA-induced encephalopathy and a review study regarding the theme available in Medline.
Brief literature review.
Three case-reports are presented and literature of this theme shortly reviewed.
The authors present cases of three adult females with Personality Disorder with lack of impulse control and Bipolar Disorder who have began treatment with VA and presented in the Emergency Department with generalized weakness and confusion. Subsequently, they developed hyperammonemia, despite its therapeutic serum levels and normal liver enzymes. În all cases the patient's mental status and ammonia level returned to baseline following discontinuation of VA.
Confusion with VA is a serious, rather frequent but reversible side affect. It has been reported that VA can interfere with the enzyme carbamoylphosphate synthetase, which is responsible for incorporating ammonia into the urea cycle. It can also increase the transport of glutamine across the mitochondrial membrane in the kidney, thereby increasing the production of ammonia causing neurotoxicity. Clinicians should be aware of changes in patient's cognitive and functional capacity, especially in elderly patients and during the first two weeks of treatment.
Factitious disorder (FD) is defined by the intentional production or feigning of physical or psychological symptoms with the objective of assuming the patient role. It's frequently difficult to adequately diagnose this disorder when the faked symptoms are those of a psychological or a psychiatric disorder. In these cases, there is often high comorbidity with other mental disorders, thus making it difficult to differentiate between real and factitious symptoms.
To present a case-report of FD with hallucinations and a review study regarding the theme available in Medline.
Brief literature review.
A case report is presented and literature of this theme shortly reviewed.
The case involves a 23-year-old female, a psychology student, born in destructured family. She had attempted suicide many times since she was 16 years old, one of them with high lethality. One month before her admission to our inpatient clinic in order to allow a clear diagnosis to be made, she began active auditory hallucinations, persecutory delusional ideation with disorganized behavior and consequent social isolation. A suitable dose of atypical antipsychotic drug was administered but Psychotic disorder was ruled out and she was dignosed with FD. After the factitious symptoms that prevented any type of therapeutic approach disappeared, the real symptoms of the patient were those characteristic of a borderline personality disorder.
This case emphasizes the need for the careful observation of these patients in order to establish the diagnosis and to improve a specific management strategy for them.
The full etiology of transsexualism is still unknown. However many factors, like biological and environmental, are being suggested as possible explanations to the cause of this entity.
We intend to revisit the major etiological theories of transsexuality, based on the description of two cases occurring in first-degree relatives.
A mother and her daughter both diagnosed with Gender Identity Disorder are followed at Multidisciplinary Clinical Sexology Group in our facilities since 2011.
This case is related to a young girl who in her childhood felt and behaved himself as a boy by adopting male gender stereotypes. She has lived with distress during the development of female secondary sexual characteristics, and the age of 17, after identifying his problem decided to tell his mother. However our patient founded that her mother, with 38 years old, was already resigned by living with a sex gender that didn't recognize as her own. In the end they decided to confront the social and family environment, joining both in the process of sexual reassignment.
The transsexualism is a complex phenomenon. The occurrence of two cases of transsexualism in a mother and daughter highlights the importance of consider and extend the knowledge about the biological aspects of gender identity disorder.
It is relevant to communicate the cases occurring within the same family to contribute to the etiology investigation in this area. In the literature the rare cases described of family transsexuals are among brothers, which makes this case between mother and daughter special.
Nutrient requirements in cattle are dependent on physiological stage, breed and environmental conditions. In Holstein × Gyr crossbred dairy heifers, the lack of data remains a limiting factor for estimating energy and protein requirements. Thus, we aimed to estimate the energy and protein requirements of Holstein × Gyr crossbred heifers raised under tropical conditions. Twenty-two crossbred (½ Holstein × ½ Gyr) heifers with an average initial BW of 102.2 ± 3.4 kg and 3 to 4 months of age were used. To estimate requirements, the comparative slaughter technique was used: four animals were assigned to the reference group, slaughtered at the beginning of the experiment to estimate the initial empty BW (EBW) and composition of the animals that remained in the experiment. The remaining animals were randomized into three treatments based on targeted rates of BW gain: high (1.0 kg/day), low (0.5 kg/day) and close to maintenance (0.1 kg/day). At the end of the experiment, all animals were slaughtered to determine EBW, empty body gain (EBG) and body energy and protein contents. The linear regression parameters were estimated using PROC MIXED of SAS (version 9.4). Estimates of the parameters of non-linear regressions were adjusted through PROC NLIN of SAS using the Gauss–Newton method for parameter fit. The net requirements of energy for maintenance (NEm) and metabolizable energy for maintenance (MEm) were 0.303 and 0.469 MJ/EBW0.75 per day, respectively. The efficiency of use of MEm was 64.5%. The estimated equation to predict the net energy requirement for gain (NEg) was: NEg (MJ/day) = 0.299 × EBW0.75 × EBG0.601. The efficiency of use of ME for gain (kg) was 30.7%. The requirement of metabolizable protein for maintenance was 3.52 g/EBW0.75 per day. The equation to predict net protein requirement for gain (NPg) was: NPg (g/day) = 243.65 × EBW−0.091 × EBG. The efficiency of use of metabolizable protein for gain (k) was 50.8%. We observed noteworthy differences when comparing to ME and protein requirements of Holstein × Gyr crossbred heifers with other systems. In addition, we also observed differences in estimates for NEm, NEg, NPg, kg and k. Therefore, we propose that the equations generated in the present study should be used to estimate energy and protein requirements for Holstein × Gyr crossbred dairy heifers raised in tropical conditions in the post-weaning phase up to 185 kg of BW.