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Fraga A, Mesquita B, Facucho-Oliveira J, Albuquerque M, Espada-Santos P, Cintra P, Paulino S, Moutinho A. Lithium: more than a mood stabilizier. Eur Psychiatry 2022. [PMCID: PMC9565390 DOI: 10.1192/j.eurpsy.2022.1027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Bipolar disorder (BD) is characterized by episodic changes in affect, motivation, cognition and behavior. This severe mental disorder has a prevalence of at least 1% and a high heritability of 60%-80%. The pathophysiology is still poorly understood but evidence indicate that the disorder relates to disturbances in front-limbic networks relevant for emotion processing and regulation. New techniques have been used to study BD and showed aberrante white matter (WM) microstructure in the corpus callosum and from-limbic pathways. However, lithium, a mood stabilizier, it looks like has celular and neuromodulatory effects. Objectives The authors elaborate a narrative literature review to identify the existing clinical evidence of lithium’s effect on the WM from BD patients. Methods Pubmed databased searched using the therms “bipolar disorder”, “white matter” and “lithium”. Results Lithium is a bipolar medication that confers treatment and long-term prophylaxis and been reported as having neuroprotective effects. Studies that used new techniques such diffusion tensor imaging measures to assess white matter integrity reported a positive effect of lithium on the integrity of WM of BD patients and suggest that response to lithium treatment in BD patients is associated with normalization of WM microstructure in regions associated with emotion processing. Conclusions Lithium appears to positively influence the evolution of the white matter abnormalities described in BD patients however further investigation is required to strongly reinforce this potential and safety. Disclosure No significant relationships.
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Fraga A, Mesquita B, Esteves-Sousa D, Facucho-Oliveira J, Albuquerque M, Espada-Santos P, Cintra P, Moutinho A. The Role of Vagus Nerve Stimulation in Depression: What We Know? Eur Psychiatry 2022. [PMCID: PMC9567188 DOI: 10.1192/j.eurpsy.2022.1449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Introduction Depression is a leading cause of disability affecting over 300 million indivuals worldwide. About 1/3 of patients with depression fail to achive remission despite treatment with multiple antidepressants and are considered to have treatment-resistant depression (TRD). In view of such facts, vagus nerve stimulation (VNS) therapy was approved as an adjunctive long-term treatment for TRD. Objectives The authors elaborate a narrative literature review about de effectiveness of VNS in treatment for TRD. Methods PubMed database searched using the terms “treatment-resistant depression”, “vagus nerve stimulation” Results The pathophysiology of depression is complex and includes social environmental stress factors, genetic and biological processes, inflammation, and disturbances in monoamine neurotransmission. The overdrive of the HPA axis is most consistently seen in subjects with more severe depression, when the cortisol feedback inhibitory mechanisms are impaired, contributing to cytokine oversecretion. It has been shown that chronic exposure to elevated inflammatory cytokines can lead to depression. The vagus nerve represents the main component of the parasympathetic nervous system, which oversees a vast array of crucial bodily functions, including control of mood and imune response. VNS therapy has a demonstrated anti-inflammatory effect which might be a significant reason for its efficacy in patients who did not respond to antidepressants. Treatments thar target the vagus nerve increase the vagal tone and inhibit cytokine production and the stimulation of vagal aferente fibers in the gut influences monaminergic brain systems. Conclusions The mecanismos by which VNS may benefit patients nonresponsive to conventional antidepressants is unclear, with further research need to clarify this. Disclosure No significant relationships.
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Mesquita B, Paulino S, Fraga A, Facucho-Oliveira J, Espada-Santos P, Albuquerque M, Costa M. Behavioural Variant of Frontotemporal Dementia or Mood Disorder? Eur Psychiatry 2022. [PMCID: PMC9567642 DOI: 10.1192/j.eurpsy.2022.1150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction The behavioural variant of frontotemporal dementia (bvFTD) is a devastating neurodegenerative syndrome with its peak in the early sixties at about 13 per 100,00. The diagnosis of bvFTD relies on clinical assessment as patients present executive and behavioural deficits, like apathy, loss of motivation and personality changes. Current diagnosis criteria lack specificity and symptomatic overlap between bvFTD and primary psychiatric disorders (PPD) pose a diagnostic conundrum, with half of bvFTD patients previously receiving a psychiatric diagnosis. Objectives The goal is to discuss the syntomatic overlap of these two entities. Methods Brief non-systematic literature review on the topic, illustrated by a case-report presentation. Results A 69 year old men, retired and single, is committed for thought and behavior disorganization and insomnia. He presented expansive mood but also temporal and spatial disorientation and periods of incongruous speech. This patient’s clinical presentation could both entice a diagnosis of bvFTD but also of an affective disorder, especially since it has been reported that neuropsychiatric presentations, like late-onset psychosis or mania, can be the initial presentation of this form of dementia, particularly in patients with C9orf72 mutations, who often display persecutory or grandiosity delusions. Conclusions This clinical case exemplifies the difficulty that lies in differentiating cases of bvFTD from late-onset idiopathic mood or psychotic disorders. It is important to consider that on cognitive assessment patients with bvFTD score significantly worse on executive function tests that PPD patients No disease- modifying therapies are available for patients with bvFTD, therefore drug treatment should focus on the most disruptive or taggable behaviours. Disclosure No significant relationships.
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Mesquita B, Fraga A, Albuquerque M, Espada-Santos P, Facucho-Oliveira J, Paulino S, Costa M. COVID-19 Psychiatric Inpatient Unit- experience and challenges. Eur Psychiatry 2022. [PMCID: PMC9565269 DOI: 10.1192/j.eurpsy.2022.1326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction On January 2021 the Department of Psychiatry became the only unit exclusively dedicated to COVID patients with severe mental illness in acute decompensation. Only patients in risk of rapid medical deterioration were excluded and forwarded to intensive care. Objectives Discussion of this unprecedented experience. Methods Analysis of 28 patients hospitalized during 3 months with both an acute psychiatric disorder and an SARS-CoV-2 infection; description of the multidisciplinary intervention made. Results Our sample was characterized by a majority of patients with an acute psychotic episode derived from a schizophrenia spectrum disorder (42%) or a bipolar affective disorder (21%). Only 3% of the patients had a diagnosis of severe major depressive disorder. And 10% of patients developed severe respiratory symptoms requiring oxygen or urgent transfer to COVID medical wards. Most patients presented periods of psychomotor agitation, lack of impulse control and self-aggression. Psychopharmacological and psychotherapeutic interventions had to be adapted to these unusual conditions. Most of them had already gone through a period of isolation in the buffer ward created to exclude false negatives, which promoted atypical deliriums and symptoms of post-traumatic stress. The psychiatric team was faced with the emergent need to adapt an intervention model based on trust to a model that had to prioritize physical safety. Conclusions The pandemic experience was transformative for all who lived through it. From the challenge perspective, it may have been enriching. But the maintained confrontation with the antithesis of therapy, defined by “caring, supporting, communicating, approaching”, was devastating in ways that we consider essential to be debated. Disclosure No significant relationships.
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Fraga A, Mesquita B, Facucho-Oliveira J, Espada-Santos P, Albuquerque M, Neves R, Moutinho A. Ketamine and Electroconvulsive Therapy: Better Together? Eur Psychiatry 2022. [PMCID: PMC9567259 DOI: 10.1192/j.eurpsy.2022.1445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Major depressive disorder (MDD) is a highly prevalent clinical condition with a leading cause of disability worldwide. The currently available therapeutic agents have important limitations regarding side effects, partial or non-responsiveness. Patients are considered to have treatment-resistant depression (TRD) if there is no effect or minimal effectiveness after receiving adequate dose-duration use of antidepressants from two different categories. For this patients, electroconvulsive therapy (ECT) can be a treatment option and new therapies appear to tackle TRD like ketamine, a dissociative anesthetic and analgesic. Objectives The authors elaborate a narrative literature review to understand if ketamine might enhance the antidepressant efficacy of ECT. Methods PubMed database searched using the terms “Electroconvulsive therapy”, “ketamine” and “treatment-resistant depression”. Results ECT is currently recommended as an end-line therapy for TRD. Memory impairment after ECT could be a consequence of indiscriminate activation or saturation of glutamate receptors during the treatment, disrupting hippocampal plasticity involved in memory. Ketamine inhibits N-methyl-d-aspartate (NMDA) receptors, while stimulating glutamate release and was proposed as an ECT adjuvant, might reduce cognitive adverse effects, time until response/ remission and inclusively improve response rates to ECT.
However, response and remission rates of ketamine in ECT showed no significant difference from the comparator groups and was associated with higher rates of psychiatric and cardiovascular adverse events. Conclusions The results did not support the use the combination of ketamine and propofol as anesthetic agents for ECT in patients with MDD. However, further studies are needed to investigate the beneficial clinical and cognitive effects of ketamine alone in ECT settings. Disclosure No significant relationships.
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Espada-Santos P, Facucho-Oliveira J, Mesquita B, Fraga A, Albuquerque M, Costa M, Marinho M, Cintra P. Aripiprazol and Hypersexuality: when partial is to much. Eur Psychiatry 2022. [PMCID: PMC9567042 DOI: 10.1192/j.eurpsy.2022.1865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction A growing number of published cases has showed that hypersexual behavior may arise with treatment with second-generation antipsychotics, including aripiprazole and olanzapine. Aripiprazole is a second-generation antipsychotic commonly used to treat schizophrenia and bipolar disorder. It has a unique pharmacologic profile acting as a partial agonist of the dopamine D2 receptor, as a partial agonist at the 5-HT1A receptor, and as an antagonist at the 5-HT2A receptor. Literature shows that medication with partial dopaminergic agonistic activity can cause compulsive behaviors, such as pathological gambling, compulsive eating, compulsive shopping, and hypersexuality. Although it is difficult to predict who would develop these behaviors, the literature suggests that patients at a higher risk of developing impulsive behaviors include those with a personal or family history of obsessive-compulsive disorder, impulse control disorder, bipolar disorder, impulsive personality, alcoholism, drug abuse, or other addictive behaviors. Objectives Here, we present a case of a 32-year-old male who developed hypersexuality symptoms after receiving aripiprazole as treatment for bipolar disorder. Methods We have done a literature review using the MeSH terms Aripiprazole and hypersexuality in the “PubMed”. Results After switching Aripiprazole to Risperidone the hypersexuality symptoms started to decrease and got almost complete relief after 2 weeks. Conclusions This case highlights the rare hypersexuality side effect that can arise in patients receiving aripiprazole for bipolar disorder treatment. Clinicians should be aware of the increased risk of hypersexuality and other impulsive behaviors as they can significantly impair a patient’s daily functioning. Disclosure No significant relationships.
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Fraga A, Mesquita B, Esteves-Sousa D, Albuquerque M, Facucho-Oliveira J, Espada-Santos P, Cintra P, Moutinho A. Irritable Bowel Syndrome: The role of the Psychiatry. Eur Psychiatry 2022. [PMCID: PMC9567833 DOI: 10.1192/j.eurpsy.2022.1220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Irritable bowel syndrome (IBS) is the most common functional gastrointestinal disorder, affecting about 20% of people worldwide. This complex and multifaceted disorder has been proposed as a system disease involving not only individual systems including the nervous, endocrine, imune, digestive, microbiota and the environment but also the interactions of these systems. The aetiology of IBS is complex and incompletely understood and this disease are frequently associated with a comorbid psychiatric disease. Current treatment is symptom-directed, rather than based on underlying pathophysiological mechanisms.
Objectives
The authors elaborate a narrative literature review to identify the pathophysiology and therapeutic approach of IBS.
Methods
Pubmed databased searched using the therms “psychiatry”, “irritable bowel syndrome” and “treatment”.
Results
The IBS is the most common and best described of the functional bowel disorders, which represents a considerable therapeutic challenge. Studies looked at the efficacy of fibre, antispasmodics and peppermint oil in the treatment of IBS found moderately effectiveness in the treatment of global symptoms. Elimination diets are helpful in improving IBS. There is evidence that a low-FODMAP diet can have a favorable impact on IBS symptoms, especially abdominal pain, bloating and diarrhea with improved irritable bowel syndrome symptoms and quality of life. Among the currently available classes of drugs for the treatment of IBS, antidepressants such as selective serotonin releasing inhibitors and tricyclic antidepressants are useful because of their analgesic properties, independent of their mood-improving effects.
Conclusions
Evidence suggest that antidepressants might be useful for treatment symptom of IBS however further investigation is required.
Disclosure
No significant relationships.
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Mauricio J, Albuquerque M. Negative impact of family religious and spiritual beliefs in schizophrenia – a 2 year follow-up case. Eur Psychiatry 2021. [PMCID: PMC9479964 DOI: 10.1192/j.eurpsy.2021.1810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionFor individuals with mental disorders and their families, religion and spirituality may have a significant influence over how these conditions are understood, managed and treated. Family can act as a moderator in which psychotic patients interpret and explain internalized events. However, they can have a negative impact when discouraging diagnosis and treatment adherence.ObjectivesExplore the impact of family religious and spiritual beliefs on clinical outcomes among a schizophrenic patient. Investigate the psychiatrist’s role in addressing barriers to treatment adherence.MethodsData retrieved from clinical interview. Subsequent non-systematic review of the most relevant literature on the topic.ResultsWe report a case of a 30-year-old single catholic woman, living with her parents. She had a past history of psychotic symptoms that were interpreted in a context of a depressive episode. After some months she fulfilled the criteria for Schizophrenia and anti-psychotic was prescribed. Family always demonstrated doubts about the disease and negatively influenced the treatment adherence. They believed she was possessed by demons and she was submitted to exorcisms and spiritual therapies. After a 2-year follow-up with erratic treatment regimens and worsening symptoms they accepted her hospitalisation. The majority of symptoms were controlled allowing complete adherence to the same treatment proposed before.ConclusionsThe disease acceptance is a complex process, influenced by multiple beliefs that play different roles in each patient and family, that can adversely influence clinical management. It is essential to understand the family sociocultural environment, by gauging the most influential elements aiming to enhance their compliance with treatment.DisclosureNo significant relationships.
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Fraga A, Esteves-Sousa D, Facucho-Oliveira J, Albuquerque M, Costa M, Moura N, Espada-Santos P, Moutinho A. The role of Mediterranean Diet in mental health in pandemic times. Eur Psychiatry 2021. [PMCID: PMC9479813 DOI: 10.1192/j.eurpsy.2021.1788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Introduction In late 2019, an epidemic outbreak emerges in China caused by a new coronavirus with high transmission and human infection potential which in March 2020, was characterized by WHO as a pandemic. The lockdown has repercussions on the population’s well-being, reflected in their food choices. There is a tendency to increase the consumption of energy dense food, rich in fat and carbohydrates, which are related to an increased risk of depression. Objectives The main goal of this non-systematic literature review was to understand the impact of the Mediterranean Diet on Mental Health promotion in SARSCoV-2 pandemic. Methods Literature from Pubmed database were searched, with the following keywords: COVID-19, Depression, Anxiety, Mental Health and Mediterranean Diet. Results Studies indicate that a diet based on the Mediterranean Diet is associated with a decreased risk of developing depressive symptoms, especially when there is moderate to high adherence to this dietary pattern. High consumption of plant and fish foods, reduced consumption of sugary products, processed and red meats and the use of olive oil as a fat source, are principles of the Mediterranean diet, associated with an improvement in endothelial function, increased levels of eicosanoids and serotonin synthesis and regulation of serotonin which seem to explain this protective effect. Conclusions In addition to decreasing the risk of obesity, diabetes, and hypertension, comorbidities associated with the most serious disease of COVID-19, the Mediterranean Diet seems to play an important role in promoting mental health, with a decreased risk of developing depressive symptoms. Disclosure No significant relationships.
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Fraga A, Esteves-Sousa D, Facucho-Oliveira J, Albuquerque M, Costa M, Espada-Santos P, Moura N, Moutinho A. Mechanisms linking gut microbiota to depression. Eur Psychiatry 2021. [PMCID: PMC9480044 DOI: 10.1192/j.eurpsy.2021.1962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The gut microbiota constitute the largest and most diverse community in the body which is primarily responsible for the maintenance of the intestinal wall integrity and the protection against pathogens. Besides having an important role in the regulation of host energy metabolism, the gut microbiota can also influence neurodevelopment, modulate behavioral and might contribute to the development of psychiatry disorders. Objectives The authors elaborated a narrative literature review to understand how gut microbiota can influence depression. Methods Using PubMed as the database, a research was conducted about how Gut Microbiota relates with Depression. Results The microbiota-gut-brain axis encompasses the strong bidirectional communication between the gut microbiota and the CNS. Multiple mechanisms may be involved in this bilateral communication, including immune, endocrine and neural pathways. Permutations in the gut microbiome composition trigger microbial lipopolysaccharides production that activates inflammatory responses. Cytokines send signals to the vagus nerve, which links the process to the hypothalamic-pituitary-adrenal axis that consequently causes behavioral effects. Beyond this, gut microbiota have the capacity to produce many neurotransmitters and neuromodulators such as serotonin and can induce the secretion of the brain-derived neurotrophic factor, an important plasticity-related protein that promotes neuronal growth, development and survival. Conclusions Neuroinflammatory processes like those that occur in depression are deeply modulated by peripheral inflammatory stimuli, especially those from the intestinal microbiota. However, the knowledge is currently limited and the information available is not enough to understand the exact mechanisms. Therefore, more studies are required to show how gut microbiota influences the human brain. Disclosure No significant relationships.
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Fraga A, Esteves-Sousa D, Facucho-Oliveira J, Albuquerque M, Costa M, Espada-Santos P, Moutinho A. The role of intranasal esketamine in treatment-resistant depression. Eur Psychiatry 2021. [PMCID: PMC9475877 DOI: 10.1192/j.eurpsy.2021.1278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IntroductionMajor depressive disorder (MDD) is a highly prevalent clinical condition with a leading cause of disability worldwide. Unfortunately, about 1/3 of patients with MDD fail to achieve remission despite treatment with multiple antidepressants and are considered to have treatment-resistant depression (TRD). Research showed abnormalities in glutamatergic transmission in neural circuits and antidepressant efficacy with the N-methyl-D-aspartate (NMDA) receptor antagonist, ketamine.ObjectivesThe authors elaborate a narrative literature review on the intranasal esketamine as a new-class antidepressant.MethodsPubMed database searched using the terms “treatment-resistant depression” and “esketamine”.ResultsKetamine, synthetized from PCP, acts as an antagonist of NMDA receptor, reducing Central Nervous System excitability. One limitation of ketamine for treating depression is that requires intravenous administration, reducing its applicability in outpatient settings. Esketamine, the S-enantiomer of ketamine, developed as an intranasal formulation has a higher affinity for the NMDA receptor. The evidence of the rapid antidepressant effect of intranasal esketamine was first made by Lapidus et al, that demonstrated intranasal esketamine ability to reduce depressive symptomatology. However, some recent studies reported significant acute cardiovascular, psychotomimetic and neurological side-effects. Thus, drug formulation, delivery device, insufflation technique, and individual factors seem to contribute importantly to the tolerability and efficacy of the intranasal administration rote.ConclusionsThere is the need to develop novel treatments providing effective, more rapid-acting, and sustained relief of depressive symptoms, especially in patients with TRD. Intranasal esketamine has shown antidepressant effects in patients with TRD but further investigation is required to strongly reinforce this potential and safety.
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Fraga A, Esteves-Sousa D, Facucho-Oliveira J, Albuquerque M, Costa M, Dos Santos PE, Moura N, Moutinho A. Effects of psilocybin-assisted therapy on treatment-resistant depression. Eur Psychiatry 2021. [PMCID: PMC9480034 DOI: 10.1192/j.eurpsy.2021.1836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction
Major depressive disorder is a highly prevalent clinical condition, affecting more than 300 million individuals worldwide. About 1/3 of patients with MDD fail to achieve remission despite treatment with multiple antidepressants and are considered to have treatment-resistant depression (TRD). Novel antidepressants with rapid and sustained effects on mood and cognition could represent a breakthrough in the TRD and may potentially improve or save lives. Psilocybin, a classic hallucinogen, more commonly found in the Psilocybe mushrooms has a combined serotonergic and glutamatergic action. The preliminary evidence of antidepressant effects of psilocybin-assisted therapy indicates the potential of psilocybin-assisted therapy as a novel antidepressant intervention. Objectives The authors elaborate a narrative literature review about the effects of Psilocybin-based therapy on patients diagnosed with treatment-resistant depression. Methods PubMed database searched using the terms “Treatment-Resistant Depression AND Psilocybin” and targeting clinical trials. References of selected articles and review articles were also assessed. Results 2 articles evaluate psilocybin effects in 32 patients with TRD and showed that two doses of psilocybin alongside psychological support significantly reduces depressive symptoms. All patients presented some reduction in symptoms from baseline to one week after the second dose and reproduced immediate and substantial improvements in depression that ultimately could sustain up to 6 months. Conclusions Psilocybin-assisted therapy is a very appealing new possibility in the treatment of depression. However, due to the small populations of the existing trials, future studies are needed to prove this positive association and to fully understand Psilocybin’s mechanisms of actions and effects. Disclosure No significant relationships.
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Dos Santos PE, Facucho-Oliveira J, Esteves-Sousa D, Costa M, Albuquerque M, Fraga A, Marinho M, Cintra P. Neuropsychiatric symptoms of multiple sclerosis: A case report. Eur Psychiatry 2021. [PMCID: PMC9475602 DOI: 10.1192/j.eurpsy.2021.1264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Multiple Sclerosis (MS) is an immune-mediated inflammatory demyelinating disease of the central nervous system. Concomitant psychiatric diseases are frequent in MS, with depression and anxiety disorders constituting the majority. The presence of psychotic disorders with MS is rare. Several studies have reported that psychotic symptoms usually develop after the neurological signs of MS and they are mostly linked to the side effects of treatment with interferon or with corticosteroids. Objectives The authors report here the case of patient with MS without psychiatric history that developed psychotic symptoms. Methods Beside the medical record of the patient a non-systematic search of the literature was carried out in the databases Pubmed and Google Scholar with the terms “Multiple Sclerosis”, “Multiple Sclerosis treatment ”and“ Neuropsychiatric symptoms ”. Results A 38 years old woman with MS, with no psychiatry history developed paranoid and reference delusions, several months after starting interferon beta-1a therapy. The inferferon therapy was stopped and the patient was started Risperidone 3 mg id with a rapid but only partial remission of the psychotic symptoms. The patient presented high blood levels of prolactine and the MRI showed a pituitary microadenome. The Risperidone was switched to Aripiprazol 15 mg also with partial remission of the psychtic symptons. Conclusions It is not possible to attribute our patient’s psychotic symptoms entirely to his Interferon therapy or to MS lesion load, but the occurrence during treatment, no psychiatric history and the rapid but parcial resolution with discontinuing suggest that Interferon therapy was at least contributory to the clinical picture.
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Mesquita G, Rocha K, Albuquerque M, Silva J, Gomes M, Monteiro T, Moraes C. Monitoring of Leptospira in captive turtles by DNA analysis. ARQ BRAS MED VET ZOO 2021. [DOI: 10.1590/1678-4162-11949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
| | | | | | - J. Silva
- Universidade Federal do Pará, Brazil
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Rizvi N, Camargo S, Escovar C, Chate R, Szarf G, Teles G, Guimarães M, Gross J, Barbosa P, Chiarantano R, Reis R, Mauad E, Ghefter M, Sarmento P, Pereira R, Rocha J, Albuquerque M, Franceschini J, Hochhegger B. P41.05 Challenges of Implementing Lung Cancer Screening in Brazil: Preliminary Results of a Multicenter Group. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Esteves-Sousa D, Moura N, Farias R, Halpern C, Albuquerque M, Facucho-Oliveira J, Espada-Santos P. PS-1-5 How to Manage Antidepressant-Induced Sexual Dysfunction. J Sex Med 2020. [DOI: 10.1016/j.jsxm.2020.04.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Albuquerque M, Guedes R, Dornbusch P, Laskoski L, Mangini P, Lange R. Ovarian radiographic and direct measurements of Japanese Quail ( Coturnix coturnix japonica ) submitted to light restriction. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-8992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Often, in pet birds, any stimulus to lay eggs is unwanted in order to reduce reproductive diseases and disorders. The objectives of this study were: to determine the time necessary to promote ovary involution after an eight hour photoperiod using laying Japanese quails (Coturnix coturnix japonica); to connect the ovarian radiographic measurements with egg production; and to compare these measurements with direct ovary data obtained at necropsy. Birds were separated into three groups: 12h/24d (control group - 12h photoperiod for 24 days), 8h/24d and 8h/36d (8h photoperiod for 24 and 36 days). After euthanasia, all cadavers were x-rayed to measure ovary length and height. Birds were necropsied to measure ovarian length and weight. Results: radiographic ovary length demonstrated strong and positive correlation (r=0.96) with direct ovary length of all three groups; laying quails showed higher ovary height (p=0.025) and length (p=0.009) than non-laying quails; eight hours of artificial light per day promotes ovary length (p=0.025) and weight (p=0.009) reduction. Conclusions: radiography can estimate the ovary measure and indicate posture; an eight hour photoperiod of 24 days is not enough to promote ovarian regression, while the use of reduced photoperiod for 36 days promotes significant ovary involution.
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Affiliation(s)
- M. Albuquerque
- Universidade Federal do Paraná, Brazil; Vida Livre Medicina de Animais Selvagens, Brazil
| | - R. Guedes
- Universidade Federal do Paraná, Brazil
| | | | | | - P. Mangini
- Vida Livre Medicina de Animais Selvagens, Brazil
| | - R. Lange
- Universidade Federal do Paraná, Brazil
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Ribeirinho Marques A, Veludo Chai M, Cintra P, Gonçalves V, Esteves de Sousa D, Albuquerque M, Nuno Costa M. Aviation mental disorders – An in-flight case of mania. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
IntroductionDue to recent aviation accidents, like German Wings flight 9525, aviation related mental health disorders have recently received much attention. Several psychological disorders have been associated with aviation ever since its beginning, both in passengers and aviation professionals. A clinical case is revised of a 33 years old air hostess, without previous psychiatric history, who was admitted twice in a manic state, and a third time abroad in Nice, France, after prolonged sleep privation due to consecutive transatlantic flights.ObjectivesScientific revision of psychological disorders in passengers (flight related psychological stress, flight phobia, post-traumatic stress disorders after plane crashes…), aviation professionals (mood changes, sexual function disorders, jet lag, sleep disorders), ground staff, and populations living within close distance to airports (burnout, circadian rhythms disorders due to high noise levels…).MethodsResearch in Pubmed, Medscape, scientific literature and other publications, with the following research terms: aviation related mental health disorders, flight related psychological disorders, flight phobia, aerophobia, aviophobia, flight related anxiety, flight related mood disorders, flight induced mania, psychological stress and air travel; articles in English, Portuguese and Spanish.ResultsFifty-eight articles, one book and four publications were considered relevant; the case of the patient is thoroughly described with data retrieved from the clinical file.ConclusionsSeveral important issues concerning both mental and physical health are highlighted by this clinical case, yet, surprisingly, scientific knowledge has progressed at a rather slow pace and mental health professionals have not given much attention to this issue.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Tijeras-Raballand A, Le Bitoux M, Maillard A, Albuquerque M, Colnot N, Barral M, Dohan A, Bonnin P, Pocard M, Benhadji K, Paradis V, Raymond E, Harari A, Faivre S, De Gramont A. Galunisertib combined with sorafenib affects in vivo tumor growth and immune landscape in hepatocellular carcinoma (HCC). Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32996-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Albuquerque M, Coutinho M, Borrego C. Long-term monitoring and seasonal analysis of polycyclic aromatic hydrocarbons (PAHs) measured over a decade in the ambient air of Porto, Portugal. Sci Total Environ 2016; 543:439-448. [PMID: 26599144 DOI: 10.1016/j.scitotenv.2015.11.064] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 11/12/2015] [Accepted: 11/13/2015] [Indexed: 06/05/2023]
Abstract
The present paper reports the analytical results of PAHs concentrations in ambient air obtained in the PM10 and gas-phase, from 2004 to 2014, in Porto, Portugal. As part of a monitoring programme conducted by IDAD - Institute of Environment and Development and supported by the regional municipal solid waste (MSW) management authorities, an extensive database of PAH concentrations in ambient air was collected in Porto's metropolitan area. During this period a total of 201 samples were collected in two sites classified as suburban. Analytical results showed a clear decreasing trend of total PAHs (∑PAH) and benzo[a]pyrene (BaP) levels during the period of study, especially in the first years of monitoring. The average annual concentrations of BaP were, throughout the monitoring period, lower than the target value for the annual average (1 ng m(-3)) defined in the European legislation. PAHs levels showed a strong seasonality, with higher concentrations values during the colder months. The winter/summer ratio of ∑PAH for the eleven years of study was 5, revealing the seasonal variation of PAHs in the studied area. The estimated toxic equivalency factors (TEFs) used to assess the contribution of the carcinogenic potential, confirmed a significant presence of the moderately active carcinogenic BaP and dibenz[ah]anthracene (DahA) in the samples collected in Porto. The ratio values of individual PAHs concentrations were used as diagnostic tool to identify the possible origin of PAH in the ambient air of Porto. Based on diagnostic ratios, it may be concluded that automobile traffic emissions, mainly related to diesel vehicles, were the major contribution of PAH levels in the ambient air, although some others contributions, such as coal and wood combustion, were identified.
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Affiliation(s)
- M Albuquerque
- IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário, 3810-193 Aveiro, Portugal.
| | - M Coutinho
- IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário, 3810-193 Aveiro, Portugal
| | - C Borrego
- IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário, 3810-193 Aveiro, Portugal; CESAM & Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
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Coutinho M, Albuquerque M, Silva AP, Rodrigues J, Borrego C. Long-time monitoring of polychlorinated dibenzo-p-dioxins and dibenzofurans over a decade in the ambient air of Porto, Portugal. Chemosphere 2015; 137:207-213. [PMID: 26246045 DOI: 10.1016/j.chemosphere.2015.07.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 07/16/2015] [Accepted: 07/18/2015] [Indexed: 06/04/2023]
Abstract
As part of a monitoring program initiated in 1998 and conducted by IDAD - Institute for Environment and Development and supported by regional municipal solid waste (MSW) management authorities, an extensive database of dioxins' and furans' (PCDD/PCDF) concentrations in ambient air was collected in Porto, in two sites classified as suburban. The present paper summarizes the analytical results of PCDD/PCDF in ambient air obtained from 2001 to 2014 through this intensive monitoring work. The toxic equivalent (WHO-TEQ 1998) concentrations of the PCDD/PCDF in the air ranged from 8.2 to 904.4 fg TEQ m(-3), with an average and median values of 104.5 fg TEQ m(-3) and 49.8 fg TEQ m(-3), respectively. The PCDD/PCDF concentration trend in Porto's ambient air shows a clear drop of the annual average values occurred during the study period. The presence of seasonal variations is very clear in the present study. Winter levels (average: 154.3 fg TEQ m(-3)) are significantly higher than summer levels (average: 42.9 fg TEQ m(-3)). The PCDD/PCDF profiles' details show that several differences occurred over time. The homologue profiles presented changes and the PCDD congeners have decreased in terms of mass. The analysis of concentrations in combination with specific homologue and congener patterns of PCDD/PCDF allowed identification of potential emission sources.
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Affiliation(s)
- M Coutinho
- IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário, 3810-193 Aveiro, Portugal.
| | - M Albuquerque
- Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
| | - A P Silva
- IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário, 3810-193 Aveiro, Portugal
| | - J Rodrigues
- IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário, 3810-193 Aveiro, Portugal
| | - C Borrego
- IDAD - Instituto do Ambiente e Desenvolvimento, Campus Universitário, 3810-193 Aveiro, Portugal; Department of Environment and Planning, University of Aveiro, 3810-193 Aveiro, Portugal
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Andrade H, Branco L, Albuquerque M, Bergo F, Nucci A, França M. Spinal cord atrophy correlates with disease severity in amyotrophic lateral sclerosis. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Casseb R, Albuquerque M, Beltramini G, Andrade H, Balthazar M, Nucci A, Weiler M, Franca M. Seed-based and functional connectivity analyses as a tool for evaluating Amyotrophic Lateral Sclerosis (ALS) progression, a pilot study. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.1679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Scorza FA, Cysneiros RM, Arida RM, Terra VC, Machado HR, Rabello GMM, Albuquerque M, Cavalheiro EA. Fish consumption, contaminants and sudden unexpected death in epilepsy: many more benefits than risks. BRAZ J BIOL 2011; 70:665-70. [PMID: 20730355 DOI: 10.1590/s1519-69842010000300026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2009] [Accepted: 01/12/2010] [Indexed: 11/21/2022] Open
Abstract
People with epilepsy have an increased risk of dying prematurely and the most common epilepsy-related category of death is sudden unexpected death in epilepsy (SUDEP). SUDEP is mainly a problem for patients with chronic uncontrolled epilepsy. The ultimate goal of research in SUDEP is to develop new methods to prevent it and actions other than medical and surgical therapies that could be very useful. Nutritional aspects, i.e., omega-3 fatty acids deficiency, could have an interesting role in this scenario. Some animal and clinical studies have suggested that omega-3 fatty acids could be useful in the prevention and treatment of epilepsy and hence SUDEP. It has been ascertained that the only foods that provide large amounts of omega-3 are seafood (fish and shellfish); however, some fish are contaminated with methylmercury, which may counteract the positive effects of omega-3 fatty acids. Our update review summarises the knowledge of the role of fish consumption on epilepsy research.
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Affiliation(s)
- F A Scorza
- Disciplina de Neurologia Experimental, Universidade Federal de São Paulo, Escola Paulista de Medicina, Rua Botucatu, 862 Edifício Leal Prado, CEP 04023-900, São Paulo, Brazil.
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Trak-Smayra V, Dargere D, Noun R, Albuquerque M, Yaghi C, Gannagé-Yared MH, Bedossa P, Paradis V. Serum proteomic profiling of obese patients: correlation with liver pathology and evolution after bariatric surgery. Gut 2009; 58:825-32. [PMID: 18403495 DOI: 10.1136/gut.2007.140087] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Chronic liver diseases, including cirrhosis, may develop in obese patients. Steatosis and non-alcoholic steatohepatitis (NASH) are risk factors for progression to fibrosis. To date, diagnosis of steatosis and NASH relies on liver biopsy. The aim of the study was to identify serum markers of steatosis and NASH in obese patients using SELDI-TOF ProteinChip. PATIENTS Eighty obese non-alcoholic patient candidates for bariatric surgery and devoid of hepatitis B and C infection were selected. Serum samples were collected before surgery and at 6 months after surgery for 33 of these patients. Wedge liver biopsy was performed at the time of bariatric surgery. Twenty-four serum samples from healthy blood donors served as controls. The protein profiles of each serum were assessed using SELDI-TOF ProteinChip technology and were compared according to liver histological lesions. RESULTS Twenty-four obese patients (30%) had non-significant liver lesions, 32 (40%) had significant steatosis and 24 (30%) had NASH. Comparison of serum protein profiles according to liver lesions identified three peaks (CM10-7558.4, CM10-7924.2 and Q10-7926.9) the intensity of which significantly increased according to the severity of the liver lesions (steatosis and NASH) and returned to normal after bariatric surgery. None was correlated with either liver function tests or metabolic parameters. Identification using immunoSELDI assay characterised these peaks as the double charged ions of alpha- and beta-haemoglobin subunits. CONCLUSION The differential proteomic method demonstrated changes in serum protein profiles in obese patients according to severity of liver lesions. Free haemoglobin subunits may serve as a serum biomarker of the severity of liver damages.
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Affiliation(s)
- V Trak-Smayra
- Centre de recherche Biomédical Bichat Beaujon, INSERM U773, Paris, France
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Albuquerque M, Pegoraro M, Mattei G, Reis A, Loguercio AD. Effect of Double-application or the Application of a Hydrophobic Layer for Improved Efficacy of One-step Self-etch Systems in Enamel and Dentin. Oper Dent 2008; 33:564-70. [DOI: 10.2341/07-145] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Clinical Relevance
The double-application and placement of a hydrophobic resin coat can improve the performance (μTBS) of one-step self-etch systems to tooth substrates, mainly in dentin.
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Costa N, Albuquerque M, Lins J, Visconde A, Stefani M. Different Patterns of Delayed-Type Hypersensitivity Skin Tests Reactivity in HIV-1-Infected and Non-Infected Children and Adolescentes Immunized with BCG in Central-West Brazil. J Allergy Clin Immunol 2006. [DOI: 10.1016/j.jaci.2005.12.1079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
In the State of Pernambuco, Brazil, leprosy has been mainly an urban disease, with an uneven geographical distribution related at least partially to the way urban space has been occupied and transformed. Spatial analysis may thus become an important tool to establish an epidemiological surveillance system for leprosy. Homogeneous micro-areas were defined in the city of Olinda through the integration of two databases, the Population Census and SINAN, and through the use of digital maps and geoprocessing techniques. Census tracts were classified according to a social deprivation index (SDI), and micro-area homogeneity was based on similar values for this indicator. Cluster analysis (K-means) was used to define cut-offs between strata. The same procedure was repeated using the income variable only. When the association was tested between the mean SDI value and the mean leprosy detection rate for the period 1991-1996, the value obtained for r2 was 66.1% in the multiplicative model, increasing to 84.3% when the income variable was used. To define different intervention strategies, census tracts were regrouped in three levels of risk: high, moderate, and low. The methodology enabled the identification (within each health district) of groups and/or areas with different risk of leprosy, hence allowing for the definition of control measures.
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Affiliation(s)
- T Lapa
- Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, 50670-420, Brasil.
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Braga C, Ximenes RA, Albuquerque M, Souza WV, Miranda J, Brayner F, Alves L, Silva L, Dourado I. [Evaluation of a social and environmental indicator used in the identification of lymphatic filariasis transmission in urban centers]. CAD SAUDE PUBLICA 2001; 17:1211-8. [PMID: 11679895 DOI: 10.1590/s0102-311x2001000500021] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The concept of a "socially organized space" supported by new analytical techniques and mapping of health events has guided innovative methodological developments in public health interventions. This study aimed to evaluate a social/environmental indicator constructed with a scoring methodology to stratify areas in the city of Olinda by different levels of risk for Bancroftian filariasis transmission. The study mapped areas and the location of sample households and identified all residents ages 5 to 65 years as part of the parasitological survey. Among the 3,232 individuals who had blood samples taken, 42 were microfilaremic (1.3% prevalence). Global statistical analysis of filarial case distribution has suggested spatial clustering. Some 85.7% of positive individuals resided in the two strata with the highest transmission risk. The high sensitivity of the proposed indicator for predicting the places where the vast majority of filariasis cases occurred justifies its use in planning and implementing interventions.
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Affiliation(s)
- C Braga
- Departamento de Parasitologia, Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, 50670-420, Brasil.
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Andrade J, Cavalcanti de Lima Filho J, Spinelli L, Albuquerque M. Crit Care 2001; 5:P26. [DOI: 10.1186/cc1359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
The social problems experienced by persons with epilepsy become increasingly apparent to those who work closely with group associations. The objective of our study was to obtain information on personal attitudes and knowledge about epilepsies. Primary and high-school teachers and professors (medical and non-medical areas) were submitted to a questionnaire which was designed to obtain this information. We concluded that most professors (including those of medical areas) do not know enough about epilepsies. We believe that problems which are perceived by epileptics regarding social aspects may be softened through improved education of the community in general. Continued education of medical practitioners, professors, teachers, patients and their families leads to a positive attitude towards epilepsies, which are essential and may help to improve life quality and the patient's medical treatment.
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Affiliation(s)
- D Simonatto
- Faculdade de Medicina da Universidade de Mogi das Cruzes, FMUMC, Brasil
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Abstract
The relationship between dreams and epilepsy is illustrated by two patients whose awake epileptic seizures and recurrent dreams during night sleep had similar content. In both of our cases the EEG showed right anterior temporal spike discharge, suggesting a role for the temporal lobe in the association between dreams and seizures.
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Affiliation(s)
- D O Reami
- Departamento de Neurologia, Escola Paulista de Medicina, São Paulo, Brasil
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Albuquerque M, de Lima JP. Articular lymphoscintigraphy in human knees using radiolabeled dextran. Lymphology 1990; 23:215-8. [PMID: 1706447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Whereas joint lymphatics are inaccessible to conventional (oil-contrast) lymphography, articular lymphatic dysfunction can be assessed by lymphoscintigraphy (isotope lymphography). Using 99mTc-labeled dextran (molecular weight-70,000 daltons), we performed dynamic lymphoscintigraphy in 38 patients with degenerative osteoarthropathy of the knee. Comparison with the normal (contralateral knee) in 25 patients demonstrated that tracer disappeared at 24 hours more slowly from the abnormal side (86.5 +/- 3.3% retention in the abnormal joint compared with 77.1 +/- 4.6%; p less than 0.01), but accumulated more intensely in regional lymph nodes on the pathologic side (3.8 +/- 2.4% vs 1.9 +/- 0.3%; p less than 0.01). The findings suggest deranged macromolecular transport and lymphatic dysfunction in degenerative knee joint disease.
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Affiliation(s)
- M Albuquerque
- Department of Orthopedics and Traumatic Surgery, University Hospital, Portugal
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