Vertex (Buenos Aires, Argentina)最新文献

This document constitutes the second part of the First Argentine Consensus on the Management of Schizophrenia and provides an updated summary of the available evidence on the clinical and diagnostic aspects of the disorder in adults. Following the methodology established in the first part of the Consensus, the panel of experts conducted an exhaustive literature review and systematically discussed and critically evaluated the information identified. This collaborative process resulted in the development of this second section, aimed at guiding clinical practice through a rigorous analysis of the scientific literature.During the deliberative stages, it was also decided to incorporate additional content considered particularly relevant for interdisciplinary teams responsible for providing comprehensive care to individuals with schizophrenia. Accordingly, the document addresses advances in key clinical aspects, diagnostic criteria and conceptual tools that enhance the evaluation of this condition. In this regard, the second part of the document outlines staging models for schizophrenia and its symptomatic variants (negative, cognitive, positive and affective symptoms), as well as the early stages of schizophrenia, ultra-high-risk states, the first psychotic episode, and the duration of untreated psychosis, together with auxiliary diagnostic methods.

The Argentine Consensus on the Diagnosis of Dementia is an initiative of the Argentine Association of Biological Psychiatry (AAPB). The primary aim of this document was to develop an efficient tool for the early diagnosis of dementia, targeting both primary care physicians and specialists (neurologists, psychiatrists, geriatricians, internists, and others). Over a five-month period (August–December 2024), followed by a brief update after the Alzheimer’s Association International Conference (AAIC, Toronto, July 2025), a panel of 23 experts analyzed and discussed the most relevant and up-to-date evidence to establish a systematic diagnostic approach to dementia, with a particular focus on the most prevalent form in Western countries, Alzheimer’s disease (AD).The document is structured into three sections. The first describes the current global landscape of dementia, its distinction from normal aging, recent diagnostic criteria, and diagnostic algorithms for both primary care and specialist settings. The second addresses the diagnostic evaluation framework, including neurocognitive and neuropsychiatric assessment, biomarkers (laboratory, CSF, plasma biomarkers, neuroimaging, genetics), and functional evaluation. The third section provides an overview of the different types of dementia, their clinical features, and current diagnostic criteria,with particular emphasis on differential diagnosis.

Suicide is one of the leading causes of preventable death globally, particularly affecting young people between the ages of 15 and 29. This public health problem has a devastating impact on individuals, families, and communities, and poses a persistent clinical challenge for health systems. Despite decades of research in prevention, professionals continue to face considerable difficulties in identifying individuals at imminent risk early on. In this context, artificial intelligence (AI) has emerged as an innovative tool with the potential to transform suicide risk assessment and detection through theanalysis of complex and multimodal data.

Essential cognitive function may be impaired in cancer patients before the initiation of chemotherapy. Cancer decreases cognitive and biological reserves, resulting in accelerated aging. Prefrontal lobe dysfunction is most commonly encountered owing to various mechanisms. Systemic inflammation causes the release of pro-inflammatory cytokines in the brain, with consequent neurotoxic effects on the Kynurenine pathway, local chronic inflammation, and hypothalamus-pituitary-adrenal dysregulation. Exosomes also play a significant role, as genetic and epigenetic changes exert differenteffects on oxidative stress proteins. Melatonin dysregulation may contribute in cognitive dysfunctions. Neuropsychological impairment has been demonstrated through various neurophysiological (event-related potentials) and neuroimaging (structural and functional MRI) studies. Paraneoplastic syndromes of the central nervous system have been considered, and specific onconeural antibodies may characterize distinctive central nervous system dysfunction patterns. Treatment of tumor-brain is based mainly on non-pharmacological approaches, such as physical activity, cognitive-behavioral therapy, and the mindfulness approach. Some researchers have recommended the prophylactic use of escitalopram in patients with head and neck cancer without depression.

Carta de la lectora: Pamela S. Sacco, Medica Neuróloga. Correspondencia: pame_sacco@hotmail.com.

Introduction: Depression is the main mental disorder in Latin America. Its etiology is multifactorial, encompassing genetic,sociodemographic, cultural and even environmental factors. Some studies have shown that living in high altitude regions may be related to depression. Therefore, this study aims to determine the correlation between altitude and the incidence of depressive episodes in Ecuador.

Materials and methods: Cross-sectional analytical study of hospital discharge databases in Ecuador from 2018 to 2022. Relative risk and Pearson correlation were estimated and linear regression was performed to evaluate association.

Results: 6460 depressive episodes were observed in the 5 years of the study. The provinces located at high altitude (≥1500 m.a.s.l.) had the highest cumulative incidences per 100,000 inhabitants. These provinces are Tungurahua (81.4), Pichincha (68.8), Chimborazo (63.8), Imbabura (55.8) and Bolívar (51.1), respectively. The relative risk of residence at high altitude was RR=2.67 (95 % CI=2.54 - 2.81, p < 0.001), while the results of the linear regressionbetween cumulative incidence per 100,000 and altitude were r=0.78, r2=0.61 and in the independent variable (altitude) t=5.84, p < 0.001.

Conclusion: A positive correlation was found between high-altitude residence and the incidence of depressive episodes, but due to the limitations of this research, further studies are required to corroborate this association, since the results may be influenced by other factors that were not considered.

Throughout history, members of the LGBTQ+ community have been victims of stigma and discrimination due to their sexual orientation, gender identity, and expression differing from societal norms. Much of this exclusion has been driven by religion, which often uses biblical references to condemn diversity. This systematic rejection has led to mistreatment of these individuals by healthcare systems and has posed significant barriers to access. Despite this, a substantial percentage of this population is, either voluntarily or involuntarily, affiliated with religious groups. This review article aimsto understand and synthesize existing literature on the complex relationship between religion and the mental health of the LGBTQ+ community. A narrative synthesis was performed. Although some religions have made progress towards acceptance, which can positively impact the mental health of this minority, the majority still maintain a stance of rejection and disapproval. This discrimination has been associated with higher rates of internalized stigma, poorer quality of life, increased depression, anxiety, suicide, substance abuse, and participation in risky sexual activities with multiple partners, which puts this population at risk for other adverse health events, such as contracting HIV. It’s essential for medical schools to train their students and residents in holistic approaches that encompass religiosity and spirituality. Further research is needed within this minority in diverse contexts to understand how to address these issues and improve health care outcomes.

This article critically examines Hans Asperger’s legacy in relation to contemporary autism diagnostics. While “Asperger’s syndrome” is widely discussed, few have engaged with Asperger’s original work or the broader historical literature, including Grunia Sukhareva, Leo Kanner, George Frankl, and Lorna Wing. The paper reviews Asperger’s contributions (1938–1980) to clarify his view of autism as a distinct neurotype with specific strengths and challenges. It then contrasts this with Wing’s reinterpretation, particularly her 1979 study and 1981 introduction of “Asperger’s syndrome”, which emphasized social and communication deficits and blurred lines between autism and intellectual disability. The article concludes with an analysis of the removal of Asperger’s syndrome from the DSM-V, arguing that the DSM-IV construct reflected Wing’s adaptation, not Asperger’s writings. This change is situated within a broader shift toward cognitive diversity and depathologization, suggesting that debates over the syndrome’s existence are more complex than often assumed.