Vertex (Buenos Aires, Argentina)最新文献

Reseña de la obra: Psicología práctica, de Gabriela Jufe, 5a. ed. Editorial Polemos, 2023.

The spectrum of neurodegenerative diseases that primarily affect cognition and behaviorspreads from asymptomatic preclinical disease to very mild cognitive impairment to frank dementia. Alzheimer's disease (AD) is the most common cause of a decline in cognitive ability. Also, it is a devastating condition that affects patients and their entirefamilies of caregivers, exacting tremendous financial hardships. Diagnosis may be complicated by other forms of dementia that have symptoms and pathologies similar to AD. Knowing the key features and pathology of each type of dementia can help in the accurate diagnosis of patients, so they will receive the treatment and support services appropriate for their condition and maintain the highest possible functioning in daily life and quality of life. Differentiate, based on clinical criteria, neuropathology, and biomarkers, AD and its atypical variants from other common dementias including Dementia with Lewy Bodies, Vascular Cognitive Impairment, Frontotemporal Degeneration, and less frequent cognitivedisorders. The importance of getting an accurate and early diagnosis of dementiais now increasingly significant to make important decisions about treatment, support, and care. Nonpharmacological as well as pharmacological interventions should be initiated once the diagnosis is obtained. Biochemical markers to identify Alzheimer's disease play a central role in the new diagnostic criteria for the disease and in the recent biological definition of AD. This review article presents up-to-date data regarding the recent diagnostic criteria of Alzheimer´s disease and related disorders, emphasizingits usefulness in routine clinical practice.

We are currently witnessing a renaissance of psychedelic science in clinical research. In Argentina, the challenges related to its study and the development of new treatments in the field of Psychiatry are subject to the adoption of certain regulatory policies. The evolution of the knowledge about the effects, mechanisms of action and therapeutic potential of serotonergic psychedelics warrants a change in the regulatory framework for their use in clinical research. In a world that demands rapid flexibility and adaptation, we should avoid waiting for advances from developed countries. It is evidentthat psychopharmacological progress in the last thirty years have not been up to the expectations of the so-called "decade of the brain". Aware of these limitations, in this paper we carry out a historical and ethnopharmacological review of the classic psychedelics, from the 50's to the present -without ignoring their ancestral uses-, in order to highlight the political and cultural controversies that these molecules have raised in the field of Psychiatry. We hope to promote in the local environment an approach devoid of stigmas and that considers the therapeutic potential of these substances,with the ultimate goal of providing relief to severe mental illnesses that to this day continue to remain unanswered.

Book Review: El peligro de estar cuerda, by Rosa Montero

Traditional psychedelics, such as LSD, psilocybin, or DMT, are psychoactive compounds that exert their effects mainly through agonism over serotonergic receptors. In appropriate doses and contexts, they produce profound changes in the subjective experience, configuring altered states of consciousness that, upon reaching a critical point, involve the appearance of phenomena of mystical, transcendental, or ego dissolution experiences. These events are associated with diverse therapeutic effects in several mental conditions. Psychedelics are safe substances, with minimal risk of serious or long-lasting adverse effects and without addictive potential. Current evidence comes from systematic reviews and meta-analyses based on phase II clinical studies, with small groups of subjects, strict exclusion criteria, and difficulties in applying the double-blind methodology. Worldwide there is a growing number of clinical trials, which seek to promote the approval of psychedelic-assisted therapies as therapeutic tools in the coming years. In this bibliographic review, we will address the phenomenological characteristics of the psychedelic experience, its potential therapeutic uses, and themechanisms that underlie them.

This article arises from the work carried out in 2020 and 2021 as an interdisciplinary psychosocial team in a high complexity hospital in the town of Cañuelas, province of Buenos Aires, Argentina, during the COVID-19 pandemic, assisting people and their families in intensive care rooms. The proposal of this work aims to give a resignification to the practices of comprehensive health care for people, applying a gender and rights perspective to hospital practice. From this experience, the postulate of empathy as the central axis of care arises.

Objective: To estimate the prevalence of Antidepressant use in patients with a history of venous thromboembolism (VTE). Describe the patient's characteristics and which drugs are the most prescribed.

Methods: A cross-sectional study involving a consecutive sample of patients included in the Registro de Enfermedad Tromboembólica (RIET) from the Hospital Italiano de Buenos Aires in a period between 01/01/2014 to 01/09/2018. All patients presented symptomatic VTE and confirmed diagnosis. Drugs considered included in this study were: Selective Serotonin Reuptake Inhibitors (SSRI), Dopamine and Norepinephrine Reuptake Inhibitors (NDRI), Serotonin and Norepinephrine Reuptake Inhibitors (SNRI) and Tricyclic antidepressants (TCA).

Results: From a total of 2373 patients with VTE, 472 were active users of antidepressants, showing a prevalence of antidepressant use of 19.9% (CI 95%). The most frequently prescribed drugs by drug classification were: SSRI 83.9%, TCA 20.5%, ISRN 14.6%, and NDRI 2.5%. Patients presented a median age of 76 years, predominantly women (71.4%), with several comorbidities: 52.24% arterial hypertension, 37.29% overweight, and 34.75% history of smoking. Concerning relevant history, we observed: 29.03% active oncologic disease, 26.27% major surgery before the VTE, and 21.61% previous VTE.

Conclusion: The prevalence of antidepressant use in patients with VTE is 19.9%, superior by far to that of the general population. Depression is a major cause of morbidity worldwide, and its prevalence is increasing over the years.

The discussion on the scientific character of psychoanalysis is continuous and multifaceted. Nowadays the extent and variety of the implied aspects in it is even increased. In this context this article presents for its analysis and assessment a reconsideration of Freud’s line of argument regarding the scientific character of psychoanalysis. Against a quite spread view that conceives Freud’s scientific perspective as a reflex of general traits of his time such as positivism, sustained by recent research on Freud this article proposes the reconsideration of Freud’s perspective in a more exhaustive andnuanced way and holds that it is based on a composed by integrated parts, unified and consistent line of argument maintained through all his work. The reconsideration of the design of Freud’s argument allows to hold that his own formulation is still fruitful and suitable for the present, particularly as it possibilitates, justifies and requires the connection of psychoanalysis to the development of knowledge.

The differential diagnosis between autism and schizophrenia in childhood has been the subject of numerous controversies. Because verbal hallucinations could be one of the main clinical phenomena when establishing a differential diagnosis, the objective was to investigate the presence or absence of verbal hallucinations in autism. For this, a selective and unsystematic review of the current scientific evidence was carried out. Added to this, the phenomenon of hallucination, and mainly verbal hallucination, was conceptualized from a historical perspective; the relevance given to hallucinationsin the delimitation of the mentioned nosographic constructs was broached; and verbal hallucinations in autism were analyzed comparing different paradigms, including contributions from psychoanalysis. We observe that from the side of scientific evidence it is not possible to state strong conclusions regarding the presence or absence of verbal hallucinations in autism. In turn, the historical review of the concept of verbal hallucination from classical psychiatry together with contributions from psychoanalysis, invite us to think that one of the differential characteristics between autism and psychosis is the absence of verbal hallucinations in the first diagnosis, and that if there were hallucinations in autism, these would present different qualities from those of psychosis. We consider it highly relevant to be able to establish this differentiation in the hallucinatory phenomenon in autism, not only in order to establish a differential diagnosis between the two conditions, but also because of the implications that this could have in pharmacotherapy.