Effect of Curcumin Consumption on Inflammation and Oxidative Stress in Patients on Hemodialysis: A Literature Review.

Advanced chronic kidney disease (CKD) stages lead to exacerbated inflammation and oxidative stress. Patients with CKD in stage 5 need renal hemodialysis (HD) to remove toxins and waste products. However, this renal replacement therapy is inefficient in controlling inflammation. Regular curcumin consumption has been shown to reduce inflammation and oxidative stress in subjects with chronic pathologies, suggesting that the daily intake of curcumin may alleviate these conditions in HD patients. This review analyzes the available scientific evidence regarding the effect of curcumin intake on oxidative stress and inflammation in HD patients, focusing on the mechanisms and consequences of HD and curcumin consumption. The inclusion of curcumin as a dietary therapeutic supplement in HD patients has shown to control the inflammation status. However, the optimal dose and oral vehicle for curcumin administration are yet to be determined. It is important to consider studies on curcumin bioaccessibility to design effective oral administration vehicles. This information will contribute to the achievement of future nutritional interventions that validate the efficacy of curcumin supplementation as part of diet therapy in HD.

Perception about psychosocial integration clubs for people with schizophrenia in Lima, Peru. / Percepción sobre los clubes de integración psicosocial para personas con esquizofrenia en Lima, Perú.

OBJECTIVE: To know the perception of users, caregivers and health professionals about the implementation, operation and satisfaction related to their participation in psychosocial integration clubs (PIC) for people with diagnosis of schizophrenia in two districts of northern Lima. MATERIALS AND METHODS: This study had a qualitative methodological approach. In-depth interviews and 3 focus groups were conducted with 21 participants including users, family caregivers, and mental health professionals. The information was collected in December 2018. We analyzed the perceptions of the implementation process and satisfaction of the club's users, their affective relationships and leisure, their link with families and socio-community networks, as well as the perceived limitations. RESULTS: The perception of club's users, caregivers and mental health professionals was favorable regarding the implementation, functioning and satisfaction of the users, as an integrating and socializing role, through their active participation, social reintegration in normalizing activities with their community, the health network and in the strengthening of family ties. PICs are perceived as spaces for socialization that have a relevant meaning in the lives of users. CONCLUSIONS: Participants perceive PICs as a space for well-being and adequate use of free time, which contributes to the rehabilitation of the user's disease.

OBJETIVO: Conocer la percepción de los usuarios, cuidadores y profesionales de la salud sobre la implementación, funcionamiento y satisfacción relacionada con su participación en los clubes de integración psicosocial (CIP) para personas con diagnóstico de esquizofrenia en dos distritos de Lima Norte. MATERIALES Y MÉTODOS: Estudio con enfoque metodológico cualitativo. Se realizaron entrevistas a profundidad y 3 grupos focales con 21 participantes, entre usuarios, familiares cuidadores y profesionales de la salud mental. Se recolectó la información en diciembre de 2018 y se analizaron las percepciones sobre el proceso de implementación y satisfacción de los usuarios del club, sus relaciones afectivas y el ocio, su vinculación con las familias y redes sociocomunitarias, así como las limitaciones percibidas. RESULTADOS: La percepción de los usuarios, cuidadores y profesionales de la salud mental fue favorable acerca de la implementación, funcionamiento y satisfacción de los socios como rol integrador y socializador a través de su participación, la reinserción social en actividades normalizadoras en su comunidad, red sanitaria y en el fortalecimiento de vínculos familiares. Los CIP se perciben como espacios de socialización que tienen un significado relevante en la vida de los usuarios. CONCLUSIONES: Los participantes perciben el CIP como un espacio de bienestar y uso de tiempo libre adecuado que contribuye en la rehabilitación de su enfermedad.

Percepción sobre los clubes de integración psicosocial para personas con esquizofrenia en Lima, Perú / Perception about psychosocial integration clubs for people with schizophrenia in Lima, Peru

RESUMEN Objetivo: Conocer la percepción de los usuarios, cuidadores y profesionales de la salud sobre la implementación, funcionamiento y satisfacción relacionada con su participación en los clubes de integración psicosocial (CIP) para personas con diagnóstico de esquizofrenia en dos distritos de Lima Norte. Materiales y métodos: Estudio con enfoque metodológico cualitativo. Se realizaron entrevistas a profundidad y 3 grupos focales con 21 participantes, entre usuarios, familiares cuidadores y profesionales de la salud mental. Se recolectó la información en diciembre de 2018 y se analizaron las percepciones sobre el proceso de implementación y satisfacción de los usuarios del club, sus relaciones afectivas y el ocio, su vinculación con las familias y redes sociocomunitarias, así como las limitaciones percibidas. Resultados: La percepción de los usuarios, cuidadores y profesionales de la salud mental fue favorable acerca de la implementación, funcionamiento y satisfacción de los socios como rol integrador y socializador a través de su participación, la reinserción social en actividades normalizadoras en su comunidad, red sanitaria y en el fortalecimiento de vínculos familiares. Los CIP se perciben como espacios de socialización que tienen un significado relevante en la vida de los usuarios. Conclusiones: Los participantes perciben el CIP como un espacio de bienestar y uso de tiempo libre adecuado que contribuye en la rehabilitación de su enfermedad.

ABSTRACT Objective: To know the perception of users, caregivers and health professionals about the implementation, operation and satisfaction related to their participation in psychosocial integration clubs (PIC) for people with diagnosis of schizophrenia in two districts of northern Lima. Materials and methods: This study had a qualitative methodological approach. In-depth interviews and 3 focus groups were conducted with 21 participants including users, family caregivers, and mental health professionals. The information was collected in December 2018. We analyzed the perceptions of the implementation process and satisfaction of the club's users, their affective relationships and leisure, their link with families and socio-community networks, as well as the perceived limitations. Results: The perception of club's users, caregivers and mental health professionals was favorable regarding the implementation, functioning and satisfaction of the users, as an integrating and socializing role, through their active participation, social reintegration in normalizing activities with their community, the health network and in the strengthening of family ties. PICs are perceived as spaces for socialization that have a relevant meaning in the lives of users. Conclusions: Participants perceive PICs as a space for well-being and adequate use of free time, which contributes to the rehabilitation of the user's disease.

[Implementation and operation of protected residences for people with serious mental illness in Iquitos, Peru (2013-2016)Implementação e funcionamento de residências terapêuticas para pessoas com transtornos mentais graves em Iquitos, Peru (2013-2016)]. / Implementación y funcionamiento de hogares protegidos para personas con trastornos mentales graves en Iquitos, Perú (2013-2016).

OBJECTIVE: Evaluate the implementation and operation of protected residences for people with serious mental illness in Iquitos, based on the benefits and perceived improvement in their quality of life. METHODS: Qualitative and cross-cutting study. Thirty-six in-depth interviews of residents, caregivers, neighbors, and health professionals were conducted. A sociodemographic and clinical file was completed for each resident, along with a file on managerial processes for each facility. Focus groups were conducted with managers and caregivers. RESULTS: Residents' previous length of stay in a psychiatric hospital was 7 years and 3 months. Only 28 % had suffered a clinical relapse in the past year. Residents reported an improvement in their quality of life and greater satisfaction with their stay in the facility compared with their stay in the psychiatric hospital. The residences evaluated are located in areas accessible to social and community services, with adequate access to transportation. Periodic supervision of caregivers, infrastructure, and residence maintenance was performed. CONCLUSIONS: Caregivers, managers, residents, and neighbors have a positive view of residence operations.

OBJETIVO: Avaliar o processo de implementação e funcionamento de residências terapêuticas ("pensões protegidas") para pessoas portadoras de transtornos mentais graves segundo a percepção de benefício e melhoria da qualidade de vida. MÉTODOS: Trata-se de um estudo transversal qualitativo realizado em Iquitos, no Peru. Trinta e seis entrevistas em profundidade foram conduzidas com os moradores de residências terapêuticas, cuidadores, vizinhos e profissionais de saúde. Foi feito o preenchimento de uma ficha sociodemográfica e clínica para cada morador e uma ficha do processo de gestão por residência. Foram realizados grupos de discussão com gestores e cuidadores. RESULTADOS: A permanência prolongada anterior em instituição manicomial dos moradores das residências foi de 7 anos e 3 meses. Apenas 28% tiveram recaída clínica no último ano. Os moradores perceberam melhoria da qualidade de vida e informaram um nível maior de satisfação com a permanência nas residências terapêuticas em comparação à permanência anterior em instituição manicomial. As residências estudadas se situavam em locais acessíveis aos funcionários dos serviços sociais e comunitários, com acesso adequado ao transporte público. O trabalho dos cuidadores e a infraestrutura e manutenção das residências receberam supervisão periódica. CONCLUSÕES: O funcionamento das residências terapêuticas é percebido favoravelmente por cuidadores, gestores, moradores e vizinhos.

Implementación y funcionamiento de hogares protegidos para personas con trastornos mentales graves en Iquitos, Perú (2013-2016) / Implementation and operation of protected residences for people with serious mental illness in Iquitos, Peru (2013-2016) / Implementação e funcionamento de residências terapêuticas para pessoas com transtornos mentais graves em Iquitos, Peru (2013-2016)

RESUMEN Objetivo Evaluar el proceso de implementación y funcionamiento de los hogares protegidos para las personas con trastornos mentales graves en Iquitos, con base en el beneficio y la mejora en la calidad de vida percibida. Métodos Estudio con enfoque cualitativo y transversal. Se realizaron 36 entrevistas a profundidad a residentes del hogar, cuidadores, vecinos y profesionales de salud. Se llenó una ficha sociodemográfica y clínica por cada residente y una ficha de procesos de gestión por cada hogar protegido. Se realizaron grupos focales con gestores y cuidadores. Resultados El tiempo de estancia prolongada manicomial previa de los residentes de hogares protegidos fue de 7 años y 3 meses. Solo 28 % habían presentado recaída clínica durante el último año. Los residentes percibieron mejoría en su calidad de vida y mayor satisfacción en la estancia en hogar protegido respecto a la estancia manicomial previa. Los hogares evaluados se encuentran en lugares accesibles a servicios sociales y comunitarios, con adecuado acceso a medios de transporte. Se realizaron supervisiones periódicas a los cuidadores, infraestructura y mantenimiento del hogar. Conclusiones Existe percepción favorable de cuidadores, gestores, residentes y vecinos sobre el funcionamiento de los hogares protegidos.

ABSTRACT Objective Evaluate the implementation and operation of protected residences for people with serious mental illness in Iquitos, based on the benefits and perceived improvement in their quality of life. Methods Qualitative and cross-cutting study. Thirty-six in-depth interviews of residents, caregivers, neighbors, and health professionals were conducted. A sociodemographic and clinical file was completed for each resident, along with a file on managerial processes for each facility. Focus groups were conducted with managers and caregivers. Results Residents' previous length of stay in a psychiatric hospital was 7 years and 3 months. Only 28 % had suffered a clinical relapse in the past year. Residents reported an improvement in their quality of life and greater satisfaction with their stay in the facility compared with their stay in the psychiatric hospital. The residences evaluated are located in areas accessible to social and community services, with adequate access to transportation. Periodic supervision of caregivers, infrastructure, and residence maintenance was performed. Conclusions Caregivers, managers, residents, and neighbors have a positive view of residence operations.

RESUMO Objetivo Avaliar o processo de implementação e funcionamento de residências terapêuticas ("pensões protegidas") para pessoas portadoras de transtornos mentais graves segundo a percepção de benefício e melhoria da qualidade de vida. Métodos Trata-se de um estudo transversal qualitativo realizado em Iquitos, no Peru. Trinta e seis entrevistas em profundidade foram conduzidas com os moradores de residências terapêuticas, cuidadores, vizinhos e profissionais de saúde. Foi feito o preenchimento de uma ficha sociodemográfica e clínica para cada morador e uma ficha do processo de gestão por residência. Foram realizados grupos de discussão com gestores e cuidadores. Resultados A permanência prolongada anterior em instituição manicomial dos moradores das residências foi de 7 anos e 3 meses. Apenas 28% tiveram recaída clínica no último ano. Os moradores perceberam melhoria da qualidade de vida e informaram um nível maior de satisfação com a permanência nas residências terapêuticas em comparação à permanência anterior em instituição manicomial. As residências estudadas se situavam em locais acessíveis aos funcionários dos serviços sociais e comunitários, com acesso adequado ao transporte público. O trabalho dos cuidadores e a infraestrutura e manutenção das residências receberam supervisão periódica. Conclusões O funcionamento das residências terapêuticas é percebido favoravelmente por cuidadores, gestores, moradores e vizinhos.

Os contos de fadas como método de projeções dos conflitos latentes em uma criança institucionalizada / Fairy tales and the projection of latent conflicts on one instititionalized child

O artigo visa explorar a ocorrência de projeções de conflitos psíquicos da criança institucionalizada a partir do uso dos contos de fadas. Considerados como recurso para a psicoterapia com crianças, os contos possibilitam uma linguagem indireta entre o psicólogo e a criança. Para tanto, realizou-se um Estudo de Caso a partir da interação de uma criança institucionalizada com a narrativa de seis contos de fadas. Como resultados considera-se que a criança pode projetar conflitos e fantasias por intermédio das histórias ou até mesmo por alguns trechos delas. A ansiedade ficou evidente frente a temas como separação, ameaça do lobo e castração. logo, ao oferecer as histórias como um recurso lúdico e terapêutico, pode-se estar colaborando com a possível elaboração de conflitos internos, ao se reviver angústias e se buscar resolvê-las no papel dos personagens. A criança fala de si e o terapeuta pode conhecê-la com maior profundidade

The article aims to explore the occurrence of psychic conflict projections of an institutionalized child from the use of fairy tales. Considered as resources for children psychoterapy, stories enable an indirect language between the psychologist and the child. For that, a Case Study was conducted, based on the interaction of an institutionalized child with the narrative of six fairy tales. As result, it is considered that the child can project conflicts and fantasies throught the stories or even some parts of them. The anxiety showed up evident regarded to subjects like separation, wolf threat and castration. Therefore, by offering stories as a playful and therapeutic resource, one can be collaborating with the possible elaboration of internal conflicts, when reviving anxieties and trying to solve them throught the role of the characters. The child speaks of oneself and the therapist can know it in further depht

Postanesthesia evaluation of emotional and psychological satisfaction in a Hispanic population.

BACKGROUND: Patient satisfaction has a positive impact on clinical care. Different strategies, such as questionnaires, have been developed to evaluate and improve patient satisfaction. A validated pediatric anesthesia questionnaire previously showed the importance of perioperative care built upon a relationship of trust between healthcare providers and children and parents, and a comfortable environment in which satisfactory answers are provided. However, the questionnaire was validated in English, and no research exists on the use of satisfaction questionnaires in Spanish. Given that there are 559 million Spanish speakers in the world, of which 53 million live in the United States, we intended to validate a Spanish version of this questionnaire to measure parental and pediatric satisfaction after anesthesia, and facilitate the provision and quality management of anesthesia care in Hispanic populations. METHODS: A questionnaire validated in English was translated to Spanish. Subsequently, it was administered to children who had undergone surgery and their parents to determine reliability, validity, acceptability, and reproducibility. RESULTS: Of the 228 recruited parents, a total of 221 agreed to participate, and 77 questionnaires were filled out completely by both parents and children. Overall response rates of 97% for parents and 90% for children were achieved. The reliability, test-retest reliability, and internal consistency were examined, and a McNemar coefficient of 0.97 and a Cronbach's alpha coefficient of 0.82 were obtained. Construct validity was obtained through comparisons of the following items: the child's perception of serenity imparted by the medical staff with the parent's satisfaction with conversations between the anesthesiologist and child, the nurse's ability to make the child feel better with the parent's satisfaction with the nurse's professionalism, and the nurse's kindness toward the child with the parent's perception of the care provided. CONCLUSION: This questionnaire proved to be simple and easy to understand within the literate Spanish-speaking population. It had adequate content validity and high reliability, acceptability, reproducibility, and construct validity. We believe that this Spanish questionnaire can be used with success among Hispanic populations resulting in improved care for those undergoing anesthesia, and therefore, patient satisfaction.

Nesidioblastosis del adulto tras derivación gástrica / Nesidioblastosis in the adult following gastric bypass

La hipoglucemia por hiperinsulinismo endógeno ha sido descrita como una complicación de la cirugía bariátrica. Se presenta el caso de un hombre de 34 años con tríada de Whipple que se manifestó ocho años después de someterse a derivación (bypass) gástrica. La hipoglucemia se asociaba con niveles elevados de insulina y péptido C, pero la localización del hiperinsulinismo endógeno solo se pudo precisar mediante cateterismo de arterias pancreáticas con estimulación intraarterial selectiva con calcio. Se decidió practicar una pancreatectomía subtotal laparoscópica, después de la cual el paciente presentó una excelente evolución posoperatoria y mejoró significativamente su sintomatología. Mediante la evaluación histopatológica e inmunohistoquímica, se confirmó una nesidioblastosis del adulto. Es importante reconocer esta enfermedad como una complicación de la cirugía bariátrica, más aún cuando estos procedimientos son tan frecuentes en la actualidad debido a la epidemia de obesidad. Los síntomas se pueden confundir con los de un síndrome de evacuación gástrica rápida (dumping), el cual no tiene repercusiones tan graves sobre la salud del paciente, como sí la tiene la nesidioblastosis

Hypoglycemia due to endogenous hyperinsulinism has been described as a complication of bariatric surgery. We present the case of a 34-year-old man who developed a Whipple's triad eight years after undergoing gastric bypass. Hypoglycemia was associated with high serum levels of insulin and C peptide; anatomic localization of endogenous hyperinsulinism was finally demonstrated with a selective intra-arterial calcium-stimulation test. Patient was offered a laparoscopic subtotal pancreatectomy, which resulted in an excellent postoperative course and significant symptoms resolution. Pathology report and inmunohistochemical analysis confirmed the diagnosis of adult nesidioblastosis. We believe it is important to recognize this condition as a complication of bariatric surgery, a procedure performed more frequently nowadays due to the obesity epidemic. Symptoms might be confused with those of dumping syndrome which does not have severe consequences in the patient´s health as nesidioblastosis does

Development of the Mexican Heart Team: The Long and Winding Road.

Heart failure (HF) is the leading cause of death worldwide. Efforts to decrease HF mortality rates include a multidisciplinary approach management. Although evidence suggests that this has been an optimal strategy for treating HF, the model remains not widely implanted. The current article explores the rationale behind the formation of a Heart Team in a developing country and its development despite the lack of an allocated budget.

Cine peruano actual y psicopatología / Current Peruvian cinema and psychopathology

La conducta humana anormal ha sido fuente inagotable para la industria cinematográfica, difusora muchas veces de prejuicios, mas también creadora de personajes memorables para la psiquiatría. En el presente artículo se presenta un análisis psicopatológico de cinco películas peruanas actuales: “Maruja en el infierno” (1983), “Caídos del cielo” (1990), “Bajo la piel” (1996), “Días de Santiago” (2004) y “La teta asustada” (2009).

Abnormal human behavior has been an inexhaustible source for the film industry, often disseminating prejudice, but also cinema has created memorable characters for psychiatry. A psychopathological analysis of five current Peruvian films are presented in this article: “Maruja en el infierno” (1983), “Caídos del cielo” (1990), “Bajo la piel” (1996), “Días de Santiago” (2004) y “La teta asustada” (2009).

Estrés postraumático y comorbilidad asociada en víctimas de la violencia política de una comunidad campesina de Huancavelica, Perú. 2013 / Post-traumatic stress disorder and co-morbidity among victims of political violence in a rural community of Huancavelica, Peru. 2013

Entre los años 1980 y 2000 nuestro país vivió uno de los más cruentos conflictos armados de su historia. El departamento de Huancavelica, zona de extrema pobreza del Perú, fue uno de los principales lugares afectados.Objetivos: Determinar las características sociodemográficas, prevalencia de trastorno de estrés postraumático (TEPT), comorbilidad psiquiátrica y factores asociados en víctimas de la violencia política de la comunidad campesina de Cuñi, en el departamento de Huancavelica. Material y métodos: Se usó un diseño observacional, de corte transversal, se seleccionó a 121 habitantes de la comunidad, mayores de 18 años, que vivieron en el lugar durante el periodo de violencia política. La muestra representativa se seleccionó mediante muestreo por conglomerados multietápico y aleatorio. Se aplicó el Cuestionario Mini International Neuropsychiatric Interview (MINI) adaptado por el Instituto Nacional de Salud Mental de Perú (INSM) para valorar TEPT y comorbilidad asociada. Resultados: La mayoría de encuestados estaban en extrema pobreza. El promedio de eventos traumáticos como consecuencia de la violencia política fue de 2,26. La prevalencia de vida de TEPT fue 25,6%. Todas las personas encuestadas tuvieron al menos un trastorno psiquiátrico comórbido: los más frecuentes fueron el trastorno de ansiedad generalizada y la depresión. Conclusiones: Se evidenció elevada prevalencia de eventos traumáticos y prevalencia de vida de TEPT y comorbilidad asociada en dicha zona rural.

Between 1980 and 2000, our country experienced one of the bloodiest conflicts in its history. The department of Huancavelica, extreme poverty area of Peru, was one of the main sites affected. Objectives: To determine the sociodemographic characteristics, prevalence of Post-traumatic Stress Disorder (PTSD), comorbidity, and associated factors in victims of political violence in the rural community of Cuñi, in the department of Huancavelica. Methods: An observational, cross-section design was used. One hundred and twenty one community residents were selected , aged 18, who lived at the site during the period of political violence. The representative sample was selected by multistage random sampling clusters. The Mini International Neuropsychiatric Interview (MINI) questionnaire adapted by the National Institute of Mental Health of Peru (INSM) was used to assess PTSD and comorbidity. Results: Most respondents were in extreme poverty (average monthly income 24.4 dollars). The average number of traumatic events relating to political violence was 2.26. The lifetime prevalence of PTSD was 25.6 %. All respondents had at least one comorbid disorder. The most prevalent comorbidity was generalized anxiety disorder and depression. Conclusions: High prevalence of PTSD and comorbidity was observed. Furthermore, high prevalence of traumatic events and extreme poverty in this rural area was evident.

Delirios de embarazo y pseudociesis una breve aproximación / Pregnancy delusions and pseudocyesis: brief approach

Introducción: Los delirios de embarazo como síntomas de distintos cuadros psicóticos hansido presentados usualmente en oposición a la naturaleza histérica y psicosomática de laPseudociesis, aunque diversos autores han advertido cierta intersección semiológica entreAmbos fenómenos. Método: Presentamos cuatro casos de pacientes psicóticas que presen-taron delirios de embarazo y revisamos y discutimos la bibliografía pertinente. Resultados: Constatamos la presencia de algunos síntomas compartidos entre psicosis con delirios de embarazo y pseudociesis, aunque sin desmedro de la respectiva diferenciación no sológicaentre los dos fenómenos; existe cierta confusión en los aspectos conceptuales y terminológicos que no contribuye a deslindarlos de forma precisa. Conclusión: Se plantea una visiónamplia y holística para el estudio de la pseudociesis y los delirios de embarazo, que podríanser más frecuentes en realidades como la latinoamericana…

Introduction: Pregnancy delusions have usually been considered as symptoms of psychotic disorders in opposition to the hysterical and psychosomatic nature of pseudocyesis, though several authors have described some semiologic intersection between the two phenomena. Method: Introduction of four cases of patients with pregnancy delusions as well as review and discussion of relevant bibliography. Results: In fact, there are symptoms shared by pregnancy delusions psychosis and pseu- docyesis, without detriment of nosological differentiation between the two phenomena. There is certain confusion regarding con- ceptual and terminological issues that does not contribute to mark precise boundaries. Conclusion: A comprehensive and holistic approach for the study of pseudocyesis and pregnancy delusion is proposed. Maybe, these disorders are more frequently observed in Latin America…

[Pregnancy Delusions and Pseudocyesis: Brief Approach]. / Delirios de embarazo y pseudociesis: una breve aproximación.

INTRODUCTION: Pregnancy delusions have usually been considered as symptoms of psychotic disorders in opposition to the hysterical and psychosomatic nature of pseudocyesis, though several authors have described some semiologic intersection between the two phenomena. METHOD: Introduction of four cases of patients with pregnancy delusions as well as review and discussion of relevant bibliography. RESULTS: In fact, there are symptoms shared by pregnancy delusions psychosis and pseudocyesis, without detriment of nosological differentiation between the two phenomena. There is certain confusion regarding conceptual and terminological issues that does not contribute to mark precise boundaries. CONCLUSION: A comprehensive and holistic approach for the study of pseudocyesis and pregnancy delusion is proposed. Maybe, these disorders are more frequently observed in Latin America.

Insulinoma, convulsiones y psicosis: a propósito de un caso / Insulinoma, seizures and psychosis: a case report

El insulinoma es una causa poco frecuente de hipoglicemia, que puede manifestarse con síntomas neurológicos y psiquiátricos. Se describe el caso de un varón con insulinoma, que presentó convulsiones y síntomas psicóticos durante varios años, hasta que fue diagnosticado e intervenido quirúrgicamente.

Insulinoma is a rare cause of hypoglycemia, which may manifest as neurological and psychiatric symptoms. We report a case of a man with insulinoma, who presented seizures and psychotic symptoms for several years, until he was diagnosed and underwent surgery.

Encuesta virtual sobre uso de internet y medios informáticos entre psiquiatras y residentes de psiquiatría en el Perú / Virtual survey of internet use and computer resources by peruvian psychiatrists and psychiatric residents

Objetivo: Describir las características del uso de Internet y medios informáticos por psiquiatras y residentes de psiquiatría peruanos.Material y métodos: Se elaboró una encuesta virtual que fue distribuida entre psiquiatras y residentes de psiquiatría vía enlace web y por correo a través de la lista de correos (grupo virtual) de la Asociación Psiquiátrica Peruana. El cuestionario estuvo constituido por 17 ítems que incluían datos demográficos, datos de acceso, uso de Internet y recursos informáticos.Resultados: La población fue de 285, contestaron 119 personas y se consideraron 100 encuestas. La edad promedio fue de 48 años (66% del sexo masculino, 34% del sexo femenino). El 83% de los encuestados tenía como principal lugar de actividad laboral un organismo público, residiendo el 87% de los encuestados en Lima. El 77% de los encuestados afirmó acceder al uso de Internet diariamente, siendo el promedio de horas semanales 11,6 horas. Respecto al uso de bases de información a texto completo, el 65%utilizaba Hinari, el 44% SciELO y el 40% Cochrane. Entre las bases referenciales el 55% utilizaba Pubmed y el 37%LILACS. El 92,6% de médicos afirmó estar de acuerdo en que los usuarios de servicios de salud busquen información orientada a la salud mental en Internet. Conclusión: La mayoría de psiquiatras y residentes encuestados utiliza el Internet y correo electrónico como medio para acceder a información académica relevante. El uso de diversas bases de datos es frecuente, a diferente edad. Existe buena aceptación de los encuestados sobre la difusión y acceso a información médica por parte de los usuarios de servicios de salud mental.(Rev Neuropsiquiatr 2011;74:191-199).

Objective: To describe the features of lntemet use and computer resources by Peruvian psychiatrists and psychiatric residents. Material and methods: A virtual survey was developed and distributed among psychiatrists and psychiatric residents by a web link and e-mail (virtual group) of the Peruvian Psychiatric Association. The questionnaire contained 17 items including demographic information, information access, use of Internet and computer resources. Results: The population was 285, 119 persons answered the survey and 100 surveys were analyzed. The average age was 48 years (66 % were male, 34 % female). Eighty three percent of the subjects had a public institution as their main working place, 87 % lived in Lima, 77 % had daily access to the Internet, and the average of weekly hours was 11.6 hours. Regarding the use of database full text information, 65% accessed Hinari, 44 % SciELO and 40 % Cochrane. Fifty five percent used Pubmed and 37% LILACS as reference database and 92.6% of psychiatrists agreed that patients seek information geared towards mental health online. Conclusion: The majority of psychiatrists and psychiatric residents surveyed used Internet and e-mail as a way to access relevant academic information. The use of several databases is frequent at different ages. There is a good acceptance of the diffusion and access to medical information by mental health service users among the surveyed practitioners.

Atualizações no setting terapêutico psicanalítico com o latente / Updates in setting psychoanalytic therapy with the latent

Terapeutas de orientação psicanalítica foram investigados a fim de se identificar particularidades no trabalho terapêutico com latentes, uma vez que estes se diferenciam em sua estruturação psíquica da criança pequena e do adolescente. Conceitos clássicos à latência são ampliados, identificando-se uma intensa reestruturação interna das defesas e um amadurecimento psíquico, cognitivo e emocional que prepara o latente para sua adultez. Tais conceitos parecem alicerçar uma (re)construção para o olhar clínico ao latente, aprofundando a leitura deste no setting de trabalho, redimensionando intervenções terapêuticas assim como sentimentos contratransferências. Embora a compreensão ótima do universo clínico com o latente ainda se encontre em construção, esta avança na medida em que se desvelam os movimentos psíquicos

A latência e sua relação com a cultura / Latency and its relationship with culture

Pensando a cultura como processo ativo na inserção e no desenvolvimento do sujeito, este artigo discute a relação da cultura com a criança em período de latência. A latência é caracterizada por um trabalho psíquico pelo qual a criança evolui do ponto de vista cognitivo e egóico, prepara-se para se inserir e interagir no mundo adulto, equilibra melhor o uso de fantasias e o contato com a realidade, ao sublimar impulsos sexuais em direção à aprendizagem e adaptação social, via regras e normas com maior teor de realidade. Busca-se então questionar possíveis aspectos psicossociais que influem ativamente no processo de desenvolvimento e estruturação egóica do latente, assim como a inter-relação de seu mundo interno com o mundo externo. Para tanto, o latente, ao estruturar defesas e adquirir habilidades comportamentais, deve haver-se com pressões e expectativas que lhe são dirigidas, adaptando-se a regras socioculturais de seu meio, visto que cada cultura busca uma determinada resposta de seus sujeitos refletidos na normatização desta