Periodontal therapy for hopeless mandibular anterior teeth: a retrospective case report with a multidisciplinary approach and a 20-year follow-up

Introduction: This case report presents the intentional periodontal maintenance of two periodontal hopeless lower central incisors with a multidisciplinary approach and 20-year follow-up. Case presentation: A 36-year-old male, in 2001, was diagnosed with aggressive periodontitis, gingival swelling, bleeding, and mandibular central incisors with mobility and poor prognosis. Following periodontal therapy (phase I), root canal treatment, and occlusal adjustment, #31 and #41 were gently extracted to remove the granulation tissues, calculus, and infected cementum from the root surface. Then, tetracycline-HCl was applied for 5 minutes on the root surfaces. The teeth were repositioned into the sockets and splinted with a lingual bar. At 3 months, the bar was removed, and a free gingival autogenous graft was done to improve the local keratinized tissue width. Mobility scores, pocket depths, and clinical attachment levels were recorded, and radiographs were taken at 1, 5, and 20 years. The 5-year follow-up showed that the teeth were clinically and radiographically in function. There was a reduction in probing depth and a gain in clinical attachment and radiographic alveolar bone levels. After 20 years, #41 was stable, but #31 had external root resorption, leading to a new treatment plan (dental implants) and extraction. Conclusion: The clinical result of this case was satisfactory for 20 years. Intentional periodontal maintenance of the teeth may be an alternative treatment, even considering the high level of complexity.

Short-, mid-, and long-term complications after multisystem inflammatory syndrome in children over a 24-month follow-up period in a hospital in Lima-Peru, 2020-2022.

Objective: To determine the short-, mid-, and long-term complications after multisystem inflammatory syndrome in children (MIS-C) over a 24-month follow-up period in a hospital in Lima, Peru, 2020-2022, and to explore differences according to the immunomodulatory treatment received and type of SARS-CoV-2 virus circulating. Methods: Ambispective 24-month follow-up study in children <14 years of age diagnosed with MIS-C at the Hospital Nacional Edgardo Rebagliati Martins (HNERM). Results: A total of 62 children were admitted with MIS-C. The most common short-term complications and serious events were intensive care unit (ICU) admission, invasive mechanical ventilation (IMV) due to respiratory failure, and shock; predominantly during the second pandemic wave (lambda predominance) and in children that received intravenous immunoglobulin (IVIG) plus a corticosteroid. Two patients died during the first wave due to MIS-C. During prospective follow-up (median of 24 months; IQR: 16.7-24), only 46.7% of patients were followed for >18-24 months. Of the total, seven (11.3%) patients were identified with some sequelae on discharge. Among the 43 remaining children, sequelae persisted in five (11.6%) cases (neurological, hematological, and skin problems). Six patients (13.9%) presented with new onset disease (hematologic, respiratory, neurological, and psychiatric disorders). One patient died due to acute leukemia during the follow-up period. None of them were admitted to the ICU or presented with MIS-C reactivation. Two patients presented persistence of coronary aneurysm until 8- and 24-month post-discharge. Conclusion: In our hospital, children with MIS-C frequently developed short-term complications and serious events during the acute phase, with less frequent complications in the mid- and long-term. More studies are required to confirm these findings.

High effectiveness of an adulticide-larvicide formulation for field control of sandflies (Diptera: Psychodidae) in the city of Clorinda, Argentina.

In Argentina, Leishmania infantum (syn. L. chagasi) is the etiologic agent of human visceral leishmaniosis (HVL), and Lutzomyia longipalpis (Diptera: Psychodidae: Phlebotominae) is the main vector. The objective of this study was to evaluate the effectiveness and residual effect of two commercial insecticide formulations, one with permethrin and pyriproxyfen as active ingredients (Dragon Max®) and the other with only permethrin (Flop®) for the control of sandflies. Both formulations were applied in chicken coops and other surroundings structures of the peridomicile of urban houses in Clorinda, Formosa (Argentina). Entomological monitoring was carried out weekly for 44 weeks after the intervention. The results showed great effectiveness and residual effect up to 21 weeks post-intervention for Dragon Max®. This result could be explained by the excellent larvicidal activity of the Insect Growth Regulator (IGR) pyriproxyfen against the immature forms of phlebotomines and by the delay on the restoration of the natural threshold of the vector population in treated sites.

Obesity in Survivors of Childhood Cancer: a Review.

Obesity is a late effect of antineoplastic treatment in childhood cancer survivors and this correlates with chronic complications. This review examines the data currently available to health professionals, for increasing awareness and identifying strategies to address the treatment and prevention of late effects. The mechanism involved in the pathophysiology of obesity remains unclear. However, damage to the hypothalamus and endocrine disorders (e.g. insulin and leptin resistance) and a positive energetic balance may play a role in increasing obesity rates. A patient's diet during, and after treatment may also influence the weight of survivors. Implementation of an effective educational program by professionals during all stages of treatment enables children to obtain basic knowledge regarding food and nutrition, thereby encouraging them to take responsibility for developing healthy eating behaviors.

Long-term effect of biochar application on yield-scaled greenhouse gas emissions in a rice paddy cropping system: A four-year case study in south China.

To evaluate long-term effect of biochar application on yield-scaled greenhouse gas emissions (YSGE) in a paddy rice cropping system, a 4-year field experiment by static chamber - gas chromatograph method was conducted in South China. Principal component analysis and terminal restriction fragment length polymorphism (T-RFLP) and real-time qPCR was used to unravel the microbial mechanisms of biochar addition. Six treatments were included: control (CK), application of 5tha(-1) biochar (BC1), application of 10tha(-1) biochar (BC2), application of 10tha(-1) biochar (BC3), rice straw return at 2400kgha(-1)(RS) and inoculated rice straw return at 2400kgha(-1)(RI). The results indicated that biochar amendment significantly decreased methane (CH4) and gross greenhouse gas (GHG) emissions. This may primarily be ascribed to the stimulated biodiversity and abundance of methanotrophic microbes, increased soil pH and improved aeration by reducing bulk density after biochar incorporation. Compared with CK, RS and RI, 26.18%, 70.02%, 66.47% of CH4 flux and 26.14%, 70.16%, 66.46% of gross GHG emissions were reduced by biochar (mean of three biochar treatments), respectively. Furthermore, biochar significantly increased harvest index of double rice production (p<0.05). In comparison with CK, RS and RI, 29.14%, 68.04%, 62.28% of YSGE was reduced by biochar, respectively, and the highest biochar addition rate (20tha(-1)) contributed most to the mitigation of GHG emissions (36.24% decrease compared to CK) and improvement of rice yield (7.65% increase compared to CK). Results of our study suggested that long-term application of biochar should be the potential way to mitigate GHGs emissions and simultaneously improve rice productivity in the paddy rice system.

Evolução a longo prazo no transplante renal de idosos / Long-term outcomes of elderly kidney transplant recipients

Resumo Introdução: O número de pacientes idosos portadores de doença renal crônica aumenta progressivamente, desafiando os algoritmos de alocação, em um cenário de escassez de órgãos para transplante. Objetivo: Avaliar o impacto da idade sobre os resultados do transplante renal. Métodos: Foram analisados todos os 366 pacientes > 60 anos transplantados entre 1998-2010 versus um grupo controle de 366 pacientes mais jovens pareados por gênero, tipo de doador (vivo/falecido) e ano do transplante. Resultados: Diabetes mellitus (HR 1,5; IC 1,0-2,2; p = 0,031) e doador falecido (HR 1,7; IC 1,2-2,7; p = 0,013) se associaram independentemente a maior risco de óbito. Diabetes mellitus (HR 1,8; IC 1,2-2,6; p = 0,003) e priorização por acesso vascular (HR 2,9; IC 1,2-2,6; p < 0,001), mas não idade, foram fatores independentes de perda do enxerto renal. Conclusão: A idade avançada não teve impacto negativo no resultado do transplante quando excluído óbito do paciente como causa de perda do enxerto. A maior mortalidade entre a população senil esteve associada à maior frequência de comorbidades, em especial diabetes mellitus. .

Abstract Introduction: The number of elderly patients with chronic kidney disease increases progressively, challenging the allocation algorithms in a scenario of organ shortage for transplantation. Objective: To evaluate the impact of age on patient and graft survival. Methods: Evolution of all 366 patients greater than 60 years transplanted between 1998 and 2010 was analyzed versus a control group of 366 younger patients matched for gender, type of donor (living or deceased) and year of transplantation. Results: Diabetes mellitus (HR 1.8; IC 1.2-2.6; p = 0,003) and prioritization (HR 2.9; IC 1.2-2.6; p < 0,001), but not age, were independent factors for kidney graft loss. Conclusion: Advanced age was not related to negative outcomes after kidney transplantation, after excluding recipient death as a cause of allograft loss. Higher mortality rate in this group was associated to a higher frequency of comorbidities, especially diabetes mellitus. .

Temporal and dose-dependent differences in simultaneously-induced cocaine hypervigilance and conditioned-place-preference in marmoset monkeys.

BACKGROUND: Although repeated exposure to cocaine can induce hypervigilance and conditioned-place-preference (CPP) in nonhuman primates (NHPs), more detailed analyses are warranted since the outcome can be influenced by different factors. METHODS: We evaluated in marmoset monkeys (Callithrix penicillata): (1) the onset time-course and dose-dependent (3 or 7mg/kg; i.p.) profile of their hypervigilance and CPP response to repeated cocaine exposure; (2) whether these behavioral measures are still detectable after a 15-day no-drug period; (3) the relationship between their hypervigilance and CPP responses; and (4) if these behavioral changes correlate with pre- and post-drug behaviors (i.e., vigilance, locomotion, exploration), and/or first response to cocaine. RESULTS: Hypervigilance had a slow-onset, was only effective with the 7mg/kg dose of cocaine, lacked long-term conditioned effects and was not related to the initial cocaine response or pre-drug behaviors, regardless of the dose tested. CPP was promptly induced with the 3 and 7mg/kg doses, and had a dose-dependent long-term effect and negative correlation with pre-drug locomotion and exploration. Hypervigilance and CPP were not significantly correlated. CONCLUSIONS: Although hypervigilance and CPP were induced, they had distinct temporal and dose-dependent profiles, and were not equally co-expressed in the same marmoset. Also, in NHPs, pre-drug locomotion and exploration were predictive of the low-dose CPP response.

Mutilación genital femenina y sus complicaciones a largo plazo / Female genital mutilation and its long-term complications

Introducción: La ablación o mutilación genital femenina incluye una amplia variedad de prácticas que suponen la extirpación total o parcial de los genitales externos o su alteración por razones que no son de índole médica. Causa daños irreversibles y pone en peligro la salud, e incluso la vida de la mujer o niña afectada. Objetivo: Caracterizar la mutilación genital femenina y sus complicaciones a largo plazo en la comunidad de Fajikunda, Gambia, entre marzo y septiembre de 2012. Método: Se realizó un estudio descriptivo prospectivo a 117 mujeres que asistieron al centro de salud por cualquier motivo que requiriera examen ginecológico y se estudiaron las variables grupo de edades, tipo de mutilación, grupo étnico y complicaciones. Resultados: Del total, 98 mujeres eran de 45 años de edad o menos; la clitoridectomía (tipo I) fue la práctica más frecuente; la inflamación pélvica crónica y el dolor en los genitales fueron las complicaciones a largo plazo que mayor asociación estadística demostraron con relación a la mutilación. La anorgasmia presentó una alta incidencia en la población estudiada. Conclusiones: La prevalencia de la mutilación genital femenina en Fajikunda es aproximadamente la misma que en Gambia, la tipo I es la más practicada y generalmente en jóvenes de la etnia Mandinga.

Introduction: The ablation or female genital mutilation includes a wide variety of practices dealing with total or partial extirpation of the external genitalia or its alterations for reasons other than of medical nature. It causes irreversible damages and puts in danger the health or even the life of the woman or child involved. Objective: The aim of the present study is to characterize female genital mutilation and its long-term complications in Fajikunda community, Gambia, between March and September 2012. Method: A descriptive prospective study was performed to 117 women that attended the health unit for reasons requiring gynecological examination and the variables age group, mutilation type, ethnic group and complications were studied. Results: Of the total, 98 women were 45 years old or less; the clitoridectomy (type I) was the most frequent practice; cronical pelvic and genital pains were the long-term complications that showed a major statistical association with relation to mutilation. Conclusions: The prevalence of female genital mutilation in Fajikunda is approximately the same as in Gambia, the type I is the most performed and generally within young women belonging to Mandinga ethnic group.

Efficacy and Safety of Drug-Eluting Stents in the Real World: 8-Year Follow-Up / Eficácia e Segurança de Stents Eluidores de Drogas no Mundo Real: Acompanhamento de 8 Anos

Background: Drug-eluting stents have been used in daily practice since 2002, with the clear advantages of reducing the risk of target vessel revascularization and an impressive reduction in restenosis rate by 50%-70%. However, the occurrence of a late thrombosis can compromise long-term results, particularly if the risks of this event were sustained. In this context, a registry of clinical cases gains special value. Objective: To evaluate the efficacy and safety of drug-eluting stents in the real world. Methods: We report on the clinical findings and 8-year follow-up parameters of all patients that underwent percutaneous coronary intervention with a drug-eluting stent from January 2002 to April 2007. Drug-eluting stents were used in accordance with the clinical and interventional cardiologist decision and availability of the stent. Results: A total of 611 patients were included, and clinical follow-up of up to 8 years was obtained for 96.2% of the patients. Total mortality was 8.7% and nonfatal infarctions occurred in 4.3% of the cases. Target vessel revascularization occurred in 12.4% of the cases, and target lesion revascularization occurred in 8% of the cases. The rate of stent thrombosis was 2.1%. There were no new episodes of stent thrombosis after the fifth year of follow-up. Comparative subanalysis showed no outcome differences between the different types of stents used, including Cypher®, Taxus®, and Endeavor®. Conclusion: These findings indicate that drug-eluting stents remain safe and effective at very long-term follow-up. Patients in the "real world" may benefit from drug-eluting stenting with excellent, long-term results. .

Fundamento: Stents eluidores de drogas têm sido utilizados na prática médica desde 2002, e apresentam grande eficácia na redução do risco de revascularização do vaso-alvo, e notável redução da taxa de reestenose de 50%-70%. No entanto, a ocorrência de trombose tardia pode comprometer os resultados a longo prazo, especialmente se o risco de trombose for mantido ao longo dos anos. Neste contexto, o registro da prática clínica assume grande importância. Objetivo: Avaliar a eficácia e segurança de stents eluidores de drogas no mundo real. Métodos: Relatamos os resultados de todos os pacientes que foram submetidos à intervenção coronária percutânea com stent eluidor de drogas no período entre janeiro de 2002 a abril de 2007, e que foram acompanhados por 8 anos. Os stents eluidores de drogas foram utilizados de acordo com as recomendações clínicas do cardiologista intervencionista e a disponibilidade do stent. Resultados: Um total de 611 pacientes foram avaliados, com acompanhamento clínico de 96,2% destes pacientes por até 8 anos. A mortalidade total foi de 8,7%. Infarto não-fatal ocorreu em 4,3% dos casos. A taxa de revascularização do vaso-alvo foi de 12,4% e a da lesão-alvo foi de 8,0%. A taxa de trombose de stent foi de 2,1%. Não houve novos episódios de trombose de stent após o quinto ano de acompanhamento. Uma subanálise comparativa indicou não haver diferenças nos desfechos clínicos apos a utilização dos stents Cypher, Taxus e Endeavor. Conclusão: Estes resultados indicam que stents eluidores de drogas são seguros e eficazes em acompanhamentos de longo prazo, e que pacientes no mundo real podem beneficiar destes stents, com excelentes resultados a longo prazo. .

Long-term health benefits of appetite suppressants remain unproven / Benefícios dos inibidores de apetite à saúde a longo prazo permanecem sem comprovação / Beneficios de los inhibidores de apetito en la salud a largo plazo permanecen sin comprobación

Because of the increasing prevalence of obesity, prevention and treatment of overweight has become a major public health concern. In addition to diet and exercise, drugs are needed for patients who failed to lose weight with behavioral treatment. The current article aimed to summarize recent concerns on the safety and efficacy of appetite suppressants. Several appetite suppressants have been banned for safety reasons. In 2010, sibutramine was withdrawn from the market because a long-term study showed it increased the risks of cardiovascular events. So far no study with a sufficiently large sample size has demonstrated that appetite suppressants can reduce morbidity and mortality associated with overweight. The withdrawal of sibutramine highlights that guidelines for the evaluation of weight control drugs must be more stringent, and studies on their long-term health benefits are needed prior to their marketing.

O aumento da prevalência da obesidade tornou a prevenção e tratamento do sobrepeso importante desafio para a Saúde Pública. Além da dieta e exercício, os medicamentos são necessários para pacientes que não conseguem perder peso com as mudanças comportamentais. O objetivo do artigo foi sumarizar as preocupações atuais com a segurança e efetividade de medicamentos inibidores do apetite. Vários anorexígenos foram banidos por razões de segurança. Em 2010, a sibutramina foi retirada do mercado porque um estudo de longa duração mostrou que ela aumentava o risco de eventos cardiovasculares. Até agora nenhum estudo com número expressivo de pacientes demonstrou que anorexígenos reduzem a morbi-mortalidade associada ao sobrepeso. A retirada da sibutramina do mercado mostra que diretrizes para avaliação de medicamentos anorexígenos devem ser mais rigorosas, e que estudos de longa duração sobre os benefícios para a saúde devem ser realizados antes da comercialização.

El aumento de la prevalencia de la obesidad ha convertido la prevención y tratamiento del sobrepeso importante desafío para la Salud Pública. Aunado a la dieta y ejercicio, los medicamentos son necesarios para pacientes que no logran perder peso con los cambios de comportamiento. El objetivo del artículo fue englobar las preocupaciones actuales con la seguridad y la efectividad de medicamentos inhibidores del apetito. Varios anorexígenos fueron eliminados por razones de seguridad. En 2010, la sibutramina fue retirada del mercado porque un estudio de larga duración demostró que ésta aumentaba el riesgo de eventos cardiovasculares. Hasta ahora ningún estudio con número considerable de pacientes demostró que anorexígenos reducen la morbi-mortalidad asociada al sobrepeso. La retirada de sibutramina del mercado muestra que directrices para evaluación de medicamentos anorexígenos deben ser más rigurosas, y que estudios de larga duración sobre los beneficios para la salud deben ser realizados antes de la comercialización.

Resultados a longo prazo da miectomia septal no tratamento da cardiomiopatia hipertrófica / Long term results of septal myectomy in the treatment of obstructive hypertrophic cardiomyopathy

OBJETIVO: Avaliação clínica e ecocardiográfica tardia da miectomia septal cirúrgica de pacientes com cardiomiopatia hipertrófica obstrutiva (CMHO). MÉTODOS: Foram analisados, retrospectivamente, 34 pacientes adultos (média de 55,7±15,2 anos) portadores de CMHO operados consecutivamente na instituição entre 1988 e 2008. Apenas quatro (11,8%) pacientes tinham conhecimento de história familiar para CMHO. Nove (26,5%) pacientes apresentavam insuficiência cardíaca (NYHA) classe funcional IV. Trinta (88,2%) pacientes apresentavam CMHO isolada e, em quatro (11,8%), a CMHO estava associada à insuficiência coronária. A técnica cirúrgica utilizada em todos os casos foi a miectomia septal transaórtica. RESULTADOS: Em 26 (76,5%) pacientes, a insuficiência mitral decorrente do movimento anterior sistólico regrediu após a miectomia. Em oito (23,5%) pacientes, houve necessidade de abordagem da valva mitral. Houve um (2,9%) óbito hospitalar. Dois (5,9%) pacientes necessitaram de marcapasso definitivo no pós-operatório. Em média, o gradiente de pico pré-operatório na via de saída do ventrículo esquerdo, que era de 84,9±29,0 mmHg, diminuiu para 27,8±12,9 mmHg no pós-operatório inicial e caiu para 19,2±11,2 mmHg no pós-operatório tardio (49,0±33,0 meses). A classe funcional (NYHA) que, em média, era de 3,1±0,8 passou para 1,4±0,5 no pós-operatório. Com seguimento médio de 9,6±8,4 anos, a sobrevida foi de 87,9% e a sobrevida livre de eventos cardiovasculares foi de 77,7%. CONCLUSÃO: A miectomia septal cirúrgica pode ser realizada de modo seguro, com excelente sobrevida, melhora dos sintomas e alívio da obstrução na via de saída do ventrículo esquerdo em pacientes com CMHO. Os benefícios iniciais se mantiveram a longo prazo.

OBJECTIVE: This study analyzed the clinical and echocardiographic late outcomes of surgical septal myectomy in patients with obstructive hypertrophic cardiomyopathy (OHCM). METHODS: We examined, retrospectively, 34 consecutive adult patients (age 55.7±15.2 years) with OHCM operated on in our institution from 1988 to 2008. Only four (11.8%) patients had family history of OHCM. Nine (26.5%) patients were in New York Heart Association (NYHA) funcional class IV. Thirty (88.2%) patients had solely OHCM, and four (11.8%) had OHCM associated with coronary insufficiency. The surgical technique used in all patients was septal myectomy performed through an aortotomy. RESULTS: In 26 (76.5%) patients the mitral insufficiency due to systolic anterior motion, decreased after the myectomy. Eight (23.5%) patients had mitral valve procedures. There was one hospitalar death (2.9%). Two (5.9%) patients required permanent pacemaker for complete heart block after the myectomy. The mean peak preoperative left ventricular outflow tract (LVOT) obstruction gradient was 84.9±29.0 mmHg, and decreased to 27.8±12.9 mmHg in the early postoperative and it was 19.2±11.2 mmHg in the late postoperative period (49.0±33.0 months). The NYHA functional class improved from 3.1±0.8 to 1.4±0.5 in the postoperative period. Survival free from death was 87.9% and survival free from cardiovascular events was 77.7% with mean follow-up 9.6±8.4 years. CONCLUSION: Surgical septal myectomy can be performed safely, with excellent survival, improvement from symptoms and relief for LVOT obstruction in patients with OHCM. The early benefits were remained at long term.

Artrodese do quadril: estudo retrospectivo com mais de 20 anos de seguimento / Hip arthrodesis: a minimum 20 year follow-up retrospective study

OBJETIVO: Avaliar os resultados a longo prazo de setenta pacientes submetidos à artrodese do quadril pela técnica original descrita por Davis. MÉTODOS: Realizamos um estudo clínico retrospectivo com 70 pacientes, operados entre 1982 e 1995. A presença de sintomas sobre a coluna lombar, joelho ipsilateral e quadril contralateral foi aferida assim como o sucesso da consolidação da artrodese, o posicionamento da mesma e a eventual indicação para conversão à artroplastia total do quadril. RESULTADOS: O tempo médio de seguimento foi 21,6 anos. Uma consolidação satisfatória foi constatada em 48 pacientes (85,7 por cento). A dor lombar foi presente em 11 pacientes (19,6 por cento) e osteoartrite dolorosa do joelho em quatro pacientes (7,1 por cento). Discussão: Dois trabalhos com seguimento superior ao nosso estudo ( 35 e 38 anos) apresentaram repercussões sobre a coluna lombar mais prevalentes (57 por cento e 62 por cento), assim como dor no joelho homolateral (45 por cento e 57 por cento) e indicação para conversão em artroplastia total do quadril (17 por cento e 28 por cento). CONCLUSÃO: Concluímos que a artrodese do quadril pela técnica de Davis apresenta resultados satisfatórios até o vigésimo ano, porém a presença de dor lombar é mais frequente com o passar dos anos e a dor no joelho homolateral sugere associação com a posição inicial em abdução do quadril artrodesado. Nivel de Evidência III, estudo clinico.

OBJECTIVE: To evaluate the long-term results of seventy patients who underwent hip arthrodesis using the original technique described by Davis. METHODS: We carried out a retrospective study involving seventy patients submitted to hip arthrodesis between 1982 and 1995. The presence of symptoms involving the lumbar spine, ipsilateral knee, and contralateral hip was noted, as well as the success of the arthrodesis fusion, its positioning, and the need for conversion surgery to total hip replacement. RESULTS: The mean follow-up time was 21.6 years. A satisfactory hip fusion was found in 48 patients (85.7 percent). Lumbar spine pain was reported by 11 patients (19.6 percent) and ipsilateral knee osteoarthritis was found in four patients (7.1 percent). Discussion: Two works, with a longer follow-up time (35 and 38 years) present more prevalent symptoms involving the lumbar spine (57 percent and 62 percent ) and ipsilateral knee joint (45 percent and 57 percent), and higher conversion surgery rates (17 percent e 28 percent). CONCLUSION: hip arthrodesis by the Davis technique presents satisfactory results until the 20th year after surgery, however lumbar spine disease seems to become more prevalent over the years, and the pain in the homolateral knee suggests an association with the initial position in abduction of the hip submitted to arthrodesis. Level of Evidence: Level III clinical study.

De la estabilización sintomática a la recuperación funcional en el tratamiento farmacológico de la Esquizofrenia y la Depresión Unipolar / From symptomatic stability to functional recovery in the pharmacological treatment of schizophrenia and unipolar depression

Este trabajo revisa en qué medida el tratamiento farmacológico incide en el curso crónico de la esquizofrenia y de la depresión unipolar. Se propone contestar tres preguntas: ¿produce la curación del trastorno?; ¿incide significativamente en su evolución sintomática?; ¿limita o modifica sustancial mente la discapacidad resultante? A partir de analizar conceptualmente la bibliografía disponible, se concluye que los antipsicóticos mejoran el curso sintomático de la esquizofrenia, aunque su eficacia es limitada, y que no tienen incidencia en la discapacidad que acompaña al trastorno. Con respecto a la depresión se observa que un porcentaje importante de pacientes permanece sintomático a pesar de recibir tratamientos adecuados. No hay datos acerca de la eficacia de la farmacoterapia en la potencial discapacidad resultante de la depresión unipolar.(AU)

This work summarizes the efficacy of pharmacotherapy does it cure these diseases? Does it exert any significant effect on the symptomatic presentation of the disorders? Which is its action on the social dysfunction provoked by schizophrenia or depression?A conceptual analysis of available bibliography was performed. It could be concluded that antipsychotics improve the symptomatic course of schizophrenia, although their efficacy is limited, and that these drugs does not act on the social dysfunction provoked by the disease. With respect to depression, it could be concluded that a significant proportion of patients remain symptomatic despite receiving adequate treatments. No data about efficacy of pharmacotherapy on the dysfunction resultant from unipolar depression is available.(AU)

De la estabilización sintomática a la recuperación funcional en el tratamiento farmacológico de la Esquizofrenia y la Depresión Unipolar / From symptomatic stability to functional recovery in the pharmacological treatment of schizophrenia and unipolar depression

Este trabajo revisa en qué medida el tratamiento farmacológico incide en el curso crónico de la esquizofrenia y de la depresión unipolar. Se propone contestar tres preguntas: ¿produce la curación del trastorno?; ¿incide significativamente en su evolución sintomática?; ¿limita o modifica sustancial mente la discapacidad resultante? A partir de analizar conceptualmente la bibliografía disponible, se concluye que los antipsicóticos mejoran el curso sintomático de la esquizofrenia, aunque su eficacia es limitada, y que no tienen incidencia en la discapacidad que acompaña al trastorno. Con respecto a la depresión se observa que un porcentaje importante de pacientes permanece sintomático a pesar de recibir tratamientos adecuados. No hay datos acerca de la eficacia de la farmacoterapia en la potencial discapacidad resultante de la depresión unipolar.

This work summarizes the efficacy of pharmacotherapy does it cure these diseases? Does it exert any significant effect on the symptomatic presentation of the disorders? Which is its action on the social dysfunction provoked by schizophrenia or depression?A conceptual analysis of available bibliography was performed. It could be concluded that antipsychotics improve the symptomatic course of schizophrenia, although their efficacy is limited, and that these drugs does not act on the social dysfunction provoked by the disease. With respect to depression, it could be concluded that a significant proportion of patients remain symptomatic despite receiving adequate treatments. No data about efficacy of pharmacotherapy on the dysfunction resultant from unipolar depression is available.