RESUMO
Neurological exacerbation observed in MS patients is usually related to a demyelinating process. We report two patients where hypothermia (32.4 degrees C and 32.5 degrees C) and neurological exacerbation were probably due to a Wernicke encephalopathy (WE). The clinical features and the rapid efficiency of parenteral thiamine were suggestive of WE. Hypothermia is an exceptional symptom observed in MS and has been considered as resulting from hypothalamic demyelination; these two cases showed that WE which is another cause of reversible hypothermia, can be associated with MS.
Assuntos
Hipotermia/fisiopatologia , Esclerose Múltipla/fisiopatologia , Encefalopatia de Wernicke/fisiopatologia , Regulação da Temperatura Corporal/efeitos dos fármacos , Regulação da Temperatura Corporal/fisiologia , Encéfalo/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Exame Neurológico , Recidiva , Tiamina/administração & dosagemRESUMO
Central nervous system infections due to Listeria monocytogenes result in a variety of clinical syndromes ranging from meningitis to rhomboencephalitis. We report the case of a previously healthy patient with rhomboencephalitis in whom the CT scan was normal, while magnetic resonance imaging (MRI) confirmed the diagnosis. We review the literature and emphasize the value of MRI for timely diagnosis.
Assuntos
Encefalite/microbiologia , Listeriose , Rombencéfalo , Encefalite/diagnóstico , Humanos , Listeria monocytogenes , Listeriose/diagnóstico , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-IdadeRESUMO
The clinical criteria used for making the diagnosis of dementia of the Alzheimer type are featured, presenting the experience with 71 patients who fulfilled those prerequisites. The manifestations began generally over the age of 60, predominantly in females, and frequently there was a history of affection in other family members. The symptoms most frequently found were memory defects, lack of abstraction and anosognosia. The diagnosis depended most often on the clinical findings rather than the laboratory studies, which could be normal. It is worth noting the variable clinical courses found indicating that we are dealing with a heterogeneous population. It is suggested that dementia of the Alzheimer type and normal senility are not contrasting conditions but rather a continuum of the same process.
Assuntos
Doença de Alzheimer/diagnóstico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/epidemiologia , Doença de Alzheimer/psicologia , Chile/epidemiologia , Demência/diagnóstico , Demência/epidemiologia , Demência/psicologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neuropsicologia , Fatores SexuaisRESUMO
The situation of Mental Health in Latin America is analyzed. Urgently creating a system able at handling the psychiatric disease increase in the years to come is a conclusion this paper strongly aims at. The beginning of Psychiatry is reviewed, and the importance of Psychiatry at the General Hospital is outlined as well as its rapprochement toward the community, which led to a better control and prevention in the field of Mental Health. A definition of Psychiatry is proposed, as a branch of Medicine which stands in between mental hospitals and communities. Active teamwork, coupled with the physician's work and the tasks other members of the health personnel are engaged in, has led to a more integrated approach onto the ill thus benefiting not only patients but also the whole community.
Assuntos
Transtornos Mentais/terapia , Saúde Mental , Equipe de Assistência ao Paciente , Psiquiatria/tendências , Encaminhamento e Consulta , Atenção à Saúde , América LatinaRESUMO
The situation of Mental Health in Latin America is analyzed. Urgently creating a system able at handling the psychiatric disease increase in the years to come is a conclusion this paper strongly aims at. The beginning of Psychiatry is reviewed, and the importance of Psychiatry at the General Hospital is outlined as well as its rapprochement toward the community, which led to a better control and prevention in the field of Mental Health. A definition of Psychiatry is proposed, as a branch of Medicine which stands in between mental hospitals and communities. Active teamwork, coupled with the physicians work and the tasks other members of the health personnel are engaged in, has led to a more integrated approach onto the ill thus benefiting not only patients but also the whole community.
RESUMO
Se analizan 317 fichas clínicas de consultantes del Servicio de Oftalmología del Hospital San Juan de Dios, Servicio Metropolitana Occidente, en el mes de agosto (34 por ciento) y otros meses de 1983. Los consultantes del sexo femenino predominaron con un 62,5 por ciento. Un 25,5 por ciento de la consulta total corresponde a personas de 60 años y más. El estudio estadístico por sexo y grupo de edad no fue significativo (p > 0,01). Se encuentra un 75,5 por ciento de visión normal en individuos menores de 59 años. El grupo de 60 años y más presenta el mayor porcentaje de ceguera en los grados 3-4 y 5 con 27,6 por ciento, 24.1 por ciento y 48,3 por ciento respectivamente para el ojo derecho y de 20,0 por ciento, 36,0 por ciento y 44,0 por ciento respectivamente para el ojo izquierdo. Los grados de ceguera 3,4 y 5 son mayores para el sexo masculino. El tratamiento más indicado fue entrega y uso de lentes (41 por ciento) con una mejoría de la agudeza visual de 70,6 por ciento. La catarata fue la mayor causa de tratamiento quirúrgico (35,3 por ciento), seguida por el glaucoma (12,2 por ciento), la enucleación (8,5 por ciento) y la retinopatía (7,4 por ciento). Las consultas con mayor frecuencia fueron: vicios de refracción y glaucoma, seguido por patología de polo posterior y pterigion, tanto en sector urbano como rural. La ceguera y su causa específica en 88 consultantes fue por: glaucoma (18,2 por ciento), catarata (17 por ciento) y miopía (10,2 por ciento). La hipertensión ocular alcanzó un 11 por ciento.
