HVFX - Psiquiatria
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- Acute Psychosis as Major Clinical Presentation of Legionnaires’ DiseasePublication . Coentre, Ricardo; Silva-dos-Santos, A; Cotrim-Talina, MWe report a case of a 61-year-old woman who presented with acute psychosis as a major manifestation of Legionnaires’ disease in the absence of other neuropsychiatric symptoms. Clinical history revealed dry cough and nausea. Observation showed fever and auscultation crackles in the lower lobe of the right lung. Laboratory testing demonstrated elevated C-reactive protein and lung chest radiograph showed patchy peribronchial and right lower lobe consolidation. Soon after admission, she started producing purulent sputum. Epidemiological data suggested Legionella pneumophila as possible cause of the clinical picture that was confirmed by urinary antigen detection and polymerase chain reaction of the sputum. She was treated with levofloxacin 750 mg/day for 10 days with complete remission of pulmonary and psychiatric symptoms. She has not had further psychotic symptoms.
- Antipsicóticos injetáveis de longa ação clássicos vs atípicos: um estudo naturalísticoPublication . Sales, MB; Silva dos Santos, A
- Antipsychotics in First-Episode Psychosis: Patterns of Use in a Sample of Portuguese PatientsPublication . Coentre, R; Talina, M
- A Closed Loop Brain-machine Interface for Epilepsy Control Using Dorsal Column Electrical StimulationPublication . Pais-Vieira, M; Yadav, AP; Moreira, D; Guggenmos, D; Silva-dos-Santos, A; Lebedev, M; Nicolelis, MLAlthough electrical neurostimulation has been proposed as an alternative treatment for drug-resistant cases of epilepsy, current procedures such as deep brain stimulation, vagus, and trigeminal nerve stimulation are effective only in a fraction of the patients. Here we demonstrate a closed loop brain-machine interface that delivers electrical stimulation to the dorsal column (DCS) of the spinal cord to suppress epileptic seizures. Rats were implanted with cortical recording microelectrodes and spinal cord stimulating electrodes, and then injected with pentylenetetrazole to induce seizures. Seizures were detected in real time from cortical local field potentials, after which DCS was applied. This method decreased seizure episode frequency by 44% and seizure duration by 38%. We argue that the therapeutic effect of DCS is related to modulation of cortical theta waves, and propose that this closed-loop interface has the potential to become an effective and semi-invasive treatment for refractory epilepsy and other neurological disorders.
- Doença mental, homocisteína, risco cardiovascular e síndrome metabólicaPublication . Silva-dos-Santos, A
- ECT: Aplicação na EsquizofreniaPublication . Coentre, R
- Efeitos Adversos da ElectroconvulsivoterapiaPublication . Coentre, R
- Electroconvulsivoterapia de Continuação e ManutençãoPublication . Coentre, R
- First-episode psychosis in a 15 year-old female with clinical presentation of anti-NMDA receptor encephalitis: a case report and review of the literaturePublication . Moura, M; Silva-dos-Santos, Amílcar; Afonso, J; Talina, MBACKGROUND: Anti-NMDA receptor encephalitis is an autoimmune disease that was identified in 2007, and manifests in a stepwise manner with psychiatric, neurological and autonomic symptoms. The disease is caused by autoantibodies against NMDA receptors. It can have a paraneoplastic origin, mainly secondary to ovarian teratomas, but it can also be unrelated to the tumor. This disease can affect both sexes and all ages. CASE PRESENTATION: Here, we present a case of a 15 year-old female adolescent with first-episode psychosis with anti-NMDA receptor encephalitis not related to tumor, which manifested with delusion, hallucinations, panic attacks, agitation, and neurological symptoms, and later with autonomic instability. She was treated with immunotherapy and psychiatric medication resulting in improvement of her main psychiatric and neurological symptoms. CONCLUSION: Our main objective in presenting this case is to alert clinicians to this challenging and recent disease that has a clinical presentation that might resemble a functional psychiatric condition and can be underdiagnosed in the context of child and adolescent psychiatry
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