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Search Results: 1 - 10 of 202408 matches for " OSVALDO P.; "
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Rodríguez P,Osvaldo;
Alpha (Osorno) , 2005, DOI: 10.4067/S0718-22012005000100006
Abstract: even though neruda sometimes pointed out his “metaphysical works” to differentiate them from his contingent poetry, the existential background of his work is evident, especially during the last stage of his lyrical creation. his questions related neruda′s essential concern about the concrete and unique existence of mankind, chiefly that of mankind and its history as well as that of the self and its individual conditioning threatened by death. this paper highlights the constant question-like attitude. this type of attitude is the one that the poet employs to face the outside world and reality and his own, which turns into an interpretative key to his work. from neruda′s beginning, his poetry intended to be all-embracing, questioning himself a gamut of aspects pertaining to reality. this does not imply necessarily a discourse dealing with a cognitive or philosophical function, but rather a metaphorical one, which focuses on “what reality is all about”.
Sex playing with the mind: effects of oestrogen and testosterone on moon and cognition
Arquivos de Neuro-Psiquiatria , 1999, DOI: 10.1590/S0004-282X1999000400028
Abstract: women now spend more than 1/3 of their lives in a state of oestrogen deprivation as a result of increased life expectancy. a similar, but milder, hypogonadal state has been described for elderly men. this paper aims to review the available literature on the effects of both oestrogen and testosterone on mood and cognition. oestrogen replacement therapy of postmenopausal women is associated with improvements in measures of well being and decline in depression scores. in addition, oestrogen seems to augment the response of postmenopausal women with major depression to antidepressant treatment. most studies designed to investigate the impact of oestrogen on cognition indicate that replacement therapy is associated with better performance on neuropsychological tests, particularly in measures of verbal memory and fluency. the data also supports claims that oestrogen replacement therapy reduces the risk of alzheimer's disease in later life and improves response of patients to anticholinesterase treatment. data on the effects of testosterone is sparser. preliminary findings suggest that testosterone therapy may improve mood when used in isolation or in association with oestrogen. the effects of testosterone on cognitive functioning are less clear - some studies indicate that the administration of testosterone to non-demented subjects is associated with better visuospatial functioning and deterioration of verbal skills. in summary, gonadal hormones seem to modulate various aspects of mental functioning. if future studies prove this to be true, hormone replacement therapy should have a major impact on the physical and mental health of older people in the years to come.
Mini exame dos estado mental e o diagnóstico de demência no Brasil
Arquivos de Neuro-Psiquiatria , 1998, DOI: 10.1590/S0004-282X1998000400014
Abstract: the diagnosis of dementia is based on the presence of memory deficits and decline of other cognitive functions. many scales have been designed to aid the clinician in the assessment of at risk subjects, such as the elderly. the mini-mental state examination (mmse) is the most widely used of such scales, although its use as an aid to the diagnosis of dementia has not as yet been studied in a brazilian sample of patients. the current study was designed with 2 main aims: (1) to determine the best cut-off point of the mmse for the diagnosis of dementia in a sample of elderly subjects assessed in a mental health outpatient unit and; (2) evaluate the impact of age and schooling on mmse scores. two hundred and eleven subjects aged 60 or over assessed at the mental health outpatient unit for the elderly at "santa casa de s?o paulo" between february 1997 and february 1998 were included in the study. they were assessed with the srq-20, mmse, and a clinical interview for the diagnosis of dementia according to the icd-10. seventy patients received the diagnosis of dementia. the mmse cut-off point of 23/24 (cases/non-cases) was associated with a sensitivity of 84.3% and specificity of 60.3%. mmse scores were associated with age (r= -0.41, p<0.001) and schooling (f=12.69, p<0.001). analysis of covariance taking age into account showed that mmse scores were significantly lower among those with no formal education (f=10.51, p<0.001). a cut-off point of 19/20 on the mmse was associated with sensitivity of 80.0% and specificity of 70.9% for the diagnosis of dementia in this particular group. subjects with previous school history were better classified to the diagnosis of dementia with the cut-off point of 23/24: sensitivity of 77.8% and specificity of 75.4%. the evaluation of elderly subjects with the mmse should take education into account, and different cut-off points should be used accordingly as a guideline to the diagnosis of dementia.
Queixa de problemas com a memória e o diagnóstico de demência
Arquivos de Neuro-Psiquiatria , 1998, DOI: 10.1590/S0004-282X1998000300010
Abstract: ageing is often associated with the decline of some cognitive abilities, although in most cases these losses do not progress to full blown dementia. the current study aimed to evaluate the association between subjective memory complaint and the diagnosis of dementia among the elderly assessed at the old age unit of the department of mental health of santa casa de s?o paulo-brazil between february and december 1997. subjects were assessed with the srq-20 and mmse. further clinical information was also collected to allow for the diagnosis of mental disorders according to icd-10 diagnostic guidelines. fifty-nine percent of the 220 patients included in the study complained of memory difficulties. seventy-one percent of the complainers were women, although there was no clear statistical association between sex, education, marital status and living conditions with the memory complaint. there was a trend for memory complainers to present with higher scores on the srq-20 (p=0.122). the complaint of memory difficulties had a sensitivity of 76.2%, specificity of 47.8%, positive predictive value of 36.9%, and negative predictive value of 83.3% for the diagnosis of dementia. memory complaints are frequent among the elderly, particularly among those with more severe depressive and anxiety symptoms. the subjective experience of memory difficulties has a low predictive value for the diagnosis of dementia. the identification of "at risk" cases should, instead, be based on new neuroimaging and genetic methods.
Sintomas psiquiátricos entre pacientes com demência atendidos em um servi?o ambulatorial
Arquivos de Neuro-Psiquiatria , 1999, DOI: 10.1590/S0004-282X1999000600007
Abstract: subjects with dementia often display an array of neuropsychiatric symptoms that include disorders of mood, delusions, hallucinations, vegetative symptoms and psychomotor abnormalities. the present study was designed to investigate the prevalence of psychiatric morbidity amongst patients with the clinical diagnosis of dementia (icd-10) assessed at a memory clinic in s?o paulo-brazil between february 1997 and may 1998. the mental and cognitive state of patients were assessed with an extended version of the srq-20 and the mmse respectively. thirty-four (45.3%) out of a total of 75 subjects scored 8 or more on the srq-20, indicating the presence of significant psychiatric morbidity. depressive symptoms were reported by 69.3% of patients. persecutory ideas and auditory hallucinations were observed in 20.0% and 16.0% of the sample respectively. eight subjects (10.7%) described suicidal ideation ? they all displayed depressive symptoms. patients with scores on the srq-20 3 8 or who described suicidal ideation were significantly younger than their counterparts. auditory hallucinations were more frequent amongst subjects with lower mmse scores. there were no sex differences in the distribution of the psychiatric symptoms under investigation. the assessment of patients with dementia should always include a detailed psychiatric examination, as the detection and treatment of such symptoms may contribute to decrease the stress of patients and the burden on carers.
Tratamento da doen?a de Alzheimer: avalia??o crítica sobre o uso de anticolinesterásicos
Arquivos de Neuro-Psiquiatria , 1998, DOI: 10.1590/S0004-282X1998000400029
Abstract: alzheimer's disease (ad) is a neurogenerative disorder that had no effective treatment until a few years ago. many studies published during the past 20 years showed that the disease is associated with the disruption of brain systems that use acetilcholine. these findings shaped the development of the cholinergic treatment strategies for ad. the cholinesterase inhibitors were the first class of drugs to show positive results in double-blind placebo controlled studies for the treatment of ad. this paper reviews efficacy and safety studies of tacrine, donepezil, rivastigmine, and metrifonate in patients with ad. factors that may interfere with patients' response to treatment are also discussed, as well as the limitations associated with the use of this class of drugs.
Transtorno bipolar de início tardio: uma variedade organica do transtorno de humor?
Almeida, Osvaldo P;
Revista Brasileira de Psiquiatria , 2004, DOI: 10.1590/S1516-44462004000700007
Abstract: bipolar disorder (bd) is commonly associated with late adolescence or early adulthood, although a substantial proportion of patients develops the condition in later life. the results of early clinical investigations suggested that cases of bipolar disorder with onset in later life were more often associated with 'organic causes', and could potentially justify the distinction between early and late onset bipolar disorder. this paper reviews currently available evidence in support of the organic hypothesis for late onset bipolar disorder. it concludes that the split of bipolar disorder according to age at onset is artificial, and lacks clinical significance and epidemiological support.
Idosos atendidos em servi?o de emergência de saúde mental: características demográficas e clínicas
Almeida, Osvaldo P.;
Revista Brasileira de Psiquiatria , 1999, DOI: 10.1590/S1516-44461999000100005
Abstract: the ageing of the population has led to an increase in the number of elderly people seeking mental health assistance. this study aimed to evaluate the most frequent diagnoses ascribed to elderly patients referred to a mental health emergency service in s?o paulo, brazil. all subjects assessed at the emergency room of the department of mental health of "santa casa de s?o paulo" between january 1st and december 31, 1997 were included in the study. the classification of patients followed the icd-10 guidelines for the clinical diagnosis of mental disorders. out of the 5.434 assessments, 398 were of subjects aged 60 or over. their mean age was 68.66 (ci=67.88 to 69.43 - range 60 to 96) and there was an excess of women among the elderly group (67.3% vs 51.2%, p<0.001). mood disorders were the most prevalent diagnosis (40.0%), and were 2.24 times more frequent among women (ciodds=1,42 to 3,54). in 78.2% of these cases a major depressive episode was the main referral cause. fourteen percent of the elderly suffered from dementia. other frequent clinical diagnoses included anxiety disorders (15,4%), schizophrenia and related disorders (14.4%), alcohol abuse or dependence (4.1%), and abuse or dependence of hypnotics or sedative drugs (2.6%). fifty-nine percent of the elderly were referred for further outpatient treatment, whereas 20.3% were admitted as inpatients after the emergency evaluation. the mental health disorders of the elderly make up an important part of the assessments at a psychiatric emergency clinic. it is important that health professionals are able to recognize and manage accordingly the most frequent psychiatric disorders of the elderly.
Sintomas psiquiátricos entre pacientes com demência atendidos em um servi o ambulatorial
Arquivos de Neuro-Psiquiatria , 1999,
Abstract: Pacientes portadores de quadros demenciais frequentemente apresentam uma série de sintomas neuropsiquiátricos que incluem distúrbios do humor, delírios, alucina es, sintomas vegetativos e altera es da atividade psicomotora. Este estudo foi desenhado com o objetivo de investigar a prevalência de morbidade psiquiátrica entre os pacientes com o diagnóstico clínico de demência (ICD-10) atendidos na clínica de memória da Santa Casa de S o Paulo entre fevereiro de 1997 e maio de 1998. O estado mental e cognitivo dos pacientes foram avaliados com uma vers o ampliada do SRQ-20 e o MMSE respectivamente. Quarenta e cinco porcento dos 75 pacientes disponíveis para análise apresentavam escores iguais ou maiores do que 8 no SRQ-20, indicando a presen a de morbidade psiquiátrica significativa. Sintomas característicos de depress o foram relatados por 69,3% dos indivíduos da amostra. Idea o persecutória e alucina es auditivas foram descritas por 20,0% e 16,0% dos idosos avaliados. Oito pacientes (10,7%) descreveram a presen a de idea o suicida 3/4 todos apresentavam sintomatologia depressiva. Pacientes com escores no SRQ-20 3 8 ou com idea o suicida eram significativamente mais jovens. Aqueles que relatavam alucina es auditivas apresentavam escores significativamente mais baixos no MMSE. N o se observou diferen a significativa entre os sexos quanto à frequência dos sintomas investigados. O exame do estado mental deve ser parte integrante da avalia o do paciente com demência. A detec o e tratamento desses sintomas pode contribuir para diminuir o sofrimento do paciente e o estresse de seus cuidadores.
Apresenta o
Almeida Osvaldo P.
Revista Brasileira de Psiquiatria , 2002,
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