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Search Results: 1 - 10 of 150 matches for " Laks Jerson "
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Doen?a de Alzheimer esporádica de início precoce
Truzzi, Annibal;Laks, Jerson;
Revista de Psiquiatria Clínica , 2005, DOI: 10.1590/S0101-60832005000100006
Abstract: alzheimer's disease (ad) is the main cause of dementia. a subgroup of patients has the familial or early-onset (<65 years) form of ad, with rapid course and a dominant genetic transmission through many generations. we report a case of a patient without a positive familiar history for ad, who presented early memory problems and progressive functional and cognitive (speech, praxis, executive functions e viso-spatial habilities) decline. behavioural (imnsonia, psychomotor agitation and hypersexuality) and psychological (depression) symptoms of ad were noticed in different stages of the disease. structural and functional neuroimaging techniques showed impairment of posterior cortical areas. early onset ad can be confounded with psychiatric disorders especially when there is no familiar history for ad. the presenile impact on both patient and family is intense and treatment in the early stages is very important to reduce patient and caregivers' burden.
A evolu??o de longo prazo pode diferenciar dois subtipos de psicose de início tardio
Gomes, Adrina Chalita;Laks, Jerson;
Revista de Psiquiatria Clínica , 2005, DOI: 10.1590/S0101-60832005000100005
Abstract: there are few studies about late-onset schizophrenia (los). los is thought to be a heterogeneous pathology with a similar cognitive profile compared to adult schizophrenia and two types of evolution: one group with steady neuropsychological deficits and another group with progressive deficits. we report on two clinical cases evaluated with neuropsychological tests camcog and mmse, hachinski's ischemic score, pfeffer functional activities questionnaire, panss and the neuropsychiatric inventory. the course of cognitive deficits and daily life activities were different, showing the need of prospective studies with neuropsychological approach to understand the clinical course and etiology of los.
XX Congresso Brasileiro de Psiquiatria: Novas Pesquisas e Revis o Sistemática
Mercadante Marcos T.,Laks Jerson
Revista Brasileira de Psiquiatria , 2002,
Aspectos neuropsicológicos da depress?o
Rozenthal, Marcia;Laks, Jerson;Engelhardt, Eliasz;
Revista de Psiquiatria do Rio Grande do Sul , 2004, DOI: 10.1590/S0101-81082004000200010
Abstract: this study aims at reviewing the main neuropsychological findings in depression and the differences between the unipolar and bipolar forms, with or without psychosis, during the acute and intercritical phases. moreover, the study intends to correlate the neuropsychological findings described in the literature with neuroanatomic and neurofunctional aspects, emphasizing frontal areas and their main circuits. considering neuropsychological studies carried out in the field of affective disorders, some alterations have shown to be more consistent, with important dysfunctions in critical phases but also in asymptomatic patients. of these, attentive and mnemic aspects, in addition to executive functioning, are of special interest. studies of this nature have important therapeutical implications, suggesting the need for the development of other supporting therapeutical techniques, such as cognitive rehabilitation and psychosocial interventions, making the treatment broader and more incisive.
Neuropsychological tests and driving in dementia: a review of the recent literature
Silva, Marcia Thereza;Laks, Jerson;Engelhardt, Eliasz;
Revista da Associa??o Médica Brasileira , 2009, DOI: 10.1590/S0104-42302009000400027
Abstract: introduction: neuropsychological tests measure several aspects of cognition and are useful to evaluate elderly drivers with cognitive impairment. however, there is no consensus on a standard battery of tests that could accurately predict safe driving. objective: the aim of this study is to review specific neuropsychological measures that may be useful to predict driving competence of demented individuals. method: to address neuropsychologicaltests used for dementia and the ability to drive, the authors searched for the keywords dementia, alzheimer's, drive, driver, drivers, driving, tests, neuropsychological, and assessment, in medline, pubmed, isi and scielo databases seeking articles from 2000 to 2008. resutls: from 131 articles, 27 met the inclusion criteria. porteus maze, clock drawing, trail b, ufov and nab tests were found to be the most relevant neuropsychological measures for the evaluation of fitness to drive. conclusion: porteus maze, clock drawing, trail b, ufov and nab tests highlight visuospatial attention demands and/ or executive function. those and other visuospatial and executive measures may be useful to predict driving competence of demented individuals.
Sintomas neuropsiquiátricos nas demências: relato preliminar de uma avalia??o prospectiva em um ambulatório do Brasil
Vega, úrsula Maria;Marinho, Valeska;Engelhardt, Eliasz;Laks, Jerson;
Arquivos de Neuro-Psiquiatria , 2007, DOI: 10.1590/S0004-282X2007000300026
Abstract: this study aimed to evaluate the behavioral and psychological symptoms in dementia (bpsd) and to correlate the level of the functional dependence, cognitive decline and neuropsychiatric symptoms in outpatients. in this prospective study, 35 elderly with dementia (dsm-iv) were evaluated over the course of one year with the mini-mental state examination (mmse), clinical dementia rating scale (cdr), neuropsychiatric inventory (npi) and functional activities questionnaire (faq). spearman correlation was used to compare cognitive, functional and behavioral symptoms in the first and last visits. the psychotic versus non-psychotic subgroups were compared by means of cognitive and functional performance. the mann-whitney test was used for the comparison. the mmse scores declined and the npi scores showed better results at endpoint. prevalence of depressive symptoms was 58.8%, agitation 55.9%, and delusion 41.2%. significant correlations were found for functional and mmse scores, years of formal education and npi, but not for duration of disease. psychotic symptoms had negative effects on daily activities of outpatients and were associated with functional decline.
Absence of dementia in late-onset schizophrenia: a one year follow-up of a Brazilian case series
Laks, Jerson;Fontenelle, Leonardo F.;Chalita, Adriana;Mendlowicz, Mauro V.;
Arquivos de Neuro-Psiquiatria , 2006, DOI: 10.1590/S0004-282X2006000600011
Abstract: background: cognitive deficits of late-onset schizophrenia (los) patients have been reported as stable, although some prospective studies show that a sub-group develop a significant cognitive decline. data on los from developing countries are scarce. objective: to evaluate the cognitive performance of brazilian patients with los over the course of one year. method: thirteen los patients were evaluated at baseline and after one year with the mini-mental state examination (mmse), the camcog, the positive and negative symptoms scale, the pfeffer?s activities of daily living (adl), and the neuropsychiatric inventory (npi). results: cognition and activities of daily living remained stable over the course of one year [baseline mmse= 21.31 (4.87) and camcog=80.31 (16.68); end-point mmse=20.77 (3.86) and camcog=82.92 (14.42) (z=-0.831; p=0.40); baseline adl=4.31 (5.65); end-point adl= 5.92 (3.86) (z=-0.831; p=0.40)]; end-point npi=10.54 (10.69) (z=-0.737; p=0.46]. conclusion: like patients from developed countries, brazilian patients with los do not seem develop dementia, at least over the course of one year.
Pharmacological treatment of frontotemporal lobar degeneration: systematic review
Portugal, Maria da Glória;Marinho, Valeska;Laks, Jerson;
Revista Brasileira de Psiquiatria , 2011, DOI: 10.1590/S1516-44462011000100016
Abstract: objective: to identify the therapeutic options available for treatment of cognitive and behavioral symptoms in frontotemporal lobar degeneration. method: systematic review using the descriptors "frontotemporal lobar degeneration" or "frontotemporal dementia" or "fronto-temporal dementia" or "fronto-temporal degeneration" or "pick's disease" or "pick's atrophy" or "semantic dementia" or "progressive aphasia" and "pharmacotherapy" or "treatment" or "efficacy" or "effects" or "management" was performed in the medline and lilacs databases. selection criteria: quality a - randomized clinical trials. quality b - open studies or reports of six or more cases. quality c - reports of five or fewer cases. two reviewers independently assessed the clinical studies. information collected included diagnostic criteria used, sample size, duration, efficacy and tolerability measures used and results obtained. results: from the 532 studies found, 29 complied with the inclusion criteria. all studies worked with a small sample, had short duration of treatment and used non-uniform measures in evaluating efficacy and tolerability. studies showed disparate results with respect to behavior and cognition. conclusion: there is still little, and poor, evidence available for treatment of frontotemporal lobar degeneration and studies with better methodological background are needed.
Consciência da doen?a na demência
Dourado, Marcia;Laks, Jerson;Leibing, Annette;Engelhardt, Eliasz;
Revista de Psiquiatria Clínica , 2006, DOI: 10.1590/S0101-60832006000600004
Abstract: background: awareness of disease is a concept related to the recognition of deficits, lack of knowledge of cognitive deficits or, also, to the awareness of deficits in activities of daily living in alzheimer's disease. objective: this review aimed at comparing definitions and etiological hypotheses for awareness of disease in alzheimer's disease. method: search of prospective, retrospective, longitudinal, and cross-sectional articles at isi, medline, lilacs and scielo databases from 1984 to 2004 using the key-words awareness of deficit, awareness of disease, insight and alzheimer's disease. articles were examined to evaluate the definition of awareness of disease and divided by areas according to the objective. results: the concepts of awareness of disease, awareness of deficit, awareness of cognitive deficit, insight, self-awareness and anosognosia were used as synonymous in the 43 articles, regardless of the organic, psychosocial explanations and of the differences of perception between patients and family. conclusion: awareness of disease may be defined as the ability to notice changes in the self-consciousness and in the daily activities due to the disease. this definition may be operationalized and can help the examination of awareness of disease in dementia.
Rastreamento cognitivo em idosos esquizofrênicos institucionalizados
Laks Jerson,Vega úrsula,Silberman Cláudia,Rozenthal Márcia
Revista Brasileira de Psiquiatria , 2000,
Abstract: Objetivos: Avaliar a cogni o de pacientes esquizofrênicas idosas institucionalizadas. Comparar os subgrupos, divididos de acordo com o grau de escolaridade, quanto aos escores cognitivos e à dura o da doen a. Métodos: Aplicou-se o Mini-Exame do Estado Mental (Mini-Mental State Examination -- MEEM) e questionários de avalia o de dura o do transtorno e de instru o e avaliou-se os medicamentos usados por classe e esquema posológico em 38 pacientes idosas institucionalizadas com diagnóstico de esquizofrenia segundo os critérios da DSM-IV. Os dados foram obtidos dos prontuários das pacientes e em entrevista direta com as mesmas. O MEEM foi aplicado sem que os examinadores tivessem conhecimento do diagnóstico dos sujeitos, já que todas as 38 pacientes foram inicialmente avaliadas e somente depois disso os procedimentos para o diagnóstico foram levados adiante. A média e o desvio-padr o foram obtidos para o grupo total e a significancia determinada com o teste t (0,05). Resultados: A média de idade desses indivíduos (n=38) foi de 69,42 ± 6,8 (min=60, max=82) anos e a dura o do transtorno foi de 40,36 ± 5,89 ( min=29, max=56) anos. As pacientes analfabetas somam 18, as que têm até 4 anos de educa o s o 14 e 6 têm mais de 4 e menos de 8 anos de educa o. O escore do MEEM foi de 12,15± 5,97 (min=0, max=28) pontos. As pacientes com até 8 anos de educa o formal (n=20) tiveram MEEM de 14,05 ± 5,97, idade de 70,15 ± 5,79 anos e a dura o do transtorno de 40,36 ± 6,44. Já as pacientes analfabetas (n=18), com idade de 68,61± 7,56 anos, tiveram desempenho de MEEM 10,05 ± 5,22, com 40,35 ± 5,20 anos de doen a. Comparando-se os grupos de escolaridade baixa/média e de analfabetos quanto à idade, ao tempo de doen a e ao escore do MEEM (14,05 ± 5,97 e 10,05 ± 5,22, respectivamente), somente este último item apresentou diferen a estatisticamente significativa (p<0,05). Conclus es: As pacientes esquizofrênicas idosas institucionalizadas no Instituto Municipal de Assistência à Saúde Juliano Moreira têm desempenho cognitivo medido pelo MEEM melhor do que os resultados de institui es americanas e inglesas. O número de anos de estudo correlaciona-se positivamente com o desempenho, isto é, analfabetas têm desempenho significativamente pior que pacientes com educa o baixa/média. Apesar da longa dura o, a pontua o no MEEM demonstra comprometimento cognitivo moderado, o que pode significar que haja também possibilidades adaptativas, desde que sob estrita supervis o.
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