Schizophrenia is a chronic syndrome involving different clinical dimensions, and causes significant disability with a negative impact on the quality of life of patients and their caregivers. Current guidelines for the treatment of schizophrenia focus on maximizing a patient’s adaptive functioning and quality of life in a recovery-oriented approach that encourages active collaboration among patients, caregivers, and mental health professionals to design and manage a customized and comprehensive care plan. In the present study, a panel of experts (psychiatrists, psychologists, nurse, and social worker) gathered to review and explore the need for contemporary use of second-generation antipsychotic long-acting injectables (SGA LAIs) in “recovery-oriented” and “patient-centered” care of schizophrenia. Starting from the available data and from sharing personal attitudes and experiences, the panel selected three clinical dimensions considered useful in characterizing each patient: phase of disease, adherence to treatment, and level of functioning. For each clinical dimension, perspectives of patients and caregivers with regard to needs, expectations, and personal experiences were reviewed and the role of SGA LAIs in achieving shared goals examined. The experts concluded that from today’s modern perspectives, SGA-LAIs may play an important role in breaking the spiral of desocialization and functional decline in schizophrenia, thus favoring the recovery process.
The authors report three cases of central nervous system cryptococcosis in children in the first decade of life, from Rio Grande do Sul State, Brazil. Diagnosis was supported by demonstration of Cryptococcus neoformans with India-ink preparations of the spinal fluid and Sabouraud's media culture. Clinical presentation included acute, subacute and chronic forms. Increased intracranial pressure and hydrocephalus were the complications during the course of the disease, and a ventriculoperitoneal shunt was used in one case. Undernutrition was associated with all cases and tubercle bacillus infection with one. Specific therapy was administered to the three patients. One patient was cured and the other two died.
Case report of a 7 1/2-year-old girl considered as being normal until the age of 2 years. From then on she progressed with gait disturbance, mental deterioration, dystonic movements, convulsions and dysarthria. She died of bronchopneumonia one year later. CT scan showed hyperdensity at the putamen, with no signs of cerebral atrophy. Pathological examination disclosed an intense red coloration of the putamen and axonal "spheroids" at electron microscopy.
PALAVRAS-CHAVE: encefalite , Herpe s simple x vírus , imuno-histoquímica . N e o n a t a l e n c e p h a l i t i s b y H e r p e » s i m p l e x : immunohistochemica l d i a g n o s i s o f a e a s e . SUMMARY -Th e author s repor t th e cas KEY WORDS : encephalitis , Herpe s simple x virus , immunohistochemistry .A encefalite pelo vírus do Herpes simplex (HSV) é difícil de ser diagnosticada clinicamente e os achados de eletroencef alografia 5 e de tomografia computadorizada 6,7 podem ser normais nos estágios precoces da doença. Mesmo as anormalidades observadas nesses exames não são específicas da encefalite pelo HSV. Assim, Whitley e col.19, ao estudarem através de biópsia cerebral 432 casos de pacientes com suspeita clínica de HSV, observaram que 55% não correspondiam às lesões de encefalite pelo HSV. Desses casos, 16% apresentavam outras lesões que eram tratáveis. Consequentemente, se a terapêutica específica para a HSV for instituída, baseada no diagnóstico clínico, deve-se continuar a investi-
RESUMO -Os autores relatam 12 casos de atrofia muscular espinhal infantil progressiva, diagnosticados no Hospital da Criança Santo Antonio, Porto Alegre. O diagnóstico foi realizado por exame clínico neurológico, dosagem de enzimas musculares séricas, eletroneuromio¬ grafia e biópsia muscular. Sâo analisados os aspectos clínicos de apresentação da doença, sua evolução e a investigação laboratorial, confrontando os resultados com os conceitos da literatura. Infantile progressive spinal muscular atrophy.SUMMARY -Twelve children with progressive spinal muscular atrophy were seen at Santo Antonio Children Hospital, Porto Alegre. Diagnosis was based on neurological evaluation, serum enzymes, electroneuromyography and muscle biopsy. Several aspects are discussed by the authors, especially those concerning the presentation mode of the illness and the laboratory investigation. Our results are reviewed under the light of the current literature.A atrofia muscular espinhal infantil progressiva é conceituada como degeneração hereditária familial das células motoras das colunas anteriores da medula espinhal, provocando atrofia muscular simétrica, geralmente de topografia proximal, e paralisias progressivas dos músculos esqueléticos 3,7,9. Em formas mais graves são acometidos os núcleos motores dos nervos cranianos Degeneração nas vias sensorials têm sido encontradas, sendo menos severas e se desenvolvendo mais lentamente do que a degeneração neuronal motora 11 . A maioria dos livros-texto sugere ser esta moléstia de caráter raro porém, atualmente, a tendência é considerar a atrofia muscular espinhal infantil progressiva como entidade não incomum 3 .Desejamos contribuir para a literatura nacional relatando 12 casos de crianças com esta doença e revendo conceitos a ela relacionados.
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