Blastomicosis prostática: presentación de un caso y revisión de la literatura

Morúa, Alejandro García; García, José Antonio Guevara; Sepúlveda, F. Valdes; Salinas, Juan Fermín Lozano; Guerra, Lauro Salvador Gómez

doi:10.1016/s0210-4806(10)70045-0

Cited by 10 publications

(3 citation statements)

References 5 publications

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“…Premorbid IQ has been proposed to mediate the relationship between BPSDs and cognition in AD as it significantly correlated with mood, frontal, and psychotic factors (Starr and Lonie, 2007). In a cross-sectional study, impairments in memory (episodic and semantic), executive function, and verbal fluency all correlated with the severity of neuropsychiatric symptoms (García-Alberca et al, 2010). The presence of specific neurocognitive deficits, such as executive dysfunction, was reported to predict greater BPSD symptom severity in patients with MCI, particularly of depression and anxiety (Rosenberg et al, 2011).…”

Section: Other Factors Associated With Bpsdmentioning

confidence: 99%

Behavioral and Psychological Symptoms of Dementia

Cerejeira¹,

Lagarto²,

2012

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Behavioral and psychological symptoms of dementia (BPSD), also known as neuropsychiatric symptoms, represent a heterogeneous group of non-cognitive symptoms and behaviors occurring in subjects with dementia. BPSD constitute a major component of the dementia syndrome irrespective of its subtype. They are as clinically relevant as cognitive symptoms as they strongly correlate with the degree of functional and cognitive impairment. BPSD include agitation, aberrant motor behavior, anxiety, elation, irritability, depression, apathy, disinhibition, delusions, hallucinations, and sleep or appetite changes. It is estimated that BPSD affect up to 90% of all dementia subjects over the course of their illness, and is independently associated with poor outcomes, including distress among patients and caregivers, long-term hospitalization, misuse of medication, and increased health care costs. Although these symptoms can be present individually it is more common that various psychopathological features co-occur simultaneously in the same patient. Thus, categorization of BPSD in clusters taking into account their natural course, prognosis, and treatment response may be useful in the clinical practice. The pathogenesis of BPSD has not been clearly delineated but it is probably the result of a complex interplay of psychological, social, and biological factors. Recent studies have emphasized the role of neurochemical, neuropathological, and genetic factors underlying the clinical manifestations of BPSD. A high degree of clinical expertise is crucial to appropriately recognize and manage the neuropsychiatric symptoms in a patient with dementia. Combination of non-pharmacological and careful use of pharmacological interventions is the recommended therapeutic for managing BPSD. Given the modest efficacy of current strategies, there is an urgent need to identify novel pharmacological targets and develop new non-pharmacological approaches to improve the adverse outcomes associated with BPSD.

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Section: Other Factors Associated With Bpsdmentioning

confidence: 99%

Behavioral and Psychological Symptoms of Dementia

Cerejeira¹,

Lagarto²,

2012

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“…These are known as behavioral and psychological symptoms of dementia (BPSD) and are a common motive for medical consultations, hospital admissions, and nursing home stays [1]. It is estimated that at least 90% of dementia patients will develop some type of BPSD over a period of 5 years, and this may have significant clinical implications in 85% of cases [2–4].…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have suggested that there may be an inverse relationship, with depression present in the initial stages of the illness and absent in later ones. However, this notion may result from the difficulty in diagnosing depression in advanced stages of dementia, and not from an actual reduction in its prevalence [4]. Study of the natural history of dementia has shown that cognitive deterioration occurs more rapidly in patients with psychotic symptoms [5].…”

Section: Introductionmentioning

confidence: 99%

Consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

et al. 2019

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BackgroundDementia patients often show neuropsychiatric symptoms, known as behavioral and psychological symptoms of dementia (BPSD). These are a common motive for medical consultations, hospitalizations, and nursing home stays. Various studies have suggested that the high prevalence of psychotropic drug use to treat BPSD in institutionalized dementia patients may lead to impaired cognitive capacity, rigidity, somnolence, and other complications during the course of the illness. The aim of this study was to design a consensus-based intervention between care levels to optimize and potentially reduce prescription of psychotropic drugs in institutionalized patients with dementia and assess the changes occurring following its implementation.MethodsDesign: Prospective, quasi-experimental, pre/post intervention, multicenter study. Scope: 7 nursing homes associated with a single primary care team. Inclusion Criteria: Institutionalized patients diagnosed with dementia and under treatment with 1 or more psychotropic drugs for at least 3 months. Sample: 240 individuals; mean age, 87 years (SD: 6.795); 75% (180) women. Intervention: Creation of evidence-based therapeutic guidelines for psychotropic drug use in the treatment of BPSD by consensus between reference professionals. Joint review (primary care and geriatric care nursing home professionals) of the medication based on the guidelines and focusing on individual patient needs. Primary variable: Number of psychotropic drugs used per patient. Assessment: Preintervention, immediate postintervention, and at 1 and 6 months.ResultsOverall, the number of psychotropic drugs prescribed was reduced by 28% (from 636 before to 458 after the intervention). The mean number of psychotropic drugs prescribed per patient decreased from 2.71 at baseline to 1.95 at 1 month postintervention and 2.01 at 6 months (p < 0.001 for both time points). Antipsychotics were the drug class showing the highest reduction rate (49.66%). Reintroduction of discontinued psychotropic drugs was 2% at 1 month following the intervention and 12% at 6 months.ConclusionsA consensus guidelines-based therapeutic intervention with a patient-centered medication review by a multidisciplinary team led to a reduction in prescription of psychotropic drugs in institutionalized dementia patients.Electronic supplementary materialThe online version of this article (10.1186/s12877-018-1015-9) contains supplementary material, which is available to authorized users.

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Effect of an 8-Week Mindfulness Meditation Training Program on Psychological Distress in Caregivers and on Behavioral and Psychological Symptoms in People with Alzheimer’s Disease: A Randomized Controlled Trial

Sánchez-Pérez,

Quesada-Rico,

Mendialdua-Canales

et al. 2024

Mindfulness

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Objectives Mental health problems are highly prevalent in people with Alzheimer’s disease (AD) and their family caregivers. Therefore, this study aimed to examine the effects of the Mindfulness-Based Health Care Program (MBHC) on the psychological distress of family caregivers of people with AD and, indirectly, on the behavioral and psychological symptoms of dementia (BPSD) in people with AD. Method A sample of 66 caregivers of people with AD was randomly assigned to either 8 weeks of MBHC or treatment as usual (TAU) groups. The psychological distress in family caregivers, measured by the Hospital Anxiety and Depression Scale (HADS), and BPSD in patients, measured by the Neuropsychiatric Inventory Questionnaire (NPI-Q), were evaluated and compared at baseline, post-intervention, and 3-month follow-up. Results A total of 50 participants (75.6%) completed the MBHC post-intervention and 30 (50%) at the 3-month follow-up. At post-intervention, compared to TAU, MBHC was associated with significantly greater decreases in psychological distress (β = − 3.86; 95%CI, − 7.67, − 0.04; p = 0.047), specifically in anxiety symptoms (β = − 2.84; 95%CI, − 5.38, − 0.30; p = 0.029), but no significant changes were observed in depressive symptoms. MBHC did not produce a significant change in psychological distress at 3-month follow-up. MBHC did not yield a significant reduction in BPSD in people with AD, neither at post-intervention nor at 3-month follow-up. Conclusions The results suggest that 8-week mindfulness training can effectively reduce psychological distress and anxiety symptoms in caregivers of people with Alzheimer’s disease. Preregistration This study was preregistered on ClinicalTrials.gov (identifier NCT03858283) on 26 February 2019.

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Blastomicosis prostática: presentación de un caso y revisión de la literatura

Cited by 10 publications

References 5 publications

Behavioral and Psychological Symptoms of Dementia

Behavioral and Psychological Symptoms of Dementia

Consensus and evidence-based medication review to optimize and potentially reduce psychotropic drug prescription in institutionalized dementia patients

Effect of an 8-Week Mindfulness Meditation Training Program on Psychological Distress in Caregivers and on Behavioral and Psychological Symptoms in People with Alzheimer’s Disease: A Randomized Controlled Trial

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