-Purpose: To assess public awareness and attitudes toward epilepsy in Brazilians of different cultural and socioeconomic backgrounds. Background: Several studies have examined public awareness and attitudes toward epilepsy in various countries but there are no equivalent data for Brazil or South America. Material and Methods: We have applied the survey proposed by Caveness and Gallup , with some modifications and adaptations to four groups (I-IV) of subjects: I-105 individuals accompanying patients to the Ophthalmologic outpatient clinic of the Hospital das Clínicas of the State University of Campinas (UNICAMP); II-93 students recently admitted to medical and nursing school; III-101 senior non-medical students; and IV-69 senior medical students. Groups II, III, and IV were students at UNICAMP. Results: Individuals with a low socioeconomic standing had a poor profile of familiarity, knowledge and attitudes toward epilepsy. The pre-university and university students had a relatively good profile when compared to the published international polls. Senior medical students had an excellent level of familiarity and knowledge, but showed no change in their objection to having a son or a daughter marry an epileptic person. Conclusions: Our data suggest that there is a clear-cut relationship between the level of education and the individual's familiarity and attitudes toward epilepsy. Effective elimination of the prejudice toward epilepsy requires specific training and not just general, superficial information about the condition. KEY-WORDS: epilepsy, attitude, prejudice, public awareness. Atitude e percepção sobre epilepsia em diferentes segmentos sociais no BrasilRESUMO-Com o objetivo de avaliar a percepção e a atitude em relação à epilepsia aplicamos questionário de 9 perguntas, modificado de Caveness e Gallup,1980. Foram entrevistados 105 acompanhantes de pacientes da Clínica de Oftalmologia do Hospital das Clínicas da UNICAMP (grupo I); 93 estudantes admitidos em 1996 nos cursos de medicina e enfermagem (grupo II); 101 estudantes do último ano de outros cursos, que não medicina (grupo III); e 69 estudantes do sexto ano do curso de medicina (grupo IV). Todos os estudantes eram da UNICAMP. Responderam que já tinham ouvido falar em epilepsia 87,6% do grupo I e 100% dos demais grupos. Com relação à causa da epilepsia responderam não sei ou respostas erradas: grupo-I 51,1%, grupo-II 30,2%, grupo-III 32,7% e grupo-IV 0%. Os autores discutem os seus achados comparativamente à literatura internacional pertinente e concluem que: 1. Há clara relação entre o nível educacional e familiaridade e atitude em relação à epilepsia; 2. Eliminação efetiva do preconceito em relação à epilepsia exige treinamento específico e não informações superficiais, de cunho amplo sobre a condição. Estes dados suportam a noção de que campanhas nacionais devam ser realizadas para melhor esclarecimento leigo sobre as epilepsias, incluindo a população universitária.
A technique is developed for finding a closed form expression for the cumulative distribution function of the maximum value of the objective function in a stochastic linear programming problem, where either the objective function coefficients or the right hand side coefficients are continuous random vectors with known probability distributions. This is the "wait and see" problem of stochastic linear programming. Explicit results for the distribution problem are extremely difficult to obtain; indeed, previous results are known only if the right hand side coefficients have an exponential distribution [1]. To date, no explicit results have been obtained for stochastic c, and no new results of any form have appeared since the 1970's. In this paper, we obtain the first results for stochastic c, and new explicit results if b an c are stochastic vectors with an exponential, gamma, uniform, or triangle distribution. A transformation is utilized that greatly reduces computational time.
IntroductionVitamin B12 deficiency may cause neurological and psychiatric symptoms, especially among elderly patients. Two clinical cases are presented of patients admitted to an Acute Inpatient Psychiatry Unit due to psychotic symptoms, being reported a B12 deficiency.ObjectivesReview clinical information about vitamin B12 deficiency as a factor involved in the development of psychiatric disorders, specifically psychotic symptoms, pointing out the peculiarities regarding clinical presentation, diagnosis, prognosis, and treatment management.MethodsSearch in the medical database PUBMED, MEDSCAPE and UPTODATE.ResultsVitamin B12 deficiency is associated with hematological, neuropsychiatric, and digestive disorders, is estimated that around 5-40% of the elderly population may present it. Neuropsychiatric syndromes may be the first, and sometimes sole, manifestation, related to a different etiological mechanism. Vitamine B12 deficiency implies enzymatic defects that cause an accumulation of methylmalonic acid and homocysteine, which is proportionally related to the severity of the neuropsychiatric symptoms. The range of clinical features includes psychotic and affective episodes, behavioral disorders, cognitive impairment, along with other neurological manifestations such as polyneuropathy and encephalopathy. The diagnosis delay is crucially important, as early detection could lead to reverse the neuropsychiatric symptoms and some of the neuroradiological alterations. Parenteral and oral vitamin B12 supplementation should be initiated, monitoring levels in plasma, together with psychiatric drugs until the symptoms are controlled.ConclusionsVitamin B12 deficiency is a factor that may be involved in the etiopathogenesis of psychiatric disorders. Thus, screening must be considered among the vulnerable population when presenting neuropsychiatric disorders as early diagnosis and treatment are key to clinical prognosis.
IntroductionChemsex is the term used to describe the use of psichoactives drugs to practice sex, mostly among men who have sex with other men. When drugs are administered by intravenously it is know as slamming or slamsex. Mephedrone is drug more used to this practice, in combination with other as anfetamines. This practice has been associated with a lot of psychiatric and organic complications.ObjectivesDescribe a case about one of chemsex complications such as drug- induce psychosis. Moreover, show the multiple medical complications associated with this practice.MethodsPatient’s data is obtained from medical history, psychiatric interviews carried out during his hospitalizations and his psychological follow-up in CAID.Results45 year-old man patient was admitted into a psychiatric unit due to paranoid ideation, behavioral disturbances and heteroaggressive behavior after mephedrone, amphetamines and other drugs intoxication in the context of slamsex practice. He has a history of two previous autolytic attempts but no psychotic episodes. After one week of hospitalization and antipsychotic treatment psychotic symptons disappear. Concerning his medical history, he was infected for HIV, syphilis, hepatitis A, visceral Leishmania.ConclusionsIt is necessary to be aware of the increased in chemsex and slamsex rates and therefore of the comorbilities that have associated. Rapid detection is important in order to reduce and control the severe addiction they entail (especially intravenous consumption).DisclosureNo significant relationships.
IntroductionEarly grief is a concept about which there is little literature. This generates difficulties in order to perform a differential diagnosis, as it poses complications to determine if the symptoms that the patient suffers are relative to the mourning or if they appear as part of a comorbid disorder.ObjectivesTo assess the difficulty in discriminating when accompaniment is necessary and when the patient can benefit from pharmacological, psychotherapeutic or combined treatment.MethodsPatients’ data is obtained from their medical history as well as psychological interviews carried out during the process.Results 32-year-old woman, with a previous history of depression. The patient was living abroad when her father was diagnosed with a terminal illness, so she decided to return home, making a radical change in her life. She is currently facing the functional deterioration of her father, who is rapidly getting worse. The patient shows symptoms of anxiety, tendency to cry and apathy. 34-year-old woman, with no history in Mental Health. As a result of her father’s illness, the patient develops a clinical manifestation of anxiety and low spirits. After one year, the clinic is maintained according to the variations in the health of her father. She also reports problems concentrating, fatigue, ruminative thoughts and structured autolithic ideas. Finally, she is referred to begin a psychotherapeutic follow-up.ConclusionsBearing in mind that we are facing an increase in diagnoses of terminal illnesses, I consider it is necessary to reflect on this concept in order to provide a better response to patients.DisclosureNo significant relationships.
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