Demographically-adjusted normative data among Latinos for the version 3 of the Alzheimer's Disease Centers' Neuropsychological Test Battery in the Uniform Data Set.

INTRODUCTION: We developed demographically-adjusted normative data for Spanish- and English-speaking Latinos on the Version 3.0 of the National Alzheimer's Coordinating Center Uniform Data Set Neuropsychological Battery (UDS3-NB). METHODS: Healthy Latino adults (N = 437) age 50-94 (191 Spanish- and 246 English-speaking) enrolled in Alzheimer's Disease Research Centers completed the UDS3-NB in their preferred language. Normative data were developed via multiple linear regression models on UDS3-NB raw scores stratified by language group with terms for demographic characteristics (age, years of formal education, and sex). RESULTS: Younger age and more years of education were associated with better performance on most tests in both language groups, with education being particularly influential on raw scores among Spanish-speakers. Sex effects varied across tests and language groups. DISCUSSION: These normative data are a crucial step toward improving diagnostic accuracy of the UDS3-NB for neurocognitive disorders among Latinos in the United States and addressing disparities in Alzheimer's disease and related dementias. HIGHLIGHTS: We developed normative data on the UDS3-NB for Latinos in the US ages 50-94. Younger age and more years of education were linked to better raw scores in several cognitive tests. Education was particularly influential on raw scores among Spanish-speakers. Sex effects varied across tests and between English- and Spanish-speaking Latinos. These normative data might improve diagnostic accuracy of the UDS3-NB among Latinos.

[Historic evolution of psychiatric care paradigms]. / La evolución histórica de los paradigmas de atención en psiquiatría.

The rehabilitation of severely mentally-ill patients and their return to the community are related to historical progress. Their potential of achieving these goals is higher or lower depending on the presence of more or less stigma attached to their condition. Watts and Bennett have divided psychiatric rehabilitation into three phases: Phase 1: Very little was done because there was not much to be done. Patients were rejected and received mistreatment. Phase 2: Their vulnerability was admitted and protection was given to the disabled; services were provided by charity and voluntary religious institutions; there was no clear distinction between illness and poverty. Phase 3: Modern psychiatric rehabilitation began after the two World Wars in the 20th century, with attempts to modify and to oppose disability with the development of other skills. Psychiatric rehabilitation programs help these patients to resume life in the community and prevent their social isolation. By ensuring continuity of their treatment, rehabilitation programs reduce relapses and hospitalizations, thereby contributing to preserve family life and social inclusion. This reduces treatment costs to both families and communities, while promoting patients' reinsertion and recovery in the community according to their individual needs.

[Primary intra-osseous carcinoma]. / Carcinoma primario intraóseo.

Primary intra-osseous carcinoma (PIOC) is a rare tumor, defined as squamous cell carcinoma that develops in the jaw bones, having no initial connection to adjacent skin or mucosa. It is locally aggressive, with metastases to regional lymph nodes, (28% of cases) and lung (5% of cases) at the time of diagnosis. Its origin may be di novo or from other odontogenic tumors. The maxillary bones have epithelial tissues; therefore this neoplasm is located exclusively on this site, predominantly in the jaw. PIOC diagnostic criteria are strict and include: squamous cell carcinoma histopathology, lack of commitment and sinus mucosa, ruling out the possibility of metastasis from a distant site with a thorough clinical study and complementary methods. The treatment is, whenever possible, oncologic resection, additional radio and / or chemotherapy. Reconstructive surgery with graft and / or prostheses for aesthetic and functional are also required. We report the case of a 72 years old man who consulted for sore jaw three months after molar extraction. Curettage biopsy was performed and then resected mandible with lymphadenectomy. Histopathological examination showed a poorly differentiated squamous cell carcinoma, infiltrating jawbone with morphological findings linking him to residual odontogenic cyst and metastatic lymph nodes in 15 of 48 isolates. Postoperative radiotherapy was performed, he died at 30 months of diagnosis by progressive deterioration.

Carcinoma primario intraóseo / Primary intra-osseous carcinoma

El carcinoma primario intraóseo (PIOC) es un tumor poco frecuente, definido como carcinoma escamoso que se desarrolla en huesos maxilares, no teniendo conexión inicial con mucosa ni piel adyacente. Es localmente agresivo, con una incidencia de metástasis en ganglios regionales del 28% y en pulmón del 5%, en el momento del diagnóstico. Su origen puede ser de novo o a partir de otros tumores odontogénicos. Los huesos maxilares son los únicos que tienen en su interior tejidos epiteliales, por lo cual esta neoplasia se localiza exclusivamente en este sitio, predominantemente en la mandíbula. Los criterios diagnósticos del PIOC incluyen: histopatología de carcinoma escamocelular, ausencia de compromiso de mucosa oral y senos paranasales, descartando metástasis de un sitio distante en base a estudios clínicos y métodos complementarios. El tratamiento de elección consiste, siempre que sea posible, en la exéresis con criterios oncológicos, y radio y/o quimioterapia adicional. Se requiere además, cirugía reconstructiva con injerto y/o prótesis con fines estéticos y funcionales. Presentamos el caso de un varón de 72 años, que consultó por molestias en maxilar inferior tres meses después de la extracción de un molar. Se efectuó biopsia por curetaje y luego se resecó el maxilar inferior con vaciamiento ganglionar. El estudio histopatológico mostró un carcinoma escamoso pobremente diferenciado, infiltrante en hueso maxilar, con hallazgos morfológicos que lo vinculaban a quiste odontogénico residual, y metástasis en 15 de 48 ganglios aislados. Se realizó radioterapia postquirúrgica, falleciendo a los 30 meses del diagnóstico por deterioro progresivo.(AU)

Primary intra-osseous carcinoma (PIOC) is a rare tumor, defined as squamous cell carcinoma that develops in the jaw bones, having no initial connection to adjacent skin or mucosa. It is locally aggressive, with metastases to regional lymph nodes, (28% of cases) and lung (5% of cases) at the time of diagnosis. Its origin may be di novo or from other odontogenic tumors. The maxillary bones have epithelial tissues; therefore this neoplasm is located exclusively on this site, predominantly in the jaw. PIOC diagnostic criteria are strict and include: squamous cell carcinoma histopathology, lack of commitment and sinus mucosa, ruling out the possibility of metastasis from a distant site with a thorough clinical study and complementary methods. The treatment is, whenever possible, oncologic resection, additional radio and / or chemotherapy. Reconstructive surgery with graft and / or prostheses for aesthetic and functional are also required. We report the case of a 72 years old man who consulted for sore jaw three months after molar extraction. Curettage biopsy was performed and then resected mandible with lymphadenectomy. Histopathological examination showed a poorly differentiated squamous cell carcinoma, infiltrating jawbone with morphological findings linking him to residual odontogenic cyst and metastatic lymph nodes in 15 of 48 isolates. Postoperative radiotherapy was performed, he died at 30 months of diagnosis by progressive deterioration.(AU)

Carcinoma primario intraóseo / Primary intra-osseous carcinoma

El carcinoma primario intraóseo (PIOC) es un tumor poco frecuente, definido como carcinoma escamoso que se desarrolla en huesos maxilares, no teniendo conexión inicial con mucosa ni piel adyacente. Es localmente agresivo, con una incidencia de metástasis en ganglios regionales del 28% y en pulmón del 5%, en el momento del diagnóstico. Su origen puede ser de novo o a partir de otros tumores odontogénicos. Los huesos maxilares son los únicos que tienen en su interior tejidos epiteliales, por lo cual esta neoplasia se localiza exclusivamente en este sitio, predominantemente en la mandíbula. Los criterios diagnósticos del PIOC incluyen: histopatología de carcinoma escamocelular, ausencia de compromiso de mucosa oral y senos paranasales, descartando metástasis de un sitio distante en base a estudios clínicos y métodos complementarios. El tratamiento de elección consiste, siempre que sea posible, en la exéresis con criterios oncológicos, y radio y/o quimioterapia adicional. Se requiere además, cirugía reconstructiva con injerto y/o prótesis con fines estéticos y funcionales. Presentamos el caso de un varón de 72 años, que consultó por molestias en maxilar inferior tres meses después de la extracción de un molar. Se efectuó biopsia por curetaje y luego se resecó el maxilar inferior con vaciamiento ganglionar. El estudio histopatológico mostró un carcinoma escamoso pobremente diferenciado, infiltrante en hueso maxilar, con hallazgos morfológicos que lo vinculaban a quiste odontogénico residual, y metástasis en 15 de 48 ganglios aislados. Se realizó radioterapia postquirúrgica, falleciendo a los 30 meses del diagnóstico por deterioro progresivo.

Primary intra-osseous carcinoma (PIOC) is a rare tumor, defined as squamous cell carcinoma that develops in the jaw bones, having no initial connection to adjacent skin or mucosa. It is locally aggressive, with metastases to regional lymph nodes, (28% of cases) and lung (5% of cases) at the time of diagnosis. Its origin may be di novo or from other odontogenic tumors. The maxillary bones have epithelial tissues; therefore this neoplasm is located exclusively on this site, predominantly in the jaw. PIOC diagnostic criteria are strict and include: squamous cell carcinoma histopathology, lack of commitment and sinus mucosa, ruling out the possibility of metastasis from a distant site with a thorough clinical study and complementary methods. The treatment is, whenever possible, oncologic resection, additional radio and / or chemotherapy. Reconstructive surgery with graft and / or prostheses for aesthetic and functional are also required. We report the case of a 72 years old man who consulted for sore jaw three months after molar extraction. Curettage biopsy was performed and then resected mandible with lymphadenectomy. Histopathological examination showed a poorly differentiated squamous cell carcinoma, infiltrating jawbone with morphological findings linking him to residual odontogenic cyst and metastatic lymph nodes in 15 of 48 isolates. Postoperative radiotherapy was performed, he died at 30 months of diagnosis by progressive deterioration.

Carcinoma primario intraóseo. / [Primary intra-osseous carcinoma].

Primary intra-osseous carcinoma (PIOC) is a rare tumor, defined as squamous cell carcinoma that develops in the jaw bones, having no initial connection to adjacent skin or mucosa. It is locally aggressive, with metastases to regional lymph nodes, (28

of cases) and lung (5

of cases) at the time of diagnosis. Its origin may be di novo or from other odontogenic tumors. The maxillary bones have epithelial tissues; therefore this neoplasm is located exclusively on this site, predominantly in the jaw. PIOC diagnostic criteria are strict and include: squamous cell carcinoma histopathology, lack of commitment and sinus mucosa, ruling out the possibility of metastasis from a distant site with a thorough clinical study and complementary methods. The treatment is, whenever possible, oncologic resection, additional radio and / or chemotherapy. Reconstructive surgery with graft and / or prostheses for aesthetic and functional are also required. We report the case of a 72 years old man who consulted for sore jaw three months after molar extraction. Curettage biopsy was performed and then resected mandible with lymphadenectomy. Histopathological examination showed a poorly differentiated squamous cell carcinoma, infiltrating jawbone with morphological findings linking him to residual odontogenic cyst and metastatic lymph nodes in 15 of 48 isolates. Postoperative radiotherapy was performed, he died at 30 months of diagnosis by progressive deterioration.

Rehabilitación psiquiátrica: claves para la recuperación / Psychiatric rehabilitation: recover keys

Contenido: Los síntomas negativos de la esquizofrenia. Sexualidad y esquizofrenia: breve revisión del tema y resultados de una encuesta a pacientes en rehabilitación. Psiquiatría metropolitana: la ascención de la psiquiatría aguda hospitalaria como una nueva especialidad. La búsqueda del tratamiento farmacológico de la esquizofrenia: desde los neurolépticos convencionales a los antipsicóticos atípicos y más allá. Tratamiento psicofarmacológico de las psicosis esquizofrénicas durante la rehabilitación. Remediación cognitiva para la enfermedad mental grave. Tratamiento integrado de la enfermedad mental grave con uso de sustancias concomitante. Recuperación de la enfermedad mental grave. Alternativas residenciales a la hospitalización crónica. La historia del Programa Second Chance. Abordaje de terapia ocupacional con enfoque psicosocial en el trastorno mental severo. Terapia ocupacional en una casa de medio camino. Internación y reponsabilidad profesional: bases médico-legales de la intervención en dispositivos previos y posteriores a la internación.

[Alternatives to chronic hospitalization in mental health]. / Alternativas a la hospitalización crónica.

It is not possible to work on alternatives to chronic institutionalization without taking into account a reform of the mental health care system. A great deal of experience has been accumulated and a lot of unsolved problems have arisen since the beginning of the deinstitutionalization in USA and Europe in the 60s. The aim was the closing of psychiatric hospitals, and so the accent was put on the physical place of treatment instead on the quality of the treatment or on the actual needs of the people involved. A review of the experiences is made and some clues are given to avoid the major problems and errors that have presented. Political decisions, experienced professionals, a stable and sufficient budget, modification of some laws, the creation of community institutions that fulfill the patient's needs before moving them, postgraduate training in rehabilitation, flexibility and creativity with empirical and scientific grounds are needed for a successful reform of the mental health care system.

[Foster Home for children with mild and moderate behavioral problems]. / Hogar infantil de tratamiento para niños con trastornos de conducta leves a moderados.

A methodology for working with children and adolescents with disruptive behavior is presented. This program has been in use since 1998 in a boarding home for boys in Buenos Aires. A common issue in this sample is the presence of non-functional families with high levels of violence between their members.

Alternativas a la hospitalización crónica / Alternatives to chronic hospitalization in mental health

No es posible ocuparse de alternativas a la hospitalización crónica sin tomar en cuenta una reforma del sistema de atención en salud mental. Desde el inicio del proceso de deshospitalización en la década de 1960, en los EE.UU. y en los países europeos, se ha acumulado mucha experiencia y se han hallado muchos problemas que aún no se han resuelto. Buscando el cierre de los hospitales psiquiátricos monovalentes se puso el énfasis en el sitio físico de tratamiento y no siempre en la calidad de la atención brindada ni en las necesidades reales de los individuos afectados. Se hace un repaso de la experiencia acumulada y se señalan pautas para evitar algunos de los principales errores y problemas que se presentaron. Para una reforma de la atención psiquiátrica exitosa son fundamentales la decisión política, la consulta a profesionales con experiencia, "un presupuesto adecuado y estable, la modificación de las leyes, la creación de las instituciones necesarias acordes con las necesidades de los pacientes antes de mudados, la formación de postgrado en rehabilitación, flexibilidad y creatividad con bases empíricas y científicas sólidas.(AU)

It is not possible to work on alternatives to chronic institutionalization without taking into account a reform of the mental health care system. A great deal of experience has been accumulated and a lot of unsolved problems have arisen since the beginning of the deinstitutionalization in USA and Europe in the 60s. The aim was the closing of psychiatric hospitals, and so the accent was put on the physical place of treatment instead on the quality of the treatment or on the actual needs of the people involved. A review of the experiences is made and some clues are given to avoid the major problems and errors that have presented. Political decisions, experienced professionals, a stable and sufficient budget, modification of some laws, the creation of community institutions that fulfill the patients needs before moving them, postgraduate training in rehabilitation, flexibility and creativity with empirical and scientific grounds are needed for a successful reform of the mental health care system.(AU)

Hogar infantil de tratamiento para niños con trastornos de conducta leves a moderados / Foster home for children with mild and moderate behavioral problems

Se presenta el modo de trabajo llevado a cabo desde hace diez años en un hogar para niños (varones) con trastornos de conducta leves a moderados que presentan diferentes trastornos mentales graves. Un denominador común es la presencia de familias disfuncionales, ausentes o expulsivas, en las que se registran altos niveles de violencia ejercida sobre estos niños. Se describe someramente el abordaje utilizado y se ilustra con una viñeta clínica.(AU)

A methodology for working with children and adolescents with disruptive behavior is presented. This program has been in use since 1998 in a boarding home for boys in Buenos Aires. A common issue in this sample is the presence of non-functional families with high levels of violence between their members.(AU)

Alternativas a la hospitalización crónica / Alternatives to chronic hospitalization in mental health

No es posible ocuparse de alternativas a la hospitalización crónica sin tomar en cuenta una reforma del sistema de atención en salud mental. Desde el inicio del proceso de deshospitalización en la década de 1960, en los EE.UU. y en los países europeos, se ha acumulado mucha experiencia y se han hallado muchos problemas que aún no se han resuelto. Buscando el cierre de los hospitales psiquiátricos monovalentes se puso el énfasis en el sitio físico de tratamiento y no siempre en la calidad de la atención brindada ni en las necesidades reales de los individuos afectados. Se hace un repaso de la experiencia acumulada y se señalan pautas para evitar algunos de los principales errores y problemas que se presentaron. Para una reforma de la atención psiquiátrica exitosa son fundamentales la decisión política, la consulta a profesionales con experiencia, "un presupuesto adecuado y estable, la modificación de las leyes, la creación de las instituciones necesarias acordes con las necesidades de los pacientes antes de mudados, la formación de postgrado en rehabilitación, flexibilidad y creatividad con bases empíricas y científicas sólidas.

It is not possible to work on alternatives to chronic institutionalization without taking into account a reform of the mental health care system. A great deal of experience has been accumulated and a lot of unsolved problems have arisen since the beginning of the deinstitutionalization in USA and Europe in the 60s. The aim was the closing of psychiatric hospitals, and so the accent was put on the physical place of treatment instead on the quality of the treatment or on the actual needs of the people involved. A review of the experiences is made and some clues are given to avoid the major problems and errors that have presented. Political decisions, experienced professionals, a stable and sufficient budget, modification of some laws, the creation of community institutions that fulfill the patient's needs before moving them, postgraduate training in rehabilitation, flexibility and creativity with empirical and scientific grounds are needed for a successful reform of the mental health care system.

Hogar infantil de tratamiento para niños con trastornos de conducta leves a moderados / Foster home for children with mild and moderate behavioral problems

Se presenta el modo de trabajo llevado a cabo desde hace diez años en un hogar para niños (varones) con trastornos de conducta leves a moderados que presentan diferentes trastornos mentales graves. Un denominador común es la presencia de familias disfuncionales, ausentes o expulsivas, en las que se registran altos niveles de violencia ejercida sobre estos niños. Se describe someramente el abordaje utilizado y se ilustra con una viñeta clínica.

A methodology for working with children and adolescents with disruptive behavior is presented. This program has been in use since 1998 in a boarding home for boys in Buenos Aires. A common issue in this sample is the presence of non-functional families with high levels of violence between their members.

Análise da propaganda de medicamentos cardiovasculares como contribuição ao uso racional / Cardiovascular drugs advertisements analysis as contribution to rational use

Introdução: A propaganda de medicamentos pode ser considerada um dos fatores que levam ao uso irracional de medicamentos e tem um papel importante na decisão de escolha do medicamento a ser prescrito pelo médico. O anúncio de propaganda é considerado uma das principais fontes de informações a esses profissionais. Dentre os medicamentos mais utilizados no Brasil atualmente, os que atuam no sistema cardiovascular apresentam grande destaque. Objetivo: O objetivo deste estudo é analisar peças publicitárias de medicamentos cardiovasculares, que são anúncios dirigidos somente a prescritores. Métodos: Análise de conteúdo dos anúncios de medicamentos quanto ao cumprimento da legislação vigente e quanto às informações técnico-científicas transmitidas por meio deles. Resultados: Foram coletados 53 anúncios em hospital e em consultório médico e verificou-se que a maioria se encontra em desacordo em pelo menos um dos critérios exigidos por meio RDC nº 102/2000. Observou-se também que o conteúdo técnico-científico de itens relacionados à resolução se encontra incompleto, dentre esses estão: contra-indicações, interações medicamentosas e cuidados e advertências. Conclusão: O conteúdo incompleto, do ponto de vista da legislação e das orientações técnico-científico, dos anúncios de medicamentos cardiovasculares analisados pode contribuir com uma prescrição irracional.

[Nosography of dementia]. / Nosografía de las demencias.

Dementia diagnostic criteria presently in use are referred. The authors underline the importance of an early diagnosis for prognosis and treatment. Diagnostic criteria from international groups and their harmonization to Argentine culture proposed by the CAED (Argentine Consortium for the Study of Dementias) are reviewed.

[Sexual behavior in patients with schizophrenia: a review of the literature and survey in patients attending a rehabilitation program]. / Sexualidad y esquizofrenia: breve revisión del tema y resultados de una encuesta a pacientes en rehabilitación.

UNLABELLED: Sexual functioning of patients with a severe psychotic illness such as schizophrenia has received little attention from clinicians. Sexual dysfunctions are an important contributing factor to a poor quality of life in this population and important factor in non-adherence to pharmacological treatment. A high percentage of individuals with schizophrenia reported to have no sexual intercourse or showed evidence of sexual dysfunction (28%; to 40%; in females and 40%; to 60%; in males), which has different etiology, like the illness itself (12%; to 15%;), aging (35%; to 41%;), or side effects from the psychiatric medication (26%; to 36%;). We alert about this problems and show the preliminary results of a survey in an adult chronic population (ranging between 27 to 57 years of age, with an equal sex distribution, attending in a psychiatric rehabilitation program in a half-way house. RESULTS: a 36%; of the patients reported to have sexual difficulties, the 50%; of the sample has had sexual intercourse with some regularity, only the 32%; of the sample reported to have sex in the last month, and less than a 5%; of this population reported to have a regular partner, among others suggestions of sexual dysfunction.

[Langerhans' cell histiocytosis of the vulva (Case report)]. / Histiocitosis de células de langerhans de la vulva. (Reporte de un caso)

Langerhans' cell histiocytosis (LCH) is a proliferative disease that most often affects children. Presentation of vulvar lesion alone in adults is rare. We report a case of a 69-year-old woman with a vulvar lesion of 6 years of evolution. HE stain and immunohistochemical study using CTK, ACL, HMB 45, VIM, S 100, LN 5 y CD 1a were performed. CLH, although unusual presentation, it is must keep in mind when appear vulvar lesions in older woman simulating infection or proliferative neoplastic lesions of skin since is necessary rule out systemic engagement and periodical control of patients.

Histiocitosis de células de langerhans de la vulva (Reporte de un caso) / Langerhans cell histiocytosis of the vulva (case report)

La histiocitosis de células de Langerhans (HCL) es una enfermedad proliferativa que afecta habitualmente a niños. La forma localizada en vulva de un adulto es de presentación rara. Reportamos un caso de una mujer de 69 años con una lesión vulvar de 6 años de evolución. Se realizó coloración con HE para microscopia óptica y estudio inmunohistoquímico con CTK, ACL, HMB 45, VIM, S 100, LN 5 y CD la. La HCL, aunque de aparición inusual, se debe tener en cuenta cuando aparecen lesiones en vulva en pacientes añosas que simulan infecciones o lesiones proliferativas neoplásicas de piel, ya que es necesario descartar compromiso sistémico y controlar periódicamente los pacientes. (AU)

Histiocitosis de células de langerhans de la vulva (Reporte de un caso) / Langerhans' cell histiocytosis of the vulva (case report)

La histiocitosis de células de Langerhans (HCL) es una enfermedad proliferativa que afecta habitualmente a niños. La forma localizada en vulva de un adulto es de presentación rara. Reportamos un caso de una mujer de 69 años con una lesión vulvar de 6 años de evolución. Se realizó coloración con HE para microscopia óptica y estudio inmunohistoquímico con CTK, ACL, HMB 45, VIM, S 100, LN 5 y CD la. La HCL, aunque de aparición inusual, se debe tener en cuenta cuando aparecen lesiones en vulva en pacientes añosas que simulan infecciones o lesiones proliferativas neoplásicas de piel, ya que es necesario descartar compromiso sistémico y controlar periódicamente los pacientes.