Psychiatric presentation of Hashimoto's encephalopathy.

INTRODUCTION: Hashimoto's encephalopathy is an unusual condition that is associated with Hashimoto's thyroiditis. Myoclonus, epileptic seizures, dementia, and disturbances of consciousness are the most common features. CASE REPORT: We present an atypical case of Hashimoto's encephalopathy in a 33-year-old woman who presented with several brief and acute psychotic episodes. After treatment with steroids, there was an improvement in the patient's psychiatric symptoms and electroencephalogram, and antithyroglobulin antibody titers returned to normal levels. CONCLUSIONS: It is our opinion that Hashimoto's encephalopathy should be considered in the differential diagnosis of atypical psychosis, especially because this is a treatable syndrome. This is particularly important in patients with a previous history of thyroid disease, despite current normal thyroid function.

[Hypochondriasis and Huntington's disease]. / Hipocondría y enfermedad de Huntington.

Psychiatric symptoms are common in Huntington's disease and can occur years before the motor symptoms. We present an unusual case that presented as a hypochondriac disorder fourteen years before the appearance of choreic movements.

A study of the sexuality of opiate addicts.

The influence of heroin use on sexual behavior was studied in individuals attending a drug abuse program in Porto, Portugal. As we expected, drug abuse was found mainly to adversely affect sexual behavior. A minority of patients reported improvement in sexual behavior with heroin use. Almost all patients remained sexually active and took no special precautions to prevent sexually transmitted diseases. Some patients reported heroin-related sexual effects to be a motivating factor for ceasing drug abuse.

[Clinical, multicentric, and open study to evaluate the efficacy of and tolerance to sildenafil in patients with erectile dysfunction]. / Estudo clínico, multicêntrico, aberto para avaliar a eficácia e a tolerância do sildenafil no tratamento de doentes com disfunção eréctil.

Erectile dysfunction (ED), defined by the Impotence-NIH Consensus Conference as the "persistent inability to achieve and/or maintain erection sufficient for satisfactory sexual activity" affect more than 100 million men worldwide, at particular severity levels. The global prevalence of ED is estimated to affect about 10%, but has been found to increase significantly with age (39% in men 40 years of age and 67% at 70 years of age). In men aged 40 to 70 years, the severe ED prevalence increased of three folds, 5 to 15%. In order to evaluate the efficacy and tolerance of sildenafil, it was conducted a national open, multicentre study on a portuguese population affected by ED. Subjects under ambulatory treatment were recruited in Psychiatry/Sexology Clinical units and Urology/Andrology. The results of the study carried out on a group of 62 men with ED, demonstrate that sildenafil was effective in the recovering of erectile function, increasing the number of attempts to sexual activity and improving their success rates (mainly in severe dysfunction). Fifty one patients treated with sildenafil, at the end of the study referred a global improvement in their erections (92.2%). Doses of 50 mg and 100 mg sildenafil were used and were well tolerated and also effective in the treatment of this pathology (70% and 69% respectively). Being this study a flexible dose one and taking into consideration that the final dose used was found the more suitable to the patients, can be concluded that 43.1% of the patients elected dose of 50 mg whereas 56.9% elected the maximum prescribed dose of 100 mg. Over and above global efficacy experimented by patients, a significant improvement in the sexual activity with partners was occurred. These results make possible a final conclusion--in the studied patients group affected by Erectile Dysfunction, aside from associated somatic pathology, sildenafil use provided a remarkable clinical profit, in what concerns global efficacy, by erectile function mechanisms improvement, concerning patients sensitivity of improvement, occurring in the major part of them, being these of high importance to the lifting up of their self-esteem.

Diagnóstico de alcoolismo oculto: uma reavaliação / Diagnosis of hidden alcoholism: a reðevaluation

Os autores realizaram, neste trabalho, uma reavaliação do diagnóstico de alcoolismo oculto em enfermarias de medicina e cirurgia de um hospital geral, replicando um estudo de 1980 de Palha, Droux Et Teixeira de Sousa. Observou-se uma prevalência de 18,3 por cento de casos de alcoolismo na população estudada. Os casos identificados foram, em sua maioria, de homens (34,3 por cento da amostra masculina). A aplicação do Michigan Alcoholism Screening Test (MAST) mostrou-se particularmente útil no sentido de evidenciar casos de alcoolismo considerados duvidosos pelo médico assistente (8,1 por cento) e identificar outros em que o diagnóstico se encontrava oculto. A concordância entre os diagnósticos de alcoolismo, realizados pelo médico assistente e através do MAST, foi extremamente próxima da obtida no trabalho anterior, verificando-se, na investigação atual, taxas de concordância diagnóstica de 69,4 por cento e de discordância de 30,6 por cento