RESUMO
ABSTRACT Introduction: Delusional infestation is a rare psychiatric disorder defined as a condition in which the patient has the unshakable belief and perception of being infested with parasites. Its treatment is difficult, and frequently includes antipsychotic medications (such as olanzapine or aripiprazole). Non-pharmacological treatment, particularly psychotherapy, can be used for less severe cases. Dermatologists and psychiatrists must take a multi-disciplinary approach (preferably in a psycodermatology dedicated clinic) since this type of patients sometimes refuse treatment. Case description: A 53-year-old female businesswoman describes a clinical history of five years of visual hallucinations, depressive symptoms, and generalized pruritus, along with the use of toxic substances to "clean" her skin and cloths. She reports similar symptoms in some relatives but they were not evaluated. Blood tests and analyses of the "specimen" brought by the patient were performed, yielding negative results. The patient had never been assessed by any specialist, and showed disoriented during the consultation. Follow-up was not possible due to the reluctance of the patient to follow the indications and seek psychiatric treatment. Moreover, the patient did not respond to further communication attempts. Discussion: Delusional infestation is an uncommon disease that endangers the patients and the people around them. Its treatment is difficult and long, and not conducting proper follow-up is a great risk. Its prevalence and incidence is variable and generally unknown. It can affect the patient, their next of kin, pets or the environment, and the "pathogen" can be a living organism or an inanimate object. Conclusion: This case is important as it shows the hardships of treatment, adequate follow-up and care, as well as the need to improve how these patients are approached. Additionally, both classical and uncommon signs and symptoms could be observed as the patient stated that her relatives were affected (possible delusional infestation by proxy).
Assuntos
Humanos , Delírio de ParasitoseRESUMO
Leishmaniasis is a common tropical disease that affects mainly poor people in underdeveloped and developing countries. This largely neglected infection is caused by Leishmania spp, a parasite from the Trypanosomatidae family. This parasitic disease has different clinical manifestations, ranging from localized cutaneous to more harmful visceral forms. The main limitations of the current treatments are their high cost, toxicity, lack of specificity, and long duration. Efforts to improve treatments are necessary to deal with this infectious disease. Many approved drugs to combat diseases as diverse as cancer, bacterial, or viral infections take advantage of specific features of the causing agent or of the disease. Recent evidence indicates that the specific characteristics of the Trypanosomatidae replication and repair machineries could be used as possible targets for the development of new treatments. Here, we review in detail the molecular mechanisms of DNA replication and repair regulation in trypanosomatids of the genus Leishmania and the drugs that could be useful against this disease.
Assuntos
Antiprotozoários/isolamento & purificação , Reparo do DNA , Replicação do DNA , Leishmania/fisiologia , Leishmaniose/tratamento farmacológico , Antiprotozoários/farmacologia , Descoberta de Drogas , Leishmania/efeitos dos fármacos , Leishmania/genética , Leishmania/metabolismoRESUMO
Se estudió una muestra de 100 (Ss) fármacodependientes que consultaron el Ambulatorio de San Bernardino de la Fundación José Felix Ribas para determinar las drogas utilizadas, el patrón de consumo, factores etiológicos, rasgos de personalidad y entidades psiquiátricas asociadas. Para ello se desarrolló un instrumento de 102 items. Se apareció que la mayoría fueron jóvenes varones menores de 26 años, con bajo nivel educacional, inestables laboralmente, con dificultades para mantener vínculos. La droga de inicio fue la Marihuana especialmente antes de los 16 años y las más usadas actualmente fueron en orden de frecuencia: Bazuco, Marihuana, Cocaina, Alcohol; predominando el uso mixto. Etiológicamente los factores resaltantes se ubicaron en experiencias de la infancia, fijaciones del desarrollo psicomotriz, desestructuración familiar y otros de tipo psicológico. En un 35%se hicieron otros diagnósticos concomitantes del axis I y 74%de transtornos de personalidad, especialmente antisocial, dependiente y borderline