RESUMO
Up to date research on Bipolar Disorders' phenomenology is in keeping with early descriptions made by E. Kraëpelin regarding the overlap in clinical presentation of both manic and depressive symptoms, namely, mixed states. The latter constitute a highly prevalent and characteristic clinical presentation of Bipolar Disorders' and entail therapeutic difficulties, prognostic implications and increased suicidal risk. Notwithstanding, mixed states', more specifically mixed depression, have been underestimated and bypassed to the point where currently neither diagnostic criteria nor specific therapeutic recommendations are provided. In addition to the lack of agreement on nosography and diagnostic criteria, mixed depression is usually excluded from Bipolar Disorders' neurobiological models. Furthermore, renewed interest in the role of dopamine in Bipolar Disorders' physiopathology has left aside hypothesis that may account for the aforementioned clinical presentation. Interestingly enough, other syndromes arising from sudden dopamine depletion such as neuroleptic dysphoria or withdrawal syndromes from dopaminergic drugs, bear remarkable clinical similarities with mixed depression. These syndromes have been subject of further research and may thus provide a model for mixed states' physiopathology. Indeed, this article accounts for clinical similarities between mixed depression, neuroleptic induced dysphoria, and other behavioural syndromes arising from sudden dopamine depletion. After reviewing neurochemical basis of such syndromes we present, to the best of our knowledge, the first neurobiological hypothesis for mixed depression. Specifically, such hypothesis regards over activation symptoms as auto regulatory attempts to compensate for sudden dopaminergic depletion. This hypothesis provides with a beginning step for the neglected problem of mixed depression, a non-antithetic link between the dopaminergic hypothesis for both manic and depressive symptoms, a plausible explanation regarding inter individual variability to mixed depression susceptibility, and suggests new approaches for the development of novel treatments in which dopamine dysregulation should be targeted.
Assuntos
Transtorno Bipolar/fisiopatologia , Dopamina/metabolismo , Regulação para Baixo , Modelos Biológicos , Transtorno Bipolar/etiologia , Transtorno Bipolar/metabolismo , HumanosRESUMO
BACKGROUND: Historical and anthropological data suggest the presence of descendents of Changos, Cuncos, Chonos and Yamanas, South American indian populations, in certain Chilean coastal villages. AIM: To assess the degree of South American indian admixture in Chilean coastal villages using protein markers, to complete the assessment of human biological diversity in Chile. SUBJECTS AND METHODS: ABO, Rh, MNS, Duffy and Kidd blood group systems were assessed in 47, 48, 55 and 24 individuals from Paposo, Carelmapu, Laitec and Ukika respectively. Phenotypic and gene frequencies were calculated. The degree of South American indian admixture was estimated from the ABO*O allele and Rh*dce haplotypes. RESULTS: High frequencies of ABO*O, Fy*a, Jk*b alleles, Dce and Ms haplotypes were found in all villages, consistent with the pattern expected for South American Aboriginal populations. The highest presence of South American indian admixture was present in Laitec with 80% and in Ukika with 74%. The figures for Paposo and Carelmapu were 60 and 65% respectively. CONCLUSIONS: According to South American indian admixture estimates, the genetic isolation of coastal populations is lower than that of inland subjects, suggesting that sea proximity facilitates gene flow.
Assuntos
Antígenos de Grupos Sanguíneos , Indígenas Sul-Americanos/genética , Alelos , Chile , Marcadores Genéticos , Variação Genética , Haplótipos , Humanos , FenótipoRESUMO
Se considera de interés la presentación de este caso, por ser la primera vez que se emplea en nuestro medio el catéter de Fogarty como bloqueador bronquial en presencia de hemoptisis masiva durante la cirugía de resección pulmonar en el niño
Assuntos
Humanos , Masculino , Criança , Anestesia Geral , Brônquios , Hemoptise/terapia , BroncoscopiaRESUMO
Se considera de interés la presentación de este caso, por ser la primera vez que se emplea en nuestro medio el catéter de Fogarty como bloqueador bronquial en presencia de hemoptisis masiva durante la cirugía de resección pulmonar en el niño (AU)
Assuntos
Humanos , Masculino , Criança , Hemoptise/terapia , Anestesia Geral , Brônquios , BroncoscopiaRESUMO
The authors present a study carried out jointly by the Gastroenterology Service and Surgical Service No. 2 of the General Hospital of the Venezuela Institute of Social Security "Dr. Ildemaro Salas". The results and objectives of the operation are analyzed insisting on its lower morbility and mortality, as well as on the lower incidence of diarrhea, dumping and other gastrointestinales discomforts. The first operation was performed on 17 november 1971 and up to the present 74 patients have been operated, 65 for duodenal ulcers, 7 for esophageal hernia of the hiatus, 1 case of hemorrhagic gastritis, and 1 case of prepyloric ulcer. Some details are given of the operations, the indications for it are pointed out, specially gastric hyperacidity, symptomatic ulcer, and absence of duodenal stenosis. There were 7 post-operative complications and 2 cases of mortality. As to the results there are presented 92% successful interventions and 8% failures.