Revista brasileira de psiquiatria : orgão oficial da Associação Brasileira de Psiquiatria, Asociación Psiquiátrica de la América Latina
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Sepsis and the multiorgan dysfunction syndrome are among the most common reasons for admission to an intensive care unit, and are a leading cause of death. During sepsis, the central nervous system (CNS) is one of the first organs affected, and this is clinically manifested as sepsis-associated encephalopathy (SAE). ⋯ Thus, it is supposed that inflammation can affect neurotransmitters, which is associated with SAE development. In this review, we will cover the current evidence (or lack thereof) for the mechanisms by which systemic inflammation interferes with the metabolism of major CNS neurotransmitters, trying to explain how systemic inflammation drives the brain crazy.
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This study evaluated the relationship between psychological coping mechanisms and symptoms of anxiety and depression in the preoperative and postoperative periods in relation to the intensity of postoperative pain among patients undergoing breast cancer surgery. ⋯ The majority of patients did not exhibit depression and anxiety. Coping mechanisms and pain in the preoperative period did not have a strong predictive value for additional postoperative pain, but those with a higher anxiety score had greater pain.
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To evaluate the relationship between brain damage biomarkers and mortality in the intensive care unit (ICU). ⋯ Levels of brain biomarkers at the time of ICU admission did not predict mortality in critically ill patients.
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The use of clinical staging models is emerging as a novel and useful paradigm for diagnosing severe mental disorders. The term "neuroprogression" has been used to define the pathological reorganization of the central nervous system along the course of severe mental disorders. In bipolar disorder (BD), neural substrate reactivity is changed by repeated mood episodes, promoting a brain rewiring that leads to an increased vulnerability to life stress. ⋯ The challenge in BD treatment is translating the knowledge of neuronal plasticity and neurobiology into clinical practice. Neuroprogression and staging can have important clinical implications, given that early and late stages of the disorder appear to present different biological features and therefore may require different treatment strategies.