António José Marques

Peer support for people with mental illness

Background Peer support is a mutual aid system based on the belief that someone who faced/overcome adversity can provide support, encouragement and guidance to those who experience similar situations. Objective To conduct a systematic review that describes this concept and characterizes peer supporters, its practice and efficacy. Method Research on ISI Web of Science, EBSCO Psychology and Behavioral Sciences Collection and Medline databases (from 2001 to December 2013) was conducted using as keywords “mental illness”, “mental health”, “psychiatric disability”, “mental health services”, combined with “peer support”, “mutual support”, “self-help groups”, “consumers as providers”, “peer-run services”, “peer-run programs” and “social support”. Results We found 1,566 articles and the application of both the exclusion (studies with children, teenagers and elderly people; disease in comorbidity; peer support associated to physical illnesses or family members/caregivers) and the inclusion criteria (full text scientific papers, peer support or similar groups directed for schizophrenia, depression, bipolar or psychotic disorders) lead to 165 documents, where 22 were excluded due to repetition and 31 to incomplete text. We analyzed 112 documents, identifying as main peer support categories: characterization, peer supporter, practices and efficacy. Discussion Despite an increasing interest about this topic, there is no consensus, suggesting realizing more studies.

Pneumonia a Varicella zoster

Resumo A varicela e uma doenca infecto contagiosa comum na infância, ocorrendo pouco mais de 2% dos casos em adultos. Desde a decada de 80 que a sua incidencia nos adultos tem vindo a aumentar, dos quais apenas 7% sao seronegativos1. A pneumonia a Varicella zoster, se bem que rara, constitui a complicacao mais grave e mais frequente no adulto. Os autores apresentam um caso clinico ilustrativo de pneumonia a Varicella zoster num adulto fumador e imunocompetente e fazem uma breve revisao teorica sobre o tema.

Anatomia endobrônquica: estudo prospectivo das variações anatómicas da árvore traqueobrônquica

A comprehensive knowledge of the normal pattern of endobronchial branching is essential to any pulmonologist. The classification systems available are predominantly static descriptions and only seldom do they refer to possible variations within the normal spectrum. To evaluate all possible anatomical variants of the tracheobronchial tree we conducted a prospective study in our endoscopy unit between February, 1st and July, 10th (2009). A total of 181 individuals were included in the study. Anatomical variants were found to be present in 79 individuals (43% of total). Overall we found 20 different anatomical variants. Variations were more frequently found within the right upper lobe (16.6% of individuals). Middle lobe and lingula presented no variations. The variant most frequently found was the presence of a bifurcate pattern of the right upper bronchus (13.8%). The present study revealed a relatively high frequency of anatomical alternatives to the normal endobronchial branching pattern. Recognition of these variants and the frequency of their expression are fundamental for the bronchologist in establishing the limits of normal anatomy and preparing endobronchial techniques or surgical procedures.

P-784 - A new fMRI paradigm to study behavioral and neural bases of visual working memory

Introduction Working memory (WM) is a cognitive process that refers to storing information in a temporary system that allows monitoring and handling this information. Objectives To propose and validate a new fMRI paradigm to study WM and its neuroanatomical substrates, using a language-free adaptation of the 2-back working memory task in order to avoid cultural and educational bias. Aims To test the hypothesis that the proposed paradigm would produce an increase of the BOLD signal in specialized areas for spatial WM (Superior Frontal Sulcus) and areas for monitoring and handling this information (Dorsolateral Prefrontal Cortex) in healthy participants. We also expected a significantly higher behavioral performance in this group than in subjects with suspected WM impairment due to acquired brain injury. Methods 10 neurologically healthy participants and 11 ABI participants performed the task in a block design experiment with four runs. These observed a 9-square matrix with one of the squares painted black and pressed a button each time the black square was the same as the one two trials back. We analyzed behavioral performance and brain activation in repeated trials. Results Higher BOLD activation of brain regions was associated with the performance of the WM task in the healthy group, as well as better behavioral performance. We also present behavior results of both groups, so these data can be compared to other clinical groups with suspected WM deficits. Conclusions This task may be used as a research methodology for behavioral and neuroimaging studies of visual WM in block-design paradigms.

P-1186 - The recovery process of persons living with psychiatric disabilities: values and principles of nova aurora community association psychosocial rehabilitation program

Introduction The Nova Aurora Community Association psychosocial rehabilitation program was developed based in the most current values of Psychosocial Rehabilitation. Some nuclear assumptions were considered, such as a) suppressing the disease stigma, b) defocusing from the mental ill role, promoting empowerment and self-determination, c) developing personal competencies directly related to the individuals’ social integration specific context (readiness, cognitive, social, emotional stress management, employability). Purpose To present the rational of this program and the outcomes of a pilot study designed to test if this psychiatric rehabilitation program effectively helps persons living with psychiatric disabilities become more successful and satisfied in living, learning, working, and social environments of their choice. Methods The program is being implemented for 13 months to 38 persons living with psychiatric disabilities and it is developed in 2 main levels: a) tranversal competencies (neurocognitive, stress and illness management, healthy lifestyle, self efficacy and anti-self-stigma); b) specific competencies directly related to the individuals’ social integration specific context (employability/housing, social cognition, etc). All users still frequent an empowerment center and develop sport and leisure activities. It is also available home support and family psicoeducation. The program effectiveness assessment integrated pre and post tests, evaluating all these different functional domains and life quality and program satisfaction. Results Preliminary results point towards very positive outcomes, specifically regarding personal competencies development, satisfaction level with the program, reduction of relapse, and absence rates. Conclusions Although these results are promising, this research is an initial step in establishing the efficiency of this rehabilitation program.

Caso Clínico/Case ReportPneumonia a Varicella zosterVaricella zoster pneumonia

Varicella (chickenpox) is a common contagious infection of childhood, with fewer than 2% of the cases occurring in adults. Since the early 1980s the incidence of chickenpox in adults has been increasing and only 7% of them are seronegative for Varicella zoster antibodies. Pneumonia, although rare, is the most common and serious complication of chickenpox infection in adults. The authors present an illustrative case of varicella pneumonia in an immunocompetent adult with smoking habits and make a brief thematic review. Rev Port Pneumol 2010; XVI (3): 493-505