Erik Guevara-Silva

Cost-of-illness study in a retrospective cohort of patients with dementia in Lima, Peru

Dementia is a major cause of dependency and disability among older persons, and imposes huge economic burdens. Only a few cost-of-illness studies for dementia have been carried out in middle and low-income countries. Objective The aim of this study was to analyze costs of dementia in demented patients of a private clinic in Lima, Peru. Methods. We performed a retrospective, cohort, 3-month study by extracting information from medical records of demented patients to assess the use of both healthcare and non-healthcare resources. The total costs of the disease were broken down into direct (medical and social care costs) and indirect costs (informal care costs). Results. In 136 outpatients, we observed that while half of non-demented patients had total care costs of less than US

Crisis epilépticas en la demencia de la enfermedad de Alzheimer

23 over three months, demented patients had costs of US

Eficacia y efectos adversos de la metoclopramida endovenosa en el tratamiento de las crisis de migraña

1500 or over (and more than US

Trombosis venosa cerebral de difícil diagnóstico

1860 for frontotemporal dementia). In our study, the monthly cost of a demented patient (US

Informal caregiver burden in middle-income countries

570) was 2.5 times higher than the minimum wage (legal minimum monthly wage in Peru for 2011: US

Perfil cognitivo en pacientes con infección por el virus de inmunodeficiencia humana neurológicamente asintomáticos

222.22). Conclusion. Dementia constitutes a socioeconomic problem even in developing countries, since patients involve high healthcare and non-healthcare costs, with the costs being especially high for the patients family.

Seizures in the dementia of the Alzheimer disease

PALABRAS CLAVE: Convulsiones, demencia, epilepsia, enfermedad de Alzheimer. SUMMARY Alzheimer’s disease and epilepsy not only share advanced age as a risk factor, also mechanisms underlying in their etiology. The seizures usually occur in late stages of Alzheimer’s disease; however patients with familial Alzheimer’s disease have even greater risk for seizures, which have been found in patients with mutations in PSEN1, PSEN2 or APP developing seizures even in early stages of the disease. Furthermore temporal lobe epilepsy per se could generate memory impairment and hippocampal sclerosis generate reorganization of excitatory and inhibitory neural networks that would result in seizure activity. Is important to recognize patients with Alzheimer’s disease and epilepsy for initiate early treatment and prevent further cognitive impairment and improve the quality of life of these patients.

Crisis epilépticas en la demencia de la enfermedad de Alzheimer Seizures in the dementia of the Alzheimer disease.

SUMMARY Objectives: Determine the adverse effects of intravenous metoclopramide in the acute treatment of migraine attacks. Patients and methods:�Wereevaluatedpatientswithaconfirmeddiagnosisofmigraineaccordingtothecriteria� of the International Headache Society, they attended with migraine crisis to emergency or outpatient neurology. Demographic data were collected and pain intensity was determined by visual analog scale (VAS ) from 0 to 10. Eachpatientwasgivenintravenousmetoclopramidediluted.�Wedeterminedtheefficacyinreducingpainintensity� and the side effects. Results: 76 patients were evaluated, of 18 to 56 years old, 77,6 % were women. The average baselineVASwas�8,6�,�afterreceivingmetoclopramideEV�80,2�%�hadareductioninVAS�≥�50�%.�The�92,1�%� of patients had any adverse effects, were the most frequent psychomotor restlessness, drowsiness, insomnia and