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Biomedical subjects

D Barcia

Publications and source records attributed to D Barcia.

At least 19 recordsLinked to original sources
PubMed1993

Ethical aspects of the doctor-patient relationship.

Recently, the doctor-patient relationship has undergone major structural change by growing pressure from an ethic of personal autonomy, that gives patients greater control over their own lives, on a paternalistic "helpful healer's" ethic, whereby the doctor determines what should be done. It is a change in which informed consent by the patient has come to the fore in the traditional relationship with his doctor-as-friend-and-counsellor. The change is not without drawbacks as regards the quality of medical practice. The main characteristics of the two kinds of ethics are contrasted and some inferences drawn for the future course of medical practice.

Ethics, Medical↗
PubMed1980

[Not Available].

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History, Modern 1601-↗
PubMedDate not supplied

[Risperidone and concept of bipolar neuroleptic].

We present a review of the stimulant properties of risperidone, analyzing them according to the model of bipolar neuroleptic proposed in 1979 by Colonna and Petit. The bipolar neuroleptics (pimozide, sulpiride) present stimulant properties at low dose and sedative effects at high dose whereas monopolar neuroleptics (levomepromazine, chlorpromazine) present from the low dose sedative effects. The stimulant properties might arise from a preferential blockade of the presynaptic dopaminergic receptors, giving and enhancement of the dopaminergic transmission. Risperidone might follow the bipolar model; we review the stimulant effects in laboratory animals and in clinical settings, showing exacerbation of manic symptoms and a possible antidepressive effect. These properties could be due to the capacity to increase the cerebral monoamines by the 5-HT2A and alpha 2 antagonism. Risperidone could be used in the treatment of clinical syndromes combining depressive and psychotic symptoms.

Antipsychotic Agents↗
PubMedDate not supplied

[Risperidone in the treatment of psychotic, affective and behavioral symptoms associated to Alzheimer's disease].

INTRODUCTION: A total of 235 patients with diagnoses of Alzheimer's dementia together with psychotic and/or affective symptomatology, as well as behavioral disturbances was included in an open label postmarketing surveillance study. The study objectives were to asses: 1) risperidone efficiency in psychotic and affective symptomatology and behavioral disturbances; 2) risperidone influence in the patient's performance, 3) dosage range at which efficiency is observed; and 4) safety in this group of patients. Patients were observed during a six month period. Risperidone was used at a mean dosage of 1.23 +/- 0.86 mg daily (range: 0.5-4.5 mg daily). MATERIAL AND METHODS: Risperidone was assessed by the Clinical Global Impression (CGI), Geriatric Depression Scale (GDS), Neuropsychiatric Inventory (NPI), Clinical Deterioration Rating (CDR), UKU subscale for neurological side effects and spontaneous reports. Patients were evaluated at baseline, 15 days and months 1, 2, 4 and 6. Sixteen patients (6.8%) were excluded from the statistical analysis due to protocol violation. Fifty four patients (24.7%) dropped out. RESULTS: Risperidone produced a significant improvement in the mean total scores of CGI, NPI, GDS (patient's satisfaction, hope.) and CDR (judgment and problem solving, community affairs, hobbies.) scales. Extrapyramidal symptoms improved from day 15 onwards in patients who had received antipsychotic treatment previously; in naive treated patients these symptoms did not change during the study period. CONCLUSIONS: Risperidone was well tolerated. Only 6 (2. 7%) discontinued treatment due to adverse events. Ninety seven percent of the patients did not suffer any adverse event; the resting 2.7% suffered one or more side effects: sedation (1.4%), constipation (0.5%) and vomiting (0.5%) among others.

Alzheimer Disease↗
PubMedDate not supplied

[Neurodevelopmental hypothesis in functional psychosis].

Evidence from several studies supports the neurodevelopmental hypothesis of schizophrenia. Others suggest a substantial body of evidence attesting to a possible neurodevelopmental origin of affective disorders. However, there is little evidence that any risk factor or neurodevelopmental marker is specific to any diagnostic category within functional psychoses. Some authors have proposed a new model which implies a continuity within the category of psychosis based on a psychopathological continuum. This research strategy has important and useful advantages which are discussed in this review.

Brain↗