Instituto Perdizes - HC/IPer
URI Permanente desta comunidade
Instituto Perdizes (IPer): Inaugurado em 8 de novembro de 2022. Construído no mesmo local onde funcionou por mais de 40 anos o Hospital Auxiliar de Cotoxó (HAC 1971-2011), espaço que precisou ser totalmente modernizado para abrigar os três blocos e 200 leitos de internação, distribuídos em área construída de aproximadamente 23 mil m². O primeiro bloco é um centro para tratamento de doenças relacionadas ao uso de álcool e drogas, com ambulatório, hospital-dia e unidade de internação; o segundo contempla a unidade de transição de cuidados, oferecendo assistência médica e multiprofissional a pacientes agudos não críticos, ensino médico de alunos de graduação e pós-graduação e desenvolvimento de pesquisas na área; e o terceiro, prevê um centro de tecnologia e inovação para maior eficiência do sistema de saúde. A Unidade de Transição de Cuidados, dotada com 120 leitos de internação, distribuídos em 60 enfermarias com 2 leitos cada, atende pacientes provenientes dos demais Institutos do HCFMUSP que necessitam de assistência em regime de internação para a efetiva transição de cuidados, visando a alta hospitalar e assim garantindo o acesso de leitos de alta complexidade desses Institutos para outros pacientes usuários do SUS que deles de fato necessitam. O Centro de Álcool e Drogas | Unidade especializada voltada à assistência, ao ensino, à pesquisa e ao desenvolvimento de metodologias de tratamento, reabilitação psicossocial e reinserção social às pessoas que fazem uso prejudicial de substâncias psicoativas (SPA). Estas atividades são distribuídas nas modalidades de internação hospitalar, assistência em hospital-dia e assistência ambulatorial. A Unidade de Internação atende pacientes provenientes, preferencialmente, do Instituto de Psiquiatria, dos demais Institutos e unidades do HCFMUSP e do Sistema Informatizado de Regulação do Estado de São Paulo (SIRESP) que necessitam de assistência médica global (psiquiátrica e clínica) em regime de internação. A Unidade Ambulatorial do Centro de Álcool e Drogas atende pacientes referenciados pelo SIRESP, pelo Instituto de Psiquiatria (IPq) e demais unidades que integram o HCFMUSP, bem como pacientes egressos da Internação e do Hospital-Dia do Centro de Álcool e Drogas do próprio Instituto Perdizes.
Site oficial: https://www.hc.fm.usp.br/hc/unidades/instituto-perdizes
Site oficial: https://www.hc.fm.usp.br/hc/unidades/instituto-perdizes
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- Instituto Perdizes - HC/IPer
- Instituto Perdizes - HC/IPer
- Instituto Perdizes - HC/IPer
Submissões Recentes
Psychopharmacology of smoking cessation medications: focus on patients with mental health disorders
(2023) CASTALDELLI-MAIA, Joao Mauricio; OLIVEIRA, Victoria Camargos de; IRBER, Flavia Mariana; BLAAS, Israel K.; ANGERVILLE, Bernard; MARTINS-DA-SILVA, Anderson Sousa; GIMENES, Gislaine Koch; CAMPOS, Marcela Waisman; TORALES, Julio; VENTRIGLIO, Antonio; GUILLOIS, Carine; OUAZZANI, Houria El; GAZAIX, Lena; FAVRE, Pascal; DERVAUX, Alain; APTER, Gisele
The adverse effects of smoking cessation in individuals with mental health disorders have been a point of concern, and progress in the development of treatment has been slow. The primary first-line treatments for smoking cessation are Nicotine Replacement Therapy, Bupropion, Varenicline, and behavioural support. Nortriptyline and Clonidine are second-line treatments used when the first-line treatments are not effective or are contraindicated. Smoking cessation medications have been shown to be effective in reducing nicotine cravings and withdrawal symptoms and promoting smoking cessation among patients living with mental disorders. However, these medications may have implications for patients' mental health and need to be monitored closely. The efficacy and side effects of these medications may vary depending on the patient's psychiatric condition, medication regimen, substance use, or medical comorbidities. The purpose of this review is to synthesise the pharmacokinetics, pharmacodynamics, therapeutic effects, adverse effects, and pharmacological interactions of first- and second-line smoking cessation drugs, with an emphasis on patients suffering from mental illnesses. Careful consideration of the risks and benefits of using smoking cessation medications is necessary, and treatment plans must be tailored to individual patients' needs. Monitoring symptoms and medication regimens is essential to ensure optimal treatment outcomes.
Women and MDMA: particularities of gender and sex
(2023) CAREZZATO, Fabio; ARRUDA, Ilana Falcao de; FIGUEIREDO, Caio Petrus Monteiro; CASTALDELLI-MAIA, Joao Mauricio
This comprehensive review delves into the intricate interplay between gender/sex and MDMA use, drawing upon recent evidence. It explores how girls, as a means of coping with negative emotions, often resort to drug use, while boys primarily initiate drug use due to peer pressure or sensation-seeking tendencies. Women, frequently having endured traumatic life events, may turn to MDMA as a form of self-medication. Notably, women face an elevated risk of contracting sexually transmitted infections due to their altered mental states and diminished condom use during MDMA consumption. Additionally, females exhibit heightened sensitivity to the subjective effects of MDMA, consistently reporting heightened anxiety, adverse effects, and negative side effects. While women may have a higher susceptibility to hyponatremia, intriguingly, they appear to be less vulnerable to MDMA-induced hyperthermia. Although limited, available data suggest that prenatal MDMA exposure could lead to motor delays in infants, necessitating further research to unravel the potential cognitive effects. Furthermore, MDMA-assisted psychotherapy holds immense promise for addressing post-traumatic stress disorder (PTSD) among female subgroups. These pronounced gender and sex disparities in MDMA use and its effects underscore the pressing need for additional research to develop tailored, effective, and safe treatment approaches that account for these fundamental factors.
Performance measures for alcohol and other drugs services: a commentary
(2023) AMARAL, Ricardo Abrantes do
Alcohol and other drugs treatment includes a wide range of service and personal characteristics, along with expected and unexpected barriers to treatment. To capture the benefits and the gaps of a designed treatment, one needs to consider process-of-care and outcome measurements. Process-of-care measures are mainly developments of the rationale proposed by The Washington Circle and capture all variants in the process-of-care as proportions. Outcome measures are strongly related to different concepts of recovery and described as simple yes/no answers type to wide levels of response, such as in Likert-type scales. According to the studies collected here, more realistic periods of data-collection for process-of-care measures and a more reliable format to capture outcome particularities should be designed.
Bariatric surgery and it influence in alcohol consumption-differences before and after surgery, a systematic review and meta-analysis
(2023) VIDES, Mariana Capelo; OLIVEIRA, Mariana Campello de; LASSI, Dangela Layne Silva; MALBERGIER, Andre; FLORIO, Ligia; PERICO, Cintia de Azevedo-Marques; AMARAL, Ricardo Abrantes do; TORALES, Julio; VENTRIGLIO, Antonio; NEGRAO, Andre Brooking; CASTALDELLI-MAIA, Joao Mauricio
BackgroundThrough new publications on the subject, the main goal of this article is to seek a change in the pattern of alcohol use before and after bariatric surgery.MethodsWe searched the National Library of Medicine, CINAHL, and PsycINFO databases. We included original articles regarding alcohol consumption before and after bariatric surgery to conduct the systematic review.ResultsOur systematic review, which included 18 articles, yielded mixed results. Meta-analysis of six articles did not reveal statistically significant differences in alcohol use behaviours before and one year after bariatric surgery. However, throughout the perspective of follow-up after bariatric surgery, nine out of the twelve articles showed improvement in the pattern of alcohol consumption when evaluated up to two years after the end of the surgical period, and four out of the five articles with monitoring beyond two years showed worsening in consumption, compared to pre-surgery alcohol use behaviours.ConclusionsConclusions about the relationship between alcohol consumption and bariatric surgery are challenging primarily because of the variety of the methods used and the alcohol consumption measures. Despite that, our research pointed to an increased risk of alcohol use disorders two years after bariatric surgery.
BRAF-testing medical education needs in Latin America
(2023) CASTALDELLI-MAIA, J. M.; GIMENES, G. K.; PERROTTE, G.; GONZALEZ, S.; OKASSOVA, A.; MALVIDO, K.; TORALES, J.
Cannabis use influences disorganized symptoms severity but not transition in a cohort of non-help-seeking individuals at-risk for psychosis from Sao Paulo, Brazil
(2024) MEDEIROS, Matheus Wanderley de; ANDRADE, Julio Cesar; HADDAD, Natalia Mansur; MENDONCA, Melina; JESUS, Leonardo Peroni de; FEKIH-ROMDHANE, Feten; BILT, Martinus Theodorus van de; GATTAZ, Wagner Farid; LOCH, Alexandre Andrade
Background: Cannabis use is associated with an increased risk of developing a psychotic disorder. However, in individuals with at-risk mental states for psychosis (ARMS) this association is not clear, as well as the impact of cannabis use on symptom severity. The objective of this study was to evaluate the association of cannabis use patterns and ARMS risk status, transition to psychotic and psychiatric disorders, and psychopathology.Method: A sample of 109 ARMS and 197 control individuals was drawn from the general population. Lifetime, maximum and current amount of cannabis use were assessed with the South Westminster modified questionnaire. Participants were followed-up for a mean of 2.5 years and reassessed for transition to any psychiatric disorder. Results: There were no differences between ARMS and controls regarding lifetime use, current amount of use, or maximum amount of cannabis use. There were also no differences between those who transitioned to a psychiatric disorder and those who did not regarding cannabis use variables. In ARMS individuals, cannabis use was significantly related to disorganization symptoms.Conclusion: The results of this study suggest that cannabis plays a role in the psychopathology of ARMS individuals, leading to more severe symptomatology.
Os efeitos de um treinamento sobre humanização entre médicos comparados a não médicos
(2023) MARTINS, Clara Barbosa; ALMEIDA, Jouce Gabriela de; MALBERGIER, André
Abstract: Introduction: The medical category has been considered of little competence regarding the attributes related to humanization. As such, changes have been made in the course curriculums of undergraduate medical courses in Brazil and worldwide to expand the Humanities disciplines. In addition to these initiatives, humanization training is needed for doctors who graduated under the aegis of old curriculums and for those who - even though they graduated with the new curricular guidelines - still need to be updated on the subject. There are few quantitative studies about humanization training, especially for medical doctors. Objective: To evaluate the effects of humanization training on doctors in comparison with non-doctors. Method: Humanization trainings lasting 135 minutes were conducted for doctors and non-doctors in a psychiatric university hospital in São Paulo (Brazil). The classes were conducted with the use of slides and included discussions and a role-playing activity. The research subjects answered a questionnaire with 34 items assessing their self-perceptions about the knowledge, skills and attitudes in humanization before and 15 days after the training. Nonparametric tests were used to compare the scores between the group of doctors and non-doctors. Moreover, multiple linear regressions were performed for the knowledge, skills and attitude dimensions aiming to evaluate whether there was a significant difference between genders, age ranges, marital status, number of children, jobs, religion, years of service. Result: Medical professionals and those with six or more years of service had lower humanization scores at the pre-training moment. The training resulted in an increase in humanization scores in all professional categories, but physicians showed a greater increase and reached the same level as the other categories. Conclusion: A fast and low-cost training resulted in an increase in the self-perception of humanization in doctors and non-doctors. The difference between the professional categories ceased to exist in the evaluation carried out 15 days after the training. The results suggest that doctors can increase their self-perception about humanization and reach the same level as other professionals.
Drug use among medical students in São Paulo, Brazil: a cross-sectional study during the coronavirus disease 2019 pandemic
(2024) LEMOS-SANTOS, Pedro; BLUMRICH, Lukas; DEBIA, Jordi Blanes; CASTALDELLI-MAIA, Joao Mauricio; SUEN, Paulo Jeng Chian; MALBERGIER, Andre
BACKGROUND: Medical students demonstrate higher rates of substance use than other university students and the general population. The challenges imposed by the coronavirus disease 2019 (COVID-19) pandemic raised significant concerns about mental health and substance use.OBJECTIVES: Assess the current prevalence of substance use among medical students at the University of Sao Paulo and evaluate the impact of the COVID-19 pandemic on drug consumption.DESIGN AND SETTING: A cross-sectional study was conducted on 275 medical students from the UniverMETHODS: Substance use (lifetime, previous 12 months, and frequency of use before and during the COVID-19 pandemic) and socioeconomic data were assessed using an online self-administered questionnaire. Symptoms of depression were assessed using the Patient Health Questionnaire-9. RESULTS: Alcohol was the most consumed substance in their lifetime (95.6%), followed by illicit drugs (61.1%), marijuana (60%), and tobacco (57.5%). The most commonly consumed substances in the previous year were alcohol (82.9%), illicit drugs (44.7%), marijuana (42.5%), and tobacco (36%). Students in the first two academic years consumed fewer substances than those from higher years. There was a decreasing trend in the prevalence of most substances used after the COVID-19 pandemic among sporadic users. However, frequent users maintained their drug use patterns.CONCLUSION: The prevalence of substance use was high in this population and increased from the basic to the clinical cycle. The COVID-19 pandemic may have affected the frequency of drug use and prevalence estimates.
Pharmacological Treatment of Alcohol Cravings
(2023) MARIN, Matheus Cheibub David; PEDRO, Maria Olivia Pozzolo; PERROTTE, Giuliana; MARTINS-DA-SILVA, Anderson S.; LASSI, Dangela L. S.; BLAAS, Israel Kanaan; CASTALDELLI, Fernando Ikeda; SANTOS, Maria Beatriz Brisola dos; KORTAS, Guilherme Trevizan; CAMPOS, Marcela Waisman; TORALES, Julio; VENTRIGLIO, Antonio; PERICO, Cintia de Azevedo-Marques; NEGRAO, Andre B.; LEOPOLDO, Kae; ANDRADE, Arthur Guerra de; MALBERGIER, Andre; CASTALDELLI-MAIA, Joao Mauricio
(1) Background: The treatment of substance addiction is challenging and has persisted for decades, with only a few therapeutic options. Although there are some recommendations for specific treatments for Alcohol Use Disorder (AUD), there is no specific medication used to treat alcohol cravings, which could benefit millions of patients that are suffering from alcoholism. Cravings, or the urge to use drugs, refer to the desire to experience the effects of a previously experienced psychoactive substance. (2) Methods: We included original studies of alcohol abuse or dependence extracted from a controlled, blind, pharmacological treatment study which presented measures and outcomes related to alcohol cravings. (3) Results: Specific drugs used for the treatment of alcoholism, such as Naltrexone and Acamprosate, have had the best results in relieving craving symptoms, as well as promoting abstinence. Baclofen and anticonvulsants such as Gabapentin and Topiramate have shown good results in promoting abstinence and the cessation of cravings. (4) Conclusions: Specific drugs used for the treatment of alcoholism to obtain the best results can be considered the gold standard for promoting abstinence and relieving cravings. Anticonvulsants and Baclofen also had good results, with these medications being considered as second-line ones. Varenicline is an option for alcohol dependents who also concomitantly ingest tobacco.
Transtornos alimentares
(2023) MARIN, Thaís Muriel; MORIKAWA, Márcia