Sistema Regional de Información
en línea para Revistas Científicas de América Latina,
el Caribe, España y Portugal

The development of "atypical" or "second generation" antipsychotics, generated great expectations from the 1990s, as they were attributed more efficacy and tolerability than the "typical", "classic" or "first generation" antipsychotics, due mostly to the impact of a huge advertising campaign by the pharmaceutical industry. However, different studies have not been able to prove, in a categorical way, the alleged superiority of that group of drugs in terms of efficacy, prevention of relapses or production of adverse effects. On the other hand, the classification of "classic" and "atypical" antipsychotics cannot be supported either by factors such as chemical structure, mechanisms of action, costs or years in the market, , given the heterogeneity that both groups exhibit. For such reasons, it is suggested that the existing dichotomy should be ruled out.

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Risperidone is a selective monoaminergic antagonist with a high affinity for dopamine receptors that can cause neuroleptic malignant syndrome (NMS), considered a life-threatening medical emergency. It has an incidence of up to 3% and its mortality is between 10 and 20%. The case of a 56-year-old female who met the clinical criteria of NMS, induced by the use of risperidone and facilitated by a sepsis of urinary origin, is reported. It was managed with a dopamine agonist and the change of antipsychotic, which resulted in a favorable clinical course. The NMS is a low-prevalence entity whose diagnosis has specificity and sensitivity greater than 90%, reason for which must be clearly differentiated from other pathologies. The mechanism by which urinary infection could facilitate the occurrence of this disease is discussed. Early diagnosis improves the response to an adequate management to be established in each case.

The case of a 32 years old. male patient who since age 17 has experienced constrictive headaches of several minutes’ duration, triggered by physical effort is reported. For the last seven years there, he has presented a progressive cognitive decline cognitive, and marked personality changes, having become extremely dependent even for conducting elemental activities. At the age of 27, he experienced total left hemiplegia from which he completely recovered in two weeks. He also shows severe confusional states and child-like behavior. Laboratory tests ruled out heart disease, atherosclerosis and systemic autoimmune diseases. Brain neuroimaging tests (CT, Angio – TEM and contrasted cerebral MRI) revealed the occurrence of six cerebral infarcts, in subacute and chronic stages, severe stenosis of the anterior cerebral arteries, and presence of microaneurysm in the M segment of the left middle brain artery. A limitation of this report is the absence of a study with digital angiography, due to economic difficulties. In short, the case of a patient with chronic headache associated with progressive dementia is presented, with neuroimaging and neuropsychological tests that support the diagnosis of of cognitive impairment associated with Moyamoya disease.

Neuroleptic malignant syndrome is a rare and potentially fatal drug adverse reaction, usually associated with antipsychotics. Signs and symptoms include: fever, muscle rigidity, altered mental status and autonomic dysfunction. Laboratory findings are nonspecific, however the presence of leukocytosis and elevated creatinine phosphokinase are frequent findings. We present the case of a 51-year-old male patient from Lima with a medical history of pulmonary tuberculosis and schizophrenia that comes to our hospital with psychotic symptoms. After being treated with ziprasidone, administered by intramuscular injection presents with typical symptoms of neuroleptic malignant syndrome. Knowing the clinical features and the pathophysiology of this syndrome will allow us to better approach the condition. Due to its infrequent presentation, it may not be considered within the differential diagnosis, which could be harmful to the patient.

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The work of the Anglo-Saxon criminologist and sociologist, David Garland, is undoubtedly internationally recognized for his study of penal policies in contemporary societies. Particularly, Garland began writing about penal welfarism and the crisis of the welfare state, to currently devote himself to the study of new control devices, new demagogic practices exercised by electoral candidates, and the degree of punitivism of public officers under the concept of Penal State arguing that the greater autonomy from society and elected representatives they have, the less punitive the action of the State itself will be. Regarding this, in this work we will have the intention of demonstrating that, from a Latin American reading of the behavior of the officers who administer the penal policies starting from the case of Argentina, his thesis that greater autonomy makes less punitivism does not reach all the contexts.

The present investigation focuses on the analysis of competition between US laws, where the competitive system among the 50 States has been in force for more than a century, and aims to highlight areas of uniformity and differences with respect to the European model. Among the latter, particular weight is given to the absence of US federal corporate models, which goes hand in hand with the constant choice of specific states historically “favorable” to the establishment of corporate entities, such as Delaware, which are particularly appealing to individuals, also thanks to the establishment of sophisticated judicial infrastructures that see the presence of highly specialized courts, competent to settle disputes only in corporate matters.