Diapositiva 1

1
ENFERMEDAD DE ALZHEIMER
ACTUALIDADES TERAPEUTICAS
Dr. Rommel J Carrillo Várguez
2
DEMENCIA El término...
MARCO TULIO CICERON (106-43 a.C) Político,
orador, escritor, romano En su ensayo,, De
Senectute ... la pérdida de la memoria era
consecuencia de una enfermedad ajena a la
senectud...
Cicerón
3
ALOIS ALZHEIMER. El padre...
En Noviembre de 1901, se presenta una mujer de 51
años al departamento de psiquiatría de la
Universidad Johann Wolfang Goethe en
Frankfurt. Cuadro Clínico deterioro progresivo
de memoria, afasia, alucinaciones auditivas,
celotipia, paranoia, llanto frecuente e
incompetencia psicosocial.
AUGUSTE D
4
ALOIS ALZHEIMER. El padre...

• Alois Alzheimer, aborda y hace seguimiento por
  espacio de 2 años. realizando exploraciones
  clínicas y neuropsicológicas.
• 1903 Alzheimer se traslada a Munich.
• La paciente es seguida por médicos anónimos.
• 8 Abril 1906, fallece Auguste D. Se realiza
  necropsia cerebral.

ALOIS ALZHEIMER
Neurofibrillas
5
ALOIS ALZHEIMER. El padre...

• El 4 de Noviembre de 1906 durante
• XXXVII Conferencia de Psiquiatras Alemanes en
  Tubingen, se presenta el primer reporte
  anatomo-clínico de la futura enfermedad.
• Una enfermedad grave caracteristica de la
  corteza cerebral título de la publicación en
  1907

Dibujo Original
Microscopia Actual
6
ALOIS ALZHEIMER. El padre...

• En la cuarta edición de su
• TRATADO DE PSIQUIATRIA
• KRAEPELIN, hace mención por
• primera vez de los casos de Auguste D y otros
  como la
• ENFERMEDAD DE ALZHEIMER

7
Y AHORA QUE?
8
Introduction
Introduction
Annual report
Interesting links
Conferences on dementia
New on our site
Introduction
Research
Introduction
Palliative care
Introduction
EU funding
Introduction
Disability Forum
Introduction
Summary
General guidelines
Introduction
Disclosure of the diagnosis
Memory
Personal hygiene
Agitation and nervousness
Aggressive behaviour
Constipation
Self-help organisations
Background information
Introduction
What is it?
Aids Dementia Complex
Down's syndrome
Introduction
Provision of Care at home
Description
Introduction
2001
Join our mailing list
Guidelines
Care manual
Suggest a link
Suggest an event
European developments
Our opinion on...  
Involuntary placement
Psychotherapy
Our opinion on...  
Clinical trials
Alzheimer projects
Neurological Associations
Country reports
Full document
Mechanical restraint
Onset of the disease  
Dealing with emotions
Communication
Dressing
Anger
Clinging and following
Dental problems
Looking after yourself
EURODEM prevalence rates
Dementia definition
Who is affected?
Alcohol Related Dementia
Huntington's disease
Our full members
Lawnet
Manual
Our aims
2000
Tell us what you think!
Donations
Provision of care at home
Our latest activities
Relevant texts  
Incapable adults
EP Resolutions
Genetic testing
Social NGOs
Recommendations  
Physical restraint
Memory and Communication  
Care arrangements
Disorientation
Eating and drinking
Anxiety and fear
Embarrassing behaviour
Eyesight
Caring in the later stages
Statistics
Alzheimer's disease  
Is it hereditary?
Binswanger's Disease
Parkinson's disease
Our associate members
Intranet
Our statutes
1999
Ask Alzheimer Europe
Sponsorship
Children's book
Activities of our members
Working groups  
Biomedical research
Relevant texts
Pharmaceutical Industry
Guidelines on restraint  
Locking doors
Daily life  
Independent living
Personal relationship
Apathy
Failure to recognise people
Fits
Arranging residential care
Other forms of dementia  
Can it be predicted?
Creutzfeldt-Jacob Disease
Become full member
Care Manual
Our Board
1998
Financial statements
Conference proceedings
Research
Human rights and Biomedicine
European projects  
Advance directives
Tagging
Changes in mood  
Younger people with dementia
Activities and exercise
Brusque changes of mood
Hiding/losing objects
Hearing
Death and bereavement
Related disorders  
Diagnosis
Lewy-Body Dementia
Become associate member
Children's book
Our staff
Legal rights of patients
Other news
AE Networking  
Video surveillance
Changes in behaviour  
Safety
Having depression
Repetitive questioning
Incontinence
Brain tissue donations
Treatment
Multi-Infarct Dementia
ERICA
Annual reports  
Passive alarms
Medical and physical issues  
Living alone
Frustration
Sexually behaviour
Jerking movements
Main characteristics
Pick's Disease
Telephone Helpline  
Medication as restraint
Coping with caring  
Helping children to cope
Hallucinations
Sleeplessness
Moving the person with dementia
Three stages
Rural areas
Psychological restraint
Over-reaction
Wandering
Loss of manual skills
Current research
Early onset dementia
YOUR COMMENTS...
Pressure sores
De acuerdo las tendencias actuales de prevalencia
de (30-50) en mayores de 85 años EPIDEMIA

9
ALZHEIMER D. DE PICK CREUTZFEL-JACKOB
PRIMARIA
DEMENCIA
PARKINSON VASCULAR HUNTINGTON Alcohólica
SECUNDARIA
DETERIORO COGNOSCITIVO
DEPRESION DELIRIUM DISTIROIDISMO PSICOFÁRMACOS DEF
ICIT NUTRICIONAL
PSEUDO DEMENCIA
10
SIGLO XX.

• Criterios Diagnósticos
• Estudios Epidemiológicos
• Prevalencia a nivel mundial

11
FISIOPATOLOGIA
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Farmacológico

• Inhibidores de Colinesterasa
• INHIBIDORES NMDA
• memantina AKATINOL-

Vitaminas, oxigenadores cerebrales,
transfusiones de células de embriones
NO SIRVEN
15
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SOBRE ESTIMULACION
MEMANTINA (AKATINOL)
DAÑO NEURONAL
17
(No Transcript)
18
Introduction
Introduction
Annual report
Interesting links
Conferences on dementia
New on our site
Introduction
Research
Introduction
Palliative care
Introduction
EU funding
Introduction
Disability Forum
Introduction
Summary
General guidelines
Introduction
Disclosure of the diagnosis
Memory
Personal hygiene
Agitation and nervousness
Aggressive behaviour
Constipation
Self-help organisations
Background information
Introduction
What is it?
Aids Dementia Complex
Down's syndrome
Introduction
Provision of Care at home
Description
Introduction
2001
Join our mailing list
Guidelines
Care manual
Suggest a link
Suggest an event
European developments
Our opinion on...  
Involuntary placement
Psychotherapy
Our opinion on...  
Clinical trials
Alzheimer projects
Neurological Associations
Country reports
Full document
Mechanical restraint
Onset of the disease  
Dealing with emotions
Communication
Dressing
Anger
Clinging and following
Dental problems
Looking after yourself
EURODEM prevalence rates
Dementia definition
Who is affected?
Alcohol Related Dementia
Huntington's disease
Our full members
Lawnet
Manual
Our aims
2000
Tell us what you think!
Donations
Provision of care at home
Our latest activities
Relevant texts  
Incapable adults
EP Resolutions
Genetic testing
Social NGOs
Recommendations  
Physical restraint
Memory and Communication  
Care arrangements
Disorientation
Eating and drinking
Anxiety and fear
Embarrassing behaviour
Eyesight
Caring in the later stages
Statistics
Alzheimer's disease  
Is it hereditary?
Binswanger's Disease
Parkinson's disease
Our associate members
Intranet
Our statutes
1999
Ask Alzheimer Europe
Sponsorship
Children's book
Activities of our members
Working groups  
Biomedical research
Relevant texts
Pharmaceutical Industry
Guidelines on restraint  
Locking doors
Daily life  
Independent living
Personal relationship
Apathy
Failure to recognise people
Fits
Arranging residential care
Other forms of dementia  
Can it be predicted?
Creutzfeldt-Jacob Disease
Become full member
Care Manual
Our Board
1998
Financial statements
Conference proceedings
Research
Human rights and Biomedicine
European projects  
Advance directives
Tagging
Changes in mood  
Younger people with dementia
Activities and exercise
Brusque changes of mood
Hiding/losing objects
Hearing
Death and bereavement
Related disorders  
Diagnosis
Lewy-Body Dementia
Become associate member
Children's book
Our staff
Legal rights of patients
Other news
AE Networking  
Video surveillance
Changes in behaviour  
Safety
Having depression
Repetitive questioning
Incontinence
Brain tissue donations
Treatment
Multi-Infarct Dementia
ERICA
Annual reports  
Passive alarms
Medical and physical issues  
Living alone
Frustration
Sexually behaviour
Jerking movements
Main characteristics
Pick's Disease
Telephone Helpline  
Medication as restraint
Coping with caring  
Helping children to cope
Hallucinations
Sleeplessness
Moving the person with dementia
Three stages
Rural areas
Psychological restraint
Over-reaction
Wandering
Loss of manual skills
Current research
Early onset dementia
YOUR COMMENTS...
Pressure sores
Otras Opciones Farmacológicas
Combinación de aminoácidos de proteína Beta
amiloide con otros prótidos (AN 1792) en
1997. 1999 fase clínica 20 pacientes 2002 Fase
clínica II suspensión del protocolo por presencia
de meningitis aséptica en 15 pacientes ussuarios
Dublin, Irlanda
THE LANCET Neurology Vol 1 May 2002

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CONCLUSIONES
1- hay opciones farmacológicas reales 2-
RESULTADOS MODESTOS PERO NOTABLES 3- MEJORAN
SINTOMATICAMENTE, CONDUCTUALMENTE Y DETIENEN
EVOLUCION? 4- LOS PACIENTES DEBEN RECIBIR ESTOS
FARMACOS