INVESTIGADORES
GARGIULO Pascual Angel
libros
Título:
Psychiatry and Neurosciences. Translational Approaches.
Autor/es:
GARGIULO, P.A. (EDITOR); MESONES ARROYO, H.L. (EDITOR)
Editorial:
Springer
Referencias:
Lugar: New York / Zurich; Año: 2017 p. 550
ISSN:
978-3-319-53125-0
Resumen:
978-3-319-53125-0 2017. As in the previous volume, the present state of the art in the knowledge of motivation or causality and the treatment of mental disorders is reviewed by researchers working in different fields who are trying to communicate what,classically, has not been well communicated, that is, the integration of basic neuroscience findings and clinical approaches to mental disorders.Furthermore, the correlation between clinical approaches and their anthropological basis is outlined here. Once again we try to avoid the lack of integrationbetween anthropology, clinical practice, and basic neuroscience.Here we offer an opportunity for the meeting of different disciplines that study human beings and their normal behavior. In these pages, laboratory findings, clinical practice, and comprehensive anthropology are integrated.Emerging ideas, different from the mere chemical-physical-mathematical concept, are proposed here. Also, the difference between understanding and explaining human mental illness is emphasized. Our main intention is to provide a bridge between different disciplines, integrating different points ofview.As in the previous volume, new trends in different fields converge in the pages of this volume. Basic studies, clinical evidence, and heuristic discussions are here drawn into a multidisciplinary confluence that opens a rich dialogue. An open forum is proposed here, with the aim of consolidating integration. Illustrative examples of lines of research originating from different areas are shown here. Additionally, invited authors come from different geographical areas and very different disciplines, providing the opportunity for an open ambit to study human behavior as a whole.The book has been designed, as was the previous one, with the aim of reaching a large number of readers. Primarily oriented to researchers and mental health professionals, the material here may prompt the actualization or initiation of studies of human behavior. In this sense, the present pages are directed to academics and students. Some chapters also deal with education strategies that are related to the application of neurosciences in teaching practice.Physicians may find here representative information in the field of neurosciences and its application to everyday practice. The effort to integrateknowledge is a difficult preoccupation for us.As in the previous volume, the book is divided into four main sections.The first section is dedicated to the philosophical, epistemological, and anthropological basis of the study of human behavior. The intention is, again,to avoid reductionism, offering a place for comprehensive psychology. This first section starts with a significant chapter by Miriam Dolly Arancibia deCalmels, who writes regarding the phenomenology of the encounter.Commenting on the ideas of Jozéf Tischner, she draws an interesting reflection on some recent manifestations of human individualism. A Manichean position related to fundamentalism, xenophobia, and other violent phenomena is here described and lucidly analyzed. The notion of encounter in Tischner is analyzed in the context of his proposal; i.e., giving to the other human being in the encounter his or her full value and meaning. This encounter with another and the involved variables of the other person are the subject of an exhaustive analysis. Some expressive windows are opened here byDolly Arancibia de Calmels.The second chapter, by Ivana Anton Mlinar, is dedicated to the role of corporality in psychopathology. It is postulated here that the notions of self and intersubjectivity have a clear link with corporality, and that these notions began to develop in pre-linguistic periods. It is postulated that these notions are present in psychiatric illnesses, even in its more dramatic forms. The relevance of these notions is highlighted, resolving the dichotomies between bodily functions and mental states, enhancing the value of concrete, bodily existence and suggesting its possible role in therapy. Ivana Anton Mlinar providesinteresting reflections here.In the third chapter, Professor Pablo Emanuel García proposes a bridge between neurosciences and philosophy, similar to that initiated between neurosciences and psychiatry. The proposal is highly interesting, avoiding the reduction of the first to the second, and vice versa. He proposes Dan Zahavi s phenomenology of mind as a valid way to continue the analytic tradition in the field of the philosophy of mind. The Zahavi proposal is presented in four steps. Firstly, García clarifies the term ?phenomenology?. Secondly, he makes a distinction between first- and third-person perspectives, the first related to the phenomenology proposal, the second related to a neuroscience framework.As the third step, Pablo García explains the methodological stages assumed by Zahavi from the Husserlian phenomenological tradition. As the fourth step, a naturalization of phenomenology is proposed, aiming to facilitate a dialogue between science and philosophy. The chapter is dense, rigorous,and relevant. Pablo García reviews a renewal of the phenomenological approach and establishes a bridge between science and phenomenology,incorporating the criteria of Zahavi.The fourth chapter, written by Professor Ricardo F. Crespo, is dedicated to the exploration of a possible philosophical proposal, tending to a non-physicalist conception of mind, here considered reductionist. Crespo proposesa classical philosophical frame. He refers to Aristotelian hylomorphism,considering it as providing an adequate non-reductionist perspective. Finally,Crespo maintains that, in the opinion of contemporary Anglo-Saxon professional philosophers, a physicalist reductionist position in the philosophy of neurosciences is not unanimous. The position defended by Ricardo Crespo,written in an elegant and precise style, prevents excesses of reductionism.In the fifth chapter, Jorge Martínez Barrera analyses the question of the soul in Aristotle, drawing a comparison with proposed contemporary body-mind relationships. Physicalist reductionism is analyzed, and proposed limitations are discussed. Martínez Barrera maintains that one limitation of this concept is that it reduces the explanation of mental activity and freechoice to neurological conditions. Additionally, he postulates that physicalist reductionism does not allow other possible explanations that would leadbeyond the determinism of the neurosciences. The chapter is well designed and written with rigor and precision, in a pure style. It constitutes a relevantexamination of the true extent of the attempt to explain mental events and human actions neurologically.The sixth chapter, by Ricardo Aranovich, analyzes the ideas of Ortega y Gasset about what that author defines as the project of life. This proposition starts with Ortega s ideas concerning what is man. Ortega maintains that manis his life. The life project must be analyzed in this context. Here, the lifeproject is what a man is already doing in his life. The notion of vocation is analyzed in this framework. Vocation is a doing responding to a defined wish,in form and objectives. When a vocation is followed, it leads to satisfaction,independently of results. Aranovich analyzes the loss of contact with us, with ourselves, as underlying the current cultural crisis. He concludes by analyzing the notions of vocation and the life project. He maintains that the lifeproject must be the expression of vocation, and that it should be considered as a fundamental objective in psychotherapy. It should be, in a wider sense,an objective of living in general. Aranovich?s analysis constitutes an interesting effort to use the philosophy of Ortega y Gasset in psychotherapy.In Chap. 7, Gilberto Gamboa-Bernal proposes a brief bioethical perspective of work in healthcare. He considers that the delivery of medical services has become a real business and this is considered an actual distortion in the field of health. The emergence of this kind of new healthcare system is analyzed from a bioethical point of view. Scientific and medical requirements,such as technical competence and human skills, that are necessary in the persons dedicated to health services are analyzed here, together with a remembrance of the Hippocratic tradition and its implications in contemporary medicine. This chapter is, interestingly, dedicated to the humanization of health services, and Gamboa-Bernal outlines here a very interesting proposal.Chapter 8 is dedicated to a discussion of the instrumentalization of human faculties. Luis Echarte maintains that, in the present post-emotional society,human faculties (rationality, affectivity, and will) are instrumentalized, with a new modern moral paradigm leading to this instrumentalization. Echarte analyzes three types of psychological problems dealing with inauthenticity:those related to: (a) the artificial origin of emotions, (b) the physical nature of emotions, and (c) the episodic coherence of emotions. Finally, he proposes solutions to these problems. In this context, the presence of cosmetic psychopharmacology is deplored. The chapter, well documented, is an example of rigor.The first section of the book ends with Chap. 9. This chapter is an invitation to rethink two terms in classical psychology: ?identity? and ?personality?.The chapter, written by Francisco Guell, Javier Bernacer, Pilar de Castro-Manglano, Gonzalo Arrondo, and José Ignacio Murillo, constitutes an interesting discussion of these topics. Authors from a Mind-Brain research group, a department of psychiatry, and a department of philosophy converge in the consideration of these relevant concepts. Psychiatric diagnoses and classifications are analyzed. The case of dissociative identity disorder (DID)is a particular focus, emphasizing the relevance of a dialogue between philosophy and psychiatry. The authors postulate that the concept of person in John Locke s philosophy is a relevant influence in this regard. This philosopher conceived the person as an apparent expression of consciousness and memories. The authors of the chapter maintain that this concept has led to some problems and misunderstandings, dissociating mental activities from the body. A dialogue between psychiatry and philosophy is postulated and favored here, in a very profound and interesting chapter.The second section of the book is dedicated, as in the first volume, to basic neuroscience. Some paradigmatic examples of lines of research that are conducive to interesting extrapolations are included here. They may serve asexamples of the continuity that we are trying to show in building the bridges between basic and clinical findings. The preclinical value of these lines of research is evident. They are closely related to the mechanisms and preclinical evidence of ?, and may contribute to the clarification of several variables related to mental illnesses. Extrapolation of the research findings to clinical conditions is evident here. These lines of research may contribute to the explanation of somatically based illnesses, and they may also contribute to the understanding of some aspects of psychoreactive disorders. Considering the near future, these studies may also contribute to current research projects in these areas.The second section of the book starts with Chap. 10, which is dedicated to exploring the effects of emotional stress on astrocytes. The implications of these effects in stress-related disorders are also considered. The authors of the chapter, Christian Bender, Gastón Calfa, and Víctor Molina, note the role of stress in the etiology of several psychiatric disorders, where it is considered a major risk factor. The authors review evidence on the role of morphological and functional changes of astrocytes in basic stress-related models and the extrapolation of this evidence to mental disorders. The concept of behavioralsequelae and their relationships with astrocyte changes, and the corresponding relationship with psychiatric illnesses, are here developed in an interesting manner. Important new lines of evidence are considered, giving remarkablevalue to this chapter.In Chap. 11, Jorge Aquino adds significantly to the information provided in the previous chapter, writing on the role of the glia in health and disease.New unexpected roles of the main glial subtypes are discussed. The role of glia in learning, memory, fear conditioning, long-term potentiation, and somecomplex neurocognitive functions is developed here. The mechanisms involved at the cellular and systemic levels led the author to review glial-neuron and glial-glial interactions. Additionally, Aquino postulates that human brain evolution required the concomitant evolution and specialization of glia, in order for these cells to interact with neurons. The role of glia in psychiatric disorders is reviewed and considered in the light of recent evidence,including that in the field of embryogenesis. The chapter is precise,elegant, and informative.In Chap. 12, Walter Manucha describes the protective role of nitric oxide pathways on the neurotoxicity mediated by glutamate-induced apoptosis.Important lines of evidence suggest the involvement of oxidative stress in neurodegenerative diseases. The author postulates, giving solid evidence, aclear deregulation of the mitochondrial respiratory mechanism in patients with neurodegeneration. Protection against neurotoxic effects is related to mitochondrial respiratory mechanisms. In this context, inflammation and apoptosis are clearly related. The nitric oxide pathways appear to be mediating modulation, preventing oxidative damage to neurons, inhibiting apoptosis.This chapter is solid and well documented, constituting a relevant source of new findings.Chapter 13, written by Gustavo Tafet, is dedicated to exploring the interaction of psychoneuroendocrinological and cognitive variables in the interface of chronic stress and depression. The chapter is directed to the explanation of converging stress factors. The role of chronic stressful experiences, in adulthood and early-life events, may produce activation of the hypothalamic-pituitary-adrenal(HPA) axis. This activation leads to the increased synthesis and release of corticotrophin-releasing hormone (CRH) and cortisol.Furthermore, chronic stressful experiences appear to be associated with functional changes in certain limbic structures, such as the amygdala and hippocampus,and changes in different monoamine and indoleamine systems.Evidence regarding these mechanisms is provided here in an elegant and interesting form by Tafet.In Chap. 14, written by a group led by Claudia Bregonzio and Gustavo Baiardi, the cognitive alteration induced by psychostimulants is studied,focusing mainly on the role of angiotensin AT1 receptors. The other members of the group are: Natalia Marchese, Osvaldo Martin Basmadjian, and Victoria Belén Ochieppo. These authors outline the role of dopamine and other monoamines and their relationship with psychostimulants. The actions of these drugs on learning and memory are also presented, in a novel form. The effects of amphetamines on several brain areas, and the corresponding effects on learning and memory, are detailed here. The authors comment here on theirown lines of research, with recent evidence, and a solid bibliography.In Chap. 15, written by some members of the same group that wroteChap. 14; Claudia Bregonzio, Natalia Andrea Marchese, María Costanza Paz,Emilce Artur de la Villarmois, Gustavo Baiardi, and Mariela Fernanda Pérez,the previous notions are expanded. The extent of the neuroadaptive responses to psychostimulant drugs is presented. In this chapter, dopamine innervated areas (the caudate putamen, nucleus accumbens, substantia nigra, hypothalamus,and ventral pallidum) that express high AT1 receptor density are studied.The recent findings of the authors show the relevant role of angiotensin II AT1 receptors induced by amphetamines in neuroadaptative behavioral and neurochemical changes. The authors report alterations in the components of theren in angiotensin system (RAS) and in the functionality of AT1 receptors observed after amphetamine exposure. This chapter constitutes an interesting and bright example of preclinical lines of research explaining drug effects.In Chap. 16, the team directed by Carlos Tomaz develops present evidence linking habit learning and addiction. This study was written by Antonella Gasbarri, Enrico Patrono, Asunta Pompili, Hisao Nishijo, and Carlos Tomaz.The relevance of the mesocorticolimbic reward system is emphasized and analyzed in a detailed form. The involvement of different brain areas and circuits in regard to cognitive functions is studied, and the authors outline the relation of motivation and memory to the above reward system. For years,this research group has made continuous and transcendent contributions to the theme of drug effects on the brain. The effects of addiction on different behavioral patterns and their corresponding brain structures are here lucidly considered, in a very original manner.Chapter 17 is dedicated to the role of stress in the dynamic of fear memory.This chapter, written by Gastón Calfa, Marcelo Giachero, and Víctor Molina, constitutes an interesting approach from the synaptic-cellular phenomena observed in preclinical approaches to psychiatric illnesses. The role of mnemonic processing is studied in close relationship to aversive neuronal circuitries. The role of these structures in the modification of behavioral responses is developed, and the implications of long-lasting emotional memories are discussed and analyzed. The fact that in some cases perturbations of the modulator mechanisms involved in adaptive responses become excessive or inappropriate is here brightly analyzed, and the relationship of these perturbations to clinical reality are interestingly commented on.In Chap. 18, written by Aline Caron Borges, Renata Duarte, and MariliaBarros, an interesting effort is made in aiming to establish a relationship between palatable foods and drug addiction. The intention of these authors isto show evidence of the mechanisms underlying addiction-like behaviors.The roles of hormones and the hedonic drive are analyzed as being related to addictive processes. The authors focus on ?food addiction? and ?food-related binge-like? and ?craving? behaviors, and a very interesting parallelism is established. The role of the hedonic drive in ?overriding? a homeostatic system is postulated. An interesting group of different animal models is then discussed. The relationship between food addiction, binge eating, and reward,and the correlation to findings in animal models, constitute the main line of discussion in this interesting chapter.Chapter 19, written by Laura Pérez-Caballero, Sonia Torres Sánchez, JuanAntonio Micó, and Esther Berrocoso, constitutes an interesting approach to deep brain stimulation (DBS) as a tool for use in patients with severe depression.Since statistics show that a high percentage of patients with depression are refractory to treatment, new strategies should be tried in this population.The postulated mechanisms of DBS are interestingly analyzed in view of recent evidence. The role of the involved brain areas (ventral capsule/ventral striatum, nucleus accumbens, subgenual cingulate cortex, lateral habenula,medial forebrain bundle, and inferior thalamic peduncle) is here detailed in an interesting manner by a group with wide experience in this research area.In Chap. 20, written by Jens Helmert and Sebastian Pannasch, parameters and mechanisms of eye movements are interestingly described and analyzed.The dynamics of the complex interaction of several types of eye movements are studied and discussed. The involvement of several components of these movements with different tasks (orienting in space, identifying objects, interacting with persons) is also discussed. The main characteristics of fixations and saccades in the context of active vision are developed. An analysis of the duration of fixations and amplitude is developed as a possibility to gain insights into the processing of visual information. Attention is a parameter closely related to these phenomena. Perception of context is involved in this discussion by a solid research team.Chapter 21 constitutes in some senses, an extension of the previous chapter.In this chapter, Gerardo Fernandez, Paola Buedo, David Orozco, and Osvaldo Agamennoni, analyze eye movement as a strategy to study cognitive performance. The relationship of this line of research to pathologies is also considered. Eye movements are analyzed. The interest, as signaled in the immediate posterior sentences, is to have applications in clinical research in mild cognitive impairment, Alzheimer disease and schizophrenia. The value of these techniques in the early diagnosis of mental illnesses is discussed.This research group opens interesting windows to clinical research.In Chap. 22 , the last chapter in section two of the book, psychotropic medication in the elderly is interestingly analyzed. This chapter, written by Alicia del Carmen Panini, Mauricio Roberto Teves, Emiliano Giraudo,Marisa Hilda Garraza, and Claudia Patricia Calderón, constitutes a very interesting approach to clinical pharmacology in a very vulnerable patient group.Problems in the use of different medications are analyzed in a very strict manner.This is an elegant study of treatment approaches in the elderly, in terms of polypharmacy, adverse drug reactions, drug interactions, medicalization,and the rational use of medicines. The authors discuss different areas of pharmacology in regard to drug use in elderly people and the consequences of this drug use. This study shows the wide knowledge and experience of this group.The third section of the book, consisting of Chaps. 23 and 24, is mainly dedicated to the relationship between neurosciences, education, and the dialogue with the social environment. Topics such as learning and teaching are discussed in relation to studies of the relevance of social variables. The study in the first chapter of this section develops ideas about cognitive stimulation to be used mainly in those who are socially vulnerable. The second chapter reports research on psychological suffering in the world of work. Some ways to improve learning are delineated in the first study, and possibilities of improving work conditions are delineated in the second. Both give interesting ideas to prevent the relevant problems.Chap. 23, written by Celina Korzeniowski and Mirta Ison, provides an interesting description of cognitive stimulation programs in children. Some interventions are proposed for children growing up in disadvantaged socioeconomic conditions. The objective is to stimulate cognitive control capacities,with the idea of counteracting the adverse effects of poverty on children in need. Here two cognitive stimulation programs promoting executive functions(EFs) in Argentine children are reported. The efficacy of this treatment,which aims to narrow the gaps in cognition associated with conditions of poverty, is discussed. The implications of the treatment reported here are very relevant for future generations.Chapter 24 is oriented to the study of the world of work. The authors,Melisa Mandolesi, Carlos Bonantini, Víctor Quiroga Calegari, María Romina Cattaneo, and Miguel Gallegos, studied psychological suffering in the staff of an electrical services company. This chapter, immersed in the world of mental health, focuses on some variables using the authors? own standardized instrument. This study continues a previous one, studying psychological stress in those employees who must meet the demands of customers. These employees, in some cases, must deal with customers? annoyance regarding services or costs. The study results showed important levels of psychological distress and suffering. This chapter is highly relevant to work conditions.The fourth section of the book is dedicated to the study of the neuroscientific evidence of psychiatric illnesses, psychoses in the sense of Kurt Schneider; that is, mental illnesses of the body or somatic base, caused by somatic alterations. The somatic illnesses described here cause behavioral disorders. The way to study them is to ?explain? (?erklaren?).The first study in this section, in Chap. 25, initiates approaches to the etiology of schizophrenia. Written by Ane Murueta-Goyena-Larrañaga, Harkaitz Bengoetxea Odriozola, Pascual Ángel Gargiulo, Naiara Ortuzar, and José Vicente Lafuente Sanchez, the chapter describes the neuropathological findings related to Dizocilpine (MK-801) murine models of schizophrenia. The relevance of neuropathology in schizophrenia is clearly established in this chapter, and the interactions of glutamate and gamma aminobutyric acid(GABA) are described and related to schizophrenia. The involved brain circuitries are described in a detailed manner. Additionally, the neurophysiological phenomena present in schizophrenia are here related to modifications in some neuron populations. The authors also note altered gamma-band oscillations in schizophrenic patients, drawing attention to a possible deficit in fast-spikingparvalbumin-expressing interneurons related to the illness. This chapter constitutes an effort to link basic and clinical evidence, and structuraland functional facts.In Chap. 26, presented by Alyssa Sbisa, Maarten Van Den Buuse, andAndrea Gogos, the effect of estradiol and its analogues on cognition is reviewed, with the effect evaluated in preclinical and clinical studies. The relevance of these findings to schizophrenia is raised. The authors start from epidemiological and clinical evidence, suggesting a relevant role of estrogen in schizophrenia. They also mention a growing body of literature suggesting the possibility of estrogen therapy in this illness. The roles of the sex steroid hormone 17β-estradiol and selective estrogen receptor modulators (SERMs)are mentioned and developed. This is really an advanced and interesting article by this solid team.Chapter 27 constitutes a very interesting review of neuropsychiatric symptoms related to cholinergic deficits in Parkinson s disease (PD). The authors,Santiago Pérez-Lloret, María Cecilia Peralta, and Francisco Barrantes, point out that in this illness not only dopaminergic neurons die. Recent findings have shown that neurodegeneration is also present in noradrenergic, serotoninergic,cholinergic, and other monoaminergic neuronal populations. In this chapter, the role of cholinergic deficits underlying cognitive dysfunction,psychosis, and sleep disturbances in PD, and the corresponding treatment, are widely explained. Studies of different drugs in related fields are also reported.This is a chapter written by a research group who have been generating recent interesting findings in the field. The authors of Chap. 28, Philipp Singer and Benjamin Yee, analyze a possible new approach for schizophrenia treatment. Following the glutamate evidence,they study here the inhibition of glycine transporters. The role of treatment with glycine reuptake inhibitors (GRIs) is reviewed, with its goals and failures. The rationale and potential of GRIs to treat other neuropsychiatric conditions beyond schizophrenia, such as obsessive compulsive disorder,depression, anxiety disorders, alcohol dependence, epilepsy, and pain is discussed.The dual action of glycine in the nervous system is described, evaluated,and discussed as a problem in the development of related drugs. These authors are, again, generators of recent information.Chapter 29, written by Francisco Ciruela, Víctor Fernández-Dueñas,Xavier Altafaj, Fernando Contreras, Antoni Vallano, José Manuel Menchón,and Marta Valle León, opens new windows to schizophrenia treatment. The authors, researchers involved in the area, review the role of the adenosinergic system in the neurobiology of schizophrenia. Starting from this point, they suggest possible new methods of schizophrenia treatment. The reasoning is that, since adenosine plays an important role in dopaminergic and glutamatergic transmission, it may be a tool with which to manage schizophrenia treatment.An ?adenosine hypothesis of schizophrenia? is also proposed,establishing a connection between the disruption of adenosine homeostasis within certain brain areas and corresponding behavioral consequences, with interesting homologies with schizophrenia symptoms.The authors of Chap. 30 are members of a clinical research group working in neuroimaging. They are Nicolás Fayed, Javier García-Campayo, Eduardo González-Toledo, and Laura Viguera. In this chapter, recent neuroimaging findings in chronic pain, fibromyalgia, somatization, and coping in somatoform pain disorders are interestingly summarized. The authors propose magnetic resonance imaging (MRI) as the investigative method of choice for standard use in clinical practice. The study of metabolism, using magnetic resonance spectroscopy and structural information obtained through voxel-based morphometry, offers, in the opinion of these authors, interesting alternatives for the study of the brain and its related illnesses. Additional imaging parameters, such as vascularity (perfusion) and cellularity (diffusion-weighted imaging) are proposed here. These authors suggest interesting newlines of neuroscience research.In Chap. 31, Eduardo González-Toledo, Nicolás Fayed, Laura Viguera,Kanika Sharma, Piyush Kalakoti, Navdeep Samra, Anil Nanda, and Hai Sunpropose the utility of magnetic resonance findings as a tool for registering structural and functional brain impairments in patients with traumatic brain injury (TBI). This problem is an important cause of death and disability in the United States, with significant morbidity (impaired thinking or memory,movement disorders, perception troubles, emotional changes, personality changes, depressive disorders, anger, insomnia, and social disturbances). The authors maintain that patients with mild TBI present with brain iron/mineral deposits, abnormal cortical thickness, abnormal metabolites, disruption of white matter tracts, and decreased or lost connectivity in brain networks. All these findings led the authors to propose magnetic resonance findings for damage detection. Once again, this group generates the information in the field.Chapter 32 concerns liaison psychiatry. The authors, María Soledad Barboza, Julia Cittadini, Milagros de Hertelendy, Mauricio Sebastián Farías,and Natacha Loiácono, have developed interesting hospital statistics regarding interconsultations. They found that a significant percentage (10%) of interconsultations were due to delirium detected in all medical inpatients,and a significant group of patients (30%) in general medical settings had consultations for a psychiatric disorder. In this study, high users of medical care presented with psychiatric disturbances (depressive disorders, anxiety,and somatization). Underdiagnosis is also considered and discussed. This chapter is written by a group with wide clinical experience in an important hospital in Argentina.Chap. 33, written by María Andrea Delgado, Adriana Fochesato, LuisIsaías Juncos, and Pascual Ángel Gargiulo, reviews evidence regarding a proposed metabolic association between a gut-brain axis and autism spectrum disorders (ASD). The role of such factors in these neurodevelopmental disorders is widely analyzed. A complex interaction between genetic and environmental factors is postulated here. Some nutritional findings, such as food intolerances, allergies, altered intestinal permeability (leaky gut), immune dysregulation, neuroinflammation, and oxidative stress may be triggering ASD symptoms. Patients with ASD have shown increased urinary levels ofβ-casomorphin and gliadorphin peptides, both compounds produced by the incomplete digestion of compounds such as gluten and casein. The possible role of opioid peptides in ASD is suggested here. Possible factors involved inthese pathologies are analyzed by this group.In Chap. 34, written by Rose Emily Nina-Estrella, an interesting update on dementia is presented. Diagnoses, pathophysiology, and treatment are discussed by this psychiatrist. An interesting comparison is drawn between the diagnostic criteria for dementia in recent manuals and the diagnostic criteria for Alzheimer disease (AD), vascular dementia (VaD), Lewy-body dementia(LBD), frontotemporal dementia (FTD). All them are analyzed and discussed.Different kinds of dementia are here presented and evaluated. An important comment is made on differential diagnoses. The fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM)are compared at this point. The author?s wide knowledge and experience isevidenced here.An interesting review regarding the action of nutritional factors on the brain is offered in Chap. 35. Silvina Álvarez, Lorena Navigatore Fonzo,Emilse Sánchez, Nidia Gómez, and María Sofía Giménez wrote this interesting update. The role of impaired brain function and cognitive performance in depressive disorders is discussed, as are micronutrient status at all ages, vitamin deficiencies, and mineral deficiencies that are related to psychiatric symptoms. Dietary schedules are proposed for preventing some chronic diseases.Proposed biochemical and molecular mechanisms of nutritional factors in the brain are described. This chapter, written by an experienced group,may have important preventive value .Finally, Chap. 36 addresses cognitive problems in patients with chronic renal disease. This review is performed by Luis Augusto Juncos, Kiran Chandrashekar, and Luis Isaías Juncos. Its main axis is the cognitive impairment and eventual dementia that occurs in patients with chronic kidney disease(CKD). Cognitive impairment and dementia (CI/D) are related here to CKD and end-stage renal disease (ESRD). Comorbidities that increase the risk of cognitive impairment are widely revised. The authors maintain that almost every stage of CKD is associated with an increased risk of CI/D. This risk appears to be increased in a parallel manner with increases in the severity of CKD. Mechanisms of vascular dementia appear to be facilitated by vascular disease in CKD/ESRD. An interesting overview of the epidemiology,pathogenesis/pathophysiology, diagnostic approaches, and therapeutic considerations of CI/D in patients with CKD/ESRD is presented here.To conclude, I again express my gratitude to my wife, Adriana, for our long life together, and our seven sons and daughters. I also thank all my family,my parents, grandparents, and brothers, who are also coauthors, in some sense, of the present book. I thank again Prof. Dr. Mesones Arroyo for our long friendship and for all our shared experiences in the clinic, and in our academic and teaching life.On behalf of the authors, I take this opportunity to thank the Springer editorial team, headed by Mr. Gabriel Pires, Mrs. Lorraine Coffey, Mrs. Saanthi Shankhararaman and Mr. Dinesh Vinayagam for their patience, dedication, and invaluable and efficient work. And, finally, I express my profound gratitude to all my colleagues, who made this book posible with their invaluable contributions.Mendoza, Argentina Pascual Ángel Gargiulo