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Article: Editorial: Current challenges and evidence-based medicine in psychiatric emergencies.

Baldaçara, Leonardo

2023 Volume 14, Page(s) 1145280

Language	English
Publishing date	2023-03-01
Publishing country	Switzerland
Document type	Editorial
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2023.1145280
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Managing drug-induced psychosis.

Baldaçara, Leonardo / Ramos, Artur / Castaldelli-Maia, João Maurício

International review of psychiatry (Abingdon, England)

2024 Volume 35, Issue 5-6, Page(s) 496–502

Abstract: Substance-induced psychosis is a secondary psychotic disorder resulting from drug abuse, characterized by one or more psychotic episodes. Drug-induced psychosis is expected to resolve after a 30-day period of sobriety, however, individuals with this ... ...

Abstract	Substance-induced psychosis is a secondary psychotic disorder resulting from drug abuse, characterized by one or more psychotic episodes. Drug-induced psychosis is expected to resolve after a 30-day period of sobriety, however, individuals with this condition are more likely to develop severe drug addiction. Compared to primary psychosis, participants with drug-induced psychosis exhibit poorer family history of psychotic diseases, higher insight, fewer positive and negative symptoms, more depressive symptoms, and greater anxiety. Substance-induced psychosis is strongly associated with the emergence of bipolar illness or schizophrenia spectrum disorder, with an increased chance of developing schizophrenia at a younger age. Episodes of self-harm after substance-induced psychosis are strongly linked to an elevated likelihood of developing schizophrenia or bipolar disorder. Effective treatment involves ruling out emergencies, investigating underlying causes, and addressing acute intoxication and withdrawal. Management includes dynamic assessment, intervention, and vigilant monitoring in cases of suicidal behaviour. Antipsychotics may be used for short term, with gradual discontinuation when a person is in a stable condition. Relapse prevention strategies, both medication and non-medication-based, are crucial in long-term management. Conversion rates to schizophrenia or bipolar disorder can be as high as one in three individuals, with
MeSH term(s)	Humans ; Psychotic Disorders/drug therapy ; Psychotic Disorders/etiology ; Psychotic Disorders/diagnosis ; Schizophrenia/drug therapy ; Schizophrenia/etiology ; Bipolar Disorder/diagnosis ; Antipsychotic Agents/adverse effects ; Substance-Related Disorders/complications ; Substance-Related Disorders/drug therapy
Chemical Substances	Antipsychotic Agents
Language	English
Publishing date	2024-02-01
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1018090-4
ISSN	1369-1627 ; 0954-0261
ISSN (online)	1369-1627
ISSN	0954-0261
DOI	10.1080/09540261.2023.2261544
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Article ; Online: Position statement of the Brazilian Psychiatric Association on the use of cannabis in psychiatric treatment.

da Silva, Antônio Geraldo / Baldaçara, Leonardo

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)

2022 Volume 44, Issue 6, Page(s) 572–573

MeSH term(s)	Humans ; Cannabis ; Brazil ; Mental Disorders/drug therapy ; Hallucinogens ; Marijuana Abuse/complications
Chemical Substances	Hallucinogens
Language	English
Publishing date	2022-08-23
Publishing country	Brazil
Document type	Editorial
ZDB-ID	2024119-7
ISSN	1809-452X ; 1809-452X
ISSN (online)	1809-452X
ISSN	1809-452X
DOI	10.47626/1516-4446-2022-0043
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Article ; Online: Can medical residency keep young specialists in the place where they graduate? Cross-sectional and exploratory study of the first seven years after implementation of medical residency programs in the State of Tocantins, Brazil.

Grandi, Giovanna Tandaya / Baldaçara, Raquel Prudente de Carvalho / Coutinho, Itágores Hoffman I Lopes Sousa / Baldaçara, Leonardo

Sao Paulo medical journal = Revista paulista de medicina

2022 Volume 140, Issue 5, Page(s) 642–650

Abstract: Background: New medical schools and new medical residencies in Brazil, mainly in its interior, were opened under the justification of collaborating towards distribution of these healthcare professionals and specialist doctors across the national ... ...

Abstract	Background: New medical schools and new medical residencies in Brazil, mainly in its interior, were opened under the justification of collaborating towards distribution of these healthcare professionals and specialist doctors across the national territory. However, this proposal did not guarantee that medical practitioners would become established in the place where they graduated and specialized. Objective: To calculate, through interviews, how many specialists who graduated in the state of Tocantins stayed there after finishing their medical residency; and to analyze the factors that made them stay or leave the place. Design and setting: Cross-sectional exploratory study conducted at a Brazilian federal public higher education institution. Methods: All graduates from medical residencies in Tocantins, who graduated between 2013 and 2019, were contacted by telephone and, after obtaining consent, an interview was conducted. The interviews took place between June 2020 and January 2021. Results: The permanence of medical residency graduates in the state increased from 50% in an earlier study to 55.8% in the current study, thus showing a situation of stability. In addition, we detected some reasons for staying or not. In a multivariate analysis, only working in the state capital was related to staying in the state of Tocantins, showing a 5.6 times greater chance. Conclusions: The percentage of those who remained was just over 50%, even some years after implementation of the first programs. Most specialists remained working for the state health department, with a smaller proportion in municipal health departments, and were concentrated in the state capital.
MeSH term(s)	Brazil ; Cross-Sectional Studies ; Education, Medical, Graduate ; Humans ; Internship and Residency ; Schools, Medical
Language	English
Publishing date	2022-08-31
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	1203171-9
ISSN	1806-9460 ; 1516-3180 ; 0035-0362
ISSN (online)	1806-9460
ISSN	1516-3180 ; 0035-0362
DOI	10.1590/1516-3180.2021.0731.R1.14122021
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Article ; Online: Puerperal psychosis: an update.

Baldaçara, Leonardo / Leite, Verônica da Silveira / Teles, Ana Luiza Silva / Silva, Antônio Geraldo da

Revista da Associacao Medica Brasileira (1992)

2023 Volume 69, Issue suppl 1, Page(s) e2023S125

MeSH term(s)	Female ; Humans ; Psychotic Disorders ; Puerperal Disorders
Language	English
Publishing date	2023-08-04
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.2023S125
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Article ; Online: Proportion of doctors who stayed in the state of Tocantins after finishing medical residency: preliminary results from a cross-sectional study.

Baldaçara, Leonardo / de Carvalho Baldaçara, Raquel Prudente

Sao Paulo medical journal = Revista paulista de medicina

2017 Volume 136, Issue 1, Page(s) 59–63

Abstract: Context and objective: Few studies have assessed the impact of medical residencies on the public healthcare system. The aim here was to assess the number of specialists who remained in the state of Tocantins after finishing the medical residency program ...

Abstract	Context and objective: Few studies have assessed the impact of medical residencies on the public healthcare system. The aim here was to assess the number of specialists who remained in the state of Tocantins after finishing the medical residency program during the first two years of the first programs (2013 and 2014). Design and setting: Cross-sectional and exploratory study conducted at the Federal University of Tocantins in Brazil. Methods: All graduates of medical residency programs in Tocantins, of the years 2013 and 2014, were interviewed by telephone and e-mail between May and July 2014. Results: Information was obtained from 37 graduates from medical residency. Seventeen (50.0%) were working in the state public healthcare system and only six (17.6%) in a municipal service in June 2014. Considering only the 24 doctors who had never worked in the state of Tocantins before their residency, it was observed that two who graduated in 2013 (20.0%) and five who graduated in 2014 (35.7%), i.e. seven out of the total number (29.2%), had established their homes in Tocantins. Conclusions: The number of graduates from medical residency who stayed in the state of Tocantins in 2013 and 2014 was small. However, this was related to the absence of other programs for continuation of the specialization. The state healthcare system was primarily responsible for employment of these doctors within public services. On the other hand, hiring by municipal services was extremely low.
MeSH term(s)	Brazil ; Career Choice ; Cross-Sectional Studies ; Female ; Humans ; Internship and Residency ; Interviews as Topic ; Male ; Physicians/supply & distribution
Language	English
Publishing date	2017-07-31
Publishing country	Brazil
Document type	Journal Article ; Observational Study
ZDB-ID	1203171-9
ISSN	1806-9460 ; 1516-3180 ; 0035-0362
ISSN (online)	1806-9460
ISSN	1516-3180 ; 0035-0362
DOI	10.1590/1516-3180.2016.0340280117
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Article ; Online: Can medical residency keep young specialists in the place where they graduate? Cross-sectional and exploratory study of the first seven years after implementation of medical residency programs in the State of Tocantins, Brazil

Giovanna Tandaya Grandi / Raquel Prudente de Carvalho Baldaçara / Itágores Hoffman I Lopes Sousa Coutinho / Leonardo Baldaçara

São Paulo Medical Journal (2022)

2022

Abstract: ABSTRACT BACKGROUND: New medical schools and new medical residencies in Brazil, mainly in its interior, were opened under the justification of collaborating towards distribution of these healthcare professionals and specialist doctors across the national ...

Abstract	ABSTRACT BACKGROUND: New medical schools and new medical residencies in Brazil, mainly in its interior, were opened under the justification of collaborating towards distribution of these healthcare professionals and specialist doctors across the national territory. However, this proposal did not guarantee that medical practitioners would become established in the place where they graduated and specialized. OBJECTIVE: To calculate, through interviews, how many specialists who graduated in the state of Tocantins stayed there after finishing their medical residency; and to analyze the factors that made them stay or leave the place. DESIGN AND SETTING: Cross-sectional exploratory study conducted at a Brazilian federal public higher education institution. METHODS: All graduates from medical residencies in Tocantins, who graduated between 2013 and 2019, were contacted by telephone and, after obtaining consent, an interview was conducted. The interviews took place between June 2020 and January 2021. RESULTS: The permanence of medical residency graduates in the state increased from 50% in an earlier study to 55.8% in the current study, thus showing a situation of stability. In addition, we detected some reasons for staying or not. In a multivariate analysis, only working in the state capital was related to staying in the state of Tocantins, showing a 5.6 times greater chance. CONCLUSIONS: The percentage of those who remained was just over 50%, even some years after implementation of the first programs. Most specialists remained working for the state health department, with a smaller proportion in municipal health departments, and were concentrated in the state capital.
Keywords	Internship and residency ; Education ; medical ; Employment ; Physicians ; Public health ; Work ; Clinical competence ; Postgraduation ; Medical residents ; Clinical skill ; Human ; Medicine ; R
Subject code	941
Language	English
Publishing date	2022-08-01T00:00:00Z
Publisher	Associação Paulista de Medicina
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The Management of Psychiatric Emergencies in Situations of Public Calamity.

Baldaçara, Leonardo / da Silva, Antônio Geraldo / Pereira, Lucas Alves / Malloy-Diniz, Leandro / Tung, Teng Chei

Frontiers in psychiatry

2021 Volume 12, Page(s) 556792

Abstract: The prevalence of mental health problems in the general population during a public calamity is high. In calamities, the number of patients who present with mental disorder outbreaks or crises may increase, but the necessary support systems to help them ... ...

Abstract	The prevalence of mental health problems in the general population during a public calamity is high. In calamities, the number of patients who present with mental disorder outbreaks or crises may increase, but the necessary support systems to help them may be impaired if they have not been planned for. Although there are several models for addressing psychiatric emergencies, the general rules are the same, especially when it comes to making these services easily available to the affected population. In this article, we seek to review and present recommendations for the management of psychiatric emergencies in situations of public calamity, including disasters, physical and medical catastrophes, epidemics, and pandemics.
Language	English
Publishing date	2021-01-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2021.556792
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Brazilian Psychiatric Association Consensus on the physical structure and ideal team for psychiatric emergencies services.

Baldaçara, Leonardo / Ismael, Flávia / Kawakami, Daniel / da Rocha, Gislene Alves / Calfat, Elie Leal de Barros / Porto, Deisy Mendes / Cavalcante, Beatriz Ferroli / Zaramella, Beatriz Plotegher / Ribeiro, Flávio Veloso / Dos Santos, Roberto Mendes / Grudtner, Roberta Rossi / Tung, Teng Chei / da Silva, Antônio Geraldo

Revista brasileira de psiquiatria (Sao Paulo, Brazil : 1999)

2024

Abstract: Introduction: An integral part of Brazil's public health system, the psychiatric emergency service (PES) has been instrumental in improving qualified support for crisis situations of mental disorders, equitable, universally accessible, and humanized. ... ...

Abstract	Introduction: An integral part of Brazil's public health system, the psychiatric emergency service (PES) has been instrumental in improving qualified support for crisis situations of mental disorders, equitable, universally accessible, and humanized. The purpose of this article is to present a systematic review and consensus about the physical area and facilities, and ideal team qualified for psychiatric emergencies services on both Brazilian settings. Methods: The authors conducted a literature search using electronic databases such as MEDLINE (PubMed), Scielo, the Cochrane Database, and documents from the WHO, the Brazilian Ministry of Health, and others deemed relevant by experts. A total of 6839 manuscripts were found, but only 46 were selected. The analysis of article content summarizes consensus statements using the Delphi method and a series of interactive versions to provide a final report. Results: Changes to PES are evaluated considering various experiences and models. The authors highlighted that The Emergency Care Network (ECN) must be coordinated with qualified management, effective implementation of integration of all health equipment's and units. PES must have adequate infrastructure; qualified staff, including a psychiatrist; sufficient consultation and observational spaces; tools and resources for differential diagnosis; training for all staff members; and communication with the health care network to facilitate referrals following patient discharge are all necessary. Conclusion: These standardized models need to be available to public health managers so that they can guide the installation of new services and adjust the existing ones, always looking for improvement. The authors propose requirements for PES as a model to be passed over.
Language	English
Publishing date	2024-04-18
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2024119-7
ISSN	1809-452X ; 1809-452X
ISSN (online)	1809-452X
ISSN	1809-452X
DOI	10.47626/1516-4446-2024-3567
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Article ; Online: Proportion of doctors who stayed in the state of Tocantins after finishing medical residency

Leonardo Baldaçara / Raquel Prudente de Carvalho Baldaçara

São Paulo Medical Journal, Iss

preliminary results from a cross-sectional study

2017

Abstract: ABSTRACT CONTEXT AND OBJECTIVE: Few studies have assessed the impact of medical residencies on the public healthcare system. The aim here was to assess the number of specialists who remained in the state of Tocantins after finishing the medical residency ...

Abstract	ABSTRACT CONTEXT AND OBJECTIVE: Few studies have assessed the impact of medical residencies on the public healthcare system. The aim here was to assess the number of specialists who remained in the state of Tocantins after finishing the medical residency program during the first two years of the first programs (2013 and 2014). DESIGN AND SETTING: Cross-sectional and exploratory study conducted at the Federal University of Tocantins in Brazil. METHODS: All graduates of medical residency programs in Tocantins, of the years 2013 and 2014, were interviewed by telephone and e-mail between May and July 2014. RESULTS: Information was obtained from 37 graduates from medical residency. Seventeen (50.0%) were working in the state public healthcare system and only six (17.6%) in a municipal service in June 2014. Considering only the 24 doctors who had never worked in the state of Tocantins before their residency, it was observed that two who graduated in 2013 (20.0%) and five who graduated in 2014 (35.7%), i.e. seven out of the total number (29.2%), had established their homes in Tocantins. CONCLUSIONS: The number of graduates from medical residency who stayed in the state of Tocantins in 2013 and 2014 was small. However, this was related to the absence of other programs for continuation of the specialization. The state healthcare system was primarily responsible for employment of these doctors within public services. On the other hand, hiring by municipal services was extremely low.
Keywords	Internato e residência ; Educação médica ; Especialização ; Emprego ; Médicos ; Medicine ; R
Subject code	941
Language	English
Publishing date	2017-07-01T00:00:00Z
Publisher	Associação Paulista de Medicina
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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