Universidad Anáhuac México Sur

Cryptococcosis is a severe but rare opportunistic fungal infection predominantly affecting immunocompromised individuals, such as posttransplant patients. The diagnosis is frequently delayed due to non-specific symptoms and lower incidence than other fungal infections.

A case of a 50-year-old male renal transplant recipient who developed disseminated cryptococcosis complicated by multi-organ failure is presented. Despite adherence to international treatment guidelines, the patient's condition rapidly deteriorated due to the extensive immunosuppression required for transplant rejection management. The patient developed pneumonia and was diagnosed with disseminated cryptococcosis on the 10th day of hospitalization, with Cryptococcus gattii identified in the pulmonary system and pleura. The patient underwent multiple interventions, including bronchoscopy, lobectomy, and pneumonectomy. Despite aggressive treatment, the infection progressed, leading to severe complications, such as neurological decline, gastrointestinal bleeding, and ultimately, multi-organ failure. The patient passed away after 53 days of hospitalization.

This report highlights the importance of early diagnosis and multidisciplinary management in post-transplant patients with suspected opportunistic infections. The high mortality associated with disseminated cryptococcosis, particularly in severely immunosuppressed patients, underscores the need for vigilance and prompt intervention to improve patient outcomes.

Impulsivity has traditionally been thought to involve various behavioral traits that can be measured using different laboratory protocols. Whereas some authors regard different measures of impulsivity as reflecting fundamentally distinct and unrelated behavioral tendencies (fragmentation approach), others regard those different indexes as analogue forms of the same behavioral tendency, only superficially different (unification approach). Unifying accounts range from mere intuitions to more sophisticated theoretical systems. Some of the more complete attempts at unifying are intriguing but have validity weaknesses. We propose a new unifying attempt based on theoretical points posed by other authors and supplemented by theory and research on associative learning. We then apply these assumptions to characterize the paradigms used to study impulsivity in laboratory settings and evaluate their scope as an attempt at unification. We argue that our approach possesses a good balance of parsimony and empirical and theoretical grounding, as well as a more encompassing scope, and is more suitable for experimental testing than previous theoretical frameworks. In addition, the proposed approach is capable of generating a new definition of impulsivity and outlines a hypothesis of how self-control can be developed. Finally, we examine the fragmentation approach from a different perspective, emphasizing the importance of finding similarities among seemingly different phenomena.

Cognitive effects caused by cocaine and crack consumption, especially deficits in executive functions may increase the likelihood of drug-seeking behaviour and interfere with the ability of users to assimilate and participate in rehabilitation programs.

To determine in early abstinence the state of executive functions, the impulsiveness and craving in cocaine and crack consumers.

This cross-sectional study functions, with a sample of 60 male aged between 31.38 ± 7.26 years old, distributed in three groups: inhaled cocaine users (CDP-I; n = 15), with 23.13 ± 7.2 age of onset of consumption; crack cocaine users (CDP-C; n = 26), with 20.81 ± 4.21 age of onset of consumption, and a control groups of no-addiction individuals (n = 19). Sociodemographic, clinical and cognitive assessments were applied.

The data showed that significant differences in socioeconomic level score and impulsiveness. Consumer groups have with lower scores with respect the control group. CDP-C group showed poor performances compared to the CDP-I and control groups, in the Berg Test, Tower of London, numbers in the direct order and subtraction. CDP-I group showed less score in planning compare with the other two groups.

In early abstinence crack users manifest a greater number of deficits, mainly in working memory, planning and cognitive flexibility.