Electro-Acupuncture Effects Measured by Functional Magnetic Resonance Imaging-A Systematic Review of Randomized Clinical Trials.

INTRODUCTION: Electro-acupuncture, an innovative adaptation of traditional acupuncture, combines electrical stimulation with acupuncture needles to enhance therapeutic effects. While acupuncture is widely used, its biological mechanisms remain incompletely understood. Recent research has explored the neurophysiological aspects of acupuncture, particularly through functional magnetic resonance imaging (fMRI) to investigate its effects on brain activity. METHODS: In this systematic review, we conducted an extensive search for randomized clinical trials examining electro-acupuncture effects measured by fMRI. We employed strict eligibility criteria, quality assessment, and data extraction. RESULTS: Five studies met our inclusion criteria and were analyzed. The selected studies investigated electro-acupuncture in various medical conditions, including carpal tunnel syndrome, fibromyalgia, Crohn's disease, irritable bowel syndrome, and obesity. Notably, electro-acupuncture was found to modulate brain activity and connectivity in regions associated with pain perception, emotional regulation, and cognitive processing. These findings align with the holistic approach of traditional Chinese medicine, emphasizing the interconnectedness of body and mind. DISCUSSION: In carpal tunnel syndrome, electro-acupuncture at both local and distal sites showed neurophysiological improvements, suggesting distinct neuroplasticity mechanisms. In fibromyalgia, somatosensory electro-acupuncture correlated with reduced pain severity, enhanced brain connectivity, and increased gamma-aminobutyric acid levels. For Crohn's disease, electro-acupuncture influenced the homeostatic afferent processing network, potentially mitigating gut inflammation. Electro-acupuncture for irritable bowel syndrome led to decreased activity in the anterior cingulate cortex, offering pain relief, while electro-acupuncture for obesity impacted brain regions associated with dietary inhibition and emotional regulation. CONCLUSION: This systematic review provides evidence that electro-acupuncture can positively impact a range of medical conditions, possibly by modulating brain activity and connectivity. While the quality of the reviewed studies is generally good, further research with larger sample sizes and longer-term assessments is needed to better understand the mechanisms and optimize electro-acupuncture protocols for specific health conditions. The limited number of studies in this review emphasizes the need for broader investigations in this promising field. The research protocol was registered in PROSPERO (CRD42023465866).

The plague: a case of delusional infestation with folie à deux / A praga: um caso de delírio de infestação com folie à deux

Folie à deux or Shared psychotic disorder (SPD) is a rare condition characterized by shared psychotic symptoms between two or more individuals. Delusional parasitosis (DP) is an uncommon psychiatric illness in that patients believe they are infested by insects, without evidence to support this belief. DP occurs in 5­15% of SPD. We report a case of cutaneous DP with SPD between an elderly mother and a daughter that lived together and withdrew from other social contacts for the last three years. We aim to highlight the relationship between SPD and DP, its prognosis, and clinical implications.

Folie à deux ou Perturbação Psicótica Compartilhada (PPC) é uma condição rara caracterizada por sintomas psicóticos compartilhados entre dois ou mais indivíduos. O delírio parasitário (DP) é uma doença psiquiátrica incomum em que os pacientes acreditam estar infestados por insetos, sem evidências que sustentem essa crença. O DP ocorre em 5 a 15% das PPC. Relatamos um caso de um DP cutâneo com PPC entre uma mãe idosa e uma filha que viviam juntas e afastadas de outros contatos sociais nos últimos três anos. O nosso objetivo é destacar a relação entre PPC e o DP, o seu prognóstico e implicações clínicas

Autism Spectrum as an Etiologic Systemic Disorder: A Protocol for an Umbrella Review.

Autism spectrum disorder (ASD) is the most common neurodevelopmental disorder with a huge prevalence increasing every year (1/44 children). Still diagnosed as a mental disorder, the last 10 years of research found possible causes, risks, genetics, environmental triggers, epigenetics, metabolic, immunological, and neurophysiological unbalances as relevant aetiology. Umbrella methodology is the highest level of scientific evidence, designed to support clinical and political decisions. A literature search for autism aetiology, pathophysiology, or causes, conducted in the last 10 years, at PubMed, Embase, Cochrane, Scopus, and the Web of Science, resulted in six umbrella reviews. Nevertheless, only one quantitative analysis reported risk factors and biomarkers but excluded genetics, experiments on animal models, and post-mortem studies. We grouped ASD's multi-factorial causes and risks into five etiological categories: genetic, epigenetic, organic, psychogenic, and environmental. Findings suggest that autism might be evaluated as a systemic disorder instead of only through the lens of mental and behavioural. The overview implications of included studies will be qualitatively analysed under ROBIS and GRADE tools. This umbrella review can provide a rational basis for a new urgent health policy to develop better and adequate integrated care services for ASD. The methodological protocol has the register CRD42022348586 at PROSPERO.

Nonalcoholic Wernicke-Korsakoff Syndrome Resulting From Psychosis.

ABSTRACT: Wernicke encephalopathy (WE) results from thiamine deficiency. If undiagnosed or inadequately treated, WE evolves into Korsakoff syndrome (KS). We herein report a case of nonalcoholic Wernicke-Korsakoff syndrome (WKS) that resulted from malnutrition due to psychosis in a 42-years-old male patient. Thiamine deficiency was secondary to severe malnourishment due to poisoning delusions and daily life disorganization in a patient with previously unrecognized schizophrenia. Besides the presence of WE's classic triad of signs, brain magnetic resonance imaging showed also typical thalamic lesions. Furthermore, the patient also presented anterograde and retrograde amnesia, executive dysfunction, and confabulations, compatible with KS being already present. Intravenous treatment with thiamine was given for 37 days. Improvement in cognitive functions and brain imaging alterations was evident. Nevertheless, persistent WKS deficits were present. This case highlights the multiplicity of etiologies of WKS, namely, psychiatric, and its debilitating consequences if not promptly recognized and treated.

Psychosis in Huntington´s Disease. a rare and Under-Investigated Psychiatric Manifestation / Psychosis in Huntington's Disease: uma manifestação psiquiátrica rara e pouco investigada

Introduction: Psychotic symptoms are among the least prevalent and under-investigated psychiatric manifestations (PM) of Huntington's disease (HD). Case report: We herein report a case of a 31-year-old male patient who presented PM with a predominance of negative symptoms, without any significant abnormal movement. HD was diagnosed based on positive DNA analysis and family history. HD imposes longitudinal follow-up through a multidisciplinary approach in order to improve the quality of life and prognosis. Conclusion: This case report highlights the importance of comprehending the PM in the initial presentation of HD so that the diagnosis is not delayed until the onset of motor symptoms.

Introdução: Os sintomas psicóticos estão entre as manifestações psiquiátricas (MP) menos prevalentes e pouco investigadas da doença de Huntington (DH). Relado de caso: Relatamos o caso de um paciente do sexo masculino, 31 anos, que apresentou MP com predomínio de sintomas negativos, sem qualquer movimento anormal significativo. A DH foi diagnosticada com base em uma análise de DNA positiva e na história familiar. A DH impõe um acompanhamento longitudinal por meio de uma abordagem multidisciplinar, a fim de melhorar a qualidade de vida e o prognóstico. Conclusão: Este relato de caso destaca a importância da compreensão das MPs na apresentação inicial da DH, para que o diagnóstico não seja atrasado até ao aparecimento dos sintomas motores

Facilitating the Delivery of Cognitive Remediation in First-Episode Psychosis: Pilot Study of a Home-Delivered Web-Based Intervention.

We explored the adherence to a home-delivered, computer-based, cognitive remediation protocol in a first-episode psychosis outpatient cohort. Seventeen patients underwent a cognitive training protocol for 6 months using an online platform accessible from their home under the supervision of a qualified neuropsychologist. Neuropsychological, psychopathological, and functional data were collected at baseline and postintervention, whereas qualitative appraisal of the intervention was assessed monthly. Overall, participants' evaluation of the program was positive. This was reflected in a good adherence rate with 12 (70%) of 17 patients completing 80% of the prescribed sessions. Exploratory analysis revealed significant improvements in sustained attention (p = 0.020) and verbal memory (p = 0.018). A decrease in negative symptoms and an improvement on the Clinical Global Impression were also found (p = 0.009). We believe these are encouraging results to further explore the adopted delivery approach, which could facilitate access to cognitive training earlier and to a larger group of patients.

[Electroconvulsive therapy: myths and evidences]. / Electroconvulsivoterapia: mitos e evidencias.

Electroconvulsive therapy (ECT) is an efficient, safe and even life saving treatment for several psychiatric disorders, namely depressive disorder, bipolar disorder and schizophrenia. Many were the doubts with it utilization, namely until the 1980s. After that it became more accepted with the publication of guidelines for many international associations of Psychiatry. Even with the development of psychopharmacology, ECT is still used with very good results, namely with affective disorders. Nowadays it is used almost exclusive with refractory patients but many studies show its efficacy in all the phases of psychiatric disorders where is indicated. The authors' review, based on literature, the history, indications, mechanism of action, procedure and adverse effects of ECT. The recent development of many procedures of magnetic stimulation could put ECT as a secondary treatment but the efficacy of that technique in comparison with ECT is still to be demonstrated, and ECT remains the most efficient treatment of psychiatry disorders.

Validation of the Temperament Evaluation of Memphis, Pisa, Paris and San Diego (TEMPS-A): Portuguese-Lisbon version.

BACKGROUND: The TEMPS-A has been validated in 8 languages, the original being American English, and includes among others such Latin languages as Italian, French, and Spanish-Buenos Aires. This is the first Portuguese-Lisbon validation. METHODS: The sample included 1173 students from six different universities and representing most disciplines (such as medicine, law, humanities, engineering, etc.), both sexes (67% female), and ages between 17 and 58 (x+/-SD=21+/-4). Standard psychometric tests were used for internal consistency, validity, and factor analysis. RESULTS: The study upheld the 5 Factor proposed structure of TEMPS-A. Cronbach alpha varied from 0.67 for the depressive and 0.83 for the anxious, with the others in-between. We could retain all 110 items of the Interview Schedule. The highest mean scores were found for the hyperthymic, and the lowest for the irritable. As expected, depressive and anxious subscales had strong correlations, followed by the cyclothymic and anxious, and cyclothymic and irritable; in exploratory factor analysis, these subscales constituted Factor I, contrasted to the depressive and the hyperthymic as a biphasic continuum (Factor II). Females scored higher on the depressive, cyclothymic and anxious, and the males on hyperthymic and irritable. Overall, however, no temperament was "dominant" in this population, all temperaments z-scores being 3.3-4%! LIMITATIONS: Study limited to university students of young age. CONCLUSIONS: TEMPS-A Lisbon is a reliable and valid instrument. The only relatively weak factor is the depressive, which is similar to other language versions. Gender differences and correlations of temperaments are generally similar to other countries. What appears relatively special to the Portuguese is the relatively "balanced" mix of temperaments in this university student population.

El Localizador de Información de Salud como herramienta para gerenciar los recursos de información en Cuba

La gerencia de recursos de información surgió cuando la sociedad reconoció que la información es un factor clave para elevar la eficiencia y efectividad del trabajo en las organizaciones. La Red Telemática de Salud de Cuba, una división del Centro Nacional de Información de Ciencias Médicas, al considerar el significado actual de la introducción de la gerencia de los recursos de información en la práctica de la entidad, ha emprendido, en principio, una labor de identificación de los recursos de información existentes en todos los órganos del Sistema Nacional de Información de Ciencias Médicas. Dicho inventario es la base del proyecto del Localizador de Información en Salud de Cuba. Se destaca la importancia de la aplicación de la gerencia de recursos de información en el Sistema Nacional de Información de Ciencias Médicas y se presenta el Localizador de Información en Salud como una herramienta útil para localizar, recuperar y acceder a los recursos que crean y gerencian las instituciones de información del sector de la salud. A partir del Localizador de Información en Salud es posible utilizar los recursos de información de manera estratégica, perfeccionar su utilización compartida, así como el manejo adecuado de la información como un recurso decisivo en el cumplimiento de los objetivos y metas de las organizaciones del Sistema Nacional de Información de Ciencias Médicas y en el éxito empresarial.

The Health Information Locator in Cuba as a tool to manage the information resources in the National System of Information on Medical Sciences. The management of information resources (IRM) appears as a result of the fact that society recognizes that the information is a key factor to increase the efficiency and effectiveness of the work at the different organizations. The Health Telematic Network of Cuba (INFOMED), a part of the National Center of Information on Medical Science, a taking into consideration the present significance of the introduction of the information resources management in the practice of the entity has begun, as a first step, to identify the information resources existing in all the information bodies of the National System of Information on Medical Sciences. This inventory is the basis of the Health Information Locator project in Cuba. It is stressed the importance of the application of the management of information resources in the National System of Information on Medical Sciences, and the Health Information Locator is presented as a useful tool to locate, retrieve and have access to the resources created and managed by the information institutions of the health sector. Starting from the Health Information Locator is possible to use the information resources strategically, to improve their shared utilization and the adequate management of information as a decisive resource for the fulfillment of the objetives and goals of the organizations of the National System of Information on Medical Sciences and for entrepenurial success.

Consideraciones generales en torno al valor añadido de la información / General aspects concerning the added value of information

Se destacan los aspectos teóricos más importantes referidos al valor añadido de la información. Se emiten algunas consideraciones útiles para la preparación y el suministro de productos y servicios de información de valor añadido, sustentadas en la filosofía de la calidad total. Se señalan las posibilidades del correo electrónico para aumentar la accesibilidad de los usuarios a dichos productos y servicios de información

Gerencia total de la calidad en las organizaciones

Con el objetivo de facilitar la comprensión de los cambios ocurridos en materia de administración empresarial y de gerencia de la calidad durante las últimas décadas, se describe brevemente la evolución histórica de los paradigmas gerenciales y de la gerencia de la calidad durante el presente siglo; se caracteriza su estado actual y se exponen los componentes fundamentales, así como los principios básicos de la gerencia total de la calidad. La gran crisis de los países industrializados a mediados de los años 70, produjo una verdadera revolución en materia de gerencia empresarial, caracterizada por la reducción del tamaño de las unidades productivas y del verticalismo en la gestión, así como por la búsqueda de una mayor participación de los trabajadores en la vida de la compañía mediante la creación de equipos de trabajo, entre otros aspectos. La administración de la calidad ha transcurrido por diferentes etapas desde su nacimiento. Algunas de ellas son: control de la calidad del producto, control de la calidad del proceso, planeamiento estratégico de la calidad y gerencia total de la calidad. Entre los principales componentes de la gerencia total de la calidad, se destacan: el liderazgo, el reconocimiento y la recompensa al empleado, el adiestramiento, el enfoque al cliente, la planificación estratégica y el benchmarking.

Total Quality Management in the Organizations It is briefly described the historic evolution of management paradigms with the goal of facilitating the understanding of changes ocurred in the field of management and quality management during the last decades; its current state is characterized and its main components are exposed as well as the basic principles of total quality management. The significant crisis of developed countries in the middle of the 70’s generated a true revolution in terms of management and it was marked by the reduction in size of productive units and by management verticality and at the same time for the search of a greater involvement of workers in the company’s life through the creation of working teams and so on. Quality management has gone through different stages since its birth among which we find: quality control of the product, quality control of the process, strategic planing of quality and total quality mangement. Among the main components of total quality management we have: leadership, employee acknowledgement and rewarding, training, customer’s approach, strategic planning, and benchmarking.

Infecciones por citomegalovirus

Se ofrece una revisión actualizada sobre la infección por citomegalovirus a partir de la consulta de artículos referidos de 1990 a 1996 en las bases de datos MEDLINE, LILACS, Literatura Cubana de Medicina y Noticias de Salud. Se revisaron 37 artículos. Se abordan los aspectos más importantes de las manifestaciones clínicas, el diagnóstico, el tratamiento, así como la prevención y los métodos de control para evitar las enfermedades citomegálicas.

An update review on the infection caused by cytomegalovirus is made based on the consultation of articles referred to from 1990 to 1996 in the MEDLINE, LILACS, Cuban Medical Literature and Health News databases. 17 articles were reviewed. The most important aspects of clinical manifestations, the diagnosis, the treatment, as well as the prevention and methods of control to avoid cytomegalic diseases are approached.

La amniocentesis como técnica de diagnóstico prenatal / Amniocentesis as a technique for prenatal diagnosis

Se ofrece una revisión teórica actualizada sobre la técnica de amniocentesis utilizada, desde 1882, para el diagnóstico prenatal de un sinnúmero de animalías congénitas, a partir de la información obtenida en las bases de datos MEDLINE, LILCAS y de la Literatura Cubana de Medicina, de los años 1988 a 1994, localizadas en los órganos de información del Sistema Nacional de Información de Ciencias Médicas. Se dan a conocer los procedimientos generales para aplicar esta técnicas, sus riesgos y beneficios, así como las variantes de amniocentesis que existen de acuerdo con la semana de gestanción en que se realicen. Se informan los 4 tipos de análisis de laboratorio que se le aplican a los distintos compenentes del líquido amniótico. Se concluye que a pesar de ser una técnica de gran complejidad y riesgo obstétrico es de gran utilidad para el diagnóstico precoz de determinadas anomalias

Actualidades en Escabiosis / The latest on scabies

Se ofrece una revisión teórica actualizada sobre la terapia, la prevención y el control de la escabiosis a partir de la literatura revisada en las bases de datos MEDLINE, LILACS, y de la Literatura Cubana de Medicina de los años 1987 a 1996; también se incluyen algunos clásicos propios de la temática, localizados en los órganos de información del Sistema Nacional de Información de Ciencias Médicas, así como la carpeta metodológica que contiene el desarrollo de las estrategias del MINSAP para 1996. Se abordan otros aspectos de interés como el modo de transmisión y las manifestaciones clínicas

Antecedentes y actualidades en el diagnostico prenatal / History and latest advances of the prenatal diagnosis

Se realiza una revision del desarrollo y evolucion del diagnostico prenatal a partir de la informacion obtenida en las bases de datos MEDLINE, LILACS y la de Literatura Cubana de Medicina, de los anos 1988 a 1994, localizadas en los organos de informacion del Sistema Nacional de Informacion de Ciencias Medicas. Se ofrece la importancia del diagnostico prenatal, asi como los aspectos a tener en cuenta en su aplicacion. Se concluye que la decision de poner en practica una u otra tecnica de diagnostico prenatal en la madre depende de los resultados de las exploraciones realizadas y de las enfermedades que van a ser investigadas, considerando los riesgos y beneficios que este implica