Volumetric alterations in the nucleus accumbens and caudate nucleus in bulimia nervosa: a structural magnetic resonance imaging study.

OBJECTIVE: Bulimia nervosa (BN) is an eating disorder characterized by recurrent episodes of binge eating and inappropriate compensatory behaviors (such as purging, fasting, or excessive exercise) to prevent weight gain. BN has been associated with deficits in inhibitory control processes. The basal ganglia specifically, the nucleus accumbens (NAc) and the caudate nucleus (CN) are part of the frontostriatal circuits involved in inhibitory control. The main goal of this study was to investigate the presence of morphological alterations in the NAc and the CN in a sample of patients diagnosed with BN. METHOD: Forty-one female participants, 21 diagnosed with BN and 20 healthy matched controls (HC), underwent a structural magnetic resonance imaging (MRI) acquisition and clinical assessment. The NAc and the CN were manually segmented using the software Slicer 3D. RESULTS: The results reveal a significant volumetric decrease in the CN and a preserved NAc volume in BN compared to the control group. DISCUSSION: These findings suggest a contributory role of the caudate nucleus part of the dorsal striatum in the psychopathology of BN.

[People with pain and intervention needs: systematic literature review]. / Pessoas com dor e necessidades de intervenção: revisão sistemática da literatura.

The study aimed to determine the economic and social impact and that needs of intervention by the health services for persons with pain. It was conducted a search in EBSCO (CINAHL, MEDLINE, British Nursing Index), using the method of PI[C]O and selecting 19 articles of the total of 325 found. The neuropathic pain and the one with musculoskeletal location were identified as the most responsible for health expenditures. The factors positively associated with cost-effective met in the research were: combination of therapeutic regimen with non-pharmacological strategies, involvement of multidisciplinary teams specialized in pain management, continuity of care program in community and a telephone line for permanent support. It was concluded that the pain causes significant deterioration in quality of life, with incalculable impact on the performance of the activities of daily living.

Pessoas com dor e necessidades de intervenção: revisão sistemática da literatura / People with pain and intervention needs: systematic literature review / Personas con dolor y necesidades de intervención: revisión sistemática de la literatura

Objectivou-se determinar qual o impacto económico e social e as necessidades de intervenção por parte dos serviços de saúde, relativamente às pessoas com dor. Foi efectuada uma pesquisa na EBSCO (CINAHL, MEDLINE, British Nursing Index), utilizando-se o método de PI[C]O e seleccionados 19 artigos do total de 325 encontrados. A dor de tipo neuropática e a com localização músculo-esquelética foram identificadas como as maiores responsáveis pelos gastos em saúde. Como factores positivamente associados à relação custo-eficácia, encontrou-se: associação do regime terapêutico com estratégias não farmacológicas, intervenção de equipas multidisciplinares especializadas no controlo da dor, continuidade de cuidados na comunidade e uma linha telefónica de apoio permanente. Conclui-se que a dor causa significativa deterioração na qualidade de vida, com incalculável impacto no desempenho das actividades de vida diária.

The study aimed to determine the economic and social impact and that needs of intervention by the health services for persons with pain. It was conducted a search in EBSCO (CINAHL, MEDLINE, British Nursing Index), using the method of PI[C]O and selecting 19 articles of the total of 325 found. The neuropathic pain and the one with musculoskeletal location were identified as the most responsible for health expenditures. The factors positively associated with cost-effective met in the research were: combination of therapeutic regimen with non-pharmacological strategies, involvement of multidisciplinary teams specialized in pain management, continuity of care program in community and a telephone line for permanent support. It was concluded that the pain causes significant deterioration in quality of life, with incalculable impact on the performance of the activities of daily living.

Objetivó-se determinar el impacto social y económico y las necesidades de intervención de los servicios de salud para las personas con dolor. Se realizó una búsqueda en EBSCO (CINAHL, MEDLINE, British Nursing Index), utilizando el método PI[C]O, siendo seleccionados 19 artículos del total de 325 que se encontró. El tipo de dolor neuropática y con ubicación musculoesquelética son los más responsables por los gastos de salud. Como factores asociados positivamente con el costo-eficacia, encontró-se: asociación de estrategias no farmacológicas con el régimen terapéutico, la intervención de equipos multidisciplinarios especializados en el tratamiento del dolor, la continuidad de la atención en la comunidad y una línea telefónica permanente. Es posible concluir que el dolor provoca un deterioro significativo en la calidad de vida, con un impacto incalculable en la ejecución de las actividades de la vida diaria.