Art and Medicine: from anatomic studies to Visual Thinking Strategies

Over the centuries the collaboration between artists and doctors and the relationship between art and medicine disciplines have been documented. Since the '60s the discipline of medical humanities has been developed in order to enrich the studies in medical sciences with the humanities. In the belief that medicine is more than just a set of knowledge and technical skills, medical educators have considered important to include the humanities as art, literature, philosophy, ethics, history, in the curriculum of training a good doctor. Despite there are examples of previous use of art as part of the curricula of medicine as a tool to develop the cognitive skills of observation and description, there is a general consensus that the semiotic competence starts from a correct and deep observation, "clinical eye", using senses to diagnose disease. It can talk about "Visual Thinking Strategy" (VTS) in this context. The VTS provides a way to enable the observation of the work of art, the process of analysis, comparison and discussion with others that allows the medical student to acquire a method to be applied also in clinical activity, improving skills in patient examination, by implementing the problem solving and critical thinking, getting used to teamwork, stimulating empathy toward patient and respect for others (whether patient or colleague). The observation practice should be key thing for medical training and this theory can be an aid to improve clinical skills. A trial of VTS for medicine students connected to Semiotic Course in collaboration with the Galleria Borghese in Rome during last academic year was carried out at The Degree Course in Medicine of the Faculty of Medicine and Psychology of Sapienza University.Keywords:Medical humanities, art, Visual Thinking StrategiesIntroductionArt understood as 'Tèchne' could be described as the application of rules set and experiences elaborated by man, therefore the knowledge, in order to make objects or to depict images taken from reality or fantasy world. Medical Science is a discipline defined as Art in so far as it able to apply the knowledge, therefore the Science of the disease cure. Over the centuries these disciplines have developed many relationships, in fact, we have document of the cooperation between artists and doctors. Let’s think , in Classical Antiquity, when artists could learn anatomical features only through the observation of athletes in gymnasium. Anatomical features, still unknown to the doctors, who could not use, for example, the dissection of corpse because this practice was prohibited for religious reasons. They were able to “admire” the representation of muscles stretching through sculpture, an example is Myron's Discobolus.In Medicine field only Herophilus of Chalcedon and Erasistratus, in the third century B.C. carried out dissections of "live" human bodies (1) until 1241 when Federico II promulgated the edict that authorized and stimulated the use of cadavers by doctors. In 1316 Mondino de Liuzzi wrote "Anothomia" founding the first School of Human Anatomy in Europe. It will have to wait the Renaissance, with the birth of the "modern" medicine, to discover that also the artists were able to use the human bodies for their anatomical studies. The first known example was Il Pollaiolo www.sensesandsciences.co

Bilateral 5 Hz transcranial alternating current stimulation on fronto-temporal areas modulates resting-state EEG

Rhythmic non-invasive brain stimulations are promising tools to modulate brain activity by entraining neural oscillations in specific cortical networks. The aim of the study was to assess the possibility to influence the neural circuits of the wake-sleep transition in awake subjects via a bilateral transcranial alternating current stimulation at 5 Hz (theta-tACS) on fronto-temporal areas. 25 healthy volunteers participated in two within-subject sessions (theta-tACS and sham), one week apart and in counterbalanced order. We assessed the stimulation effects on cortical EEG activity (28 derivations) and self-reported sleepiness (Karolinska Sleepiness Scale). theta-tACS induced significant increases of the theta activity in temporo-parieto-occipital areas and centro-frontal increases in the alpha activity compared to sham but failed to induce any online effect on sleepiness. Since the total energy delivered in the sham condition was much less than in the active theta-tACS, the current data are unable to isolate the specific effect of entrained theta oscillatory activity per se on sleepiness scores. On this basis, we concluded that theta-tACS modulated theta and alpha EEG activity with a topography consistent with high sleep pressure conditions. However, no causal relation can be traced on the basis of the current results between these rhythms and changes on sleepines

Diagnostic Delay in Oncology: A Case Report of Metastatic Seminoma

Germ cell tumours are the most common malignancy among young men; cryptorchidism is a possible risk factor for the development of testicular cancer. Psycho-oncology studies indicate that diagnostic delay can often be explained by different social conditions and that symptoms worsened under lack of appropriate treatment can lead to an urgent admission to the hospital. Nevertheless, germ cell tumours are considered curable malignancies even in advanced stages since the introduction of a chemotherapy regimen based on bleomycin, etoposide and cisplatin. Cell lines derived from germ cell tumours are sensitive to cisplatin-based treatment more than other solid cancers, which is reflected in the good clinical response. We report an unusual manifestation of malignancy in an adult man presenting with a metastatic seminoma of the left testicle. The large ulcerate and necrotic mass suggested a secondary infection from a tumour site. The patient reported surgical orchiopexy for left cryptorchidism in his childhood. Despite worsening of physical features, he had not sought help at the hospital for social reasons. The patient achieved complete clinical remission after receiving standard chemotherapy, and a good objective response of the primitive mass was clearly visible. Complete response was persistent at the 30-month clinical follow-up. The chemotherapy administration was later complicated by acute haemorrage in the site of the primitive tumour that needed urgent surgical management; in addition to this, the artificial graft material was rejected and the arterial prosthesis had to be removed

Retroperitoneal cellular schwannoma (CS): a potential pitfall of malignancy. Report of a case and review of the literature

n/

Envelhecimento e seus impactos sobre os requisitos de desempenho ergonômico: abordagem teórica e metodológica / Aging and its impacts on ergonomic performance requirements: Theoretical and methodological approach

O processo normal de envelhecimento acarreta alterações biológicas, fisiológicas e psicológicas que impactam a interação entre indivíduo e espaço, ao influenciar a maneira como os estímulos do ambiente são recebidos e interpretados, assim como a reação gerada a esses estímulos. Os requisitos e critérios de desempenho ergonômico aos quais o espaço deve atender, portanto, alteram-se com o avanço da idade do usuário, demandando adaptações no meio físico para garantir a segurança, o conforto e a autonomia do idoso. Esse artigo apresenta um método proposto para a avaliação quantitativa e qualitativa de espaços residenciais de acordo com as necessidades advindas do envelhecimento. Seu desenvolvimento pautou-se em aspectos normativos e em estudos sobre envelhecimento, acessibilidade, Design Universal e habitação voltada para usuários idosos. A aplicação do método permite a identificação de adequações e inadequações do meio físico frente ao envelhecimento, embasando o desenvolvimento de projetos de intervenção

Arte e Medicina dagli studi anatomici alla Visual Thinking Strategy

L'utilizzo dell'arte per lo sviluppo di competenze di base in ambito medic

Increased levels of neurotrophins in the cerebrospinal fluid of children with Epstein–Barr virus meningoencephalitis

SummaryObjectiveThe aim of this study was to evaluate the expression of nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) in the cerebrospinal fluid (CSF) of children with Epstein–Barr virus (EBV)-induced meningoencephalitis (ME) in order to establish a possible correlation with laboratory findings and neurological manifestations.MethodsA prospective observational clinical study was performed on 10 children with viral ME, five of them with EBV-induced ME. As controls, we used CSF samples collected from children admitted with febrile seizures. Neurotrophin levels were measured using an enzyme immunoassay.ResultsSignificantly higher levels of BDNF and NGF were detected in all patients with viral ME compared to controls. Moreover, in patients with EBV-induced ME, the neurotrophin levels were higher than in those with other viral ME. Of note, in children with EBV-induced ME, we found a significant correlation between neurotrophic factor levels and the number of lymphocytes in the CSF (p<0.001). In these patients we also found a significant correlation between BDNF expression and the blood platelet count (p<0.001). Interestingly, two patients with EBV-induced ME showed a correlation between neurotrophin increase and persistent brain abnormalities, such as prolonged alteration of mental status, psychomotor agitation, and athetosis.ConclusionsViral ME induces an early and strong increased biosynthesis of neurotrophic factors. This neurotrophin over-expression is likely to play a key role in the mechanisms of neuronal inflammation and in the severity of brain damage, particularly in EBV-induced ME