Las complicaciones respiratorias por la COVID-19 pueden llevar a la muerte, por lo que, dentro de las políticas de protección para evitar los contagios masivos, se han sugerido estrategias de cuarentena y confinamiento en muchos países, que han originado alteraciones en la salud mental y el sueño. A través de la siguiente revisión narrativa se pretende sistematizar los hallazgos más significativos en cuanto a la presencia de insomnio en pacientes hospitalizados con COVID-19, y de personas sanas que han estado sometidas a confinamiento como medida preventiva. Las condiciones propias de la enfermedad han hecho que los pacientes desarrollen insomnio, lo que puede empeorar su estado de salud y alterar su sistema inmunológico. Para las personas sanas en cuarentena los cambios en el estilo de vida, el miedo a contraer la enfermedad, la edad joven, el sexo femenino, los antecedentes de enfermedades mentales y una menor capacidad de afrontamiento al estrés parecen ser factores de riesgo para el insomnio. Al igual que la implementación de medidas epidemiológicas de cuidado y prevención contra el COVID-19, se debe tener en consideración promover la higiene del sueño como una estrategia de afrontamiento integral contra esta pandemia.

The placebo effect can be defined as the improvement of symptoms in a patient after the administration of an innocuous substance in a context that induces expectations regarding its effects. During recent years, it has been discovered that the placebo response not only has neurobiological functions on analgesia, but that it is also capable of generating effects on the immune and endocrine systems. The possible integration of changes in different systems of the organism could favor the well-being of the individuals and go hand in hand with conventional treatment for multiple diseases. In this sense, classic conditioning and setting expectations stand out as psychological mechanisms implicated in the placebo effect. Recent advances in neuroimaging studies suggest a relationship between the placebo response and the opioid, cannabinoid, and monoaminergic systems. Likewise, a possible immune response conditioned by the placebo effect has been reported. There is evidence of immune suppression conditioned through the insular cortex and the amygdala, with noradrenalin as the responsible neurotransmitter. Finally, a conditioned response in the secretion of different hormones has been determined in different studies; however, the molecular mechanisms involved are not entirely known. Beyond studies about its mechanism of action, the placebo effect has proved to be useful in the clinical setting with promising results in the management of neurological, psychiatric, and immunologic disorders. However, more research is needed to better characterize its potential use. This review integrates current knowledge about the psycho-neuro-endocrine-immune basis of the placebo effect and its possible clinical applications.

Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11–2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51–0.95); p=0.025). Conclusion: Cigarette smoking represents a related factor with metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.

No abstract

Electroconvulsive therapy (ECT) is based on conducting an electrical current through the brain to stimulate it and trigger generalized convulsion activity with therapeutic ends. Due to the efficient use of ECT during the last years, interest in the molecular bases involved in its mechanism of action has increased. Therefore, different hypotheses have emerged. In this context, the goal of this review is to describe the neurobiological, endocrine, and immune mechanisms involved in ECT and to detail its clinical efficacy in different psychiatric pathologies. This is a narrative review in which an extensive literature search was performed on the Scopus, Embase, PubMed, ISI Web of Science, and Google Scholar databases from inception to February 2022. The terms “electroconvulsive therapy”, “neurobiological effects of electroconvulsive therapy”, “molecular mechanisms in electroconvulsive therapy”, and “psychiatric disorders” were among the keywords used in the search. The mechanisms of action of ECT include neurobiological function modifications and endocrine and immune changes that take place after ECT. Among these, the decrease in neural network hyperconnectivity, neuroinflammation reduction, neurogenesis promotion, modulation of different monoaminergic systems, and hypothalamus–hypophysis–adrenal and hypothalamus–hypophysis–thyroid axes normalization have been described. The majority of these elements are physiopathological components and therapeutic targets in different mental illnesses. Likewise, the use of ECT has recently expanded, with evidence of its use for other pathologies, such as Parkinson’s disease psychosis, malignant neuroleptic syndrome, post-traumatic stress disorder, and obsessive–compulsive disorder. In conclusion, there is sufficient evidence to support the efficacy of ECT in the treatment of different psychiatric disorders, potentially through immune, endocrine, and neurobiological systems.

Desde la perspectiva histórico-cultural, el trastorno por déficit de atención (TDA) se asocia con la inmadurez del factor de programación y control, que involucra el funcionamiento de regiones frontales del cerebro y hace parte del sistema ejecutivo. El artículo aborda un estudio de caso clínico en el que se exploró el impacto sistémico de un programa de intervención breve basado en el análisis del factor neuropsicológico, para comprobar su efectividad y eficiencia en el manejo sintomatológico del (TDA) y para proponer nuevos estudios controlados y aleatorizados que eventualmente validen esta metodología. Para lograrlo, se describieron los alcances del programa de corrección neuropsicológica orientada al fortalecimiento del factor de regulación y control mediante el desarrollo de la función reguladora del lenguaje, para incrementar las capacidades de planeación, control de espera, de autoverificación y la atención voluntaria. La intervención se basó en un diseño de línea de base múltiple tipo A-B-A, cuyos resultados se analizaron a partir de los puntajes de pruebas normalizadas y del análisis cualitativo de sus ejecuciones, realizadas al inicio del estudio y seis meses después. El caso analizado mostró un fortalecimiento de la función reguladora del lenguaje que impactó el desarrollo de los procesos psicológicos ejecutivos y se tradujo en un incremento del control atencional voluntario, la regulación de espera y la capacidad de planeación. Se concluye que el resultado de este caso ubica a este método como alternativa de manejo del (TDA) susceptible de ser estudiada en mayores grupos poblacionales controlados para validar el resultado, y eventualmente ofrecer un manejo extrapolable a la población diagnosticada.

Background: A growing body of evidence suggests that cigarette smoking can cause the onset of metabolic syndrome prior to cardiovascular diseases. Therefore, the objective of this study was to evaluate the relationship between smoking habit and metabolic syndrome components in an adult population from Maracaibo city, Venezuela. Methods: The Maracaibo City Metabolic Syndrome Prevalence Study is a descriptive, cross-sectional study with random and multi-stage sampling. In this sub-study, 2212 adults from both genders were selected. On the basis of their medical background, they were classified as smokers, non-smokers and former smokers. Metabolic syndrome was defined according to Harmonizing 2009 criteria, using population-specific abdominal circumference cut-off points. The association between risk factors was evaluated using a logistic regression model. Results: In the studied population, 14.8% were smokers, 15.4% were former smokers. In the multivariate analysis, the presence of metabolic syndrome (smokers: OR, 1.54; 95% CI, 1.11–2.14; p=0.010) and its components were related to cigarette smoking, with the exception of hyperglycemia. High blood pressure was inversely associated with current smoking status (smokers: OR, 0.70 (0.51–0.95); p=0.025). Conclusion: Cigarette smoking represents an independent risk factor for the development of metabolic syndrome, being associated with low high-density lipoprotein-cholesterol, increased abdominal circumference and elevated triacylglyceride levels. Former smokers did not present a greater risk for developing this metabolic disease when compared to non-smokers. The effect of avoiding this habit should be evaluated in future studies in our population.

En las relaciones sexuales de jóvenes, las variables asociadas al uso del condón son diversas y comúnmente se presentan con otras variables que, a su vez, se asocian con la práctica sexual desprotegida. Los objetivos de este estudio consistieron en determinar en qué medida la percepción de auto eficacia, la baja percepción de riesgo y el rechazo del uso del condón se relacionan con el uso del condón en las relaciones sexuales de jóvenes colombianos. Participaron en él 308 estudiantes universitarios de la ciudad de Cúcuta, Colombia. Los resultados indican correlaciones significativas en hombres entre el uso del condón y la percepción de auto eficacia, y correlaciones negativas en mujeres entre el uso del condón, la baja percepción de riesgo y el rechazo del uso del condón. Solo en el grupo de hombres, la percepción de autoeficacia predice el uso del condón.