M S-medecine Sciences最新文献

Patients with long Covid experience multiple, often very debilitating symptoms, yet their test results frequently appear normal. In the absence of objective indicators of a recognized disease, some professionals may conclude that the patient is suffering from a psychosomatic disorder. These patients face an epistemic injustice, that is, a failure to recognize their suffering as real. This injustice is rooted in a longstanding history of medically invisible disorders, which are diagnosed mainly on the basis of the patient's own narrative. The difficulties experienced by patients with long Covid cannot be dissociated from this history.

This article analyses the nosological and aetiological conceptualisation of mental disorders in the late Middle Ages. Medieval physicians viewed humans as composed of a body and soul that were united and closely interrelated. They located mental processes in the brain, distributed among different areas according to the faculties of the soul, in particular imagination, reason/judgement, and memory. Mental diseases, were distinguished and diagnosed on the basis of a complex and subtle symptomatology, and their causes were the subject of thorough reflection in order to situate them within the physiological theories of the time. Medieval nosology mainly distinguished three categories of mental disease: frenzy, mania, and melancholy, taking into account observed behaviors and relying on a multifactorial aetiology. Examining these medieval conceptualizations allows us to place the search for a precise classification of mental disorders and diseases, and for an etiology consistent with the physiological conceptual framework, within a long-term historical trajectory. This article thus provides insights from a historical and epistemological perspective highlighting the resonance between the concerns of medieval physicians and those of contemporary psychiatrists.

This review highlights the crucial role of olfaction in regulating energy homeostasis. Neurons in the olfactory system stimulate the limbic and hedonic pathways involved in food-related behaviors. These neurons are modulated by the body's energy metabolism status, which they, in turn, help to regulate. Olfactory sensitivity is reduced in obesity, while bariatric surgery restores olfactory function. In type 2 diabetes, the onset of olfactory dysfunction is predictive of cognitive decline. Finally, in a mouse model of obesity, local activation of glucagon-like peptide 1 (GLP-1) and its receptors in the olfactory bulb -the main brain structure responsible for encoding odorsleads to improved glycemic control and regulation of food intake. Activation of this new neurometabolic pathway connecting the olfactory system to the pancreas leads to increased insulin secretion and sensitivity to this hormone.

Smoking remains a major challenge for global public health. Neuromodulation techniques appear to be promising alternatives to current therapies. Repetitive transcranial magnetic stimulation (rTMS), by modulating prefrontal circuits, seems to reduce craving and cigarette consumption with good tolerance, although its effects often fade over time. Transcranial direct current stimulation (tDCS) yields more variable outcomes, influenced by the number of sessions, patient motivation, and combination with other treatments. Neurofeedback (using functional magnetic resonance imaging or electroencephalogram), allowing individuals to voluntarily regulate their brain activity, has provided encouraging preliminary results which however need to be replicated and further investigated through controlled trials. Overall, these approaches appear safe and potentially effective, but larger, standardized clinaical trials are required to confirm their role in smoking cessation.