Phantom limb pain (PLP) affects up to 80% of amputees. Despite the lack of consensus about the etiology and pathophysiology of phantom experiences, previous evidence pointed out the role of changes in motor cortex excitability as an important factor associated with amputation and PLP. In this systematic review, we investigated changes in intracortical inhibition as indexed by transcranial magnetic stimulation (TMS) in amputees and its relationship to pain. Four electronic databases were screened to identify studies using TMS to measure cortical inhibition, such as short intracortical inhibition (SICI), long intracortical inhibition (LICI) and cortical silent period (CSP). Seven articles were included and evaluated cortical excitability comparing the affected hemisphere with the non-affected hemisphere or with healthy controls. None of them correlated cortical disinhibition and clinical parameters, such as the presence or intensity of PLP. However, most studies showed decreased SICI in amputees affected hemisphere. These results highlight that although SICI seems to be changed in the affected hemisphere in amputees, most of the studies did not investigate its clinical correlation. Thus, the question of whether they are a valid diagnostic marker remains unanswered. Also, the results were highly variable for both measurements due to the heterogeneity of study designs and group comparisons in each study. Although these results underscore the role of inhibitory networks after amputation, more studies are needed to investigate the role of a decreased inhibitory drive in the motor cortex to the cause and maintenance of PLP.

Objective:To describe first medical students' profile of the Faculdade Israelita de Ciências da Saúde Albert Einstein. Methods:Data were collected using an electronic questionnaire during the Biostatistics course in August of 2016. The students were inquired about demographic characteristics, data on their secondary education and college entrance exams, practice of physical exercise, leisure activities done, to have a physician in the family, and specialty that they intended to pursue as a career.Results:Most of the students were women aged 18 to 21 years and who were originally from the state of São Paulo, had received secondary education in a private school, took a course to prepare for college entrance exam, and participated in more than 5 college entrance exams in the same year they entered in the School of Medicine. The majority of participants practiced physical exercise regularly and were engaged in common leisure activities. Most of students (58%) had a physician in the family and more than half (52%) did not know which specialty to pursue as career. There was no association between relationship with a physician and the student's choice of a specialty (p=0.390).Conclusion:Although it was the first group of student of School of Medicine at Faculdade Israelita de Ciências da Saúde Albert Einstein who took a different admission process, our data showed that students' profile is similar to students from other colleges.

Introduction: Migraine is a common primary headache and a major cause of disability. In at least a third of migraine attacks, the headache is preceded and/or accompanied by aura and the visual manifestation is the most frequent phenotype. Migraine with aura, a subtype of migraine disorder, are underdiagnosed and undertreated. So, a detailed aura iconography is important for better recognition, prevention and treatment of migraine with aura. Objective: A visual aura art contest was performed by ABRACES (Brazilian Association of Cluster Headaches and Migraines), in order to provide new images for raising awareness among population and professionals and decreasing the gap between diagnosis and treatment. Methods: The contest involved free subscription of drawings, paintings and digital art that expressed realistic results of a visual aura of migraine and answering of a questionnaire. The awards were separated in two categories (painting/drawing and digital art/photography) and amounted up to R$ 5,000. Results: There were 139 participants, 24% men and 76% women. The most common visual aura’s characteristic was the presence of colorful points, and the less frequently was golden. The mean duration of visual aura was 110.6 minutes (450.5 of standard deviation), median of 20 minutes, minimum of 1 minute and maximum of 3600 minutes. 36.7% of the subscribers have only one kind of visual aura and 33.8% answered that have more than one kind. 46,5% said that their visual aura almost never occurs without pain after or while aura and 19% reported that their visual aura always occurs without a headache. Conclusion: Art contests are useful tools for disease awareness. Further actions in disseminating aura images may help migraine aura underdiagnosis and undertreatment.

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Headache is a most prevalent neurological condition in the world and has a major impact on quality of life. The causes are usually multifactorial and may have a chronic character. Headache management involves pharmacological and non-pharmacological approach; invasive and noninvasive. Peripheral nerve block is already a viable, safe, and effective treatment option, such as major occipital nerve block. Full head block is a minimally invasive proposal of peripheral pain neuromodulation for the treatment of refractory or severe headache, mainly. The aim of this paper is to describe a technique and discuss the role of full head block in the headache management. The proposal is bilaterally anesthetizing the following nerves: major and minor occipital, supraorbital, supratrochlear, zygomatic-temporal and auriculo-temporal with local anesthetic and a corticosteroid. Many aspects should be studied: efficacy and safety of the technique, clinical indications, professional training, need for USG guidance, adequate dose of anesthetic and corticosteroids. In order to further evaluate the role of peripheral blocks in headaches randomized controlled trials are required.