Michelangelo’s art on the Sistine Chapel ceiling: sacred representation or anatomy lessons?

The Renaissance was a period of extensive scientific and cultural production, which occurred between the fourteenth and sixteenth centuries. One of the exponents of this artistic period was the poet, architect, sculptor and painter Michelangelo Buonarroti, who was born and lived in Italy between 1475 and 1564. Among his best known artworks are the frescoes painted on the Sistine Chapel ceiling. Currently, there is discussion if the paintings are only representations made from the sacred guidance of the church at the time, or if there are other meanings hidden in the images. From this context, we analyzed studies that associated the frescoes painted on the Sistine Chapel ceiling with anatomical structures hidden in the images, taking into account their significance, importance, and if these structures are not simply an imaginative interpretation of the researchers. This study was performed aiming to complement the work published by Ellwanger, Mohr and Campos (2012) in this journal.

Anatomy lessons in the Michelangelo' s works?

Michelangelo Bounarroti born in Italy and lived between 1475 and 1564. He had a vast knowledge inanatomy and it is confirmed by the perfection in which human  is represented in his works. This fact drawsthe attention of scholars from a variety of areas concerning the study of human body to be interested in his artworks. We discuss the possible presence of the representation of anatomical structures included in the worksof Michelangelo presented by several authors.

A modified technique improved histology similarity to human intracranial aneurysm in rabbit aneurysm model.

Persistent undigested elastic membranes and collagen in the tunic media of rabbit elastase-induced aneurysm models lowered their histology similarity to human intracranial aneurysm. Our purpose was to make good the deficiency. Ten New Zealand white rabbits were divided into three groups: six rabbit in two groups for evaluating the difference in various treatments, and four rabbits for long-term observation. We inflated and occluded the right common carotid artery (CCA) by an endovascular technique. The first group of three rabbits was only given 200u elastase in the proximal segment of right CCA; the second group was given 100u elastase and 1.5mg collagenase, then the right CCA was ligated. The first and second groups were studied by magnetic resonance angiography (MRA), sacrificed at three weeks after aneurysm creation, their histology results were obtained and compared with human aneurysm. The third group underwent the same procedure as the second group only for three months of observation with enhanced MRA. Saccular aneurysms formed in all rabbits. Degeneration of the extracellular matrix and atrophy of smooth muscular cells in tunic media were more apparent in the second group. The third group remained stable for more three months. Two modifications included inflating the right CCA with a balloon and adding collagenase incubation can promote an aneurysm model more histologically similar to human aneurysm. In addition the improved aneurysm model remains stability for a long time.

Efectividad de la técnica de intervención en crisis (IC) en un servicio de urgencia de un hospital general / Effectiveness of the Crisis Intervention Technique (IC) in an emergency service of a general hospital

Siguiendo experiencias internacionales y locales, se implementó durante 6 meses dentro del servicio de urgencia del Hospital San José un plan piloto de atención psicológica para pacientes en crisis. El objetivo fue evaluar la efectividad de la técnica psicoterapeutica de intervención en crisis (IC) en este contexto. Se utilizó un diseño cuasi-experimental y comparaciones entre grupos experimental y control. El instrumento de evaluación de efectividad fue el OQ45.2 (Lambert & Burlingame, 1996). Se incluye un seguimiento del grupo experimental a los 3 meses de terminado el tratamiento. Los resultados muestran que la técnica de IC ha sido efectiva en el alivio sintomático, pero sin diferencias significativas entre los grupos con respecto a la adaptación social y la calidad de las relaciones interpersonales. Se aprecia estabilidad de la mejoría en el seguimiento del grupo tratado. Se discuten algunos resultados en el ámbito de las relaciones interpersonales y el papel defensivo que juegan los síntomas durante las crisis.

Atención psicológica en un servicio de urgencia de hospital general / Psychological assistance in a general hospital emergency room service

En un informe sobre atención psiquiátrica en servicios de urgencia de Santiago (Escobar & Escobar, 1989), los autores daban cuenta de una cifra de 30.000 consultas al año cuyo diagnóstico estaba asociado a la morbilidad psiquiátrica. Mucha de esta consulta está asociada a algún problema somático o bien corresponde a intentos de suicidios o crisis psicológica grave. La mayor parte de estos pacientes no son derivados a especialidad, produciéndose en algunos de ellos el fenómeno de "puerta giratoria" con gastos de recursos económicos y profesionales. Este trabajo describe la experiencia piloto de un programa de atención psicológica en el servicio de urgencia del Hospital San José. El programa se implementó durante 6 meses con diversas alternativas de intervención psicológica. La experiencia es inédita en nuestro país y podría ser un campo de desarrollo para psicólogos clínicos con potenciales proyecciones a servicios de salud de todo el país.

Motor and cognitive aspects of motor retardation in depression.

BACKGROUND: Motor retardation is a common feature of major depressive disorder having potential prognostic and etiopathological significance. According to DSM-IV, depressed patients who meet criteria for psychomotor retardation, must exhibit motor slowing of sufficient severity to be observed by others. However, overt presentations of motor slowing cannot distinguish slowness due to cognitive factors from slowness due to neuromotor disturbances. METHODS: We examined cognitive and neuromotor aspects of motor slowing in 36 depressed patients to test the hypothesis that a significant proportion of patients exhibit motor programming disturbances in addition to psychomotor impairment. A novel instrumental technique was used to assess motor programming in terms of the subject's ability to program movement velocity as a function of movement distance. A traditional psychomotor battery was combined with an instrumental measure of reaction time to assess the cognitive aspects of motor retardation. RESULTS: The depressed patients exhibited significant impairment on the velocity scaling measure and longer reaction times compared with nondepressed controls. Approximately 40% of the patients demonstrated abnormal psychomotor function as measured by the traditional battery; whereas over 60% exhibited some form of motor slowing as measured by the instruments. Approximately 40% of the patients exhibited parkinsonian-like motor programming deficits. A five-factor model consisting of motor measures predicted diagnosis among bipolar and unipolar depressed patients with 100% accuracy. LIMITATIONS: The ability of motor measures to discriminate bipolar from unipolar patients must be viewed with caution considering the relatively small sample size of bipolar patients. CONCLUSIONS: These findings suggest that a subgroup of depressed patients exhibit motor retardation that is behaviorally similar to parkinsonian bradykinesia and may stem from a similar disruption within the basal ganglia.

P300 scalp amplitude distribution as an index of deception in a simulated cognitive deficit model.

Truth-telling (Truth) and simulated malingering (Malinger) groups were tested in a matching-to-sample procedure in which each sample three-digit number was followed by a series of nine test numbers, only one of which matched the sample. P300 was recorded during test-number presentation. Group analyses revealed differences between the P300s of the groups in unscaled amplitude, but not latency, in response to match and mismatch stimuli. P300 amplitudes at Fz, Cz, and Pz were scaled to remove possible confounding effects of amplitude in tests of the interactions of site with other variables. Significant interactions of both stimulus-type (match vs. mismatch) and group (Truth vs. Malinger) with site were obtained. Within the Malinger group, a significant interaction was obtained (scaled data) between site and response type (honest vs. dishonest). These interactions suggest that deceptive and honest responding are associated with different neurogenerator sets or different sets of P300-overlapping components. In within-individual analyses, 100% of the Truth participants and 87% of the Malinger participants were found to have larger P300 responses at Pz to match stimuli than to mismatch stimuli on the basis of intra-individual bootstrap tests. This represents an improvement in comparison with our related, previous report on a matching-to-sample test using only one test stimulus per sample.

P300 as an index of recognition in a standard and difficult match-to-sample test: a model of amnesia in normal adults.

Earlier research has supported the use of a P300 (P3)-based procedure to detect simulated amnesia. In the present experiment, an attempt was made to model the behavior and event-related potentials (ERPs) that amnestic patients might demonstrate with relatively easy recognition memory tests, by increasing the difficulty of a match-to-sample recognition memory test taken by 18 memory-unimpaired undergraduates. None of the participants in the modeled amnesic condition were classified as having intact recognition memory as the result of P3-based intra-individual tests (specificity = 100%). The results support the utility of a P3 procedure for the detection of malingering by demonstrating the procedure to be a valid measure of impaired recognition with this model of amnesia.

Identifying simulators of cognitive deficit through combined use of neuropsychological test performance and event-related potentials.

Event-related potential (ERP) methods for identifying malingering of cognitive deficit assume that elements of brain/cognitive functioning are not under a person's direct control, whereas neuropsychological methods assume that malingered cognitive deficit will present differently than true impairment in terms of level or pattern of errors on tests of cognitive function. Two studies were conducted to examine the combined use of neuropsychological and ERP methods for identifying malingering because of the potential independence of these approaches. All normal control participants performing at their best level (n = 25) were correctly classified by both ERP and neuropsychological methods. All participants simulating cognitive deficit (n = 35) were correctly classified on the basis of a positive outcome on either the neuropsychological or the ERP method. Results suggest that the neuropsychological and psychophysiological measures of malingering that were studied contribute non-redundant information in the classification of simulators.

P300 correlates of simulated malingered amnesia in a matching-to-sample task: topographic analyses of deception versus truthtelling responses.

Two experiments using a P300-enhanced Forced Choice Procedure (P3FCP) investigated simulated amnesia in a matching-to-sample task. In Experiment 1, successful manipulation of subjects towards different behavioral hit rates (75-80% vs. 85-90%) did not adversely affect the diagnostic sensitivity of match-mismatch Pz-P300 amplitude analyses, allowing detection of 69% of simulators. P300 amplitudes of simulators (Malinger group) were as large as those of truth-tellers (truth group, a control), indicating no dual task-related (Malingering) reduction across different behavioral hit rates. Experiment 2 found no main effect of oddball type, match vs. mismatch, on P300 (P3) amplitude with a mismatch-rare variant of the P3FCP. This study also revealed larger Pz-P3s in the Malingering (vs. Truth-telling) condition. Subsequent topographic analyses suggested different Truth and Malinger scaled P3 amplitude topographies in both these sets of P3FCP data and in those from a previous autobiographical memory paradigm. Further analysis yielded preliminary evidence for a common deception-related P3 amplitude topography across different paradigms/conditions.

Detecting simulated amnesia for autobiographical and recently learned information using the P300 event-related potential.

To investigate whether the P300 (P3) event-related potential (ERP) can be used as an index of the intactness of recognition memory in subjects trying to simulate amnesia, two groups of subjects (n = 12 and n = 15) were instructed to simulate amnesia and one group of control subjects (n = 14) did not simulate amnesia while taking three recognition tests, during which ERPs were recorded. The three tests consisted of three different types of memory items: (1) the subject's birthday (birth), (2) the experimenter's name (name), (3) a word list of 14 nouns (words). The memory item was presented in a random series with other, similar in type, non-memory items. In group tests, memory items evoked larger amplitude P3s than non-memory items (p < 0.001). Within-subjects tests were used to determine whether the P3 amplitude in response to memory items was larger than the P3 amplitude in response to non-memory items for each individual. There was no difference between the sensitivity of the best within-subjects tests for amnesia simulators (birth = 0.9, name = 0.85, words = 0.53) versus non-simulators (birth = 1.0, name = 0.81, words = 0.5) averaged across the three test types. This suggests that P3 used as an index of the intactness of recognition memory may be useful in cases of suspected malingering.

Detecting simulated amnesia with event-related brain potentials.

Two experiments were done in which groups of normal college undergraduate subjects were instructed to simulate autobiographical amnesia related to head injury. The subjects were tested for autobiographical knowledge with pencil-and-paper recall and recognition tasks, and on another day, with recognition tasks in which event-related potentials were recorded in response to the same autobiographical items, this time presented on a display screen. In the first study, three Event-Related Potential (ERP) block types were utilized: 1) a block in which the subject's birthdate was an oddball with p = 0.11 and other dates (not relevant to the subject) had p = 0.89, 2) a block in which phone numbers were used as stimuli, and 3) a block in which (mothers' maiden) names were used as stimuli. Only birthdate blocks were used in the second study. A P300 ERP was seen in response to rare, personally relevant items. In both studies, the main effect of stimulus type (personally relevant versus not personally relevant) on P300 amplitude was significant (p < 0.0001) and there was no main effect of block type in the first study. Under a sophisticated malingering instruction set, about 15% of the items were correctly recalled and about 50% were correctly recognized by simulators in pencil-and-paper tests. Under a naive malingering instruction set, most simulating subjects failed to recall and recognize autobiographical items. In the first study, an arbitrarily but a priori derived discrimination criterion based on a subject's average P300 amplitude afforded 92% correct discrimination of simulating individual subjects for birthdates and phone numbers. The value was 77% for mothers' maiden names. The same criterion applied to the single birthdate block in the second study yielded 93% correct discrimination. The results suggest the P300 may be useful in detection of malingered amnesia.