Explore the vast range of titles available.

The “Alice in Wonderland syndrome” (AIWS) is a neurological disorder characterized by altered body schema perception, visual, or somesthetic symptoms, which is frequently associated with migraine. In this article, we present the earliest known description of symptoms attributable to AIWS in the medical literature. During a lecture held on November 22, 1887, at the Salpêtrière, Jean-Martin Charcot (1825–1893) examined a patient with somesthetic symptoms (partial macrosomatognosia) in the context of migraine with aura. Although this condition was not known at the time, Charcot tried to provide an accurate semiological and nosographic framework of this case, attributing the complex of symptoms to migraine with aura and epilepsy with sensory symptoms. With intellectual honesty and clinical prudence, Charcot correctly pointed to a disturbance in the excitability of cortical areas responsible for processing and perceiving sensory stimuli.

The increasingly swift changes in the field of medicine require a reassessment of the skills necessary for the training of technically qualified doctors. Today’s physicians also need to be capable of managing the complex issue of personal relationships with patients. Recent pedagogical debates have focused on so-called “soft skills”, whose acquisition is presented in literature as a quite recent addition to medical studies. Moreover, the historical investigation of deontological texts dating from the mid-nineteenth century back to the Hippocratic Oath shows that medicine has always discussed the need to integrate technical expertise in medicine with specific personal and relationship-based skills. Debates have often circled around whether these “soft skills” could actually be taught or how they could be successfully transmitted to training physicians. The belief that defining medicine is more complex than defining other similar sciences and that the instruments to be used in the relationship with patients cannot be limited to those provided by technical aspects shows a new awareness. Today, this view is often stated as an innovative realization on the part of doctors with regard to the complexity of training and action in a delicate area in which they are entrusted with the management of the balance of the system that is the human body.

The recent spreading of Zika virus represents an emerging global health threat. As such, it is attracting public interest worldwide, generating a great amount of related Internet searches and social media interactions. The aim of this research was to understand Zika-related digital behavior throughout the epidemic spreading and to assess its consistence with real-world epidemiological data, using a behavioral informatics and analytics approach. In this study, the global web-interest and reaction to the recently occurred outbreaks of the Zika Virus were analyzed in terms of tweets and Google Trends (GT), Google News, YouTube, and Wikipedia search queries. These data streams were mined from 1st January 2004 to 31st October 2016, with a focus on the period November 2015-October 2016. This analysis was complemented with the use of epidemiological data. Spearman's correlation was performed to correlate all Zika-related data. Moreover, a multivariate regression was performed using Zika-related search queries as a dependent variable, and epidemiological data, number of inhabitants in 2015 and Human Development Index as predictor variables. Overall 3,864,395 tweets, 284,903 accesses to Wikipedia pages dedicated to the Zika virus were analyzed during the study period. All web-data sources showed that the main spike of researches and interactions occurred in February 2016 with a second peak in August 2016. All novel data streams-related activities increased markedly during the epidemic period with respect to pre-epidemic period when no web activity was detected. Correlations between data from all these web platforms resulted very high and statistically significant. The countries in which web searches were particularly concentrated are mainly from Central and South Americas. The majority of queries concerned the symptoms of the Zika virus, its vector of transmission, and its possible effect to babies, including microcephaly. No statistically significant correlation was found between novel data streams and global real-world epidemiological data. At country level, a correlation between the digital interest towards the Zika virus and Zika incidence rate or microcephaly cases has been detected. An increasing public interest and reaction to the current Zika virus outbreak was documented by all web-data sources and a similar pattern of web reactions has been detected. The public opinion seems to be particularly worried by the alert of teratogenicity of the Zika virus. Stakeholders and health authorities could usefully exploited these internet tools for collecting the concerns of public opinion and reply to them, disseminating key information.

Background Health-related quality of life (HRQoL) measurement in elderly people can provide appropriate information for an optimal management of physical/mental conditions. The main objective of the present study was to quantitatively assess the HRQoL among healthy elder Iranian individuals as measured by the Short-Form 36 (SF-36) questionnaire, both overall and at the level of each its single component/domain. Methods This study was designed as a systematic review and meta-analysis, following the \"Preferred Reporting Results of Systematic Reviews and Meta-Analyses\" (PRISMA) guidelines. Embase, PubMed/MEDLINE, ISI/Web of Science (WOS), Scopus, and Iranian databases such as MagIran, SID and Irandoc were mined from inception up to 1st September 2017. Also the grey literature (via Google Scholar) was mined. Two reviewers independently screened titles/abstracts, assessed full-text articles, extracted data, and appraised their quality using the \"Strengthening the Reporting of Observational Studies in Epidemiology\" (STROBE) checklist. Results Twenty five studies were included. Mean overall HRQoL was 54.92 [95%CI 51.50–58.33], lower than the value found by studies done in other countries, especially in those economically developed. The sensitivity analysis indicated stability and reliability of results. Pooled scores of each HRQoL domain/sub-scale of the SF-36 questionnaire ranged from 49.77 (physical role functioning) to 63.02 (social role functioning). Conclusions HRQoL among healthy elder Iranian individuals is generally low. Health policy-makers should put HRQoL among the elderly as a priority of their agenda, implementing ad hoc programs and providing social, economic and psychological support, as well as increasing the participation of old people in the community life and use their experiences.

The World Health Organization (WHO) appeal of January 15, 2024, stated \"The current number, size and concurrence of multiple outbreaks, the spread to areas free of cholera for decades and alarmingly high mortality rates present a major threat to global health security.\" The current state is extremely worrying, considering the difficulties of countries in dealing with cholera epidemics due to the lack of funding and the difficulty in oral cholera vaccine production and administration. This study aims to analyse the past and current influence of anthropization on cholera onset. We analysed the literature, particularly of the last 5 years, on the influence of human actions that impact the spread of cholera. The epidemiological data published by WHO and the available literature highlight a strong impact of human actions on the epidemic spread of cholera, the government's difficulty in making decisions on epidemic prevention or containment, and the fear of the population. Cholera should be considered an anthropogenic disaster, considering the historical health analysis of the cholera epidemics in Italy in the last two centuries and in southern Italy and in Naples in 1973.

Background Health Technology Assessment (HTA) is a vital tool for evidence-based healthcare decision-making, yet its adoption in Iran remains limited despite its potential to improve policy and resource allocation. This qualitative study explores the challenges hindering the integration of HTA into Iran’s healthcare system, providing insights from key stakeholders. Methods A qualitative research design was employed, using in-depth, semi-structured interviews with 23 stakeholders, including health policymakers, HTA experts, and healthcare professionals. Participants were selected through purposive sampling to ensure diverse representation across Iran’s healthcare sectors. Data were analyzed using thematic content analysis based on Braun and Clarke’s framework, with MAXQDA software for coding and analysis. Validation was achieved through member-checking and peer debriefing. Results The challenges were categorized into internal and external factors. Internal factors included institutional challenges such as a lack of clear policies or guidelines, inadequate institutional support, and bureaucratic constraints; resource limitations, including insufficient financial resources, human resource shortages, and gaps in technological infrastructure; knowledge and awareness gaps, characterized by limited awareness among decision-makers, insufficient training and education, and a preference for traditional methods; and data and evidence gaps, including a lack of reliable data, a limited local evidence base, and challenges in data sharing. External factors included political and economic influences, such as political instability, policy shifts, economic pressures, and the influence of interest groups; as well as ethical and equity concerns, which involved challenges in ethical decision-making, equity concerns, and public perception and acceptance. Conclusion This study highlights the multifaceted challenges to HTA adoption in Iran, emphasizing the need for stronger institutional frameworks, increased resources, enhanced stakeholder awareness, and improved public engagement. Addressing these challenges through targeted policy interventions can facilitate the integration of HTA into healthcare decision-making, promoting more equitable and evidence-based policies in Iran. These findings can guide policymakers and healthcare leaders in designing context-specific solutions to enhance HTA utilization. The findings also offer valuable lessons for other low- and middle-income countries facing similar challenges, contributing to the global discourse on HTA implementation in resource-constrained settings.

Background Brucellosis remains a persistent public health challenge in Iran, particularly in rural regions such as Lorestan province, due to systemic, economic, and cultural barriers. Effective disease control requires multisectoral collaboration among stakeholders. This study aimed to map the stakeholder network involved in brucellosis prevention in Lorestan province, identify gaps in coordination, and provide actionable recommendations for improving control strategies. Methods This cross-sectional study employed social network analysis (SNA) to explore the relationships among key stakeholders in brucellosis prevention. Data were collected through a structured questionnaire administered to 75 experts from various sectors, including health, veterinary, agriculture, and non-governmental organizations. The SNA evaluated network density, clustering coefficient, and centrality metrics to determine the levels of collaboration and influence among stakeholders. Results The analysis revealed a moderately dense network (density: 0.2745; clustering coefficient: 0.2839) with central roles played by the Veterinary Organization of Lorestan Province, Lorestan University of Medical Sciences, and the Ministry of Agriculture. These organizations exhibited high levels of influence, support, and interest in brucellosis prevention. However, limited involvement of community-based organizations and environmental agencies was identified, highlighting a critical gap in grassroots engagement. Fragmented coordination was particularly evident in rural areas, where traditional livestock practices, inadequate veterinary services, and the consumption of unpasteurized dairy products perpetuate disease transmission. Economic constraints, such as the high cost of vaccines, along with limited public awareness, further hinder effective control efforts. Conclusions Brucellosis prevention in Lorestan province requires a comprehensive, multisectoral approach. The adoption of a One Health framework can improve collaboration among stakeholders, enhance resource allocation, and address systemic barriers. Community engagement and intersectoral coordination are essential for improving public awareness and compliance with preventive measures. These findings provide a foundation for developing a National Brucellosis Control Program and inform strategies to mitigate zoonotic diseases in similar high-risk regions.

Background Brucellosis, a zoonotic disease caused by Brucella species, remains a major public health and economic challenge in regions dependent on livestock farming. In Iran, particularly in the western provinces, the disease imposes a heavy burden on healthcare systems and households through medical costs and productivity losses. This study quantified the economic burden of brucellosis in western Iran to inform policy and resource allocation. Methods A cross-sectional cost-of-illness study was conducted among 427 brucellosis patients in Lorestan province . Data on direct medical costs (hospitalization, medications, diagnostics), direct non-medical costs (transportation, accommodation), and indirect costs (productivity losses) were collected using a bottom-up approach. All costs were expressed in 2024 USD, and sensitivity analyses were conducted at 0% and 5% discount rates. The catastrophic health expenditure (CHE) index was used to assess financial hardship. Results The mean total cost per patient was 1,060 USD, with direct medical costs representing 73.6% of the total. Hospitalization was the largest component (38%), followed by surgical interventions (26%) and medications (13%). Indirect costs accounted for 18.9% of the total burden. The CHE index reached 66.3%, indicating severe financial strain for affected households. Sensitivity analyses showed notable variability in medical and non-medical cost estimates. Conclusion Brucellosis imposes a substantial economic burden in western Iran, reflecting both healthcare and productivity losses. Effective control measures such as livestock vaccination, improved diagnosis, and expanded insurance coverage are essential to reduce financial hardship and support sustainable disease management.