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Dídia B Cury,1,2 Loyná E Flores Paez,1 Ana C Micheletti,3 Sabrina T Reis4 1Inflammatory Bowel Disease Center, Scope Clinic, Campo Grande, MS, Brazil; 2Center for Crohn’s and Colitis, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; 3Institute of Chemistry, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil; 4Laboratory of Medical Investigation 55 (LIM55) – Urology Department, University of São Paulo Medical School, São Paulo, SP, BrazilCorrespondence: Dídia B CuryInflammatory Bowel Disease Center, Scope Clinic, Maracaju Street 1148, Campo Grande, MS, 79002-212, BrazilTel +55 67 3325 6040Email didiacury@gmail.comIntroduction and Objectives: Patients with chronic illnesses, such as inflammatory bowel disease (IBD), may often consult the internet, which can cause anguish, fear, stress and anxiety. The aim of our study is to evaluate the use of the internet and its effects on patients with IBD.Patients and Methods: This is a descriptive, cross-sectional study with quantitative frequency analysis. We applied a questionnaire comprising questions about internet use, and the DASS21 questionnaire to analyze internet impact on patients’ stress and/or anxiety for 36 months.Results: A total of 104 patients were included over a period of 45 days (82% CD, 18% UC). The mean age was 41.3 years (± 15.9 years). Internet use was more frequent in patients with a mean age of 39.5 years (± 14.4 years), with the highest frequencies found in the age group of 26– 36 years. Internet use were related to: 72.6% general information about the disease, 87.3% symptom information (42.1% once a week, 27.4% never, 18.8% once a month, 10.5% daily, and 3.2% twice a day). The most visited search engine was Google 63.7% and the most visited sites were: patient group sites 16.7%, health sites 16.2% medical sites 12.8%.Conclusion: The internet is often a resource utilized by patients with IBD and although these patients sought to obtain more information about their disease and their symptoms. The internet was not a factor influencing anxiety and stress for these patients.Keywords: inflammatory bowel disease, electronic media, internet, Brazil

Background: Although vortioxetine demonstrates superior efficacy relative to placebo, there is still a lack of robust evidence to determine whether it offers advantages over commonly prescribed antidepressants for treating major depressive disorder (MDD). Thus, we aimed to perform a systematic review and meta-analysis comparing vortioxetine vs reuptake inhibitors in adults with MDD, analyzing two classes separately: (i) vortioxetine vs SSRIs and (ii) vortioxetine vs SNRIs., Methods: We searched MEDLINE, Embase, and Cochrane Library databases for randomized controlled trials comparing vortioxetine with SSRIs or SNRIs in adults with a primary diagnosis of MDD following standardized diagnostic criteria. Independent examiners conducted the literature search, study selection, data extraction, and risk of bias assessment. Data were pooled in random-effects analyses. Statistical significance was considered at p<0.05., Results: We included 6 trials (n=478) in the vortioxetine vs SSRIs analysis and 11 (n=4230) in the vortioxetine vs SNRIs analysis. There were no significant differences between vortioxetine and SSRIs/SNRIs in the probability of response, remission, overall dropouts, and dropout due to lack of efficacy. Vortioxetine provided a significantly lower risk of dropout due to adverse events compared with SNRIs, while not significant compared with SSRIs. Vortioxetine did not differ significantly from SNRIs regarding variation in MADRS score post-treatment. In general, vortioxetine exhibited a statistically lower risk of individual adverse events compared with SNRIs, while not significant compared with SSRIs., Conclusions: Our study reveals that vortioxetine is as effective as SSRIs and SNRIs for treating MDD, with safety equivalent to SSRIs and superior to SNRIs., Competing Interests: Declaration of Competing Interest No competing interests were declared., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Cultural traditions attribute to pineal gland an important role for spiritual experiences. Mediumship and spirit possession are cultural phenomena found worldwide which have been described as having dissociative and psychotic-like characteristics, but with nonpathological aspects. A sympathetic activation pattern in response to spirit possession has been reported in some studies, but empirical data on pineal gland is scarce in this context., Methods: We aimed to investigate pineal gland and pituitary volumes, as well as urinary 6-sulfatoxymelatonin levels in 16 alleged mediums (Medium Group-MG) compared with 16 healthy nonmedium controls (Control Group) (Experiment 1). Furthermore, we aimed to evaluate urinary 6-sulfatoxymelatonin and stress reactivity in GM (n = 10) under different physiological conditions (Experiment 2)., Results: In Experiment 1, MG presented higher scores of anomalous experiences, but there were no between-group differences regarding mental health or subjective sleep quality. Similar pineal gland and pituitary volumes were observed between groups. There were no between-group differences in urinary 6-sulfatoxymelatonin collected under equivalent baseline conditions. In Experiment 2, the rise of anxiety and heart rate in response to mediumistic experience was intermediate between a nonstressful control task (reading) and a stressful control task (Trier Social Stress Test-TSST). No significant differences were observed in 6-sulfatoxymelatonin urinary levels between the three conditions. The pattern of stress reactivity during the TSST was normal, but with an attenuated salivary cortisol response., Conclusion: The normal neuroimaging and stress reactivity findings in MG contrast with the abnormal results usually observed in subjects with psychotic and dissociative disorders., (© 2020 The Authors. Brain and Behavior published by Wiley Periodicals LLC.)