Abstract in English:

Abstract Background Self-compassion (SC), defined as a positive and accepting attitude towards oneself during times of suffering or failure, is receiving more attention in the context of chronic pain disorders. However, very little is known regarding the link between SC, psychological symptoms, and migraine features. Objective To compare the SC levels of migraine patients to those of healthy controls and investigate the relationships among SC, anxiety, depression, and migraine features. Methods This cross-sectional study comprised 90 healthy controls (age: 35 ± 9.8 years, 75 female patients) and 98 migraine sufferers (age: 36.7 ± 11.3 years, 84 female patients). The Beck depression inventory, Beck anxiety inventory, and self-compassion scale were completed by the participants. Results The SC levels were considerably lower in migraine patients. Patients with chronic migraine performed worse than those with episodic migraines on the self-kindness, common humanity, and mindfulness subscales. Patients with medication overuse also had reduced SC. Higher isolation scores were linked to aura presence. Conclusion We found impaired SC in individuals with migraine, and a connection with greater emotional distress and migraine characteristics. These results demonstrate the possible value of emphasizing SC in migraine therapies, especially for those who suffer from chronic migraine, aura, or medication overuse.

Abstract in English:

Abstract Background Neurodevelopmental disorders (NDDs) are substantial burdens for individuals and health systems; yet, their long-term epidemiology in South America is poorly characterized. Objective To describe the trends from 1990 to 2023 in the age-standardized prevalence rates (ASPRs) of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and idiopathic developmental intellectual disability (IDID) across 12 South American countries using Global Burden of Disease (GBD) 2023 estimates. Methods Country-specific annual ASPRs and 95% uncertainty intervals (95%UIs) were obtained from the GBD 2023. Sex-stratified ASPRs were used to calculate male-to-female ratios (MFRs) and summarize long-term sex disparities. Temporal trends were assessed using the average annual percent change (AAPC) from log-linear regression for each country. Results In 2023, the ASPRs ranged from 0.57 to 1.06% for ASD, from 1.00 to 2.55% for ADHD, and from 0.42 to 0.54% for IDID across countries. Between 1990 and 2023, the ASD ASPRs increased in all countries, with AAPCs from +0.35%/year (Paraguay) to +0.79%/year (Chile). The ADHD ASPRs showed little net change, with AAPCs from −0.10%/year (Argentina) to +0.39%/year (Brazil). And the IDID ASPRs declined consistently, with AAPCs from −0.79%/year (Bolivia) to −0.30%/year (Suriname). Sex differences in ASPRs were large and persistent for ASD and ADHD, but small for IDID. The MFR trajectories suggested a slight widening of the ASD male–female gap, largely stable ADHD disparities, and minimal variability for IDID. Conclusion Over 3 decades, the ASD ASPRs rose modestly, the ADHD ASPRs were broadly stable, and the IDID ASPRs declined across South America. The GBD 2023 estimates point to enduring diagnostic and structural inequities and to the need for strengthened surveillance and more equitable access to developmental assessment.

Abstract in English:

Abstract Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction characterized by fluctuating skeletal muscle weakness. We report a 61-year-old woman presenting with progressive dysphagia as the sole initial symptom for 15 months, leading to diagnostic delay. Esophageal manometry suggested ineffective motility, and electroneuromyography was normal, reinforcing a non-neurological hypothesis. During hospitalization for worsening dysphagia, cervical magnetic resonance imaging (MRI) incidentally revealed an anterior mediastinal nodule consistent with thymoma. Pulse corticosteroid therapy caused abrupt clinical deterioration, prompting neurological evaluation. Pyridostigmine produced marked improvement within 48 hours, and acetylcholine receptor antibody testing confirmed MG (18.7 nmol/L, radioimmunoassay). Robotic thymectomy revealed a type AB thymoma. The patient remains stable on azathioprine 2.5 mg/kg/day, with oncologic follow-up. This case highlights that MG should be considered in persistent unexplained dysphagia, particularly when symptoms worsen after corticosteroid exposure. Early recognition avoids morbidity and unnecessary invasive procedures.