Morphine Perinatal Exposure Induces Long-Lasting Negative Emotional States in Adult Offspring Rodents.

Psychoactive substances during pregnancy and lactation is a key problem in contemporary society, causing social, economic, and health disturbance. In 2010, about 30 million people used opioid analgesics for non-therapeutic purposes, and the prevalence of opioids use during pregnancy ranged from 1% to 21%, representing a public health problem. This study aimed to evaluate the long-lasting neurobehavioral and nociceptive consequences in adult offspring rats and mice exposed to morphine during intrauterine/lactation periods. Pregnant rats and mice were exposed subcutaneously to morphine (10 mg/kg/day) during 42 consecutive days (from the first day of pregnancy until the last day of lactation). Offspring were weighed on post-natal days (PND) 1, 5, 10, 15, 20, 30, and 60, and behavioral tasks (experiment 1) or nociceptive responses (experiment 2) were assessed at 75 days of age (adult life). Morphine-exposed female rats displayed increased spontaneous locomotor activity. More importantly, both males and female rats perinatally exposed to morphine displayed anxiety- and depressive-like behaviors. Morphine-exposed mice presented alterations in the nociceptive responses on the writhing test. This study showed that sex difference plays a role in pain threshold and that deleterious effects of morphine during pre/perinatal periods are nonrepairable in adulthood, which highlights the long-lasting clinical consequences related to anxiety, depression, and nociceptive disorders in adulthood followed by intrauterine and lactation morphine exposure.

Repeated cycles of binge-like ethanol exposure induce immediate and delayed neurobehavioral changes and hippocampal dysfunction in adolescent female rats.

Binge-like ethanol intake (BEI) is a socioeconomical problem among adolescents and increasingly affects women. BEI can leave a long-term imprint in the brain, but it is unknown if its effect on cognition and anxiety is cumulative on repeated binge-ethanol episodes. We now submitted female Wistar rats to repeated cycles of binge-like ethanol treatment by intragastrically administering ethanol (3.0 g/kg/day, 20% w/v ethanol; 3 days on/4 days off) starting at postnatal day 35 (PND35). To investigate the short-term effects of BEI during adolescence, rats underwent 1 or 4 cycles of BEI, being evaluated at PND37 and PND58, respectively: both groups displayed anxiety-like behavior in the open field and elevated plus-maze tests, as well as short-term memory deficits in the object recognition task; this was associated with transient decreases of BDNF levels and increases of GFAP levels in the hippocampus. To evaluate the short- and long-lasting effects of BEI in adulthood, rats were subjected to 8 cycles of BEI and evaluated after 7.5 h (PND86) or after 14 days of ethanol withdrawal (PND100). This caused a persistent anxiogenic profile whereas recognition memory was impaired on the short-term, but not 14 days post-administration. The reduced BDNF level observed shortly after BEI recovered upon withdrawal, whereas increased GFAP immunoreactivity was persistent up to 14 days post-administration in adulthood. These findings show that repeated binge-like ethanol episodes from adolescence to adulthood in female rats cause consistent and long-term alterations of anxiety and hippocampal astrogliosis, whereas they trigger a recognition memory deficit paralleled by lower hippocampal BDNF levels, both recovering upon ethanol withdrawal.

An improved intragastric balloon procedure using a new balloon: preliminary analysis of safety and efficiency.

BACKGROUND: The authors developed a new intragastric balloon procedure with the objective of making it safer, faster, and less expensive than the established ones. The proposed procedure uses a new gastric balloon with technical improvements in the placement and removal procedures. METHODS: From June 2006 to July 2007, 52 patients were submitted to the new treatment with the Silimed Gastric Balloon (SGB), as part of a multidisciplinary program involving clinical, psychological, and behavioral approaches. RESULTS: The new placement and removal procedures of the SGB were effective and safe in all the cases. Due to simplicity and shortened duration of the procedures, all the patients left the outpatient clinic in less than 1 h after the placement or removal of the SGB. For the 14 patients who had completed the 6-month treatment, the initial mean weight, mean body mass index (BMI), and mean excess of weight (EW) were, respectively, 100.7 kg, 35.7 kg/m(2), and 30.0 kg. After the 6-month treatment, these values decreased significantly: 89.4 kg, 31.8 kg/m(2), and 19.6 kg. CONCLUSIONS: Preliminary data suggest that the procedure with the new balloon comes forth as a safe and effective alternative to the treatment of weight loss in patients with appropriate indication of use.

[Binge eating disorder in a population of morbid obese candidates to bariatric surgery at the Oswaldo Cruz University Hospital in Recife, PE]. / Transtorno da compulsão alimentar periódica em uma população de obesos mórbidos candidatos a cirurgia bariátrica do Hospital Universitário Oswaldo Cruz, em Recife--PE.

OBJECTIVES: To analyze the frequency of binge eating disorder (BED) and of the main psychiatric disorders associated with morbid obesity in individuals on the waiting list for bariatric surgery. METHOD: Cross sectional study. Interviews with patients from the Surgery for Obesity Program of Oswaldo Cruz University Hospital were conducted evaluating socio-demographic profile, quality of life (SF-36 scale), BED (Binge Eating Scale BES) and psychiatric disorders (M.I.N.I./DSM-IV). RESULTS: 67 out of 400 patients enrolled in the program were interviewed (16.8%). The BMI varied from 36.1 to 81.8 kg/m(2) (average 48.5 +/- 8.8). All have associated diseases, the most frequent being systemic arterial hypertension, sleeping disorders and osteopathies. The most frequent psychiatric disorders were: 47.8% generalized anxiety disorder, 29.9% major depressive disorder, single episode, 34.3% recurrent major depressive disorder. In this group 56.7% showed BED (25.4% moderate and 31.3% severe) and the worse scores in all the domains of quality of life (SF-36 scale). CONCLUSIONS: High prevalence of BED. The compulsive eaters showed a higher number of obesity treatments, higher prevalence of actual major depression, and the worse scores in all the domains of the SF-36 scale. Considering the ample range of psychopathology associated with BED and the greater probability of jeopardizing the surgery results it is very important to improve the detection of these disorders in order to provide adequate treatment.

Transtorno da compulsão alimentar periódica em uma população de obesos mórbidos candidatos a cirurgia bariátrica do Hospital Universitário Oswaldo Cruz, em Recife - PE / Binge eating disorder in a population of morbid obese candidates to bariatric surgery at the Oswaldo Cruz University Hospital in Recife, PE / Binge eating disorder in a population of morbid obese candidates to bariatric surgery at the Oswaldo Cruz University Hospital in Recife, PE

OBJETIVOS: Avaliar a freqüência de transtorno da compulsão alimentar periódica (TCAP) e dos principais transtornos psiquiátricos associados à obesidade mórbida em indivíduos à espera de cirurgia bariátrica. MÉTODOS: Estudo de corte transversal. Foram entrevistados pacientes do programa de cirurgia da obesidade do Hospital Universitário Oswaldo Cruz e avaliados o perfil sócio-demográfico, a qualidade de vida (escala SF-36), o TCAP (Binge Eating Scale ­ BES) e os transtornos psiquiátricos (Mini International Neuropsychiatry Interview ­ M.I.N.I./DSM-IV). RESULTADOS: Dos 400 pacientes inscritos no programa, 67 (16,8 por cento) foram entrevistados. O IMC variou de 36,1 a 81,8 kg/m² (média 48,5 ± 8,8). Todos os entrevistados apresentavam doenças associadas, sendo a HAS, os distúrbios do sono e as osteopatias as mais freqüentes. Os transtornos psiquiátricos mais freqüentes foram: 47,8 por cento transtorno de ansiedade generalizada; 29,9 por cento depressão atual e 34,3 por cento depressão no passado. Verificou-se TCAP em 56,7 por cento dos pacientes (25,4 por cento TCAP moderado e 31,3 por cento, grave) e esses apresentaram os piores escores em todos os domínios de qualidade de vida da escala SF-36. CONCLUSÕES: Constatou-se elevada prevalência de TCAP. Grupo com TCAP apresentou maior número de tratamentos realizados com objetivo de perder peso, elevada prevalência de depressão maior no momento da avaliação, piores escores em todos os domínios da escala de qualidade de vida SF-36. Visto que os portadores de TCAP apresentam vasta psicopatologia e maior probabilidade de comprometimento nos resultados da cirurgia, deve-se aprimorar a detecção desses distúrbios a fim de proporcionar-lhes o tratamento adequado.

OBJECTIVES: To analyze the frequency of binge eating disorder (BED) and of the main psychiatric disorders associated with morbid obesity in individuals on the waiting list for bariatric surgery. METHOD: Cross sectional study. Interviews with patients from the Surgery for Obesity Program of Oswaldo Cruz University Hospital were conducted evaluating socio-demographic profile, quality of life (SF-36 scale), BED (Binge Eating Scale ­ BES) and psychiatric disorders (M.I.N.I./DSM-IV). RESULTS: 67 out of 400 patients enrolled in the program were interviewed (16.8 percent). The BMI varied from 36.1 to 81.8 kg/m² (average 48.5 ± 8.8). All have associated diseases, the most frequent being systemic arterial hypertension, sleeping disorders and osteopathies. The most frequent psychiatric disorders were: 47.8 percent generalized anxiety disorder, 29.9 percent major depressive disorder, single episode, 34.3 percent recurrent major depressive disorder. In this group 56.7 percent showed BED (25.4 percent moderate and 31.3 percent severe) and the worse scores in all the domains of quality of life (SF-36 scale). CONCLUSIONS: High prevalence of BED. The compulsive eaters showed a higher number of obesity treatments, higher prevalence of actual major depression, and the worse scores in all the domains of the SF-36 scale. Considering the ample range of psychopathology associated with BED and the greater probability of jeopardizing the surgery results it is very important to improve the detection of these disorders in order to provide adequate treatment.

[The cerebral protection technique in angioplasty plus stenting of carotid: an effective procedure against cerebral embolism]. / Técnica de proteção cerebral na angioplastia e "stent" de carótida: um procedimento eficaz contra embolia.

OBJECTIVE: To describe the cerebral protection technique used in the angioplasty and stenting to treat stenotic lesions of carotid artery bifurcation, showing its efficiency in avoiding cerebral emboli during the procedure. METHOD: Forty two patients (47 arteries) were treated with the cerebral protection technique, which consists in the temporary occlusion of the internal carotid artery, above the stenotic lesion, performing the aspiration and flushing of glucose solution into the internal carotid artery after the delivery of the stent and the angioplasty, to remove any atherosclerotic plaque's fragments. RESULTS: The angioplasty was efficient in all cases. There were no cerebral emboli in the patients in whom the complete cerebral protection technique was used, showing its efficiency. Distal embolism occurred in one patient, during pre angioplasty and before the use of cerebral protection. CONCLUSION: The cerebral protection technique was efficient to avoid cerebral emboli in the procedures performed. This data is in agreement with the literature and the use of this technique increases the indications of carotid angioplasty.

Técnica de proteção cerebral na angioplastia e "stent" de carótida: um procedimento eficaz contra embolia / The cerebral protection technique in angioplasty plus stenting of carotid: an effective procedure against cerebral embolism

OBJETIVO: Descrever a técnica de proteção cerebral usada na angioplastia com colocação de "stent" para tratamento de lesões estenóticas da bifurcação carotídea, mostrando sua eficiência em evitar a embolia durante o procedimento. MÉTODOS: Quarenta e dois pacientes (47 artérias) foram tratados com a técnica de proteção cerebral que consistiu na oclusão temporéria da carótida interna acima da estenose, fazendo-se aspiração e injeção de solução de glicose a 5 por cento na carótida interna após a colocação de "stent" e angioplastia, para remover eventuais fragmentos da placa. RESULTADOS: A angioplastia foi eficiente em todos os casos. Não ocorreu embolia nos pacientes deste estudo nos quais se utilizou a técnica de proteção cerebral na sua versão completa. Embolia ocorreu em um paciente, durante pré-dilatação da estenose, antes de se usar a técnica de proteção cerebral. CONCLUSÃO: A técnica de proteção cerebral foi eficiente em evitar a embolia nos procedimentos realizados. Esses dados concordam com os da literatura e o uso desta técnica amplia as indicações da angioplastia carotídea.

International comparison of hip fracture rates in 1988-89.

A comparison of hip fracture rates among nine countries (Canada, Chile, Finland, Hong Kong, Scotland, Sweden, Switzerland, the United States and Venezuela) was made using national hospital discharge data for the same time interval. The rates increased by age and were higher for females than males in all nine countries. When based on overall discharge rates, the incidence of hip fracture appeared high in three European countries (Finland, Scotland and Sweden) relative to the other countries. However, when transfer cases were removed and adjustments made for differences in case definition, the risk of hip fracture for both men and women was much similar among the four European and two North American countries, but higher than in Hong Kong. Rates of fracture were lowest in Venezuela and Chile, varying from three to 11 times less than for residents of the other seven countries. Although there are limitations in using hospital discharge data as a measure of incidence, the wide variation in the risk of hip fracture across the nine countries appears real but differences between North American and north European countries may not be as great as previously reported. Such cross-national comparisons may help clarify different etiologic hypotheses.

Canadian cardiovascular disease mortality: first generation immigrants versus Canadian born.

Cardiovascular disease (CVD) is the major cause of death in Canada, as it is in most industrialized countries. Studies have shown that CVD mortality rates vary among ethnic groups. Since about one in six Canadian residents is a first generation immigrant, it is important to consider ethnic background when interpreting Canadian health statistics or planning health services. Overall, lower CVD mortality rates were found for first generation Canadians from Latin America, China and South Asia; higher rates are indicated for those from Scandinavia and Africa. The rates for North America are similar to those found for Eastern and Western Europe. Between two five-year time periods (1969-73 and 1984-88), CVD mortality rates generally were found to decrease, except for immigrants from Africa (age 35+). The rates were consistently higher for males than for females.