Colorectal adenocarcinoma in children and adolescents.

INTRODUCTION: Colorectal adenocarcinoma is rare in children and adolescents and tends to present with nonspecific signs and symptoms, leading to late diagnoses. OBJECTIVES: Our aim was to describe the clinical presentation and progression in children and adolescents with colorectal adenocarcinoma treated at our hospital and detect possible predisposing conditions of this disease. MATERIALS AND METHODS: Eight patients with colorectal adenocarcinoma were followed at the Hospital Posadas within the time frame of January 2000 and December 2021. We searched for diseases predisposing to this cancer. RESULTS: The mean patient age was 16 years (between 11 and 17 years of age). Clinical presentation was abdominal pain in the 8 patients; 4 of them had pain in the right hypochondrium, 3 had abdominal tumor, 4 had rectal bleeding, and 3 had weight loss. Mean symptom duration was 9 weeks (range: 1-24 weeks). None of the patients showed predisposing illnesses. One patient presented with polyposis, with no cases in any other family member. Histology showed mucinous adenocarcinoma in all the patients, 4 of whom had the signet ring cell subtype. The primary tumor was located in the right colon in 6 patients. At diagnosis, staging according to the modified Dukes classification was: I: one patient; IIb: one patient; IIIb: one patient; IIIc: one patient; and IV: 4 patients. All patients except 2 received chemotherapy and one patient received radiotherapy. Overall survival at 3 years was 25%. CONCLUSIONS: All patients presented with mucinous adenocarcinoma, no predisposing diseases were found, and the children with colorectal cancer had a very poor prognosis. Colorectal cancer diagnosis should be considered in children presenting with acute abdominal pain, abdominal tumor, or lower gastrointestinal bleeding, especially if there is weight loss.

Yield of white clover and orchard grass cultivated in mining passives adding black earth and compost as a substrate.

Mining environmental liabilities generate environmental pollution. The objective of the present study was to determine the yield of white clover (Trifolium repens) and orchard grass (Dactylis glomerata) cultivated in mining environmental passives adding black earth and compost as a substrate in the Buenaventura Julcani Huancavelica Company. The treatments were the combinations: 4: 3.1: 3.1: 3:1.1 kg of RP: RP, TN: RP, C: RP, TN, C respectively. They were distributed in four treatments with twelve experimental units for each species of leguminous and gramineous grass, we worked according to the completely randomized design (DCA) with a 2 x 4 factorial arrangement, the experimental unit being a treatment with twelve repetitions. The variables evaluated were: germination percentage (TG) and stem survival percentage (TST). For the statistical analysis, the SPSS software was used.

Controlling systemic corruption through group size and salary dispersion of public servants.

We investigate an agent-based model for the emergence of corruption in public contracts. There are two types of agents: business people and public servants. Both business people and public servants can adopt two strategies: corrupt or honest behavior. Interactions between business people and public servants take place through defined payoff rules. Either type of agent can switch between corrupt or honest strategies by comparing their payoffs after interacting. We measure the level of corruption in the system by the fractions of corrupt and honest agents for asymptotic times. We study the effects of the group size of the interacting agents, the dispersion with respect to the average salary of the public servants, and a parameter representing the institutional control of corruption. We characterize the fractions of honest and corrupt agents as functions of these variables. We construct phase diagrams for the level of corruption in the system in terms of these variables, where three collective states can be distinguished: i) a phase where corruption dominates; ii) a phase where corruption remains in less than 50% of the agents; and iii) a phase where corruption disappears. Our results indicate that a combination of large group sizes of interacting servants and business people and small dispersion of the salaries of public servants, contributes to the decrease of systemic corruption in public contracts.

An animal model of trait anxiety: Carioca high freezing rats as a model of generalized anxiety disorder.

Despite being one of the main components of anxiety and playing a pivotal role in how an individual perceives and copes with anxiogenic situations or responds to a given treatment, trait anxiety is paradoxically omitted in most animal models of anxiety. This is problematic and particularly more concerning in models that are used to screen drugs and other treatments for specific anxiety disorders and to investigate their neurobiological mechanisms. Our group has been engaged in the search for specific anxiety-related traits in animal models of anxiety. We developed two new lines of rats with strong phenotypic divergence for high (Carioca High-conditioned Freezing [CHF]) and low (Carioca Low-conditioned Freezing [CLF]) trait anxiety as expressed in the contextual fear conditioning paradigm. Here, we summarize key behavioral, pharmacological, physiological, and neurobiological differences in one these lines, the CHF rat line, relative to randomized-cross controls and discuss how far they represent a valid and reliable animal model of generalized anxiety disorder and so high trait anxiety.

Neuropsychological evaluation of children and adolescents with fetal alcohol spectrum disorders in the Brazilian population.

Fetal Alcohol Spectrum Disorder (FASD) is a collective name for lifelong physical and neurodevelopmental problems caused by the gestational consumption of alcohol affecting fetal development. In Brazil, the lack of awareness among healthcare professionals, and the scarcity of suitable diagnostic tools and trained clinicians, can contribute to the underestimation of FASD prevalence and severity. The present review aims to map and analyze studies conducted in Brazil on children and adolescents with FASD or a history of prenatal alcohol exposure (PAE). Additionally, it intends to report the psychometric properties of the neurodevelopmental assessment tools applied in the selected articles. Searches were carried out in the databases Scielo, LILACS, PePSIC, EMBASE, PsycINFO, Web of Science, selecting original clinical studies that have investigated the neurodevelopment of this population. From a total of 175 studies, ten articles fit the inclusion criteria in which 18 instruments were identified. The most reported deficits were related to language, general intelligence quotient (IQ), adaptive behavior, attention, and visual perception. Our results point to the need for more clinical research on FASD in Brazil, as well as for the standardization and validation of neurodevelopmental assessment tools for the accurate diagnosis of FASD in Brazil.

Increased hippocampal CREB phosphorylation after retrieval of remote contextual fear memories in Carioca high-conditioned freezing rats.

The participation of the hippocampal formation in consolidation and reconsolidation of contextual fear memories has been widely recognized and known to be dependent on the activation of the cAMP response element (CRE) binding protein (CREB) pathway. Recent findings have challenged the prevailing view that over time contextual fear memories migrate to neocortical circuits and no longer require the hippocampus for retrieval of remote fearful memories. It has also recently been found that this brain structure is important for the maintenance and recall of remote fear memories associated with aversive events, a common trait in stress-related disorders such as generalized anxiety disorder (GAD), major depression, and post-traumatic stress disorder. In view of these findings, here we examined the putative role of CREB in the hippocampus of an animal model of GAD during the retrieval of remote contextual fear memories. Specifically, we evaluated CREB phosphorylation in the hippocampus of male Carioca High- and Low-conditioned Freezing rats (CHF and CLF, respectively) upon re-exposure of animals to contextual cues associated to footshocks weeks after fear conditioning. Age-matched male rats from a randomized crossbreeding population served as controls (CTL). Adrenal catecholamine levels were also measured as a biological marker of stress response. Seven weeks after contextual fear conditioning, half of the sample of CHF (n = 9), CLF (n = 10) and CTL (n = 10) rats were randomly assigned to return to the same context chamber where footshocks were previously administrated (Context condition), while the remaining animals were individually placed in standard housing cages (Control condition). Western blot results indicated that pCREB levels were significantly increased in the hippocampus of CHF rats for both Context and Control conditions when compared to the other experimental groups. CHF rats in the Context condition also exhibited significant more freezing than that observed for both CLF and CTL rats. Lastly, CHF animals in the Context condition displayed significantly higher adrenal catecholamine levels than those in the Control condition, whereas no differences in catecholamine levels were observed between Context and Control conditions for CLF and CTL rats. These findings are discussed from a perspective in which the hippocampus plays a role in the maintenance and recall of remote contextual fear memories via the CREB pathway.

A primer on modelling pancreatic islets: from models of coupled ß-cells to multicellular islet models.

Pancreatic islets are mini-organs composed of hundreds or thousands of ɑ, ß and δ-cells, which, respectively, secrete glucagon, insulin and somatostatin, key hormones for the regulation of blood glucose. In pancreatic islets, hormone secretion is tightly regulated by both internal and external mechanisms, including electrical communication and paracrine signaling between islet cells. Given its complexity, the experimental study of pancreatic islets has been complemented with computational modeling as a tool to gain a better understanding about how all the mechanisms involved at different levels of organization interact. In this review, we describe how multicellular models of pancreatic cells have evolved from the early models of electrically coupled ß-cells to models in which experimentally derived architectures and both electrical and paracrine signals have been considered.

Systemic Chronic Treatment with Cannabidiol in Carioca High- and Low-Conditioned Freezing Rats in the Neuropathic Pain Model: Evaluation of Pain Sensitivity.

Studies have shown high comorbidity of anxiety disorder and chronic pain; generalized anxiety disorder (GAD) and neuropathic pain are among these pathologies. Cannabidiol (CBD) has been considered a promising treatment for these conditions. This study investigated whether chronic systemic treatment with CBD alters pain in high- (CHF) and low-freezing (CLF) Carioca rats (GAD model) and control rats (CTL) submitted to chronic neuropathic pain. The rats were evaluated in the sensory aspects (von Frey, acetone, and hot plate tests) before the chronic constriction injury of the ischiatic nerve (CCI) or not (SHAM) and on days 13 and 23 after surgery. Chronic treatment with CBD (5 mg/kg daily) was used for ten days, starting the 14th day after surgery. The open field test on the 22nd also evaluated locomotion and anxiety-like behavior. CBD treatment had an anti-allodynic effect on the mechanical and thermal threshold in all lineages; however, these effects were lower in the CHF and CLF lineages. Considering emotional evaluation, we observed an anxiolytic effect in CTL+CCI and CHF+CCI after CBD treatment and increased mobility in CLF+SHAM rats. These results suggest that the CBD mechanical anti-allodynic and emotional effects can depend on anxiety level.

Acute stroke in COVID-19 patients: A first year experience in a Colombian hospital.

Background: COVID-19 may be a new risk factor for stroke. Stroke in COVID-19 varies from 1.1 to 8.1%. Various pathophysiological pathways predispose SARS-CoV-2 infected patients to stroke. Aim: To describe COVID-19 patients with acute stroke in one Colombian Center. Methods: From March 6 2020 and March 6 2021 records of patients with acute stroke and in-hospital positive PCR (Polymerase Chain Reaction) test for Sars-CoV-2 infection were reviewed. Demographic, stroke and COVID-19 characteristics were extracted. Continuous variables were reported in means and ranges. Categorical variables were presented in frequencies and percentage. A descriptive narrative was performed. Results: Of 328 acute stroke patients 14 (4.2%) tested positive for PCR SARS-CoV-2. Mean age 56.4 years with 57% males. Five were (35.7%) without vascular risk factors but 9 (64.3%) overweight. Brain infarct diagnosed in 11 (78.5%), 53% with anterior circulation syndromes. Mean NIHSS score 11.8 and 7 (63%) received intravenous thrombolysis. Acute inflammatory blood biomarkers (D-dimer, ferritin, LDH elevated) were positive in all. 11 (78.5%) had symptomatic COVID-19 before stroke with a mean latency of 7 days. 12 (85.7%) had severe COVID-19 and 6 (42.8%) required mechanical ventilation. Outcome was unfavorable in 9 (64.3%) (The Modified Rankin Scale (mRS) > 2), mean hospital stay was 21.8 days and in-hospital case fatality rate was 14.2%. Conclusion: In susceptible individuals COVID-19 predisposes to stroke. Hypercoagulation and immune thrombosis may be at the culprit for this state. In Colombia, COVID-19 patients with stroke have similar characteristics to the described worldwide.

Psychometric Properties and Cross-Cultural Invariance of the Beck Depression Inventory-II and Beck Anxiety Inventory among a Representative Sample of Spanish, Portuguese, and Brazilian Undergraduate Students.

Clinical psychologists often use the Beck Depression Inventory, 2nd edition (BDI-II), and Beck Anxiety Inventory (BAI) to aid in the diagnosis of mental health issues and verify the effectiveness of treatments. Despite this common practice, studies that implement a cross-cultural design to check psychometric properties and the invariance of these scales are still scarce in the literature, which can lead to biased results that prevent comparisons among different groups. The present study investigated the internal structure of both tools and their level of invariance. From a representative sample of undergraduate students from Spain (n = 1216), Portugal (n = 426), and Brazil (n = 315), Confirmatory Factor Analysis and Multigroup Confirmatory Factor Analysis were performed. The results revealed suitable fit indices for the two-factor structure of the BDI-II and BAI, assessed by Confirmatory Factor Analysis procedures. Additionally, the two-factor model of the BDI-II reached invariant properties at three levels, whereas the structural model of the BAI did not. Altogether, these results suggest using the BDI-II in this group in these three countries and imply that BAI scores should be interpreted cautiously.

Nondeclarative associative learning in Alzheimer's disease: An overview of eyeblink, fear, and other emotion-based conditioning.

Alzheimer's disease is a neurodegenerative disorder that is characterized by progressive cognitive decline, particularly in declarative memory, and the presence of ß-amyloid plaques, neurofibrillary tangles, and cortical atrophy (especially in the temporal lobe). Unlike the relationship between the temporal cortex and declarative memory, nondeclarative memories (e.g., motor, fear, and other emotion-based memories) involve distinct neural structures. The present review investigates nondeclarative associative learning ability in Alzheimer's disease. We discuss eyeblink conditioning, fear conditioning, and other emotion-based learning and present the functions and brain areas that are involved in each type of learning. Evidence suggests that nondeclarative learning is also affected by Alzheimer's disease, although some forms of learning may be relatively preserved. Details about each nondeclarative associative learning process and the implications of these findings are presented.

Mood or energy/activity symptoms in bipolar mania: which are the most informative?

INTRODUCTION: Bipolar disorder (BD) in DSM-III and DSM-IV is classified as a mood disorder and requires the presence of a mood change, i.e., euphoria or irritability. Differently, DSM-5 states that there must be some increase in energy or motor activity in addition to the mood change. OBJECTIVE: Our aim was to identify which types of symptoms (i.e., mood- or energy/activity-related symptoms) are the most informative in a manic episode. METHOD: Symptoms of manic episodes in 106 outpatients with BD were assessed through the Young Mania Rating Scale between November 2002 and November 2015 in a naturalistic study. The items of the scale were divided into three groups according to clinical criteria: mood, energy/activity, and other. The Samejima Graded Response Model of the Item Response Theory was computed as well as the Test Information Function for comparisons between groups. Chi-squared tests were used to verify the association between the groups of symptoms by comparing the area under the curve of the TIF results. RESULTS: The information accounted for energy/activity represents 77% of the proportion of the total TIF; about 23% is related to mood and other groups of symptoms. Both proportions are statistically different (X2(1) = 30.42, p < 0.001). CONCLUSION: On average, changes in energy/activity tend to be more informative than mood changes during the manic phases of BD.

Combined exposure to alcohol and cannabis during development: Mechanisms and outcomes.

Exposure to substances of abuse during pregnancy can have long-lasting effects on offspring. Alcohol is one of the most widely used substances of abuse that leads to the most severe consequences. Recent studies in the United States, Canada, and the United Kingdom showed that between 1% and 7% of all children exhibit signs and symptoms of fetal alcohol spectrum disorder (FASD). Despite preventive campaigns, the rate of children with FASD has not decreased during recent decades. Alcohol consumption often accompanies exposure to such drugs as tobacco, cocaine, opioids, and cannabis. These interactions can be synergistic and exacerbate the deleterious consequences of developmental alcohol exposure. The present review focuses on interactions between alcohol and cannabis exposure and the potential consequences of these interactions.

Lack of voluntary interest and difficulty making eye contact are the most discriminative behaviors of the ASQ:SE and might suggest delays: Results from a large-scale assessment.

BACKGROUND: Every child is unique, but development tends to occur in predictable steps and stages. The early identification of infants who face developmental delays is critical, boosting the use of screening tools to determine risks for delays. The city of Rio de Janeiro conducted a large-scale assessment of children who were enrolled in educational facilities using the Ages & Stages Questionnaires: Social-Emotional (ASQ:SE). OBJECTIVES: We examined the internal structure of the ASQ:SE and its most discriminative items of risks of delays in development among 12- to 60-month-old children. The trajectory of the discrimination parameter of eight anchor items was used to check how well they inform the risk of social-emotional competence delays throughout development. METHODS: Data from 79,332 children (1-5 years) were analyzed via Samejima Graded Response model of Item Response Theory (IRT). The discrimination (a) and threshold (b) parameters were computed, and errors were achieved via maximum likelihood. Data/codes are available at https://osf.io/by6sf/. RESULTS: (a) Item Response Theory analyses supported the unidimensionality of data via the root mean square error of approximation and standardized root mean square residual results (RMSEA). (b) The lack of voluntary interest was the most discriminative risk behavior in the first 5 years. (c) Lack of interest was the most persistent risk behavior. (d) Difficulty making eye contact was nearly as informative as lack of interest. CONCLUSION: Lack of voluntary interest in things should be considered a critical risk-related behavior, and making eye contact is a vital aspect of typical development. Both behaviors may be predictors of children's delays.MAIN OUTCOMESThe ASQ:SE is a valid and reliable tool to measure child development.The internal structure of the ASQ:SE is well-fitted with a unidimensional solution.A child's age is a vital aspect of the discrimination parameter of the IRT model.Lack of interest in things and difficulty making eye contact are critical risk-related behaviors.

Pharmacological and Physiological Correlates of the Bidirectional Fear Phenotype of the Carioca Rats and Other Bidirectionally Selected Lines.

The Carioca rat lines originated from the selective bidirectional breeding of mates displaying extreme defense responses to contextual conditioned fear. After three generations, two distinct populations could be distinguished: the Carioca High- and Low-conditioned Freezing rats, CHF, and CLF, respectively. Later studies identified strong anxiety-like behaviors in the CHF line, while indications of impulsivity and hyperactivity were prominent in the CLF animals. The present review details the physiological and pharmacological-related findings obtained from these lines. The results discussed here point towards a dysfunctional fear circuitry in CHF rats, including alterations in key brain structures and the serotoninergic system. Moreover, data from these animals highlight important alterations in the stress-processing machinery and its associated systems, such as energy metabolism and antioxidative defense. Finally, evidence of an alteration in the dopaminergic pathway in CLF rats is also debated. Thus, accumulating data gathered over the years, place the Carioca lines as significant animal models for the study of psychiatric disorders, especially fear-related ones like anxiety.

Psychometric properties of the Brazilian version of the Canine Brief Pain Inventory (CBPI) for dogs with clinical signs of osteoarthritis and preliminary evidence of its clinical utility / Propriedades psicométricas da versão brasileira do Breve Inventário de Dor Canina (BIDC) em cães com sinais clínicos de osteoartrite e evidências preliminares da sua utilização clínica

This study aimed to determine the psychometric properties and clinical use of the Brazilian version of the Canine Brief Pain Inventory (CBPI) in dogs with hip dysplasia (HD). Forty-three dogs with HD and 16 clinically normal dogs were enrolled. The HD dogs were treated daily with 4.4mg/kg carprofen (GT = 21) or placebo (GP = 19), for four weeks. Owners completed the CBPI at two weeks (W-2) and immediately before the start of the treatment (W0), two (W2) and four (W4) weeks during treatment, and two weeks (W6) after the end of treatment. The internal structure was accessed, and the Cronbach's alpha coefficient was 0.97, indicating the high internal consistency of the instrument. Principal Component Analysis (PCA) suggested the retention of one component, which accounted for 78% of the variability. The ROC curve analysis concluded that the score 3 has an excellent performance to discriminate between normal and possible HD dogs (AUC of 0.973). There was no difference between dogs treated with carprofen versus placebo. The instrument in Portuguese showed construct and criterion validity and reliability to be used in dogs with HD.

Objetivou-se determinar as propriedades psicométricas e a utilidade clínica do Breve Inventário de Dor Canina na língua portuguesa, em cães com displasia coxofemoral (DCF). O inventário foi preenchido por tutores de 43 animais com DCF e por 16 tutores de cães saudáveis. Os animais com DCF foram tratados com carprofeno 4,4mg/kg (GT = 21) ou placebo (GP =19), administrados uma vez ao dia durante quatro semanas. As avaliações foram realizadas duas semanas e imediatamente antes do tratamento, duas e quatro semanas durante o tratamento e após duas semanas do término do tratamento. A estrutura interna calculada pelo alfa de Cronbach = 0,97 indicou alta consistência dos dados. A análise dos componentes principais identificou a retenção de apenas um componente responsável por 78% da variabilidade dos dados. A análise da curva ROC indicou que o escore 3 discrimina cães saudáveis de cães com possível DCF (ASC de 0,973). Não houve diferença entre os cães tratados com carprofeno daqueles que receberam placebo. O questionário apresentou validade de constructo e critério e confiabilidade e pode-se empregá-lo para avaliar a dor crônica em cães com osteoartrite em países de língua portuguesa.

Disentangling crucial factors of the pandemic in Brazil: Effect of lockdown restrictions on mental health.

Quarantine and social distance restrictions have been enforced worldwide to reduce the spread of coronavirus disease 2019 (COVID-19). The effects of these measures on mental health are recognised, but remaining unclear, is whether these effects are a consequence of the virus itself or policies that are enforced to prevent it. The present study investigated the impact of lockdown restrictions on anxiety and depression at two different times in 2020. Data were collected from 118 participants from all regions of Brazil. After easing quarantine restrictions in the second half of 2020, two natural groups were formed. One group included participants who voluntarily remained at home (n = 73). The other group consisted of those who decided to leave home (n = 45). A linear mixed model was used to determine the effects of group and time and their interaction. The McNemar test was used to determine intragroup differences in perceptions and concerns about COVID-19. Logistic regression identified predictors of high and stable depression and anxiety. None of the factors or their interactions was significant. Indicators of depression and anxiety remained stable over time, regardless of whether the participants left home or remained at home. Significantly, a strong and stable agreement with quarantine was found. The participants agreed that COVID-19 was a threat to public health. Political orientation was a predictor of high and stable levels of depression but not anxiety. Participants who self-identified as liberal politically were at a greater risk of developing depression. The results suggest that the lockdown policy did not contribute to disruptions of mental health, which instead was a consequence of the pandemic and virus itself. We also found wide and strong support amongst the participants for lockdown and mandatory stay-at-home policies.

An Exploratory Analysis of the Internal Structure of Test Through a Multimethods Exploratory Approach of the ASQ:SE in Brazil.

Background A wide range of exploratory methods is available in psychometrics as means of gathering insight on existing data and on the process of establishing the number and nature of an internal structure factor of a test. Exploratory factor analysis (EFA) and principal component analysis (PCA) remain well-established techniques despite their different theoretical perspectives. Network analysis (NA) has recently gained popularity together with such algorithms as the Next Eigenvalue Sufficiency Test. These analyses link statistics and psychology, but their results tend to vary, leading to an open methodological debate on statistical assumptions of psychometric analyses and the extent to which results that are generated with these analyses align with the theoretical basis that underlies an instrument. The current study uses a previously published data set from the Ages & Stages Questionnaires: Social-Emotional to explore, show, and discuss several exploratory analyses of its internal structure. To a lesser degree, this study furthers the ongoing debate on the interface between theoretical and methodological perspectives in psychometrics. Methods From a sample of 22,331 sixty-month-old children, 500 participants were randomly selected. Pearson and polychoric correlation matrices were compared and used as inputs in the psychometric analyses. The number of factors was determined via well-known rules of thumb, including the parallel analysis and the Hull method. Multidimensional solutions were rotated via oblique methods. R and Factor software were used, the codes for which are publicly available at https://luisfca.shinyapps.io/psychometrics_asq_se/ . Results Solutions from one to eight dimensions were suggested. Polychoric correlation overcame Pearson correlation, but nonconvergence issues were detected. The Hull method achieved a unidimensional structure. PCA and EFA achieved similar results. Conversely, six clusters were suggested via NA. Conclusion The statistical outcomes for determining the factor structure of an assessment diverged, varying from one to eight domains, which allowed for different interpretations of the results. Methodological implications are further discussed.

Resultados a mediano plazo de la prótesis invertida en la artropatía de manguito / Results in the medium long term of the reverse shoulder prosthesis in the cuff arthropathy

Resumen: Introducción: El estadio final de la artropatía de manguito (AM) genera dolor e invalidez, el tratamiento mediante artroplastía invertida (AI) muestra buenos índices de reducción de dolor y mejoras en movilidad. El objetivo de nuestro trabajo fue evaluar de manera retrospectiva los resultados a mediano plazo de la artroplastía invertida de hombro en nuestro centro. Material y método: Retrospectivamente analizamos 21 pacientes (23 prótesis) sometidos a AI con el diagnóstico de AM. La edad media fue de 75.21 años. El seguimiento mínimo fue de 60 meses. Analizamos las escalas ASES, DASH y CONSTANT preoperatorias y en la última visita de seguimiento. Se analizó la escala VAS preoperatoria y postoperatoria y rango de movilidad preoperatoria y postoperatoria. Resultados: Mejoraron todas las escalas funcionales y dolor (p < 0.001). ASES en 38.91 puntos (IC 95% 30.97-46.84); CONSTANT en 40.89 puntos (IC 95% 34.57-47.21); DASH en 52.65 puntos (IC 95% 46.31-59.0) p < 0.001; y 5.41 puntos (IC 95% 4.31-6.50) en VAS. Mejoraron con significación estadística la flexión (66.52o a 113.91o); y la abducción (63.69o a 105.85o). No obtuvimos significación estadística en rotación externa ni en rotación interna. Aparecieron complicaciones en 14 pacientes; 11 notching glenoideo, una infección crónica, una infección tardía y una fractura intraoperatoria de glenoides. Conclusiones: La AI de hombro representa una alternativa eficaz para el tratamiento de la AM. Puede esperarse alivio del dolor y una mejoría en la flexión y abducción del hombro; la ganancia en rotaciones es poco predecible.

Abstract: Introduction: The final stage of rotator cuff tear arthropathy generates pain and disability, treatment with reverse shoulder arthroplasty shows in different published studies good rates of pain reduction and improvements in mobility. the objective of our study was to retrospectively evaluate the medium-term results of inverted shoulder replacement at our center. Material and methods: Retrospectively, we analyzed 21 patients (23 prosthetics) undergoing reverse shoulder arthroplasty with the diagnosis of rotator cuff tear arthropathy. The average age of patients was 75.21 years The minimum follow-up was 60 months. We analyzed in all preoperative ASES, DASH and CONSTANT patients, and a new functional assessment was made using these same scales at the last follow-up visit. We analyzed pre and postoperative VAS as well as pre and postoperative mobility range. Results: We achieved a statistically significant improvement in all functional scale and pain values (p < 0.001). The ASES scale showed an improvement of 38.91 points (95% CI 30.97-46.84); the 40.89-point CONSTANT scale (95% 34.57-47.21) and the 52.65-point DASH scale (95% 46.31-59.0) p < 0.001. We found an improvement of 5.41 points (95% CI 4.31-6.50) on the VAS scale. We also achieved a statistically significant improvement in flexion values 66.52o to 113.91o degrees; abduction 63.69o to 105.85o degrees at the end of the follow-up. We did not get statistical significance in terms of external rotation but with a tendency to improve in the obtained values; instead in internal rotation we obtained results that showed a tendency to worsen. Complications occurred during follow-up in 14 patients; 11 in relation to notching glenoid, one patient with a chronic infection, one patient with a late infection and one intraoperative fracture of glenoid. Conclusions: Reverse shoulder arthroplasty is an effective treatment of rotator cuff arthropathy. Pain relief and improvement in shoulder flexion and abduction can be expected especially; the gain in rotations is unpredictable.

High-sugar/high-fat diet modulates the effects of chronic stress in cariocas high- and low-conditioned freezing rats.

Stress and eating disorders are closely related and are a topic of major concern due to their burden on human health. Engaging in unhealthy eating habits may come as a result of stress, and it often serves to alleviate the symptoms of anxiety or as a distraction from the stressor itself or self-awareness. However, it can also lead to negative feelings of a person's body figure, guilty, or shame. As diverse as these consequences are in humans, so are the effects of the combined administration of stress and hypercaloric food in animals' models. In this study, we assessed the influence of individual innate behavioral predisposition on the effects of chronic unpredictable mild stress and the dietary supplementation with high-sugar/high-fat food. These conditions were applied to male Carioca low- and high-conditioned freezing (CLF and CHF) rats for 21 days. Behavioral results show that the hypercaloric supplement had a protective effect over the alterations caused by the stress. Notably, it was more strongly observed in CHF rather than CLF animals. As the chronic stress led to an impaired behavior in the contextual fear conditioning and the forced swimming tests in the CLF line, animals fed with the HSHF pellet scored responses similar to their untreated control. On CHF rats, these effects also were seen to a broader extent on the open field test, where the locomotor behavior was also increased. No major effects of the diet were seen in the unstressed groups. Overall, our results show that the influences of both chronic stress and hypercaloric feeding depend on innate differences in fear response traits of male Carioca rats.