Lymph node metastasis in level IIb in oropharyngeal squamous cell carcinoma: a multicentric, longitudinal, retrospective analysis.

INTRODUCTION: Nowadays, 70% of patients in Europe and the USA are affected by a p16 + , potentially HPV driven oropharyngeal squamous cell carcinoma. However, despite the improved survival rate in this group, the quality-of-life remains low in cases which neck dissection took place. In this vein, in recent years, some surgeons have considered to avoid dissection of level IIB, proposing a supra-selective non-IIb neck dissection. MATERIALS AND METHODS: A retrospective, longitudinal, multicentric study was conducted, including patients with pathologically confirmed primary HPV + or HPV - OPSCC who went through surgical treatment for the primary lesion and neck dissection. RESULTS: 141 patients were included. Among them, 99 (70.2%) were male and 42 (29.8%) were female. The mean age was 62 ± 9 years (range 36-81). The most frequent anatomical location was the tonsil in 63 (44.7%) of patients. The most common approach was the classic transoral oropharyngectomy in 51 (36.2%) patients. Immunohistochemistry for p16 was positive in 62 (44%) patients. One-hundred and five (74.5%) patients received a unilateral ND, and a 36 (25.5%) a bilateral ND. Of those, a 12.8% (18/141) of patients were level IIb LN + . According to our results, level IIb ND should be considered in patients underwent therapeutic ND with positive LN metastasis in level IIa (OR = 9.83; 95% CI 3.463-27.917) or III (OR = 6.25; 95% CI 2.158-18.143), advanced (T3/T4) oropharyngeal primary tumors (OR = 3.38; 95% CI 1.366-8.405), and patients with ENE (OR = 6.56; 95% CI 2.182-19.770), regardless of p16 status. CONCLUSIONS: According to our results, level IIb ND should be considered in patients who underwent therapeutic ND with positive LN metastasis in level IIa or III, advanced oropharyngeal primary tumors, and patients with ENE, independently of p16 status. Prospective data are necessary to definitively ensure the safety of omitting ipsilateral or contralateral level IIb ND in cN - patients with early stage disease.

Latin American Older people and neuropsychiatric symptoms: a mini-systematic review of effects of COVID-19 Pandemic.

BACKGROUND: Ending December 2019, the world had to face to COVID-19. Latin America and the Caribbean suffered the effects where the contiguous and the number of deaths has been significant. Studies indicate that older adults with some degree of cognitive impairment are at greater risk of worsening their cognitive status and mental health, for this reason it's exposed that social isolation and loneliness has harmful effects on the health of this population. This mini-review inquires on the effects of COVID-19 due to social isolation on neuropsychiatric symptoms (NPS) in Latin American older adults with and without dementia. METHOD: A search was carried out in PubMed, SCOPUS, and ScienceDirect identifying all articles published up to July 31, 2021 using the keywords "social isolation", "lockdown", "quarantine", "COVID-19",, "neuropsychiatric symptoms ", "neurobehavioral", "dementia"," mild cognitive impairment "," Older People ", "aging", "elderly". Two independent reviewers screened and selected appropriate articles and a third researcher helped resolve disagreements. The selected articles met the following criteria: written in English, Spanish or Portuguese, original article; focused on elderly subjects, articles that provided information on the NPS effects in Latin American populations during the COVID-19 pandemic. The review was based on the PRISMA Statement and used the SIGN criteria. RESULT: From 61 articles recovered from electronic databases (PubMed, Science Direct and Scopus) 10 of them were chosen for this review. The majority of the articles reported in a general way a negative impact on the mental health of the population in Latin America. They referred to a significant increase in the anxiety and depression symptoms. The majority of the articles were studies developed in Brazil, Argentina and Chile. CONCLUSION: The COVID-19 has shown a negative impact on the mental health of older adults. Latin America is a region with important socio-sanitary problems which increase the impact of the pandemic in SNP, especially in older adults. It's necessary to increase the studies in Latin America that glimpse the real situation in the region.

Revisión del estado actual de la cirugía de reasignación genital en pacientes con disforia de género enfocada en el contexto colombiano / Review of the Current Status of Genital Reassignment Surgery in Patients with Gender Dysphoria within the Colombian Contex

La disforia de género o transexualismo es una condición que comprende a las personas que padecen profundo malestar o rechazo hacia el sexo biológico por cuanto se identifican con el sexo opuesto. Por lo tanto, se asocia a disfunción biopsicosocial y compromiso severo de la calidad de vida. En Colombia se han producido notables avances de índole constitucional y legislativa en las dos últimas décadas, los cuales son discutidos en la presente revisión. En el tratamiento multidisciplinario de los pacientes transexuales, el último paso corresponde a la cirugía de reasignación genital. El propósito de esta revisión es investigar el estado actual de la cirugía de reasignación genital enfocada en el contexto nacional.

Gender dysphoria or transsexualism is a condition that includes people who suffer from deep discomfort or rejection of biological sex because they identify with the opposite sex. Therefore, it is associated with biopsychosocial dysfunction and severe compromise of their quality of life. In Colombia there have been notable advances of a constitutional and legislative nature in the last two decades, which are discussed in the present review. In the multidisciplinary treatment of transgender patients, the last step corresponds to genital reassignment surgery. The purpose of this review is to investigate the current status of genital reassignment surgery within the national context.

Análisis neuroforense de la violencia: propuesta de revisión / Neuroforensic analysis of violence: proposed revision

Frente a la conducta homicida se presenta una diferenciación de posiciones biologicistas que relacionan la pauta homicida con factores filogenéticos y posibles daños en funciones neuropsicológicas complejas principalmente relacionadas con el control consciente de la conducta y la planeación. El planteamiento neuropsicológico relaciona el funcionamiento del cerebro con el comportamiento homicida principalmente con alteraciones en funciones ejecutivas y de planeación relacionadas con el lóbulo frontal, así como con alteraciones en el cuerpo calloso, la amígdala, el tálamo y alteraciones en la región medial de los lóbulos temporales...

Facing homicidal behavior differentiation biologicist positions relating to phylogenetic pattern homicidal factors and possible damage to complex neuropsychological functions related primarily conscious control of behavior and planning is presented. Neuropsychological approach to brain function related to homicidal behavior primarily with changes in executive and planning related to the frontal lobe functions, as well as alterations in the corpus callosum, amygdala, thalamus and alterations in the medial lobes temporary...

Validación de un programa de estimulación neuropsicológico NEUROPROTENIC en pacientes con daño cerebral adquirido / Validation of a neuropsychological stimulation program NEUROPROTENIC in patients with acquired brain injury

El objetivo de la presente investigación fue realizar el diseño de un software de estimulación neuropsicológica denominado NEUROPROTENIC y validación de las actividades incluidas en el software, como proyecto de grado para el programa de Maestría en Neuropsicología Clínica de la Facultad de Psicología de la Universidad de San Buenaventura. Esta es la primera fase general del estudio que posteriormente será sistematizado e implementado en pacientes que han presentado daño cerebral adquirido, específicamente aquellos con las etiologías correspondiente a accidente cerebrovascular y trauma cráneo encefálico. En el contexto actual de investigaciones sobre rehabilitación neuropsicológica y/o estimulación neuropsicológica, se ha iniciado una tendencia mayor al uso de nuevas herramientas tecnológicas, por tanto es quizás por esto la gran oportunidad de NEUROPROTENIC de ser un software pionero en Colombia que se somete a validación las actividades de rehabilitación, consiguiendo un alto índice de validez en las actividades diseñadas lo que garantiza en una gran parte que realmente que las personas con Daño Cerebral Adquirido que participen de la estimulación neuropsicológica mediante presenten una mejoría significativa en la curva de recuperación espontanea...

The objective of this research is to design software called NEUROPROTENIC neuropsychological stimulation, as degree project for Master of Clinical Neuropsychology, Faculty of Psychology at the University of San Buenaventura. This generally is the first phase of the study which will later be systematized and implemented in patients who have acquired brain injury, specifically those corresponding to the stroke etiologies and Traumatic Brain Injury. In the current context of neuropsychological rehabilitation research and / or neuropsychological stimulation, has started a greater tendency to use new technological tools, so it is perhaps for this NEUROPROTENIC the great opportunity to be a pioneer in Colombia that software undergoes validation rehabilitation activities, achieving high level of validity in activities designed which guarantees really much that people with Acquired Brain Injury to participate by presenting neuropsychological stimulation significantly improved the spontaneous recovery curve...

Efecto de la aplicación aguda de fluoxetina sobre una tarea de miedo condicionado al contexto en ratas sometidas a restricción comportamental / Effect of acute Fluoxetine application on a context fear conditioned task in behaviorally restrained rats Laura A

Para estudiar el efecto del aumento comportamental o farmacológico de la ansiedad sobre la adquisición del miedo condicionado al contexto, 32 ratas Wistar (275±25 gm) divididas en dos grupos (restricción comportamental y control) recibieron fluoxetina (ig, 4 mg/kg; 1ml) o solución salina (ig, 0.9%). Luego fueron entrenadas en una tarea de miedo condicionado al contexto. El ANOVA de dos vías mostró diferencias significativas para el factor tratamiento (F[1,28] = 25.261; P < 0.001). Los sujetos tratados con fluoxetina presentaron menor tiempo de congelamiento (Student Newman-Keuls; P < 0.05). No hubo diferencias significativas para la restricción, ni para la interacción entre factores (F[1,28] = 0.115; P = 0.737 y F[1,28] = 0.016; P = 0.899). Así, la restricción no alteró la adquisición del miedo condicionado indicando que el aumento de liberación de 5-HT así inducido, no es comparable al inducido por fluoxetina. La fluoxetina deterioró la adquisición de la respuesta de miedo, indicando que el mecanismo por el cual la ansiedad interrumpe el aprendizaje puede ser serotoninérgico...

In order to study the effect of behavioral or pharmacologically enhanced anxiety on the acquisition of contextual fear conditioning, thirty two Wistar rats (275±25 gm) were divided in two groups (behavioral restriction and control). Half of each group received saline solution (ig.; 0.9%) or fluoxetine (ig.; 4mg/Kg) before the fear conditioning procedure. The two way ANOVA showed significant differences for treatment (F[1,28] = 25.261; P < 0.001). Student Newman-Keuls showed that subjects treated with fluoxetine had lower freezing times. There were no significant differences nor for restriction neither for the interaction between the factors (F[1,28] = 0.115; P = 0.737 y F[1,28] = 0.016; P = 0.899). Thus, the restriction procedure used did not modify the acquisition of the conditioned fear response suggesting that the putative 5-HT enhancement induced is not comparable to that induced by fluoxetine. Acute fluoxetine disrupted the acquisition of the conditioned fear response, suggesting that the mechanism by means of which anxiety disrupts learning could be serotonergic in nature...