Nitrous oxide as an adjunctive therapy in major depressive disorder: a randomized controlled double-blind pilot trial

Objective: Major depressive disorder (MDD) is related to glutamatergic dysfunction. Antagonists of glutamatergic N-methyl-D-aspartate receptor (NMDAR), such as ketamine, have antidepressant properties. Nitrous oxide (N2O) is also a NMDAR antagonist. Thus, this study aimed to evaluate the effects of augmenting antidepressant treatment with N2O. Methods: This double blind, placebo-controlled randomized parallel pilot trial was conducted from June 2016 to June 2018 at the Hospital das Clínicas, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo. Twenty-three subjects with MDD (aged 18 to 65, on antidepressants, with a score > 17 on the 17-item-Hamilton Depression Rating Scale [HAM-D17]) received 50% N2O (n=12; 37.17±13.59 years) or placebo (100% oxygen) (n=11; 37.18±12.77 years) for 60 minutes twice a week for 4 weeks. The primary outcome was changes in HAM-D17 from baseline to week 4. Results: Depressive symptoms improved significantly in the N2O group (N2O: from 22.58±3.83 to 5.92±4.08; placebo: from 22.44±3.54 to 12.89±5.39, p < 0.005). A total of 91.7% and 75% of the N2O group subjects achieved response (≥ 50% reduction in HAM-D17 score) and remission (HAM-D17 < 7), respectively. The predominant adverse effects of N2O treatment were nausea, vomiting, and headache. Conclusion: N2O treatment led to a statistically significant reduction in HAM-D17 scores compared to placebo. Clinical trial registration: Brazilian Register of Clinical Trials, RBR-5rz5ch

Mucinous adenocarcinoma of the appendix with inguinal node metastases

Mucinous adenocarcinoma of the appendix is a rare neoplasm with a low propensity for lymph node metastasis. The present case refers to an appendicular mucinous adenocarcinoma with inguinal lymph node metastasis. A 71-year-old woman underwent an appendectomy due to a clinical presentation of acute appendicitis. However, the histological examination of the surgical specimen revealed a mucinous adenocarcinoma of the appendix. After staging, the patient underwent a right hemicolectomy and was proposed for adjuvant chemotherapy. At the 3rd year of follow-up, inguinal lymphadenopathy was diagnosed, which biopsy confirmed inguinal node metastases from primary colorectal cancer, with areas of extracellular mucin. Restaging revealed liver and peritoneal metastasis, and the patient was proposed for palliative chemotherapy. Appendicular neoplasms, due to their rarity, represent a diagnostic and therapeutic challenge. This clinical case depicts an unusual metastasis pathway for an unusual neoplasm.

Cross-cultural adaptation of the Internet Gaming Disorder Scale - Short Form (IGDS9-SF) to the Brazilian context

Abstract Introduction The Internet Gaming Disorder Scale - Short Form (IGDS9-SF) assesses the severity, harmful effects and/or consequences of excessive online and offline gaming. Its conciseness and theoretical foundations on current diagnostic criteria of gaming disorders make it a useful resource for clinical and screening settings. Objective To describe the process of cross-cultural adaptation of the IGDS9-SF to the Brazilian context. Methods The cross-cultural adaptation involved the steps of independent translation of the instrument, synthesis version, back-translation, pre-test and elaboration of the final version. Content validity assessment was conducted by a multidisciplinary committee of experts and consisted of both a quantitative analysis (calculation of content validity coefficients - CVC) and a qualitative analysis (assessment of the experts' comments and suggestions). The pre-test sample consisted of 30 gamers with variable sociodemographic characteristics. Results The cross-cultural adaptation of the scale followed the proposed protocol, and the CVC was satisfactory (≥ 0.83) for all the structures and equivalences assessed. Most of the suggestions made by the experts were accepted (mainly adjustments and language standardization). The gamers who participated in the pre-test judged the scale easy to understand and did not suggest changes. Discussion The Brazilian version of the IGDS9-SF showed adequate content validity and is available for researchers and clinicians, as well as for the investigation of additional psychometric characteristics.

Cross-cultural adaptation of the City Birth Trauma Scale for the Brazilian context

Abstract Background Posttraumatic stress disorder consists of a set of symptoms that occurs in response to one or more traumatic events and can occur in postpartum, from traumatic situations related to the birth or to the baby's health in the first days of life. It is important tracking the presence of birth trauma, but there is not available instruments in the Brazilian context for this purpose. Objectives To present the cross-cultural adaptation of City Birth Trauma Scale (BiTS) into Brazilian portuguese. Methods Cross-cultural adaptation involved independent translations, synthesis,back-translation, and submission to the original author's appreciation. After the scale was subjected to face validity, followed by a pilot study with postpartum mothers. Results All steps were performed for the cross-cultural adaptation. Regarding face validity, items evaluated concerning different types of equivalence, presented satisfactory agreement values (≥4.20). Most of the expert's suggestions were followed, being the main ones related to adjustments in prepositions, pronouns and verbal subjects. Pilot study showed that the mothers had been able to understand and respond to the instrument without adjustments. Discussion BiTS's Brazilian version proved to be cross-culturally adapted, ensuring the possibility of intercultural data comparison from the semantic, idiomatic, cultural, and conceptual perspectives. New studies are being conducted to attest its psychometric adequacy.

Transcutaneous tibial nerve stimulation versus parasacral stimulation in the treatment of overactive bladder in elderly people: a triple-blinded randomized controlled trial

OBJECTIVES: To evaluate the effect of transcutaneous tibial nerve stimulation (TTNS) and transcutaneous parasacral stimulation on the treatment of overactive bladder (OAB) in elderly people and to compare the final results between groups. METHODS: Fifty female volunteers, mean age 68.62 (±5.9) years, were randomly allocated into two groups: those receiving TTNS (G1, N=25) and those receiving transcutaneous parasacral stimulation (G2, N=25). The primary outcome was the International Consultation on Incontinence Questionnaire (ICIQ-OAB) score, and secondary outcomes were the International Consultation on Incontinence Questionnaire - short form (ICIQ-SF) score and 3-day bladder diary measurements. Volunteers were assessed before and after the treatment. Clinical Trials (ReBeC): RBR-9Q7J7Y. RESULTS: Both groups' symptoms improved as measured by the ICIQ-OAB (G1 = <0.001; G2 = <0.001) and ICIQ-SF (G1 = <0.001; G2 = <0.001). In the 3-day bladder diary assessments after treatment, G1 showed a reduced number of nocturia (p<0.001), urgency (p<0.001) and urge urinary incontinence episodes (p<0.001), whereas G2 showed only a reduced number of nocturia episodes (p<0.001). No difference between groups was found. CONCLUSION: Both of the proposed treatments were effective in the improvement of OAB symptoms, but TTNS showed a reduction in a greater number of symptoms as measured by the 3-day bladder diary. No differences were found between groups.

Incidental diagnosis of breast cancer in the pursuit of the treatment of intestinal obstruction

Intestinal lipomatosis is rare and often asymptomatic but can present with intestinal obstruction. Occasionally, metastatic breast cancer is identified in the ovary before a breast primary is discovered. We report the case of a 50-year-old woman diagnosed with synchronous intestinal obstruction due to lipomatosis, and incidental ovarian metastases from breast cancer. The patient presented with a 12-day history of nausea, diffuse abdominal pain, and constipation. An abdominal x-ray showed air-fluid levels, and computed tomography documented small bowel distention. An explorative laparotomy was performed, which revealed small bowel distention, an obstructive lesion of the ileocecal valve, three terminal ileum lesions, ascites, and heterogeneous ovaries. Right ileocolic resection and left oophorectomy were performed. The pathological diagnosis revealed lipomatous submucosal lesion of the ileocecal valve and ileum, and 17 lymph nodes, which were all negative for malignant cells. The oophorectomy revealed ovarian metastasis from breast carcinoma. Ascitic fluid was positive for malignant cells. Mammography and breast/axillary ultrasonography showed a solid nodule of the left breast, ductal carcinoma, and multiple enlarged left axillary lymph nodes, which were positive for neoplastic cells. Immunohistochemical evaluation showed hormonal receptor positivity and C-erb2 negativity. Breast magnetic resonance imaging showed a 14 mm left nodule and a positron emission tomography scan revealed 18F-FDG uptake in the left breast, left axillary lymph nodes, right ovary, and peritoneum. The tumor was staged as stage IV ductal breast carcinoma, cT1N1M1, Grade 2, Luminal B-like. The multidisciplinary oncological meeting proposed chemotherapy, and a re-staging breast MRI after chemotherapy, which showed a complete response. The patient started treatment with letrozole and remains disease-free 22 months after finishing chemotherapy.

Effects of sodium nitroprusside in the prevention of schizophrenia-like symptoms induced by ketamine - A translational double-blind study

Abstract Background: Recent evidence has shown improvements in schizophrenia symptoms after the infusion of sodium nitroprusside (SNP), a nitric oxide (NO) donor. In the rat model of schizophrenia using ketamine injection, pretreatment with SNP seems to prevent behavioral changes associated with positive symptoms for up to one week. Objective: We investigated whether SNP would have preventative effects on psychogenic symptoms induced by ketamine in healthy subjects. Methods: Healthy subjects (N = 38) were assigned to distinct groups that received SNP in different doses (0.15, 0.25, and 0.5 mcg/kg/min). First, participants received an infusion of SNP or placebo over 75 minutes. After 10 minutes, they were injected for 1 minute with a bolus of 0.26 mg/kg of ketamine and a maintenance dose was started 5 minutes later, with 0.25 mg/kg/h of ketamine for 50 minutes. Results: Ketamine-induced psychopathological alterations induced were reduced by SNP, as assessed with the Brief Psychological Rating Scale. Scores in the objective subscale of the Clinician-Administered Dissociative States Scale were also lower in SNP sessions compared to placebo. SNP had protective effects against deterioration in facial emotion and identity recognition tasks induced by ketamine. Discussion: Our findings support the view that SNP has preventative properties against psychotic manifestations.

Arterial spin labeling in patients with schizophrenia: a systematic review

Abstract Background: Neuroimaging studies are an invaluable source of information about the physiopathology of schizophrenia. Arterial spin labeling (ASL) is a new magnetic resonance technique (MRI) that is able to effectively evaluate brain function without the use of radiation. Objective: To make a systematic review of studies using ASL to compare resting-state regional cerebral blood flow (rCBF) patterns in patients with schizophrenia and healthy controls. Methods: Original articles were searched for on PubMed, Scopus, Web of Science and PsycINFO electronic databases. The search terms used were 'arterial', 'spin', 'labeling', and 'schizophrenia'. Only studies comparing resting-state rCBF were included, a qualitative synthesis was then performed. Results: Ten articles were included in the review among a total of 22. Decreased rCBF in schizophrenia patients was described in the anterior cingulate, cuneus, fusiform gyrus, frontal lobe, left middle frontal gyrus, inferior frontal gyrus, lingual gyrus, middle occipital gyrus, and parietal lobe. The putamen was the only region with increased rCBF in schizophrenia. Discussion: The evidence of the studies reviewed lends support to the concept of hipofrontality in schizophrenia. rCBF alterations were found in regions classically associated with schizophrenia. ASL seems to be valid, and reliable tool to assess schizophrenia.

Structural and functional neuroimaging findings associated with the use of clozapine in schizophrenia: a systematic review

Objective: Schizophrenia is one of the most severe psychiatric disorders, and its current treatment relies on antipsychotic medications with only partial effectiveness. Clozapine is an atypical antipsychotic with a specific profile of action indicated for treatment-resistant schizophrenia. Neuroimaging studies assessing the effects of clozapine could help shed light on the neural underpinnings of the effects of this drug in the brain. The objective of this study was to review the available literature on the structural and functional neuroimaging findings associated with use of clozapine. Method: We conducted a systematic review of the indexed literature using the PubMed, BIREME, and ISI Web of Knowledge search engines and the following keywords: clozapine, neuroimaging, computed tomography, MRI, functional magnetic resonance, PET, SPECT, and DTI. Results: A total of 23 articles were included in the review. In structural studies, the use of clozapine was associated with volume reductions in the basal ganglia, especially the caudate nucleus, where functional neuroimaging studies also found decreased perfusion. In the frontal lobe, clozapine treatment was associated with increased gray matter volume and reduced perfusion. Conclusion: The results of the studies reviewed suggest that the use of clozapine is associated with distinctive structural and functional neuroimaging findings that are not shared with other antipsychotics. .

Quality of life in patients with Charcot-Marie-Tooth disease type 1A / Análise da qualidade de vida de pacientes com a doença de Charcot-Marie-Tooth tipo 1A

We assessed the functional impairment in Charcot-Marie-Tooth resulting from 17p11.2-p12 duplication (CMT1A) patients using the Short-Form Health Survey (SF-36), which is a quality of life questionnaire. Twenty-five patients of both genders aged ≥10 years with a positive molecular diagnosis of CMT1A were selected. Age- and gender-matched Control Group (without family history of neuropathy), and the sociodemographic and professional conditions similar to the patients' group were selected to compare the SF-36 results between them. The results showed that the majority quality of life impairments in CMT1A patients occurred in the social and emotional domains. Functional capacity also tended to be significantly affected; other indicators of physical impairment were preserved. In conclusion, social and emotional aspects are mostly neglected in the assistance provided to CMT1A Brazilian patients, and they should be better understood in order to offer global health assistance with adequate quality of life as a result.

Avaliou-se o comprometimento funcional de pacientes com Charcot-Marie-Tooth provenientes da duplicação 17p11.2-p12 (CMT1A), utilizando o SF-36, que é um questionário para medir a qualidade de vida. Vinte e cinco pacientes de ambos os sexos com idades ≥10 anos e diagnóstico molecular de CMT1A foram selecionados. Idade, sexo, condições sociodemográficas e profissionais foram pareados com o Grupo Controle (sem histórico familiar de neuropatia). Os resultados mostraram que o maior impacto da CMT1A na qualidade de vida ocorreu nos domínios social e emocional dos pacientes avaliados. A capacidade funcional também tende a ser significativamente afetada, enquanto outros indicadores de deficiência física foram preservados. Por fim, os aspectos sociais e emocionais dos pacientes acometidos por CMT1A costumam ser negligenciados na assistência médica prestada aos pacientes brasileiros, e devem ser melhor compreendidos a fim de oferecer uma assistência global à saúde, resultando em adequada qualidade de vida.

Qualidade de frutos de noni (Morinda citrifolia L.) cultivados em Trairi-CE / Quality of Noni fruits (Morinda citrifolia L.) grown in Trairi-CE / Calidad de la fruta del noni (Morinda citrifolia L.) cultivado en Trairi-CE

Introdução: o noni é uma fruta que chegou ao Brasil como uma matéria-prima com forte apelo comercial devido a todas as características benéficas a ele atribuídas e os benefícios relacionados ao seu consumo. Objetivo: este trabalho teve como objetivo efetuar a caracterização física e físico-química de frutos de noni no estádio de maturação "maduro" (coloração amarelo esbranquiçado). Métodos: foram colhidos frutos de noni em cinco plantas que se encontram na Fazenda Alberto Antônio, localizada próximo ao município de Trairi, Ceará (Trairi-CE). Para a caracterização do fruto, realizaram-se as seguintes análises: massa fresca do fruto (g), comprimentos longitudinal (mm) e transversal (mm), DL/DT, firmeza (N), vitamina C (mg.100 g-1 de polpa), sólidos solúveis (° Brix), acidez titulável (%), pH e relação SS/AT. Adotou-se um delineamento inteiramente casualizado, em que os tratamentos foram cinco plantas no estádio de maturação "maduro" com dez repetições compostas de um fruto, totalizando 50 frutos. Resultados: o fruto do noni é de formato ovóide, suculento e apresenta várias sementes triangulares de coloração vermelha. Considerando a polpa, ocorre mudança de coloração, passando da cor verde para a amarela esbranquiçada, à medida que o fruto amadurece. De acordo com os resultados obtidos, os estádios apresentam variabilidade para quase todos os caracteres físicos e físico-químicos. Conclusões: de acordo com os resultados obtidos, os frutos de noni "maduro" apresentaram para a massa fresca valor médio de 221,50 g, diâmetro longitudinal e transversal médio de 106,60 e 59,96 mm, respectivamente, altos valores para a relação DL/DT, com média geral de 1,94, firmeza da polpa média de 12,82 N, teor médio de sólidos solúveis de 8,40 °Brix, acidez titulável de 0,28 %, pH de 4,53, relação SS/AT de 34,26 e elevados teores de vitamina C, com valor médio de 177,33 mg.100 g-1 de polpa, fator este de grande importância para a indústria.

Introduction: Noni is a fruit brought to Brazil as raw material with strong commercial appeal due to all its beneficial features and consumption-related benefits. Objective: to make the physical and physicochemical characterization of the "mature" noni fruit in the maturation stage (yellowish white coloration). Methods: Noni fruits were harvested on five plants at Alberto Antônio Farm, located near the city of Trairi, Ceará (Trairi-CE). For the fruit characterization, the following analysis were made: fresh fruit mass (g), longitudinal and transverse length (mm), DL/DT, firmness (N), vitamin C (mg.100 g-1 of pulp), soluble solids (° Brix), titratable acidity (%), pH and SS/AT ratio. A completely randomized approach was adopted, and the treatments consisted of five plants in "mature" stage with ten repetitions, composed by one fruit, for a total of 50 fruits. Results: Noni fruit is ovoid, succulent, and juicy, and presents several triangular red seeds. The pulp's color changed from green to yellowish white according to the ripeness of the fruits. As to the obtained results, the stages showed variability in almost all the physical and physical-chemical characters. Conclusions: "mature" noni fruit presented fresh average weight of 221,50 g, longitudinal and transverse diameter of 106,60 and 59,96 mm, respectively, high values for the DL/DT ratio, with overall average of 1,94; pulp firmness average of 12,82 N, soluble solids content average of 8,40 °Brix, titratable acidity of 0,28 %, pH of 4.53; SS/AT ratio of 34,26 and high levels of vitamin C, with pulp average of 177,33 mg.100 g-1, which is a feature of great importance for the industry.

Introducción: el noni es una fruta que llegó a Brasil como una materia prima con fuerte atractivo comercial, por todas las características beneficiosas asignadas y los beneficios relacionados con su consumo. Objetivo: realizar la caracterización física y fisicoquímica de las frutas del noni en etapa de maduración ("maduran" amarillo blanquecino). Métodos: las frutas de noni se cosecharon de 5 plantas que se encontraban en la granja Alberto Antônio, situada cerca de la ciudad de Trairi-CE. Para la caracterización de la fruta se hicieron los análisis siguientes: pasta fresca de fruto (g), medidas longitudinales (mm) y transversales (mm), DL/DT, firmeza (N), vitamina C (mg 100 g-1 de la pulpa), sólidos solubles (° Brix), acidez titulable (%), (pH) y SS/AT. Se tomó un diseño completamente al azar, los tratamientos fueron 5 plantas en etapa "madura" con 10 repeticiones, compuestos de una fruta, un total de 50 frutos. Resultados: la fruta de noni es ovoide, jugosa y presenta varias semillas triangulares de color rojo. En la pulpa se produce un cambio de color, pasando de verde a un color amarillo blanquecino como la fruta madura. Según los resultados, los estadios tienen variabilidad para casi todos los caracteres físicos y fisicoquímicos. Conclusiones: la fruta de noni "madura" presenta 221,50 g masa promedio fresca, diámetro longitudinal y transversal de 106,60 y 59,96 mm, respectivamente; valores altos para el DL/DT, con un promedio general de 1,94, firmeza de pulpa un promedio de 12,82 N, contenido de sólidos solubles de 8,40 ° Brix, acidez titulable de 0,28 %, pH de 4,53, 34,26 SS/AT; y altos niveles de vitamina C, con un promedio de pulpa de 177,33 mg.100 g-1, factor de gran importancia para la industria.

Nitric oxide plasma/serum levels in patients with schizophrenia: a systematic review and meta-analysis / Níveis plasmáticos/séricos do óxido nítrico em pacientes com esquizofrenia: uma revisão sistemática e metanálise

For the last 40 years, schizophrenia has been considered to be the result primarily of a dysfunction in brain dopaminergic pathways. In this review, it is described and discussed findings concerning nitric oxide-mediated neurotransmission in schizophrenia. Studies were searched in PubMed, SciELO, and LILACS using the terms schizophrenia and nitric oxide plasma levels or nitric oxide serum levels, with no time limit. The reference lists of selected articles were also hand-searched for additional articles. From 15 potential reports, 10 were eligible to be included in the review and meta-analysis. These studies included a total of 505 patients with schizophrenia and 339 healthy volunteers. No significant difference was found between patients and healthy controls regarding total nitrite plasma/serum levels (effect size g = 0.285, 95%CI = -0.205 to 0.774, p = 0.254). However, when studies with patients under antipsychotic treatment were examined separately, there was a significant difference between patients and healthy volunteers (effect size g = 0.663, 95%CI = 0.365 to 0.961, p < 0.001), showing that patients under treatment have higher levels of plasma/serum nitric oxide than controls. These results suggest that antipsychotics increase nitric oxide plasma/serum levels and that the nitrergic pathway would be a fertile target for the development of new treatments for patients with schizophrenia.

Durante os últimos 40 anos, a esquizofrenia foi considerada, principalmente, como o resultado de disfunções dopaminérgicas no cérebro. Esta revisão descreve e discute algumas descobertas sobre a neurotransmissão mediada pelo óxido nítrico na esquizofrenia. A busca foi feita nas bases PubMed, SciELO e LILACS usando-se os termos schizophrenia e nitric oxide plasma levels ou nitric oxide serum levels, sem limites de tempo. As listas de referências dos artigos selecionados foram examinadas em busca de outras publicações pertinentes. Dentre 15 artigos passíveis de serem incluídos, 10 preenchiam os critérios estabelecidos para a revisão e metanálise. Esses estudos incluíram 505 pacientes com esquizofrenia e 339 voluntários saudáveis. Não foram encontradas diferenças significativas entre pacientes e voluntários saudáveis quanto aos níveis plasmáticos de nitrito total (effect size g = 0,285, IC 95% = -0,205 a 0,774, p = 0,254). No entanto, o exame separado dos estudos envolvendo pacientes em tratamento antipsicótico apresentou diferenças significativas entre pacientes e voluntários saudáveis (effect size g = 0,663, IC 95% = 0,365 to 0,961, p < 0,001), demonstrando que pacientes em tratamento possuem níveis plasmáticos mais altos de óxido nítrico. Esses resultados sugerem que os antipsicóticos podem aumentar os níveis plasmáticos de óxido nítrico e que a via nitrérgica (e sua estimulação) constituiria um alvo propício para o desenvolvimento de novos tratamentos para pacientes com esquizofrenia.

Performance of schizophrenic patients in the Stroop Color Word Test and electrodermal responsiveness after acute administration of cannabidiol (CBD) / Desempenho de pacientes esquizofrênicos no Stroop Color Word Test e responsividade eletrodérmica após administração aguda de canabidiol (CBD)

OBJECTIVE: The last decade has seen increasing evidence of dysfunctions in the endogenous cannabinoid system in schizophrenia and of its relationship with the typical cognitive impairment of the disorder. Studies in animal models, healthy volunteers, and psychotic patients clearly suggest an antipsychotic-like effect of cannabidiol. This study investigated the effects of cannabidiol on selective attention in 28 schizophrenic patients using the Stroop Color Word Test and on these patients' electrodermal responsiveness to auditive stimuli. METHOD: The subjects attended two experimental sessions, the first one without the administration of drugs. In the second session the subjects were divided into three groups that received either a single dose of cannabidiol 300mg or cannabidiol 600mg or placebo. RESULTS: The three groups did not differ significantly with respect to electrodermal measures in the two experimental sessions. When the first and second sessions were compared improved performance was found in all three groups, with patients who received placebo and cannabidiol 300mg performing better than those who received cannabidiol 600mg. CONCLUSION: The single, acute administration of cannabidiol seems to have no beneficial effects on the performance of schizophrenic patients in the Stroop Color Word Test, although the hypothesis that chronic administration may lead to improvement cannot be disregarded.

OBJETIVO: Descobertas relativas a possíveis disfunções do sistema canabinóide endógeno na esquizofrenia e sua relação com o prejuízo cognitivo característico da doença têm aumentado durante a última década. Estudos com modelos animais, voluntários saudáveis e pacientes psicóticos sugerem claramente que o canabidiol possui efeitos antipsicóticos. Este estudo investigou os efeitos do canabidiol sobre a atenção seletiva por meio do Stroop Color Word Test e a responsividade eletrodérmica a estímulos auditivos em 28 pacientes com esquizofrenia. MÉTODO: Duas sessões experimentais foram realizadas, a primeira sem a administração de drogas. Na segunda sessão, os sujeitos foram divididos em três grupos que receberam dose única de canabidiol 300mg, canabidiol 600mg ou placebo. RESULTADOS: Os três grupos não diferiram significativamente no que se refere às medidas eletrodérmicas nas duas sessões experimentais. Os três grupos apresentaram melhora da primeira para a segunda avaliação, com os grupos placebo e canabidiol 300mg superiores ao grupo canabidiol 600mg. CONCLUSÃO: A administração aguda de canabidiol em dose única parece não ter efeitos benéficos sobre o desempenho de pacientes com esquizofrenia no Stroop Color Word Test, embora estes dados não sejam suficientes para refutar a hipótese de que a administração continuada de canabidiol possa resultar em melhora no funcionamento cognitivo em esquizofrenia.

Morfología e histología del apendice vermicular: hallazgos en necropsias / Morphology and histology of the appendix vermicular: finding in necropsy

Las enseñanzas de anatomía morfológica y descriptiva que recibimos desde las aulas de pre-grado hasta el post-grado están basadas fundamentalmente en textos extranjeros, ya que no disponemos en nuestro medio de estudios prospectivos en este campo. En este trabajo se revisó el colon de 133 cadáveres a los que se les realizó necropsias en el Instituto de Medicina Legal de Caracas y en el Departamento de Anatomía Patológica del Hospital Central de las FF.AA "Dr. Carlos Arvelo", en esta revisión el apéndice vermicular (AV) estaba presente en 126 cadáveres (94,74 por ciento). Se determinó la posición del AV, y se midió su longitud in situ. Luego fueron colocadas en una solución de formaldehido para su estudio histopatológico. Se encontró que el apéndice estaba presente en 94,74 por ciento y ausente en 5,26 por ciento de los cadáveres. A diferencia de lo descrito en la literatura internacional la posición retrocecal fue la más frecuente (34,12 por ciento). El 48,15 por ciento de los casos no existía el receso por debajo de la desembocadura del ileon, conocido como ciego, y el apéndice se implantaba en el colón inmediatamente después de la válvula ileo-cecal. El lumen apendicular progresivamente disminuía a medida que aumentaba la edad. Determinamos en 7 sujetos (5,5 por ciento periapendicitis sin que alrededor de la pieza existiera un proceso inflamatorio que lo pudiera explicar. Para el cirujano es importante conocer datos morfológicos de nuestra población pues ello le permitirá una mejor orientación anatómica en el momento de planificar una cirugía, o de resolver una patología