The presence of gastroesophageal reflux disease increases the risk of developing post-operative shoulder stiffness after arthroscopic rotator cuff repair

Purpose: Postoperative shoulder stiffness (SS) after arthroscopic rotator cuff (RC) repair has been reported with variable incidence and numerous preoperative risk factors have been described. This prospective study aims to document the incidence of postoperative SS and to evaluate the role of preoperative risk factors in the development of this complication, with special focus on the role of gastroesophageal reflux disease (GERD). Methods: Preoperative risk factors for SS were prospectively evaluated in 237 consecutive patients undergoing single-row arthroscopic RC repair. The presence of GERD was evaluated with the GerdQ diagnostic tool. Postoperative SS was diagnosed according to the criteria described by Brislin and colleagues in 2007. Results: The incidence of postoperative SS was 8.02%. The presence of GERD was significantly associated with development of postoperative SS (OR: 5.265; 95% CI, 1.657-1.731; p=0.005). Older age (OR: 0.896; 95% CI, 0.847-0.949; p<0.001), male gender (OR: 0.126; 95% CI, 0.0252-0.632; p=0.012) and number of pregnancies (OR: 0.47; 95% CI, 0.228-0.967; p=0.040) emerged as protective factors. Conclusions: The presence of GERD significantly influences the development of postoperative SS after single-row arthroscopic RC repair. An underlying a specific pro-inflammatory condition, characterized by increased expression of TNF-\u3b1 and TGF-\u3b2, and disorders in retinoid metabolism are hypothesis which could explain this previously unknown association. The documented incidence of postoperative SS falls among previously reported ranges, with females significantly more affected than men

Intraocular and plasma kinetics of tenoxicam in rabbits

Non-steroidal anti-inflammatory drugs (NSAID) represent potentially useful agents in the treatment of a number of ocular pathologies, but their intraocular penetration and distribution have not yet been reported. With the aim of clarifying this point, we evaluated the concentrations of the well known NSAID, tenoxicam, in the aqueous and vitreous humors of rabbits treated i.m. with the drug (7 mg/kg). The tenoxicam kinetics in these ocular fluids followed that in plasma with the time-to-peak shifted to higher values in the vitreous (1 h) as compared to that in the aqueous and plasma (40 min). AUC was also higher in the vitreous (10.4 micrograms.h/ml) than in the aqueous humor (2.8 micrograms.h/ml)

Ultrasonographic investigation of human fetus responses to maternal communicative and non-communicative stimuli

During pregnancy fetuses are responsive to the external environment, specifically to maternal stimulation. During this period, brain circuits develop to prepare neonates to respond appropriately. The detailed behavioral analysis of fetus' mouth movements in response to mothers' speech may reveal important aspects of their sensorimotor and affective skills; however, to date, no studies have investigated this response. Given that newborns at birth are capable of responding with matched behaviors to the social signals emitted by the caregiver, we hypothesize that such precocious responses could emerge in the prenatal period by exploiting infants' sensitivity to their mother's voice. By means of a two-dimensional (2D) ultrasonography, we assessed whether fetuses at 25 weeks of gestation, showed a congruent mouthmotor response to maternal acoustic stimulation. Mothers were asked to provide different stimuli, each characterized by a different acoustic output (e.g., chewing, yawning, nursery rhymes, etc.) and we recorded the behavioral responses of 29 fetuses. We found that, when mothers sang the syllable LA in a nursery rhyme, fetuses significantly increased mouth openings. Other stimuli provided by the mother did not produce other significant changes in fetus' behavior. This finding suggests that fetuses are sensitive only to specific maternal vocalizations (LA) and that fetal matched responses are rudimentary signs of early mirroring behaviors that become functional in the postnatal period. In conclusion, fetuses seem to be predisposed to respond selectively to specific maternal stimuli. We propose that such responses may play a role in the development of behavioral and emotional attunement with their mothers long before birth