Abstract Atopic dermatitis is a chronic, recurrent, and multifactorial skin-mucosal manifestation resulting from the interaction between elements mainly associated with the skin barrier deficit, the homeostasis of the immune response, neurological aspects, and patterns of reactivity to environmental antigens, which are established in genetically predisposed individuals. In addition to the skin, atopic diathesis involves other organs such as the airways (upper and lower), eyes, digestive tract, and neuropsychiatric aspects, which inflict additional morbidity on the dermatological patient. The different phenotypes of the disease fundamentally depend on the participation of each of these factors, in different life circumstances, such as age groups, occupational exposure patterns, physical activity, pollution, genetic load, and climatic factors. A better understanding of the complexity of its pathogenesis allows not only the understanding of therapeutic targets but also how to identify preponderant elements that mediate disease activity in each circumstance, for selecting the best treatment strategies and mitigation of triggering factors. This narrative review presents an update on the pathogenesis of atopic dermatitis, especially aimed at understanding the clinical manifestations, the main disease phenotypes and the context of available therapeutic strategies. chronic recurrent skinmucosal mucosal deficit response aspects antigens individuals upper lower, lower , lower) eyes tract patient factors circumstances groups pollution load circumstance manifestations

ABSTRACT Introduction: For thousands of years, Traditional and Complementary Medicine has provided natural advantages in the treatment of infectious diseases. Due to drug resistance, public health faces a global crisis, marked by the need to develop new drugs and find therapeutic alternatives. A documentary review was carried out in biomedical databases using the Google academic information search engine, in Spanish and English, during the period from January to June 2023. Objective: To delve into the alternatives for using the modalities of natural and traditional medicine approved in Cuba, as an antimicrobial therapeutic option. Development: Although there are multiple traditional therapies used globally, in Cuba phytotherapy, apitherapy, acupuncture and related techniques, ozone therapy, homeopathy, floral therapy, medical hydrology, traditional therapeutic exercises, heliothalassotherapy, naturopathic nutritional guidance and adyurvedic medicine are approved. All of them offer, to a greater or lesser extent, therapeutic possibilities as adjuvants to antimicrobial therapy. Conclusions: The growing antimicrobial resistance and the social and economic consequences it causes connote the need to use therapeutic alternatives today for the treatment of infectious diseases. Traditional and Complementary Medicine constitutes a useful tool in this sense, since it offers a different approach to treatment these nosological entities.

RESUMEN Introducción: Durante miles de años la medicina natural y tradicional ha brindado ventajas naturales en el tratamiento de enfermedades infecciosas. A causa de la farmacorresistencia, la salud pública enfrenta una crisis global, marcada por la necesidad de desarrollar nuevos fármacos y encontrar alternativas terapéuticas. Se realizó una revisión documental en bases de datos biomédicas mediante el motor de búsqueda de información Google académico, en los idiomas español e inglés, durante el período comprendido entre enero a junio de 2023. Objetivo: Profundizar en las alternativas del empleo de las modalidades de la medicina natural y tradicional aprobadas en Cuba, como opción terapéutica antimicrobiana. Desarrollo: Aunque son múltiples las terapias tradicionales empleadas en el ámbito internacional, en Cuba están aprobadas la fitoterapia, apiterapia, acupuntura y técnicas afines, ozonoterapia, homeopatía, terapia floral, hidrología médica, ejercicios terapéuticos tradicionales, heliotalasoterapia, orientación nutricional naturista y la medicina adyurvédica. Todas ofrecen en mayor o menor medida, posibilidades terapéuticas como coadyuvantes de la terapia antimicrobiana. Conclusiones: La creciente resistencia antimicrobiana y las consecuencias sociales y económicas que provoca connotan la necesidad de utilizar en la actualidad, alternativas terapéuticas para el tratamiento de las enfermedades infecciosas. La medicina natural y tradicional constituye una herramienta útil en este sentido, pues ofrece un enfoque diferente para el tratamiento de estas entidades nosológicas.

Resumo A ideia do tema surgiu da fala racional da aluna,primeira autora sobre homeopatia e o questionamento sobre ciência e pseudociência. No processo de construção da química como ciência a alquimia deixou contribuições importantes como técnicas de laboratório e a figura de Paracelsus que organizou as primeiras comunidades científicas. A ciência é uma construção humana e essa construção se deu por um processo influenciado por diferentes fatores.O conhecimento científico é resultado de processos que seguem formalidades e surge do rigor do que é chamado método científico. A metodologia de trabalho foi a aplicação de um questionário do tipo formulário eletrônico que teve o cuidado de ser direcionado a pessoas que tivessem ligação com a ciência em seu cotidiano profissional,para esta etapa específica foi feito um recorte nas respostas dos participantes e selecionados somentes docentes do IQ da UnB.Os resultados foram analisados utilizando um método quali-quantitativo. Quando o formulário foi interrrompido para respostas contava com 61 participações e deste total 16 docentes. Foi verificado que os participantes estão divididos na crença sobre a homeopatia e a ciência, contudo o interessante é que mesmo dois participantes que nao acreditam recorrem a homepatia para tratar sintomas que tratam também com medicamentos alopáticos. Em tempos pós pandemia é importante que se volte o olhar para a ciência e de crédito ao papel do cientista no enfretamento das questões. Contudo a homepatia não pode ser desconsiderada como uma prática de cuidado pois faz parte de um rol de linhas terapeuticas do SUS que tem um olhar para o indivíduo e sua integralidade e não desconsideram a alopatia.

Abstract The idea for the theme came from the student's rational speech, the first author on homeopathy and the questioning of science and pseudoscience. In the process of building chemistry as a science, alchemy left important contributions such as laboratory techniques and the figure of Paracelsus who organized the first scientific communities. Science is a human construction and this construction took place through a process influenced by different factors. Scientific knowledge is the result of processes that follow formalities and arises from the rigor of what is called the scientific method. The work methodology was the application of an electronic form-type questionnaire that was careful to be directed to people who had a connection with science in their professional routine. UnB IQ. The results were analyzed using a quali-quantitative method. When the form was interrupted for responses, there were 61 participants and of this total, 16 teachers. It was verified that the participants are divided in their beliefs about homeopathy and science, however, the interesting thing is that even two participants who do not believe resort to homeopathy to treat symptoms that they also treat with allopathic medicines. In post-pandemic times, it is important to look at science and credit the scientist's role in dealing with these issues. However, homeopathy cannot be disregarded as a care practice, as it is part of a list of therapeutic lines of the SUS that look at the individual and his integrality and do not disregard allopathy.

BACKGROUND: Infertility affects millions of people worldwide and has a negative social and psychological impact on the lives of infertile couples. Homeopathy offers an alternative treatment option for female infertility; however, there is currently no research describing how homeopaths manage this condition in their practice. AIM: To determine homeopathic practitioners' approaches to managing female infertility. METHOD: The electronic Delphi technique consisting of three rounds was used to establish consensus among homeopaths. Twelve registered homeopaths with a minimum of 5 years of clinical experience in managing female infertility participated, 11 of whom completed the study. In round one, participants elaborated on interventions found beneficial in clinical practice for female infertility. Responses were qualitatively analysed to create a structured list of items; participants rated their level of agreement with these items on a 5-point Likert scale in the second and third rounds. Consensus was determined for items that reached an agreement level of 75% or more. RESULTS: Thirty-two statements achieved expert consensus, which were placed into the following categories: homeopathic treatment, dietary and lifestyle modifications, supplementation and referrals. CONCLUSION: The results of this study provide a baseline depicting the homeopathic approach to treating female infertility. Several research gaps have been identified and further studies are necessary to explore these interventions to improve future patient care. CONTRIBUTION: This study highlights the various approaches used by homeopathic practitioners in the management of female infertility.

Introduction: antiphospholipid syndrome is an autoimmune thrombo-inflammatory disease with thrombotic and non-thrombotic macro- and microvascular manifestations. It constitutes a cause of obstetric morbidity with positive persistence of antiphospholipid antibodies. Its incidence is estimated at 2 per 100,000 inhabitants annually. Its diagnosis requires evaluation of the antiphospholipid antibody profile, clinical phenotype and risk factors. Anticoagulation is the effective treatment of thrombosis. However, immunosuppression is essential in microvascular and non-thrombotic episodes. Objective: to summarize the updated scientific knowledge on this syndrome from the epidemiology, pathogenesis, diagnosis, classification and treatment criteria based on its recognition, mainly in primary health care. Methods: a search was carried out in SciELO, LILACS, Google Scholar, Cochrane Library and Pubmed databases over the last 5 years. A number of 82 articles were found and 37 were included in the study with 97.3% updated. Conclusions: despite the advances obtained in the pathogenesis, diagnosis, treatment and classification criteria including livedo reticularis, thrombocytopenia, valvular diseases and nephropathy, it is necessary to develop tools to measure disease activity, long-term prognosis and improve the scale of organ damage. This is in order to reduce mortality and increase quality of life in patients with antiphospholipid syndrome.

Introducción: El síndrome antifosfolípido es una enfermedad tromboinflamatoria autoinmune, con manifestaciones macro y microvasculares trombóticas y no trombóticas. Constituye una causa de morbilidad obstétrica, con persistencia positiva de anticuerpos antifosfolípidos. Su incidencia se estima en 2 por cada 100 000 habitantes anualmente. Su diagnóstico requiere la evaluación del perfil de anticuerpos antifosfolípidos, del fenotipo clínico y de los factores de riesgo. La anticoagulación es el tratamiento eficaz de la trombosis; sin embargo, en los episodios microvasculares y no trombóticos, resulta fundamental la inmunosupresión. Objetivo: Resumir el conocimiento científico actualizado acerca de este síndrome, desde la epidemiología, patogenia, diagnóstico, criterios de clasificación y tratamiento; en función de su reconocimiento, principalmente en la atención primaria de salud. Métodos: Se realizó una búsqueda en las bases de datos SciELO, LILACS, Google académico, Biblioteca Cochrane y Pubmed, durante los últimos 5 años. Se encontraron 82 artículos y se incluyeron 37 en el estudio, con un 97, 3% de actualización. Conclusiones: A pesar de los avances obtenidos en la patogenia, el diagnóstico, el tratamiento y los criterios de clasificación, que incluyen el livedo reticular, la trombocitopenia, las valvulopatías y la nefropatía, es necesario desarrollar herramientas para medir la actividad de la enfermedad, el pronóstico a largo plazo y perfeccionar la escala de daño orgánico. Esto en función de reducir la mortalidad y aumentar la calidad de vida en pacientes con síndrome antifosfolípido.

RESUMEN Fundamento: la Medicina Natural y Tradicional es una especialidad médica que usa métodos de promoción de salud, prevención de enfermedades, diagnóstico, tratamiento y rehabilitación. Su adecuado conocimiento por los residentes de Pediatría permite un alto grado de desarrollo profesional y una atención integral al paciente. Objetivo: caracterizar el nivel de conocimientos sobre Medicina Natural y Tradicional de los residentes de Pediatría según modalidades y afecciones. Métodos: se realizó un estudio observacional, descriptivo y transversal en los centros docente-asistenciales Hospital Infantil Norte “Juan de la Cruz Martínez Maceira” y Hospital Infantil Sur “Antonio María Béguez César” de la provincia Santiago de Cuba, en el primer trimestre de 2023. Se utilizaron métodos teóricos: análisis-síntesis e inductivo-deductivo; empírico: cuestionario; y matemático-estadísticos para el análisis de los datos encontrados. Resultados: la mayoría de los residentes consideraron tener un nivel medio de preparación referente a la Medicina Natural y Tradicional. La homeopatía, seguida de la terapia floral, fueron las modalidades terapéuticas más empleadas; y las afecciones respiratorias en las que más se prescribe su uso a los pacientes. Conclusiones: la caracterización demostró que los residentes requieren conocimientos y habilidades para aprovechar la amplia gama de beneficios que esta especialidad les aporta para la promoción, prevención, diagnóstico, tratamiento y rehabilitación de las enfermedades pediátricas.

ABSTRACT Background: Herbal and folk Medicine is a medical specialty that uses methods of health promotion, disease prevention, diagnosis, treatment and rehabilitation. Its adequate knowledge by Pediatric residents allows a high degree of professional development and comprehensive patient care. Objective: to characterize the level of knowledge about Herbal and folk Medicine of Pediatrics residents according to modalities and conditions. Methods: an observational, descriptive and cross-sectional study was carried out in the teaching-care centers “Juan de la Cruz Martínez Maceira” Hospital and“Antonio María Béguez César” pediatric Hospital in the province of Santiago de Cuba, in the first quarter of 2023. Theoretical methods were used: analysis-synthesis and inductive-deductive; empirical ones: questionnaire; and mathematical-statistical for data analysis. Results: the majority of residents considered they had an average level of preparation regarding Herbal and folk Medicine. Homeopathy, followed by floral therapy, were the most used therapeutic modalities; and the respiratory conditions in which its use is most prescribed to patients. Conclusions: the characterization demonstrated that residents require knowledge and skills to take advantage of the wide range of benefits that this specialty brings them for the promotion, prevention, diagnosis, treatment and rehabilitation of pediatric diseases.

Resumo Objetivos Analisar desenhos de avaliação econômica em Práticas Integrativas e Complementares em Saúde (PICS). Métodos O estudo é uma revisão integrativa de estudos disponíveis na Biblioteca Virtual em Saúde, de 2009 a 2021. Resultados Vinte e um estudos foram selecionados para análise final, apresentando importante conformidade com as recomendações dos especialistas. Em geral, a população foi composta por mulheres adultas com distúrbios osteomusculares, que receberam terapias manipulativas, acupuntura/acupressão e homeopatia. Para avaliar essas intervenções, foram utilizadas as perspectivas da sociedade ou do provedor, a partir de análises de custo-efetividade e de custo-consequência, concentrando-se em estimar os custos diretos de saúde, e por vezes, os custos indiretos. Quanto aos desfechos, a maioria dos estudos coletou mais de uma medida, principalmente relacionadas a manifestações sintomáticas, bem-estar global e/ou fatores psicossociais. Conclusões A avaliação econômica está evoluindo para considerar perspectivas mais amplas, com maior variedade de custos e resultados, adaptando-se a diversos cenários de intervenção, atendendo às especificidades das PICS. Conciliar o desenho metodológico ao contexto de inserção das PICS no Brasil é possível e necessário, dada a carência de avaliações nacionais, aos vieses gerados por comparações internacionais e às disputas pela sustentabilidade desse conjunto de práticas no Sistema Único de Saúde. . (PICS) 200 2021 final especialistas geral osteomusculares manipulativas acupunturaacupressão acupuntura acupressão homeopatia intervenções provedor custoefetividade custo efetividade custoconsequência, custoconsequência consequência, consequência custo-consequência concentrandose concentrando se saúde vezes indiretos desfechos medida sintomáticas bemestar bem estar eou psicossociais amplas resultados adaptandose adaptando intervenção necessário nacionais (PICS 20 202 2

Abstract Objectives To analyze economic evaluation designs in Integrative and Complementary Health Practices (PICS). Methods This study is an integrative review of available studies in the Virtual Health Library, from 2009 to 2021. Results Twenty-one studies were selected for final analysis, showing significant compliance with the experts’ recommendations. In general, the population consisted of adult women with musculoskeletal disorders, who received manipulative therapies, acupuncture/acupressure and homeopathy. To evaluate these interventions, society's or provider's perspectives were used, based on cost-effectiveness and cost-consequence analyses, focusing on estimating direct health costs, and sometimes indirect costs. As for outcomes, most studies collected more than one measure, mainly related to symptomatic manifestations, overall well-being and/or psychosocial factors. Conclusions The economic evaluation is evolving to consider broader perspectives, with a greater variety of costs and results, adapting to different intervention scenarios, meeting the specificities of PICS. Reconciling methodological design and PICS’ context of insertion in Brazil is possible and necessary, given the lack of national assessments, the biases generated by international comparisons, and the disputes over the sustainability of this set of practices in the Brazilian Unified Healht System. PICS . (PICS) Library 200 2021 Twentyone Twenty analysis experts recommendations general disorders therapies acupunctureacupressure acupuncture acupressure homeopathy interventions societys society s providers provider used costeffectiveness cost effectiveness costconsequence consequence analyses outcomes measure manifestations wellbeing well being andor factors results scenarios necessary assessments comparisons System (PICS 20 202 2

Resumo Introdução A relevância do tema estudado reside na comple-xidade do tratamento da infeção causada pelo SARS-CoV-2. Objetivo Discutir as potenciais vantagens e desvantagens dos tratamentos alternativos em comparação com as abordagens médicas convencionais e realçar a importância da comunicação colaborativa entre os doentes e os prestadores de cuidados de saúde na tomada de decisões informadas sobre os tratamentos alternativos do vírus SARS-CoV-2. Métodos A metodologia de investigação utilizou métodos de análise da literatura, incluindo abordagens bibliográficas e bibliosemânticas. O estudo utilizou métodos teóricos, sistemáticos e estatísticos, incluindo análise, síntese, generalização, interpretação, classificação e meta-aná-lise para explorar tratamentos alternativos para as infecções por SARS-CoV-2, suas inter-relações e tendências estatísticas da incidência. Resultados O estudo identifica diversas terapias alternativas para o tratamento das infecções por SARS-CoV-2, destacando a fitoterapia, a acupunctura, a reflexologia, o biohacking, a homeopatia e a magnetoterapia. Sublinha os potenciais benefícios dos remédios à base de plantas como o alho, o gengibre, a camomila e a madressilva, bem como das vitaminas (C, D, B12) e dos minerais (zinco, selénio) na gestão dos sintomas da COVID-19. Conclusão Embora ofereçam benefícios holísticos, estas terapias devem ser consideradas com cautela devido ao apoio científico limitado e às potenciais interações. A compreensão cultural, o diálogo paciente-prove-dor e as escolhas informadas são fundamentais para aproveitar o potencial da medicina alternativa juntamente às abordagens convencionais para gerir os desafios da COVID-19. complexidade comple xidade SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. 2 SARS-CoV-2 literatura bibliosemânticas teóricos estatísticos síntese generalização interpretação metaanálise meta aná lise SARSCoV2, 2, interrelações inter relações incidência fitoterapia acupunctura reflexologia biohacking magnetoterapia alho gengibre madressilva C, C (C D B12 B zinco, zinco (zinco selénio COVID19. COVID19 COVID 19. 19 COVID-19 holísticos interações cultural pacienteprovedor paciente prove dor SARS-CoV- B1 COVID1 1 COVID-1 SARS-CoV COVID-

Abstract Introduction The relevance of the studied topic lies in the complexity of the treatment of infection caused by SARS-CoV-2. Objective To discuss the potential advantages and disadvantages of alternative treatments compared to conventional medical approaches, and to highlight the importance of collaborative communication between patients and healthcare providers in making informed decisions about alternative treatments of the SARS-CoV-2 virus. Methods The research methodology employed literature analysis methods, including bibliographic and bibliosemantic approaches. The study used theoretical, systematic, and statistical methods, including analysis, synthesis, generalization, interpretation, classification, and meta-analysis to explore alternative treatments for SARS-CoV-2 infections, their interrelationships, and statistical trends in incidence. Results The study identifies diverse alternative therapies for treating SARS-CoV-2 infections, highlighting herbal medicine, acupuncture, reflexology, biohacking, homoeopathy, and magnetotherapy. It underscores the potential benefits of herbal remedies like garlic, ginger, chamomile, and honeysuckle, as well as vitamins (C, D, B12) and minerals (zinc, selenium) in managing COVID-19 symptoms. Conclusion While of-fering holistic benefits, these therapies warrant cautious consideration due to limited scientific backing and potential interactions. Cultural understanding, patient-provider dialogue, and informed choices are key in harnessing the potential of alternative medicine along-side conventional approaches for managing COVID-19 challenges. SARSCoV2. SARSCoV2 SARSCoV SARS CoV 2. 2 SARS-CoV- virus methods theoretical systematic synthesis generalization interpretation classification metaanalysis meta infections interrelationships incidence acupuncture reflexology biohacking homoeopathy magnetotherapy garlic ginger chamomile honeysuckle C, C (C D B12 B zinc, zinc (zinc selenium COVID19 COVID 19 COVID-1 symptoms offering fering interactions understanding patientprovider patient provider dialogue alongside along side challenges SARS-CoV B1 COVID1 1 COVID-

RESUMO Objetivo. Identificar e analisar incidentes de produtos médicos abaixo do padrão, falsificados, não registrados e roubados no início da pandemia de COVID-19. Métodos. Foi realizada uma busca detalhada nos sites das autoridades reguladoras das Américas. Foram identificados incidentes envolvendo medicamentos e dispositivos médicos (incluindo para diagnóstico in vitro) abaixo do padrão, falsificados, não registrados e roubados. Foram determinados os tipos de produtos, os estágios da cadeia de abastecimento em que foram detectados e as medidas tomadas pelas autoridades. Resultados. Foram identificados 1 273 incidentes em 15 países (1 087 produtos abaixo do padrão, 44 falsificados, 123 não registrados e 19 roubados). O maior número de incidentes estava relacionado a dispositivos médicos, desinfetantes e antissépticos. O ponto na cadeia de abastecimento com a maior frequência de relatos foi a de aquisição pela internet. As medidas tomadas pelas autoridades reguladoras foram principalmente alertas, proibições de uso, proibições de publicidade e fabricação, recolhimento de produtos do mercado e monitoramento de eventos adversos. Conclusões. Houve um número significativo de incidentes envolvendo produtos médicos abaixo do padrão falsificados, não registrados e roubados no início da pandemia de COVID-19. A escassez de insumos, a flexibilização das exigências regulatórias e o aumento da demanda são fatores que podem levar a um maior número de incidentes. As autoridades reguladoras nacionais de referência informaram um aumento na frequência de detecção de incidentes e implementação de medidas sanitárias. O canal de vendas pela internet precisa ser abordado com alguma estratégia regulatória para garantir a distribuição segura de produtos médicos.

RESUMEN Objetivo. Identificar y analizar los incidentes de productos médicos subestándares, falsificados, no registrados y robados al inicio de la pandemia de COVID-19. Métodos. Búsqueda detallada en los sitios web de las autoridades reguladoras de las Américas. Identificación de los incidentes de medicamentos y dispositivos médicos (incluidos los de diagnóstico in vitro) subestándares falsificados, no registrados y robados. Se determinaron los tipos de productos, las etapas de la cadena de suministro en las que se detectaron y las medidas tomadas por las autoridades. Resultados. Se identificaron 1 273 incidentes en 15 países (1 087 productos subestándares, 44 falsificados, 123 no registrados y 19 robados). La mayor cantidad de incidentes corresponden a dispositivos médicos, desinfectantes y antisépticos. El punto en la cadena de suministro con mayor frecuencia de informes fue la adquisición a través de internet. Las medidas tomadas por las autoridades reguladoras corresponden en su mayoría a: alerta, prohibición de uso, prohibición de publicidad y fabricación, retiro del mercado y seguimiento de eventos adversos. Conclusiones. Se evidenció un número destacable de incidentes de productos médicos subestándares, falsificados, no registrados y robados al inicio de la pandemia por COVID-19. La escasez de insumos, la flexibilización en los requisitos regulatorios y el aumento de la demanda son factores que pueden favorecer el incremento del número de incidentes. Las autoridades reguladoras nacionales de referencia presentaron mayores frecuencias de detección de incidentes y de aplicación de medidas sanitarias. Se observó que se debe abordar el canal de venta por internet con alguna estrategia reguladora para garantizar la distribución segura de productos médicos.

ABSTRACT Objective. Identify and analyze incidents of substandard, falsified, unregistered, and stolen medical products at the onset of the COVID-19 pandemic. Methods. Detailed search of the websites of regulatory authorities in the Americas. Identification of incidents of substandard, falsified, unregistered, and stolen medicines and medical devices (including in vitro diagnostics). The types of products were determined, as were the stages in the supply chain where they were detected, and the actions taken by authorities. Results. A total of 1 273 incidents were identified in 15 countries (1 087 substandard, 44 falsified, 123 unregistered, and 19 stolen products). The largest number of incidents involved medical devices, disinfectants, and antiseptics. The most frequently reported point in the supply chain was online purchasing. The principal measures taken by the regulatory authorities were: alerts, prohibition of use, prohibition of advertising and manufacture, recall, and monitoring of adverse events. Conclusions. A substantial number of incidents involving substandard, falsified, unregistered, and stolen medical products at the onset of the COVID-19 pandemic were identified. Shortages of supplies, easing of regulatory requirements, and increased demand are factors that may have led to an increase in the number of incidents. The national regulatory authorities of reference reported more frequent detection of incidents and more frequent application of health measures. A regulatory strategy is needed in order to address online sales and ensure the safe distribution of medical products.

Resumo Objetivos Analisar desenhos de avaliação econômica em Práticas Integrativas e Complementares em Saúde (PICS). Métodos O estudo é uma revisão integrativa de estudos disponíveis na Biblioteca Virtual em Saúde, de 2009 a 2021. Resultados Vinte e um estudos foram selecionados para análise final, apresentando importante conformidade com as recomendações dos especialistas. Em geral, a população foi composta por mulheres adultas com distúrbios osteomusculares, que receberam terapias manipulativas, acupuntura/acupressão e homeopatia. Para avaliar essas intervenções, foram utilizadas as perspectivas da sociedade ou do provedor, a partir de análises de custo-efetividade e de custo-consequência, concentrando-se em estimar os custos diretos de saúde, e por vezes, os custos indiretos. Quanto aos desfechos, a maioria dos estudos coletou mais de uma medida, principalmente relacionadas a manifestações sintomáticas, bem-estar global e/ou fatores psicossociais. Conclusões A avaliação econômica está evoluindo para considerar perspectivas mais amplas, com maior variedade de custos e resultados, adaptando-se a diversos cenários de intervenção, atendendo às especificidades das PICS. Conciliar o desenho metodológico ao contexto de inserção das PICS no Brasil é possível e necessário, dada a carência de avaliações nacionais, aos vieses gerados por comparações internacionais e às disputas pela sustentabilidade desse conjunto de práticas no Sistema Único de Saúde.

Abstract Objectives To analyze economic evaluation designs in Integrative and Complementary Health Practices (PICS). Methods This study is an integrative review of available studies in the Virtual Health Library, from 2009 to 2021. Results Twenty-one studies were selected for final analysis, showing significant compliance with the experts’ recommendations. In general, the population consisted of adult women with musculoskeletal disorders, who received manipulative therapies, acupuncture/acupressure and homeopathy. To evaluate these interventions, society's or provider's perspectives were used, based on cost-effectiveness and cost-consequence analyses, focusing on estimating direct health costs, and sometimes indirect costs. As for outcomes, most studies collected more than one measure, mainly related to symptomatic manifestations, overall well-being and/or psychosocial factors. Conclusions The economic evaluation is evolving to consider broader perspectives, with a greater variety of costs and results, adapting to different intervention scenarios, meeting the specificities of PICS. Reconciling methodological design and PICS’ context of insertion in Brazil is possible and necessary, given the lack of national assessments, the biases generated by international comparisons, and the disputes over the sustainability of this set of practices in the Brazilian Unified Healht System.

Resumen Este artículo analiza las representaciones sobre la epilepsia en la publicidad de la prensa en la ciudad de México durante el Porfiriato. Para ello, se siguieron dos estrategias metodológicas. Por una parte, un estudio cuantitativo que nos arrojó las tendencias de la publicidad sobre los remedios y medicamentos curativos para la epilepsia, y por otra, uno de tipo cualitativo en el que se indaga sobre las sustancias que contienen. Finalmente se analiza el contenido escrito de los anuncios de los remedios (sus eslóganes y textos), para entender la lógica o el sustento de la representación sobre la epilepsia que había detrás de ellos. Con este análisis pudimos darnos cuenta de que la terapéutica para la epilepsia era muy variada e iba desde los productos que contenían sustancias químicas y homeopáticas hasta aquellos de origen vegetal; e incluso más: se recurrió a artilugios eléctricos con los que se proponía recuperar la salud. Entre otros hallazgos, podemos mencionar que la retórica publicitaria estableció una relación entre la epilepsia y la locura, seguramente con la finalidad de causar temor en los enfermos para que los productos fueran adquiridos con la esperanza de evitarla.

Abstract This article analyses the representations of epilepsy in publicity, in Mexico City during the mandate of Porfirio Díaz, by means of two distinct methodological strategies. On one side, there is a quantitative study showing trends in publicity regarding remedies and medicine meant to heal epilepsy; on the other, a qualitative study, which looks into the kind of substances contained in said cures. Finally, the article also analyses the written content of the remedies’ advertisements (text and slogan), to understand the reasoning and the logic behind their representation of epilepsy. This analysis allows us to see just how diverse the treatments for epilepsy were. They ranged from products containing chemical and homeopathic substances, to those made from plants, and even electrical contraptions supposed to restore one’s health. Amongst various findings, we can say that it was the rhetoric in publicity that established a link between epilepsy and insanity. This was surely done in order to inspire fear in the infirm, so they would acquire the products in the hopes of avoiding the illness.

La fiebre Chikungunya es causada por un arbovirus ARN perteneciente a la familia Togaviridae del género alphavirus, llamado “virus del chikungunya”, este virus tiene como vector el Aedes aegypti y el Aedes albopictus. En su fase aguda la enfermedad se manifiesta por fiebre, artritis o artralgias severas, mialgias, cefalea, fotofobia, linfadenopatías y brotes cutáneos, los síntomas pueden progresar a una fase subaguda hasta crónica, donde persisten las manifestaciones articulares y la fatiga. Se realizó una revisión sistemática en las bases de PubMed, Cochrane, Dovepress y SciELO, utilizando las palabras claves: chikungunya y chikunguña, cruzadas con las palabras: artritis crónica y tratamiento. Se incluyeron en el estudio un total de 16 artículos, 6 artículos de revisión, 4 artículos originales, 2 ensayos clínicos, 2 reportes de caso, 1 revisión sistemática y 1 carta al editor. Entre las opciones farmacológicas, el metotrexato es el fármaco más estudiado y compite con los efectos de los AINE. Como terapias no farmacológicas se encuentran la fisioterapia y la terapia física, utilizados como complementos a la terapia farmacológica. El uso de terapias caseras, incluso la homeopatía, también podrían agregarse, atendiendo principalmente el factor psíquico y cultural de los pacientes.

Chikungunya fever is caused by an RNA arbovirus belonging to the Togaviridae family of the alphavirus genus, called "chikungunya virus", this virus is vectored by Aedes aegypti and Aedes albopictus. In its acute phase, the disease is manifested by fever, arthritis or severe arthralgia, myalgia, headache, photophobia, lymphadenopathy and skin rashes. The symptoms can progress to a subacute to chronic phase, where joint manifestations and fatigue persist. A bibliographic search was carried out in the PubMed, Cochrane, Dovepress and SciELO databases, using the keywords: chikungunya and chikunguña, crossed with the words: chronic arthritis and treatment. A total of 16 articles were included: 6 review articles, 1 systematic review, 4 original articles, 2 clinical trials, 1 letter to Editor letter and 2 case reports. Among the pharmacological options, methotrexate is the most studied drug and competes with the effects of NSAIDs. Non-pharmacological therapies are physiotherapy and physical therapy, used as complements to pharmacological therapy. The use of home therapies, including homeopathy, could also be added, mainly addressing the psychological and cultural factors of the patients.

Abstract Introduction. Iatrogenic allogenosis is due to the application of biopolymers for aesthetic purposes, with an increasing prevalence and without specific medical treatment. Objective. To describe the results of treatment with Arnica montana L in a patient with facial allogenosis. Clinical case. A 46-year-old male patient, who received facial injections on two occasions, with a biopolymer of unknown chemical composition and density and applied by a non-certified cosmetologist, 12 years ago. He presents a picture of severe inflammatory reaction and palpebral edema that almost completely prevented biocular opening and the physical examination confirmed the presence of erythematous plaques and nodules, well defined, indurated and adhered to deep planes, located in the periorbital regions and in the nasolabial folds. Treatment with Arnica montana L 6CH alcoholic base, 5 drops, 4 times a day, sublingually; application of lukewarm fomentations, 3 times a day; gentle massages on the lesions and in a circular direction around them, as well as morning postural drainage (supine position with slight descent of the head). After a week of treatment, softening of the lesions and spontaneous drainage of yellowish, transparent, non-fetid fluid were observed; which suppurated through the lacrimal ducts, intraoral salivary and sublingual route. Conclusions. Homeopathic natural medicine with the use of Arnica montana L. is an alternative for the treatment of facial allogenosis.

Resumen Introducción. La alogenosis iatrogénica se debe a la aplicación de biopolímeros con fines estéticos, con una prevalencia en aumento y sin un tratamiento médico específico. Objetivos. Describir los resultados del tratamiento con Árnica montana L en un paciente con alogenosis facial. Caso clínico. Paciente masculino de 46 años de edad, que recibió inyecciones faciales en dos ocasiones, con un biopolímero de composición química y densidad desconocida y aplicado por un cosmetólogo no certificado hace 12 años. Presenta un cuadro de severa reacción inflamatoria y edema palpebral que le prohibía la apertura biocular casi en su totalidad y el examen físico constató la presencia de placas y nódulos eritematosos, bien definidos, indurados y adheridos a planos profundos, localizados en las regiones periorbitarias y en los surcos nasogenianos. Tratamiento con Árnica montana L 6CH base alcohólica, 5 gotas, 4 veces al día, vía sublingual; aplicación de fomentos tibios, 3 veces al día; masajes suaves en las lesiones y en dirección circular alrededor de las mismas, así como drenaje postural matutino (decúbito supino con ligero descenso de la cabeza). A la semana de tratamiento se apreció un reblandecimiento de las lesiones y drenaje espontáneo de líquido amarillento, transparente, no fétido; que supuró a través de los conductos lagrimales, salivales intraorales y vía sublingual. Conclusiones. La medicina natural homeopática con el empleo de la Árnica montana L. es una alternativa para el tratamiento de la alogenosis.