ABSTRACT Purpose: This video aims to present an in-depth, step-by-step tutorial on microsurgical reconstruction for obstructive azoospermia, featuring a distinctive case involving anastomosis from vas deferens to rete testis. The primary aim of this endeavor is to offer thorough and practical insights for healthcare professionals and researchers within the realm of reproductive medicine. The video endeavors to disseminate expertise, methodologies, and perspectives that can be advantageous to individuals grappling with obstructive azoospermia, providing a significant contribution to the progress of reproductive medicine and the augmentation of existing treatment alternatives. Materials and Methods: Surgical footage was recorded using the ORBEYE 4K 3D Orbital Camera System by Olympus America, with patient consent acquired for research purposes. Additionally, a retrospective examination of patient records was undertaken to compile relevant medical histories. Results: This video furnishes an exhaustive guide to microsurgical reconstruction for obstructive azoospermia, encompassing a distinctive instance of anastomosis from vas deferens to rete testis. State-of-the-art technology, such as the ORBEYE 4K 3D Orbital Camera, heightens procedural transparency, accentuating the significance of advanced instrumentation. The ethical underpinning is emphasized by obtaining patient consent for footage utilization, and a retrospective chart review augments the repository of valuable patient data. This comprehensive approach serves as an invaluable reservoir of knowledge for medical professionals and underscores excellence in clinical and ethical healthcare research. Conclusions: Anastomosis from vas deferens to rete testis emerges as a viable surgical reconstruction alternative for obstructive azoospermia, particularly when confronted with non-dilated tubules within the epididymis. Purpose indepth, indepth depth, depth in-depth stepbystep step azoospermia expertise methodologies alternatives Methods K D America purposes Additionally histories Results Stateoftheart State art technology transparency instrumentation utilization data Conclusions nondilated non dilated epididymis

Resumo Por um lado, a investigação tem evidenciado diversos correlatos da saúde dos indivíduos, por outro, suporta alguma preocupação com o crescente recurso a práticas de cuidados de saúde que se podem apelidar de não convencionais. Assim, o objectivo do presente estudo é: estudar práticas de (auto-)cuidados de saúde não convencionais e a relação entre saúde e religião. Assim, entre 1/10/2021 e 27/9/2023, 449 adultos (18-88 anos) que moravam em Portugal responderam a um questionário via Google Forms (estudo transversal). A maioria reportou interesse por práticas não convencionais e usava-as com as convencionais. A maioria tinha religião, era não praticante e considerava que a religião não influenciava as suas decisões sobre cuidados de saúde. Não se verificaram diferenças estatisticamente significativas nas percepções de saúde, do cuidado com a saúde, dos resultados da e satisfação com a última prática de (auto-)cuidados, na satisfação com a saúde ou nos itens do MHI-5 em função destas características religiosas. Estes resultados apoiam a exploração rotineira das práticas de cuidados de saúde não convencionais para alcançar a segurança, eficácia, equidade, inclusão e sustentabilidade na prática da psicologia da saúde. Não revelam, todavia, a pertinência de certos aspectos religiosos no âmbito da saúde.

Abstract On the one hand, research has shown several correlates of individuals' health, on the other hand, it supports some concern about the growing use of health care practices that can be included in CAM - Complementary and Alternative Medicine. Therefore, the aim of the present study is: to study CAM (self-)health care practices and the relationship between health and religion. Thus, between 1/10/2021 and 27/9/2023, 449 adults (18-88 years old) living in Portugal answered to a questionnaire via Google Forms (cross-sectional study). The majority reported interest in CAM practices and used them with conventional ones. The majority had a religion, were non-practising and considered that religion did not influence their decisions about health care. There were no statistically significant differences in perceptions of health, health care, results of and satisfaction with the last (self-)care practice, satisfaction with health or MHI-5 items depending on these religious characteristics. These results support the routine exploration of CAM health care practices to achieve safety, effectiveness, equity, inclusion, and sustainability in health psychology practice. They do not, however, reveal the relevance of certain religious aspects in the context of health.

RESUMEN Introducción: La medicina regenerativa y terapia celular representa una alternativa segura y eficaz en la regeneración hística. La fibrina rica en plaquetas y leucocitos favorece la cicatrización de la base craneal, con una disminución significativa en las complicaciones, en especial la fístula de líquido cefalorraquídeo. Objetivo: Describir los resultados del empleo de la fibrina rica en plaquetas y leucocitos como elemento accesorio en la reparación de la base craneal. Métodos: Se realizó un estudio descriptivo, transversal en 250 pacientes en el Hospital Hermanos Ameijeiras, operados por procedimientos endonasales endoscópicos con diversos tumores de la base craneal, en los cuales se empleó la fibrina rica en plaquetas y leucocitos durante la fase de reconstrucción. Se realizó una evaluación de la barra de reparación y las complicaciones presentes. Para el análisis de los datos se utilizaron frecuencias absolutas y relativas como medidas resumen. Resultados: El 97,2 % de las barreras de reparación fue catalogada de óptima. Se reporta con el uso de la fibrina rica en plaquetas y leucocitos 2,0 % de fístula de líquido cefalorraquídeo, 0,8 % de infección del sistema nervioso central, 4,0 % de costras nasales posoperatorias. Conclusiones: El presente estudio evidencia el efecto positivo del empleo de la fibrina rica en plaquetas y leucocitos en la reparación del base craneal con gran impacto en el índice de fístula de líquido cefalorraquídeo y la calidad de vida nasosinusal.

ABSTRACT Introduction: Regenerative medicine and cell therapy represents a safe and effective alternative in tissue regeneration. Fibrin rich in platelets and leukocytes promotes healing of the cranial base, with a significant decrease in complications, especially cerebrospinal fluid leak. Objective: Describe the results of using fibrin rich in platelets and leukocytes as an accessory element in the repair of the cranial base. Methods: A descriptive, cross-sectional study was carried out in 250 patients at the “Hermanos Ameijeiras” Hospital operated by endoscopic endonasal procedures with various tumors of the cranial base, in which fibrin rich in platelets and leukocytes was used during the reconstruction phase. An evaluation of the repair bar and the complications present was performed. For data analysis, absolute and relative frequencies were used as summary measures. Results: 97.2% of the repair barriers were classified as optimal. With the use of fibrin rich in platelets and leukocytes, 2.0% of cerebrospinal fluid leak, 0.8% of central nervous system infection, 4.0% of postoperative nasal scabs are reported. Conclusions: The present study evidences the positive effect of the use of leukocyte-platelet-rich fibrin in the repair of the skull cranial base, with great impact on the rate of cerebrospinal fluid leak and sinonasal quality of life.

Abstract Introduction: The pressing need to train autonomous and proactive professionals demands new ways of mediating content. In this context, the use of active teaching and learning methods can improve the profile of the new professional. Case-Based Learning (CBL) is a strategy based on the student’s ability to relate theory and practice, with autonomy and decision-making. The discipline of Genetics addresses contents that may seem distant from everyday life and future professional practice, so it is necessary to use teaching strategies that facilitate the understanding of the application of this knowledge in medical practice. Objective: This study aimed to evaluate the CBL as a pedagogical approach in the teaching-learning process of Genetics for Medicine courses in a public institution. Methods: An active methodology protocol that consisted of nine clinical cases was applied to 46 medical students from Universidade de Brasília, who were later divided into nine groups. The performance and perceptions regarding the methodology were evaluated by questionnaires. Quantitative results were analyzed using Student’s t test. Results: The performance of group work was statistically higher in 8 of 9 cases compared to individual work. Most students considered the activity good or very good (76%), but approximately half reported no increase in motivation. Moreover, 71.4% felt motivated to learn more about the subject after class and 20% considered they were able to teach the subject to others and 42% assessed they would get all or most of the questions correct if they were submitted to a new assessment. Regarding teamwork, 38% reported feeling more motivated. Finally, 86% considered the discussion of clinical cases relevant or very relevant for professional training. Final considerations: The results show, in general, success in the use of CBL on the study of genetic diseases but point out that there are difficulties in the use of alternative teaching methods to the lecture. Despite this, it is clear that learning based on clinical cases can lead to the mobilization of previous knowledge in situations of professional practice. Introduction content context CaseBased Case Based (CBL student s practice decisionmaking. decisionmaking decision making. making decision-making Objective teachinglearning institution Methods 4 Brasília groups questionnaires Students Student test Results 76%, 76 76% , (76%) motivation Moreover 714 71 71.4 20 42 assessment teamwork 38 Finally 86 training considerations show general lecture 7 (76% 71. 2 3 (76 (7 (

Resumo Introdução: A necessidade premente de formar médicos autônomos e proativos implica novas abordagens didáticas e formas de mediar o conteúdo. Nesse contexto, a utilização de métodos ativos de ensino e aprendizagem pode incrementar o perfil do novo profissional. A Aprendizagem Baseada em Casos (ABC) é uma estratégia fundamentada na capacidade de o estudante relacionar teoria e prática com autonomia e tomada de decisão. A disciplina de genética aborda conteúdos que podem parecer distantes do cotidiano e da prática profissional futura, e, por isso, a necessidade de utilizar estratégias de ensino que facilitem a compreensão da aplicação desse conhecimento na prática médica. Objetivo: O presente trabalho teve por objetivo avaliar a ABC como abordagem pedagógica no processo de ensino-aprendizagem de genética para o curso de Medicina de uma instituição pública. Método: Aplicou-se um protocolo de método ativo composto por nove casos clínicos a 46 estudantes de Medicina da Universidade de Brasília que, posteriormente, foram divididos em nove grupos. Por meio de questionários, avaliaram-se o desempenho e as percepções em relação ao método. Os resultados quantitativos foram analisados por meio do teste t de Student. Resultado: O rendimento do trabalho em grupo foi estatisticamente maior em oito dos nove casos em comparação ao trabalho individual. A atividade foi considerada boa ou muito boa por 76% dos estudantes, e 90% mencionaram que houve aumento da motivação. Além disso, 71,4% destes demonstraram interesse em estudar mais sobre o assunto após a aula, 20% se consideraram capazes de ensinar o assunto a outras pessoas, e 42% avaliaram que acertariam todas ou a maioria das questões caso fossem submetidos a uma nova avaliação. Com relação ao trabalho em equipe, 38% relataram se sentir mais motivados. Por fim, 86% consideraram relevante ou muito relevante a discussão de casos clínicos para a formação profissional. Conclusão: Os resultados demostraram sucesso no uso do método ABC na abordagem de genética, porém apontaram que há dificuldades na utilização de métodos de ensino alternativos à aula expositiva. Apesar disso, fica explícito que a estratégia adotada pode levar à mobilização de conhecimentos prévios em situações da prática profissional. Introdução conteúdo contexto (ABC decisão futura isso médica Objetivo ensinoaprendizagem pública Método Aplicouse Aplicou 4 posteriormente grupos questionários avaliaramse Student Resultado individual 76 90 motivação disso 714 71 71,4 20 pessoas 42 avaliação equipe 38 motivados fim 86 Conclusão expositiva 7 9 71, 2 3 8

During the COVID-19 outbreak, there was a sharp increase in generalized anxiety disorder (GAD). Acupuncture therapy has the advantages of accurate clinical efficacy, safety and reliability, few adverse reactions, and no dependence, and is gradually becoming one of the emerging therapies for treating GAD. We present a study protocol for a randomized clinical trial with the aim of exploring the mechanism of brain plasticity in patients with GAD and evaluate the effectiveness and reliability of acupuncture treatment. Transcranial magnetic stimulation (TMS) will be used to assess cortical excitability in GAD patients and healthy people. Sixty-six GAD patients meeting the inclusion criteria will be randomly divided into two groups: TA group, (treatment with acupuncture and basic western medicine treatment) and SA group (sham acupuncture and basic western medicine treatment). Twenty healthy people will be recruited as the control group (HC). The parameters that will be evaluated are amplitude of motor evoked potentials (MEPs), cortical resting period (CSP), resting motor threshold (RMT), and Hamilton Anxiety Scale (HAMA) score. Secondary results will include blood analysis of γ-aminobutyric acid (GABA), glutamate (Glu), glutamine (Gln), serotonin (5-HT), and brain-derived nerve growth factor (BDNF). Outcomes will be assessed at baseline and after the intervention (week 8). This study protocol is the first clinical trial designed to detect differences in cerebral cortical excitability between healthy subjects and patients with GAD, and the comparison of clinical efficacy and reliability before and after acupuncture intervention is also one of the main contents of the protocol. We hope to find a suitable non-pharmacological alternative treatment for patients with GAD. COVID19 COVID 19 COVID-1 outbreak . (GAD) reactions dependence TMS (TMS Sixtysix Sixty six groups sham HC. HC (HC) MEPs, MEPs , (MEPs) CSP, CSP (CSP) RMT, RMT (RMT) HAMA (HAMA score γaminobutyric γ aminobutyric GABA, GABA (GABA) Glu, Glu (Glu) Gln, Gln (Gln) 5HT, 5HT HT 5 (5-HT) brainderived derived BDNF. BDNF (BDNF) week 8. 8 8) nonpharmacological non pharmacological COVID1 1 COVID- (GAD (HC (MEPs (CSP (RMT (GABA (Glu (Gln (5-HT (BDNF

ABSTRACT Purpose: Osteoporosis is a bone disease which commonly occurred in postmenopausal women. Almost 10 percent of world population and approximately 30% of women (postmenopausal) suffer from this disease. Alternative medicine has great success in the treatment of osteoporosis disease. Bryodulcosigenin, a potent phytoconstituent, already displayed the anti-inflammatory and antioxidant effect. In this study, we made effort to analyze the antiosteoporosis effect of bryodulcosigenin against ovariectomy (OVX) induced osteoporosis in rats. Methods: Swiss albino Wistar rats were grouped into fIve groups and given an oral dose of bryodulcosigenin (10, 20 and 30 mg/kg) for eight weeks. Body weight, uterus, bone mineral density, cytokines, hormones parameters, transforming growth factor (TGF)-β, insulin-like growth factor (IGF), osteoprotegerin (OPG), receptor activator of nuclear factor kappa-Β ligand (RANKL), and its ratio were estimated. Results: Bryodulcosigenin significantly (p < 0.001) suppressed the body weight and enhanced the uterine weight and significantly (p < 0.001) increased the bone mineral density in whole femur, caput femoris, distal femur and proximal femur. Bryodulcosigenin significantly (P < 0.001) altered the level of biochemical parameters at dose dependent manner, significantly (P < 0.001) improved the level of estrogen and suppressed the level of follicle stimulating hormone and luteinizing hormone. Bryodulcosigenin significantly (P < 0.001) improved the level of OPG and suppressed the level of RANKL. Conclusions: Bryodulcosigenin reduced the cytokines level and suppressed the TGF-β and IGF. We concluded that bryodulcosigenin is an antiosteoporosis medication based on the findings. Purpose 1 (postmenopausal phytoconstituent antiinflammatory anti inflammatory study OVX (OVX Methods 10, (10 2 3 mg/kg mgkg mg kg weeks uterus TGFβ, TGFβ TGF β, β (TGF)-β insulinlike insulin like IGF, IGF , (IGF) OPG, (OPG) kappaΒ kappa Β RANKL, RANKL (RANKL) estimated Results p 0.001 0001 0 001 femoris P manner Conclusions findings (1 (IGF (OPG (RANKL 0.00 000 00 ( 0.0 0.

Abstract Plants used in traditional medicine offer an affordable new alternative in tissue repair therapy. This study aimed to evaluate the effectiveness of the 5% Rhizophora mangle cream compared to the 5% dexpanthenol cream in healing open surgical wounds on the upper eyelid. A total of 18 patients were submitted to the experiment and divided into 2 groups with 9 patients each who used topically and daily 5% dexpanthenol cream (control group) or 5% R.mangle cream (intervention group) for 7 days. Clinical, morphometric and histomorphometric analyses of wounds and surgical procedures for skin removal were performed. In the morphometric analysis, all wounds treated with R.mangle and dexpanthenol creams showed complete macroscopic scars, without inflammatory signs and infection free. The skin hydration values in pre and post application periods of the cream were 43.82 ± 43.93 and 62.12 ± 67.40 respectively. The histomorphometric study showed lower values of epithelium distance in R. mangle group and higher in dexpanthenol group with significant difference between groups (p < 0.05). The R.mangle 5% cream proved to be effective in healing wounds of human upper eyelid skin with a significant improvement in epithelization compared to dexpanthenol 5% cream. therapy 5 1 control Rmangle R intervention days Clinical performed analysis scars free 4382 43 82 43.8 4393 93 43.9 6212 62 12 62.1 6740 67 40 67.4 respectively p 0.05. 005 0.05 . 0 05 0.05) 438 4 8 43. 439 621 6 62. 674 67. 00 0.0 0.

ABSTRACT: Veterinary acupuncture is a complementary and alternative medicine practiced widely in Brazil and is recognized as a specialty by the Federal Council of Veterinary Medicine. However, despite the growing interest of professionals for training and of clients for care, there are no studies on the socioeconomic profile of these veterinary acupuncturists in Brazil. The present survey received 295 (complete) replies, the majority of the respondents were 40 years old or less, female (87%) and were from the southeastern region of Brazil. Furthermore, 57% of respondents were at the beginning of their acupuncture careers with less than 5 years of practice. Most respondents chose to be an acupuncturist for personal satisfaction and perceived effectiveness of acupuncture. Experienced acupuncturists received better financial rewards and were more satisfied with their earnings and valued by their clients. Most respondents believe that acupuncture has scientific evidence through experimental and clinical studies. The socioeconomic profile of veterinary acupuncturists is essential to elaborate future action plans and help improve the quality of veterinary professionals. ABSTRACT Medicine However care 29 complete (complete replies 4 87% 87 (87% Furthermore 57 practice 2 8 (87 (8 (

RESUMO: A acupuntura veterinária é uma medicina complementar e alternativa amplamente praticada no Brasil e reconhecida como especialidade pelo Conselho Federal de Medicina Veterinária. No entanto, apesar do crescente interesse dos profissionais pela capacitação e dos clientes pelo atendimento, não há estudos sobre o perfil socioeconômico desses acupunturistas veterinários no Brasil. A presente pesquisa recebeu 295 respostas (completas), a maioria dos respondentes tinha 40 anos ou menos, era do sexo feminino (87,1%) e era da região sudeste do Brasil. Além disso, 56,6% dos entrevistados estavam no início de suas carreiras de acupuntura com menos de cinco anos de prática. A maioria dos entrevistados escolheu ser acupunturista para satisfação pessoal e eficácia percebida da acupuntura. Acupunturistas experientes receberam melhores salários e ficaram mais satisfeitos com seus ganhos e se sentem mais valorizados por seus clientes. A maioria dos entrevistados acredita que a acupuntura possui comprovação científica por meio de estudos experimentais e clínicos. O perfil socioeconômico dos acupunturistas veterinários é fundamental para o planejamento de ações futuras e melhoria da qualidade dos profissionais veterinários. RESUMO Veterinária entanto atendimento 29 completas, completas , (completas) 4 87,1% 871 87 1 (87,1% disso 566 56 6 56,6 prática clínicos 2 (completas 87,1 8 (87,1 5 56, 87, (87, (87 (8 (

Abstract Nerve injuries present a substantial challenge within the medical domain due to their prevalent occurrence and significant impact. In nerve injuries, a range of physiopathological and metabolic responses come into play to stabilize and repair the resulting damage. A critical concern arises from the disruption of connections at neuromuscular junctions, leading to profound degeneration and substantial loss of muscle function, thereby hampering motor tasks. While end-to-end neurorrhaphy serves as the established technique for treating peripheral nerve injuries, achieving comprehensive morphofunctional recovery remains a formidable challenge. In pursuit of enhancing the repair process, alternative and supportive methods are being explored. A promising candidate is the utilization of heterologous fibrin biopolymer, a sealant devoid of human blood components. Notably, this biopolymer has showcased its prowess in establishing a stable and protective microenvironment at the site of use in multiple scenarios of regenerative medicine. Hence, this scoping review is directed towards assessing the effects of associating heterologous fibrin biopolymer with neurorrhaphy to treat nerve injuries, drawing upon findings from prior studies disseminated through PubMed/MEDLINE, Scopus, and Web of Science databases. Further discourse delves into the intricacies of the biology of neuromuscular junctions, nerve injury pathophysiology, and the broader utilization of fibrin sealants in conjunction with sutures for nerve reconstruction procedures. The association of the heterologous fibrin biopolymer with neurorrhaphy emerges as a potential avenue for surmounting the limitations associated with traditional sealants while also mitigating degeneration in nerves, muscles, and NMJs post-injury, thereby fostering a more conducive environment for subsequent regeneration. Indeed, queries arise regarding the long-term regenerative potential of this approach and its applicability in reconstructive surgeries for human nerve injuries. impact damage junctions function tasks endtoend end process explored components Notably medicine Hence PubMedMEDLINE PubMed MEDLINE PubMed/MEDLINE Scopus databases pathophysiology procedures nerves muscles postinjury, postinjury post injury, post-injury regeneration Indeed longterm long term

Este estudo visa descrever e analisar o pluralismo médico e o tipo de relação de hegemonia-subalternidade entre diversas formas de atendimento ou conhecimentos, que ocorreram no tratamento de um paciente com glaucoma, com a finalidade de mostrar o processo articulatório e transacional entre diferentes recursos terapêuticos, bem como entender quais elementos estruturais moldaram o itinerário e a opção de tratamento. Trata-se de uma pesquisa qualitativa, que utilizou um estudo de caso com abordagem narrativa. Para a reconstrução da narrativa, foi realizada uma entrevista semiestruturada, com base em um roteiro temático previamente estabelecido por um conjunto de categorias a priori, para posteriormente transcrever os dados e realizar a triangulação hermenêutica. Os resultados mostraram que a hegemonia no pluralismo médico esteve baseada em relações de equivalência, de modo que o paciente substituiu o uso de medicamentos farmacológicos por tratamentos da medicina alternativa; no entanto, o processo relacional de equivalência desenvolveu-se em um contexto de significância biomédica, na qual o tratamento ou controle da pressão intraocular foi a premissa para a substituição. Desse modo, os processos que desencadearam a presença de relações hegemônicas foram constituídos por fatores sociais, culturais e econômicos diversos como desemprego, previdência social e gênero, os quais tiveram papel fundamental durante a busca por atendimento e cuidado. hegemoniasubalternidade subalternidade conhecimentos glaucoma terapêuticos Tratase Trata se qualitativa narrativa semiestruturada priori hermenêutica alternativa entanto desenvolveuse desenvolveu biomédica substituição sociais desemprego gênero cuidado

This study aims to describe and analyze the medical pluralism and the type of hegemony-subordination relation between forms of care or knowledge in the treatment of a patient with glaucoma to show the articulatory and transactional process between several therapeutic resources and understand which structural elements shaped the treatment itinerary and option. This is a qualitative research that used a narrative case study. To reconstruct the narrative, a semi-structured interview was conducted based on a thematic script previously established by a set of a priori categories to later transcribe the data and perform hermeneutic triangulation. Results showed that the hegemony in medical pluralism was based on equivalence relations, so that the patient replaced the use of pharmacological drugs with alternative medicine treatments. However, the relational process of equivalence developed itself in a context of biomedical significance, in which the treatment or control of intraocular pressure configured the substitution premise. Thus, the processes that triggered the hegemonic relations were constituted by various social, cultural, and economic factors such as unemployment, social security, and gender, which played a fundamental role during the search for care. hegemonysubordination subordination option semistructured semi structured triangulation treatments However significance premise Thus cultural unemployment security gender

Este estudio tiene como objetivo describir y analizar el pluralismo médico y el tipo de relaciones de hegemonía-subalternidad entre diversas formas o saberes de atención, que se desarrollaron en el itinerario terapéutico de una padeciente de glaucoma, para mostrar el proceso articulatorio y transaccional entre distintos recursos terapéuticos, así como comprender qué elementos estructurales configuraron el itinerario y la elección terapéutica. La investigación es cualitativa, un estudio de caso en el cual se utilizó el enfoque narrativo. Para la reconstrucción de la narrativa se realizó una entrevista semiestructurada, dirigida por una guía temática previamente determinada por un conjunto de categorías apriorísticas, para posteriormente transcribir la entrevista y realizar un proceso de triangulación hermenéutica. Los resultados mostraron, en este caso, que la hegemonía en el pluralismo médico se constituyó mediante relaciones de equivalencia, así, la padeciente sustituyó el uso de medicamentos farmacológicos por terapias de medicina alternativa, no obstante, el proceso relacional de equivalencia se desarrolló en un contexto de significación biomédica, en el cual tratar o controlar la presión intraocular fue la premisa del remplazo. Asimismo, los procesos que desencadenaron la presencia de relaciones hegemónicas se constituyeron por diversos factores sociales, culturales y económicos como el desempleo, la seguridad social y el género, que desempeñaron un papel fundamental durante la búsqueda de la atención y del cuidado. hegemoníasubalternidad subalternidad glaucoma terapéuticos terapéutica cualitativa narrativo semiestructurada apriorísticas hermenéutica mostraron alternativa obstante biomédica remplazo Asimismo sociales desempleo género cuidado

Mesenchymal stromal cells (MSCs) have therapeutic potential due to their abilities of differentiation, immunomodulation, and migration to injured tissues, potentiating such effects when cells are activated. Guarana (Paullinia cupana) is a tropical plant species found in South America that is known for its antioxidant, stimulant, and cicatricial effects. The guarana extract is composed of many substances and caffeine is the main component. The objective was to evaluate the effects of guarana and caffeine on MSCs. After the initial characterization, MSCs were treated with Paullinia cupana (10, 100, and 1000 μg/mL) or caffeine (0.4, 4, and 40 μg/mL) for 24 h. MSCs treatment with 1000 μg/mL guarana increased cell polarity, viability, cell migration to chemoattractant, antioxidant potential, and liberation of extracellular vesicles (EVs), while it reduced the levels of autophagy. MSCs treated with 100 and 1000 μg/mL guarana or 40 μg/mL caffeine showed a decrease of cell proliferation. No treatment affected the cellular area and cell cycle of MSCs. The study shows in vitro evidence that guarana could be a promising alternative for activating MSCs to promote better cellular products for future clinical therapies. (MSCs differentiation immunomodulation tissues activated stimulant component characterization 10, 10 (10 μgmL μg mL 0.4, 04 0 4 (0.4 2 h polarity viability chemoattractant EVs, EVs , (EVs) autophagy proliferation therapies 1 (1 0.4 (0. (EVs ( 0. (0

This study aims to describe and analyze the medical pluralism and the type of hegemony-subordination relation between forms of care or knowledge in the treatment of a patient with glaucoma to show the articulatory and transactional process between several therapeutic resources and understand which structural elements shaped the treatment itinerary and option. This is a qualitative research that used a narrative case study. To reconstruct the narrative, a semi-structured interview was conducted based on a thematic script previously established by a set of a priori categories to later transcribe the data and perform hermeneutic triangulation. Results showed that the hegemony in medical pluralism was based on equivalence relations, so that the patient replaced the use of pharmacological drugs with alternative medicine treatments. However, the relational process of equivalence developed itself in a context of biomedical significance, in which the treatment or control of intraocular pressure configured the substitution premise. Thus, the processes that triggered the hegemonic relations were constituted by various social, cultural, and economic factors such as unemployment, social security, and gender, which played a fundamental role during the search for care.

Este estudio tiene como objetivo describir y analizar el pluralismo médico y el tipo de relaciones de hegemonía-subalternidad entre diversas formas o saberes de atención, que se desarrollaron en el itinerario terapéutico de una padeciente de glaucoma, para mostrar el proceso articulatorio y transaccional entre distintos recursos terapéuticos, así como comprender qué elementos estructurales configuraron el itinerario y la elección terapéutica. La investigación es cualitativa, un estudio de caso en el cual se utilizó el enfoque narrativo. Para la reconstrucción de la narrativa se realizó una entrevista semiestructurada, dirigida por una guía temática previamente determinada por un conjunto de categorías apriorísticas, para posteriormente transcribir la entrevista y realizar un proceso de triangulación hermenéutica. Los resultados mostraron, en este caso, que la hegemonía en el pluralismo médico se constituyó mediante relaciones de equivalencia, así, la padeciente sustituyó el uso de medicamentos farmacológicos por terapias de medicina alternativa, no obstante, el proceso relacional de equivalencia se desarrolló en un contexto de significación biomédica, en el cual tratar o controlar la presión intraocular fue la premisa del remplazo. Asimismo, los procesos que desencadenaron la presencia de relaciones hegemónicas se constituyeron por diversos factores sociales, culturales y económicos como el desempleo, la seguridad social y el género, que desempeñaron un papel fundamental durante la búsqueda de la atención y del cuidado.

Este estudo visa descrever e analisar o pluralismo médico e o tipo de relação de hegemonia-subalternidade entre diversas formas de atendimento ou conhecimentos, que ocorreram no tratamento de um paciente com glaucoma, com a finalidade de mostrar o processo articulatório e transacional entre diferentes recursos terapêuticos, bem como entender quais elementos estruturais moldaram o itinerário e a opção de tratamento. Trata-se de uma pesquisa qualitativa, que utilizou um estudo de caso com abordagem narrativa. Para a reconstrução da narrativa, foi realizada uma entrevista semiestruturada, com base em um roteiro temático previamente estabelecido por um conjunto de categorias a priori, para posteriormente transcrever os dados e realizar a triangulação hermenêutica. Os resultados mostraram que a hegemonia no pluralismo médico esteve baseada em relações de equivalência, de modo que o paciente substituiu o uso de medicamentos farmacológicos por tratamentos da medicina alternativa; no entanto, o processo relacional de equivalência desenvolveu-se em um contexto de significância biomédica, na qual o tratamento ou controle da pressão intraocular foi a premissa para a substituição. Desse modo, os processos que desencadearam a presença de relações hegemônicas foram constituídos por fatores sociais, culturais e econômicos diversos como desemprego, previdência social e gênero, os quais tiveram papel fundamental durante a busca por atendimento e cuidado.

Abstract Public health systems have to evaluate how the use of traditional and complementary medicine can improve the population's health, mainly in developing countries. This research was carried out in the Salta city and the objectives were: 1) to know the plants used in urban herbal medicine; 2) inquire about the reasons for the consumption of medicinal plants, ailments, conditions and therapeutic practices; 3) know the cultural importance of plants through the Relative Importance Indices (RI), the Consensus Factor among informants (FCI) and the origin of the linked knowledge; 4) describe the plant acquisition spaces; 5) to know the perception of health personnel of formal medicine concerning the use of medicinal plants in the domestic environment and 6) to compare the diseases treated with herbal medicine and those with formal medicine. The quality-quantitative methodology of classical ethnobotany was implemented. Thirty-five participants residing in five neighborhoods were interviewed, and focus groups were held with health staff from three health centres located in the northern sector of the city linked to the neighborhoods mentioned above. The wealth of urban herbalism amounts to 120 medicinal taxa belonging to 110 genera and 52 botanical families; 63% are non-native plants and the most represented families were Asteraceae and Lamiaceae. The inhabitants of Salta have hybrid and dynamic botanical knowledge. The hybridization processes detected were fusion, recombination, new developments in innovative products and circulation of species. Three hundred thirteen medicinal uses were recorded for 63 types of conditions and ailments involving 13 body systems. The influential presence of complementary alternative medicines and the media in the dissemination of medicinal plants and derived products is noted. Among health staff, a great heterogeneity of feelings and knowledge was noted, highlighting the recognition of the use of plants by the related population; the lack of quantifiable scientific evidence on the benefits of its practice; the fear of adverse effects and the absence of formal knowledge about phytotherapy. Phytotherapy research must be deepened, and the processes of diversification and resignification of knowledge and practices about medicinal plants must be evaluated.

Resumen Los sistemas públicos de salud tienen que evaluar cómo el uso de la medicina tradicional y complementaria puede mejorar la salud de la población, principalmente en países en vía de desarrollo. Esta investigación se llevó a cabo en la ciudad de Salta y los objetivos fueron: 1) conocer las plantas utilizadas en medicina herbolaria urbana; 2) indagar acerca de las razones del consumo de las plantas medicinales, las dolencias, las afecciones y las prácticas terapéuticas; 3) conocer la importancia cultural de las plantas mediante los Índices de Importancia Relativa (IR), el Factor de Consenso entre los informantes (FCI) y el origen del conocimiento vinculado; 4) describir los espacios de adquisición de las plantas; 5) conocer la percepción del personal de la salud de la medicina formal en relación al uso de plantas medicinales en el ámbito doméstico y 6) comparar las enfermedades tratadas con la medicina herbolaria y aquellas con la medicina formal. Se implementó la metodología cuali-cuantitativa de la etnobotánica clásica. Se entrevistaron a 35 participantes residentes en cinco barrios y se realizaron grupos focales con el personal de salud de tres centros de salud ubicados en el sector norte de la ciudad vinculados a los barrios mencionados. La riqueza de la herbolaria urbana asciende a 120 taxones medicinales pertenecientes a 110 géneros y 52 familias botánicas; el 63% son plantas no nativas y las familias más representadas fueron Asteraceae y Lamiaceae. Los pobladores salteños poseen un conocimiento botánico híbrido y dinámico. Los procesos de hibridación detectados fueron fusión, recombinación, nuevos desarrollos en productos innovadores y circulación de especies. Se registraron 313 usos medicinales de 63 tipos de afecciones y dolencias que involucran a 13 sistemas corporales. Se advierte la presencia influyente de las medicinas alternativas complementarias y los medios de comunicación en la difusión de plantas medicinales y productos derivados. Entre el personal de salud se advirtió una gran heterogeneidad de sentires y saberes, destacándose el reconocimiento del uso de plantas por parte de la población vinculada; la falta de evidencia científica cuantificable sobre los beneficios de su práctica; el temor a los efectos adversos y la ausencia de conocimiento formal sobre la fitoterapia. Las investigaciones sobre fitoterapia se deben profundizar y estudiar los procesos de diversificación y resignificación de los saberes y prácticas sobre plantas medicinales.

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 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: In 2020, the new coronavirus pandemic affected the whole world, causing historic changes in several sectors, including education, in which students were forced to quickly adapt to online learning. Objective: This study aimed to compare medical students’ adaptation to remote learning during the COVID-19 pandemic depending on whether they were following a PBL curriculum or a curriculum based on an expository disciplinary model. Method: This was a cross-sectional study. The sample was composed of students enrolled in the 2nd to 4th year of the Medicine course who had fully completed the questionnaire and attended at least one semester of remote learning during 2020. Result: A significant difference was found between the students’ adaptation to remote learning during the Covid-19 pandemic according to their study methodology; students using the PBL model showed better adaptation than those following an expository learning model. Conclusion: The study corroborated the results in the existing literature on the subject, which defends PBL as a better alternative for online learning. Introduction 2020 world sectors education Objective COVID19 COVID 19 COVID-1 Method crosssectional cross sectional nd th Result Covid19 Covid Covid-1 methodology Conclusion subject 202 COVID1 1 COVID- Covid1 Covid- 20 2

RESUMO Introdução: Em 2020, o mundo foi afetado pelo novo coronavírus, e isso gerou mudanças históricas em diversos setores, incluindo o da educação, que teve que se adaptar rapidamente ao formato online. Objetivo: Este estudo teve como objetivo comparar se houve uma melhor adaptação ao ensino remoto durante a pandemia de Covid-19 dos acadêmicos de Medicina que estudam em currículos PBL quando comparada a de alunos com currículos em modelo disciplinar expositivo. Método: Trata-se de um estudo transversal. Foram incluídos na pesquisa os estudantes matriculados do segundo ao quarto ano do curso de Medicina que tenham preenchido o questionário completamente e cursado pelo menos um semestre de ensino remoto durante o ano de 2020. Resultado: Houve uma diferença significativa entre as metodologias, com maior adaptação dos estudantes que utilizaram o modelo PBL em comparação aos que cursaram no modelo disciplinar expositivo durante a pandemia de Covid-19. Conclusão: Na amostra estudada, o método PBL mostrou-se superior ao método disciplinar, nos quesitos avaliados, na adaptação de estudantes de Medicina ao ensino remoto. Introdução 2020 coronavírus setores educação online Objetivo Covid19 Covid 19 Covid-1 Método Tratase Trata transversal Resultado metodologias Covid19. 19. Conclusão estudada mostrouse mostrou avaliados 202 Covid1 1 Covid- 20 2