RESUMO Objetivo: Descrever as características epidemiológicas de pacientes pediátricos com doença falciforme (DF) e avaliar o uso de plantas medicinais concomitantemente ao tratamento medicamentoso. Métodos: Realizou-se revisão de prontuários de pacientes pediátricos de uma instituição pública com nível de atendimento terciário; o critério de seleção foi ser criança ou adolescente com DF em acompanhamento pediátrico neste ambulatório. Nos prontuários dos pacientes selecionados foi procurado o registro do uso de plantas com finalidades medicinais. Resultados: Foram revisados 154 prontuários (100% dos pacientes ativos desse ambulatório): 99 crianças e 55 adolescentes. O genótipo predominante foi SS (58,4%), seguido do SC (29,2%). O uso de ao menos uma medicação para a DF foi relatada em 95,5% dos prontuários. Em 70,1% dos prontuários havia o relato do uso de plantas medicinais, em 276 citações, sendo 64 plantas citadas ao todo; destas, seis espécies foram citadas para o tratamento da doença de base (DF), sendo “ora-pro-nobis” (Pereskia aculeata) a principal. Das 276 citações de plantas medicinais nos prontuários, 60,5% incluíram o uso de plantas medicinais em sintomas gripais e/ou COVID-19 (tanto prevenção quanto tratamento), sendo relatadas 35 para este uso, exclusivamente ou não. Essa foi a principal finalidade de uso encontrada nos prontuários dos pacientes, seguida do uso para sintomas de dor (14,2% das citações). Conclusões: Notou-se que a maioria dos pacientes avaliados faz uso da medicina convencional, aliada à tradicional/ complementar/ alternativa, o que leva à necessidade de mais estudos nessas áreas, especialmente na pediatria, visando principalmente à segurança do paciente. Objetivo (DF medicamentoso Métodos Realizouse Realizou se terciário ambulatório Resultados 15 100% 100 (100 ambulatório) 9 5 adolescentes 58,4%, 584 58,4% , 58 4 (58,4%) 29,2%. 292 29,2% . 29 2 (29,2%) 955 95 95,5 701 70 1 70,1 27 6 todo destas DF, orapronobis ora pro nobis “ora-pro-nobis Pereskia aculeata 605 60 60,5 eou COVID19 COVID 19 COVID-1 tanto tratamento, tratamento) 3 não 14,2% 142 14 (14,2 citações. citações) Conclusões Notouse Notou convencional tradicional complementar alternativa áreas pediatria paciente 10 (10 58,4 (58,4% 29,2 (29,2% 95, 7 70, 60, COVID1 COVID- 14,2 (14, (1 58, (58,4 29, (29,2 14, (14 ( (58, (29, (58 (29 (5 (2

ABSTRACT Objective: The aim of this study was to describe the epidemiological characteristics of pediatric patients with sickle cell disease (SCD) and evaluate the use of medicinal plants in these patients concomitantly with their drug treatment. Methods: This is a review of the medical records of pediatric patients at a public institution with tertiary care. The selection criterion was to be a child or adolescent with SCD undergoing pediatric follow-up at this outpatient clinic. In the medical records of the patients selected, records of the use of plants for medicinal purposes were sought. Results: In total, 154 records (100% of total active patients followed in this clinic) were reviewed: 99 children and 55 adolescents. The predominant genotype was SS (58.4%), followed by SC (29.2%). The use of at least one medication for SCD was reported in 95.5% of the medical records. The use of medicinal plants was reported by 70.1% of patients, with 276 citations in the medical records referring to 64 different types of plants. Six plants were used for the treatment of SCD, the main one being Lemonvine/Ora-pro-nóbis (Pereskia aculeata). The use of medicinal plants was reported for flu-like symptoms and/or COVID-19 (both for prevention and treatment) by 60.5% of the citations, with 35 different plants reported for this use, exclusively or not. This use was followed by pain symptoms (14.2% of citations). Conclusions: The majority of patients in this study use both conventional and traditional/complementary/alternative medicine, highlighting the need for more studies in the area, with a special focus on patient safety. Objective (SCD Methods care followup follow up clinic selected sought Results 15 100% 100 (100 reviewed 9 5 adolescents 58.4%, 584 58.4% , 58 4 (58.4%) 29.2%. 292 29.2% . 29 2 (29.2%) 955 95 95.5 701 70 1 70.1 27 6 Lemonvine/Orapronóbis LemonvineOrapronóbis Lemonvine/Ora pro nóbis Lemonvine Ora Pereskia aculeata. aculeata aculeata) flulike flu like andor COVID19 COVID 19 COVID-1 605 60 60.5 3 not 14.2% 142 14 (14.2 citations. citations) Conclusions traditionalcomplementaryalternative traditional complementary alternative medicine area safety 10 (10 58.4 (58.4% 29.2 (29.2% 95. 7 70. Orapronóbis LemonvineOra COVID1 COVID- 60. 14.2 (14. (1 58. (58.4 29. (29.2 14. (14 ( (58. (29. (58 (29 (5 (2

Abstract Considering that currently in Mexico there is a trend toward greater consumption of natural products that benefit health and that, in the long term, do not produce adverse effects, the objective of this research is to evaluate if the main extracts and by-products derived from the roselle flower can be considered strategic, based on its properties, impact on health, value chain and that Mexico is one of the 10 main producers worldwide. For this, the following method was used: a) research on the roselle flower and its benefits to humans were compiled and analyzed; b) the information was analyzed with the Delphi tool; c) a dendrogram was developed to categorize the relevance in its use, and, d) the value chain of the processes that make up its supply chain was analyzed to determine its conditions and potential. The results show that it does not present toxic or mutagenic activity and that it has a great impact in 3 aspects: alternative medicine, as a disinfectant and food supplement. It was found that its value chain is incipient, but with potential in: planting regions, research centers and links with the industrial sector for its use, marketing and sales coverage.

Resumen Actualmente, en México existe la tendencia hacia un mayor consumo de productos naturales que beneficien la salud y a largo plazo no produzcan efectos negativos, por lo cual, el objetivo de esta investigación es evaluar si los principales extractos y subproductos de la flor de jamaica se pueden considerar estratégicos, en función de sus propiedades, impacto en la salud, cadena de valor, pues México es uno de los 10 principales productores a nivel mundial. Para esto, se utilizó el siguiente método: a) se recopilaron y analizaron investigaciones sobre la flor de jamaica y beneficios al ser humano; b) se analizó la información con la herramienta Delphi; c) se desarrolló un dendrograma para categorizar la relevancia en su uso, y, d) se determinaron las condiciones y potencial de la cadena de valor de los procesos que integran su cadena de suministro. Los resultados muestran que no presenta actividad tóxica o mutagénica y que tiene un gran impacto en 3 vertientes: medicina alternativa, como desinfectante y complemento alimenticio. Se encontró que su cadena de valor es incipiente, pero con potencial en: regiones de siembra, centros de investigación y vinculación con el sector industrial para su aprovechamiento, cobertura de comercialización y venta.

RESUMEN: El presente estudio tuvo como objetivo investigar la utilidad del fémur proximal en la estimación forense de la edad mediante la evaluación de cambios en las densidades óseas a través de radiografías. Utilizando el umbral de Otsu, la densidad ósea se cuantificó contando todos los valores de pixeles blancos dentro de regiones de interés seleccionadas, que incluyen la cabeza femoral (CF), el cuello femoral (CF), el triángulo de Ward (WT) y el trocánter mayor (TM) de 354 fémures izquierdos de ascendencia del norte de Tailandia. También se estimó el ancho de pixeles de la cavidad medular (CM). Además, el estudio evaluó el rendimiento de modelos de regresión lineal (RL) para la estimación de la edad a partir de imágenes radiográficas de fémur proximal. Se observaron correlaciones negativas entre la intensidad de los pixeles CF, CF, WT y TM con la edad de muerte, y las mujeres exhibieron correlaciones más fuertes que los hombres. Además, se encontró una correlación positiva entre la edad y el ancho del CM en muestras de mujeres, mientras que el ancho del CM del hombre no mostró ninguna relación con el aumento de la edad. Los resultados mostraron una ligera diferencia entre el modelo RL aplicado a ambos sexos, que integraba todas las variables, y la configuración alternativa que sólo utilizaba atributos relevantes. Ambos modelos mostraron un rendimiento similar, con un rango estrecho de valores del error cuadrático medio (RMSE), que oscilaba entre 12,67 y 12,71 años, y un rango de coeficiente de correlación de 0,51 a 0,52. Para las mujeres, el modelo RL con CF y WT como atributos seleccionados (RMSE = 11,85 años, coeficiente de correlación = 0,65) tuvo un desempeño satisfactorio, mientras que para los hombres, el modelo RL con todas las variables mostró un RMSE de 12,52 años y un coeficiente de correlación de 0,46. Este estudio mostró la posible aplicación de la intensidad de los pixeles en la predicción de la edad.

SUMMARY: The present study aimed to investigate the utility of the proximal femur in the forensic age estimation by assessing changes in bone densities through radiographs. Using Otsu’s threshold, bone density was quantified by counting all white pixel values within selected regions of interest, which include femoral head (FH), femoral neck (FN), Ward’s triangle (WT), and greater trochanter (GT) from 354 left femora of Northern Thai descent. The pixel width of medullary cavity (MC) was also estimated. Furthermore, the study evaluated the performance of linear regression (LR) models for age estimation from radiographic images of proximal femora. Negative correlations were observed between FH, FN, WT, and GT pixel intensity with the age-at-death of the samples, with females exhibiting stronger correlations than males. Moreover, a positive correlation was found between age and MC width in female samples, while male MC widths did not show any relationship with increasing age. The results showed a slight difference between the LR model applied to both sexes, which integrated all variables, and the alternative configuration that only utilized relevant attributes. Both models exhibited similar performance, with a narrow range of root mean square error (RMSE) values, ranging from 12.67 to 12.71 years, and a correlation coefficient range of 0.51 to 0.52. For females, the LR model with FN and WT as selected attributes (RMSE = 11.85 years, correlation coefficient = 0.65) performed decently, while for males, the LR model with all variables showed RMSE of 12.52 years and correlation coefficient of 0.46. This study showcased the potential application of pixel intensity in predicting age.

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

RESUMEN Introducción: Son múltiples los tratamientos que existen para las urgencias estomatológicas, también se utilizan medios o instrumentos alternativos para ofrecer alivio o coadyuvar a los tratamientos convencionales, uno de estos instrumentos es la terapia láser. Objetivo: Evaluar la efectividad del láser de baja potencia, combinado con tratamiento medicamentoso en la pulpitis transitoria. Métodos: La población de estudio estuvo conformada por 40 pacientes que acudieron al Servicio de Estomatología del Hospital General Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, de marzo de 2021 a marzo del 2022; los cuales se dividieron en grupo de estudio y grupo control. Al primero se le realizó tratamiento convencional combinado con la terapia por láser y al segundo, solo tratamiento convencional. Resultados: Se observó un predominio del sexo femenino (60,0 %), mientras que las edades más frecuentes fueron de 19 a 59 años, donde se agrupó 87,5 % de los pacientes. Los molares fueron los más afectados (42,5 %) en el grupo estudio, 90,0 % de los pacientes tuvo remisión de los síntomas a los 7 días, lo que muestra una mayor efectividad que el grupo estudio. Conclusiones: El láser constituyó una opción terapéutica más efectiva debido a sus efectos antinflamatorios y analgésico.

ABSTRACT Introduction: There are multiple treatments for the stomatologic emergencies, means or alternative instruments are also used to offer relief or contribute to the conventional treatments, and one of these instruments is laser therapy. Objective: To evaluate the effectiveness of low power laser, combined with drug treatment in transitory pulpitis. Methods: The study population was constituted by 40 patients that went to the Stomatology Service of Dr. Juan Bruno Zayas Alfonso General Hospital in Santiago de Cuba, from March, 2021 to March, 2022; which were divided into study group and group control. The first group received conventional treatment combined with laser therapy and the second group, only received conventional treatment. Results: There was a prevalence of the female sex (60.0 %), while the most frequent ages were 19 to 59, where 87.5% of the patients were grouped. Molars were the most affected (42.5 %) in the study group, 90.0 % of the patients got into remission 7 days later, what shows a higher effectiveness than the group study. Conclusions: Laser constituted a more effective therapeutic option due to its antinflammatory and analgesic effects.

RESUMEN Introducción: El procedimiento terapéutico con células mononucleares autólogas ha abierto una alternativa dentro del arsenal con que se cuenta para la reparación y regeneración de los defectos óseos máxilo-mandibulares derivados de procederes quirúrgicos, que se asocian con discapacidad y detrimento de la calidad de vida. Objetivo: Evaluar la evolución de los pacientes tratados con células mononucleares autólogas como terapia regenerativa ante defectos óseos máxilo-mandibulares. Métodos: Se realizó un estudio descriptivo transversal en los Servicios de Cirugía Máxilo-facial de la Clínica Estomatológica Provincial Docente y los Hospitales Provincial Docente Clinicoquirúrgico Saturnino Lora Torres, General Docente Juan Bruno Zayas Alfonso, Clinicoquirúrgico Docente Joaquín Castillo Duany de Santiago de Cuba, en el periodo de enero de 2017 a diciembre de 2019. Los pacientes incluidos en el estudio fueron sometidos a procedimientos quirúrgicos por enfermedades que afectaban la arquitectura ósea, implantándose células madre movilizadas con factor estimulante de colonias de granulocitos al finalizar el acto quirúrgico. Las variables investigadas fueron enfermedades quirúrgicas, complicaciones posquirúrgicas, tamaño del defecto óseo, evidencia radiográfica y evolución del tratamiento. Resultados: Entre los 6 y 12 meses posteriores a la cirugía y la terapia celular, todas las variables de respuesta al tratamiento probaron mejoras clínicas y radiológicas, observándose hueso de neoformación y aumento de la densidad ósea. Conclusiones: La regeneración de los defectos óseos, asociados a intervenciones quirúrgicas, mediante el implante de células mononucleares autólogas de sangre periférica suspendidas en plasma rico en plaquetas quedó evidenciada clínica y radiográficamente de forma satisfactoria.

ABSTRACT Introduction: The therapeutic procedure with autologous mononuclear cells has opened an alternative within the arsenal available for repair and regeneration of the maxillomandibular bone defects derived from surgical procederes which are associated with disability and detriment to life quality. Objective: To evaluate the clinical course of patients treated with autologous mononuclear cells as regenerative therapy for maxillofacial bone defects. Methods: A cross-sectional descriptive study was carried out in the Maxillo Facial Surgery Services of the Teaching Provincial Dentistry Clinic and the Provincial Teaching Clinical Surgical Hospitals Saturnino Lora Torres, Teaching General Juan Bruno Zayas, Teaching Clinical Surgical Joaquin Castillo Duany, in Santiago de Cuba, from January, 2017 to December, 2019. The patients included in the study underwent surgical procedures due to diseases that affected bone architecture, implanting mobilized stem cells with granulocyte colony stimulating factor at the end of the surgical procedure. The variables investigated were surgical diseases, post-surgical complications, size of the bone defect, radiographic evidence and treatment evolution. Results: Six to 12 months after the surgery and cell therapy, all the response variables to the treatment proved clinical and radiological improvements, being observed bone neoformation and increase of bone density. Conclusions: Regeneration of bone defects, associated with surgical interventions, implanting autologous mononuclear cells of peripheral blood suspended in plasm rich in platelets was clinic and radiographically evidenced in a satisfactory way.

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.

Resumen Introducción: La comunicación es la base de la interacción humana, y por consiguiente una herramienta fundamental en cualquier institución. Los profesionales de la salud que proporcionan cuidado en los Servicios de Medicina Intensiva (UCI) a veces tienen dificultades para comunicarse con los pacientes críticos, por lo que es fundamental adaptar estrategias que faciliten el proceso de comunicación, como la Comunicación Aumentativa y Alternativa (CAA). Objetivo: Evaluar el conocimiento de los profesionales sanitarios sobre la comunicación con el enfermo crítico, identificando las barreras y los facilitadores de la comunicación. Métodos: Se realizó una revisión de la literatura científica y se elaboró un cuestionario sobre “Comunicación con el Enfermo Crítico”, que luego se aplicó a una muestra de 46 profesionales de la salud de la UCI. Resultados: 89% de los profesionales de la muestra consideran la comunicación un recurso primario en la prestación de cuidados, 63% desconocen la CAA, 91% tienen dificultad para entender lo que transmite el paciente y 52% se sienten frustrados por no poder establecer una comunicación bidireccional. Las principales barreras a la comunicación mencionadas fueron la falta de formación en técnicas de comunicación, la falta de recursos materiales y el estado de conciencia del paciente. Conclusión: Los profesionales de la salud tienen lagunas de conocimiento al comunicarse con los enfermos críticos, sin embargo, según la literatura, la adopción de herramientas y estrategias de CAA, así como acciones de capacitación, se han confirmado como una importante estrategia de aprendizaje en la transmisión de conocimientos.

Resumo Introdução: A comunicação é a base da interação humana sendo uma ferramenta essencial em qualquer instituição. Os profissionais de saúde que prestam cuidados em Serviços de Medicina Intensiva (SMI) deparam-se com dificuldades na comunicação com o doente crítico sendo essencial a adaptação de estratégias facilitadoras do processo comunicativo, tal como a Comunicação Aumentativa e Alternativa (CAA). Objetivo: Avaliar os conhecimentos dos profissionais de saúde sobre comunicação com o doente crítico e identificar as barreiras e os facilitadores comunicativos. Métodos: Elaborada uma revisão da literatura científica e desenvolveu-se e aplicou-se um questionário sobre “Comunicação com o Doente Crítico” a uma amostra constituída por 46 profissionais de saúde do SMI. Resultados: Constatou-se que 89% considera a comunicação uma ferramenta chave na prestação de cuidados, 63% desconhece a CAA, 91% sentem dificuldade em compreender o que o doente transmite e 52% sentem-se frustrados por não conseguir estabelecer uma comunicação bidirecional. As principais barreiras à comunicação referidas foram a falta de formação sobre técnicas comunicacionais, a inexistência de recursos materiais e o estado de consciência do doente. Conclusão: Os profissionais de saúde apresentam lacunas no conhecimento sobre comunicação com o doente crítico, contudo segundo a literatura a adoção de ferramentas e estratégias de CAA e ações de formação confirmam-se como uma estratégia de aprendizagem importante na transmissão de conhecimentos.

Abstract Introduction: Communication is the basis of human interaction and, therefore, an essential tool in any institution. Health professionals who provide care in Intensive Medicine Services (ICU) sometimes struggle to communicate with critically ill patients, making it essential to adopt strategies that facilitate the process of communication, such as Augmentative and AlternativeCommunication(AAC). Objective: Evaluate the knowledge of health professionals about communication with the critically ill while identifying barriers and communication facilitators. Methods: A review of the scientific literature was carried out, and a questionnaire on “Communication with the Critically Ill” was developed and then applied to a sample of 46 health professionals from the ICU. Results: 89% of the sample professionals consider communication a primary resource in providing care, 63% are unaware of the AAC, 91% struggle with understanding what the patient transmits, and 52% feel frustrated for being unable to establish bidirectional communication. The main barriers to communication mentioned were the lack of training in communication techniques, the lack of material resources, and the patient's state of consciousness. Conclusion: Health professionals have knowledge gaps when communicating with the critically ill; however, according to the literature, the adoption of AAC tools and strategies, as well as training actions, have been confirmed as an important learning strategy in the transmission of knowledge.

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: El empleo del ozono como agente terapéutico es uno de los descubrimientos más notables en la medicina alternativa. A pesar de su extendido uso, es tóxico por vía inhalatoria, la exposición a este gas puede producir, daños de la vía respiratoria superior y del epitelio bronquial. Objetivo: Evaluar la exposición ocupacional a ozono en áreas de tratamiento de ozonoterapia de La Habana. Métodos: Estudio exploratorio descriptivo, se estudiaron 21 trabajadores de 16 áreas de tratamiento de ozonoterapia, se les realizaron análisis clínicos, incluyendo ceruloplasmina, además de pruebas funcionales ventilatorias. Se determinaron las concentraciones de ozono en el aire del ambiente laboral en 29 áreas de tratamiento. Resultados: La insuflación rectal fue la forma de aplicación más utilizada. El 42,8 % refirieron padecer de rinitis alérgica, seguido de gripes frecuentes y de asma bronquial. El 33,3 % de los valores de la ceruloplasmina resultaron alterados. Los resultados de las pruebas funcionales ventilatorias mostraron que el 28,6 % de los trabajadores presentaron patrón obstructivo. En la evaluación ambiental se reportaron 2 centros de salud con concentraciones promedio por encima de los límites admisibles. Conclusiones: La hipertensión arterial y la rinitis alérgica fueron las patologías más frecuentes. Las cifras de ceruloplasmina alteradas se presentaron en trabajadores con mayor tiempo de exposición. Los trastornos ventilatorios obstructivos observados, coinciden con las patologías respiratorias referidas por los trabajadores. El 93,1 % de los valores de concentración promedio, en el aire de la zona de trabajo, se comportó por debajo de los límites admisibles.

ABSTRACT Introduction: The use of ozone as a therapeutic agent is one of the most notable discoveries in alternative medicine. Despite its widespread use, it is toxic by inhalation; exposure to this gas can cause damage to the upper respiratory tract and bronchial epithelium. Objective: To evaluate occupational exposure to ozone in ozone therapy treatment areas of Havana. Methods: Descriptive exploratory study, 21 workers from 16 ozone therapy treatment areas were studied, clinical analyzes were performed, including ceruloplasmin, in addition to ventilatory functional tests. Ozone concentrations in the air of the work environment were determined in 29 treatment areas. Results: Rectal insufflation was the most used form of application. 42.8% reported suffering from allergic rhinitis, followed by frequent flu and bronchial asthma. 33.3% of ceruloplasmin values were altered. The results of the ventilatory functional tests showed that 28.6% of the workers presented an obstructive pattern. In the environmental evaluation, 2 health centers were reported with average concentrations above the admissible limits. Conclusions: High blood pressure and allergic rhinitis were the most frequent pathologies. The altered ceruloplasmin levels occurred in workers with longer exposure times. The obstructive ventilatory disorders observed coincide with the respiratory pathologies reported by the workers. 93.1% of the average concentration values, in the air of the work area, were below the permissible limits.

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.

El artículo analiza las experiencias de los médicos y capellanes militares que participaron en la campana al Perú y Bolivia durante la Guerra del Pacífico (1879-1884). Desde su punto de vista, presentaron una narrativa alternativa a la de las autoridades, donde describieron las actividades que realizaron, así como las dificultades y la escasez de material para suplir las necesidades de las tropas. En los documentos personales de médicos y capellanes (diarios y cartas), el fenómeno de la guerra se reconstruye a escala humana, cruzando sus historias, recuperando su trabajo, reflexiones y experiencias bélicas.

This article analyzes the experiences of military physician and chaplains who participates in Peru and Bolivia's campaign during the War of the Pacific (1879-1884). From their point of view, they presented an alternative narrative away from authorities, where they described the activities, they carried out, as well the difficulties and material shortages to achieve the troop´s needs. In physician and chaplains personal documents (diaries and letters), the war phenomenon is reconstructed on a human scale, crossing their stories, recovering his work, reflections and war experiences.

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 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 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.