RESUMO Objetivo: Avaliar a correlação entre a religiosidade e o uso de álcool em adolescentes com fissura orofacial. Métodos: Estudo transversal, desenvolvido em um hospital público e terciário brasileiro entre dezembro de 2021 e março de 2022. A coleta de dados foi híbrida, e foram utilizados três instrumentos: Questionário Sociodemográfico, Escala de Religiosidade de Durel e o Alcohol Use Disorders Identification Test. Para a análise estatística foram empregados os testes: qui-quadrado, exato de Fisher, Mann-Whitney e o coeficiente de correlação de Spearman, além das análises de forças de correlação linear e de regressão logística bivariada. O nível de significância adotado para todos os testes foi de 5% (p≤0,05). Resultados: Participaram 370 adolescentes, com média de idade de 15,2 anos (±1,8). Entre eles, 23 (5,4%) usavam o álcool de forma arriscada ou prejudicial. A religiosidade organizacional, não organizacional e a intrínseca foram significativamente menos frequentes entre adolescentes que utilizavam o álcool de forma arriscada ou prejudicial (p=0,005; p<0,001 e p=0,002, respectivamente). Evidenciou-se correlação moderada entre o uso arriscado ou prejudicial do álcool e a religiosidade não organizacional (r=0,31; p=0,002) e a intrínseca (r=0,36; p<0,001). Apresentaram maiores chances de usar o álcool adolescentes do sexo masculino (p<0,001; odds ratio — OR=6,58), com idade mais próxima aos 18 anos (p<0,001; OR=1,37) e que não praticavam a religião (p<0,001; OR=6,48). Conclusões: Adolescentes com maiores níveis de religiosidade organizacional e intrínseca utilizaram menos frequentemente álcool de forma arriscada ou prejudicial, enquanto ser homem, possuir idade mais próxima aos 18 anos e não praticar a religião aumentou a chance de utilizar álcool. Objetivo orofacial Métodos transversal 202 2022 híbrida instrumentos Sociodemográfico Test quiquadrado, quiquadrado qui quadrado, quadrado qui-quadrado Fisher MannWhitney Mann Whitney Spearman bivariada 5 p≤0,05. p005 p p≤0,05 . 0 05 (p≤0,05) Resultados 37 152 15 2 15, ±1,8. ±1,8 1 8 (±1,8) eles 5,4% 54 4 (5,4% p=0,005 p0005 005 (p=0,005 p0001 001 p<0,00 p0002 002 p=0,002 respectivamente. respectivamente respectivamente) Evidenciouse Evidenciou se r=0,31 r031 r 31 (r=0,31 r=0,36 r036 36 (r=0,36 p<0,001. p<0,001) (p<0,001 OR=6,58, OR658 OR OR=6,58 , 6 58 OR=6,58) OR=1,37 OR137 OR=6,48. OR648 OR=6,48 48 OR=6,48) Conclusões homem 20 p00 p≤0,0 (p≤0,05 3 ±1, (±1,8 5,4 (5,4 p=0,00 p000 00 (p=0,00 p<0,0 r=0,3 r03 (r=0,3 (p<0,00 OR65 OR=6,5 OR=1,3 OR13 OR64 OR=6,4 p0 p≤0, (p≤0,0 ±1 (±1, 5, (5, p=0,0 (p=0,0 p<0, r=0, r0 (r=0, (p<0,0 OR6 OR=6, OR=1, OR1 p≤0 (p≤0, ± (±1 (5 p=0, (p=0, p<0 r=0 (r=0 (p<0, OR=6 OR=1 p≤ (p≤0 (± ( p=0 (p=0 p< r= (r= (p<0 OR= (p≤ p= (p= (r (p< (p

ABSTRACT Objective: To evaluate the correlation between religiosity and alcohol use among adolescents with orofacial clefts. Methods: Cross-sectional study, developed in a Brazilian public and tertiary hospital, between December 2021 and March 2022. Data collection was hybrid, and three instruments were used: Sociodemographic Questionnaire, Durel Religiosity Scale, and the Alcohol Use Disorders Identification Test. For statistical analysis, the following tests were used: χ2, Fisher’s Exact, Mann-Whitney and Spearman’s Correlation Coefficient, in addition to analyses of linear correlation strength and bivariate logistic regression. The significance level adopted for all tests was 5% (p≤0.05). Results: 370 adolescents participated, with a mean age of 15.2 years (±1.8). Among them, 23 (5.4%) used alcohol riskly or harmfully, being more frequent among male adolescents (p=0.001), those of mixed race (p=0.046), attending high school (p=0.011), with no religion (p<0.001), or who did not attend religious services (p<0.001). Levels of organizational, non-organizational and intrinsic religiosity were significantly lower among adolescents with risky or harmful alcohol use (p=0.005; p<0.001 and p=0.002, respectively). There was a moderate correlation between risky or harmful alcohol use and non-organizational (r=0.31; p=0.002) and intrinsic (r=0.36; p<0.001) religiosity. Male adolescents (p<0.001; OR=6.58), closest in age to 18 years (p<0.001; OR=1.37), and non-practitioners of religion (p<0.001; OR=6. 48) presented higher odds of risky or harmful alcohol use. Conclusions: Adolescents with higher levels of organizational and intrinsic religiosity used less alcohol, while males, closest in age to 18 years, and non-practitioners of religion presented higher odds of using alcohol riskly or harmfully. Objective clefts Methods Crosssectional Cross sectional study hospital 202 2022 hybrid Questionnaire Scale Test analysis χ2 χ Fishers Fisher s Exact MannWhitney Mann Whitney Spearmans Spearman Coefficient regression 5 p≤0.05. p005 p p≤0.05 . 0 05 (p≤0.05) Results 37 participated 152 15 2 15. ±1.8. ±1.8 1 8 (±1.8) them 5.4% 54 4 (5.4% harmfully p=0.001, p0001 p=0.001 , 001 (p=0.001) p=0.046, p0046 p=0.046 046 (p=0.046) p=0.011, p0011 p=0.011 011 (p=0.011) p<0.001, (p<0.001) p<0.001. nonorganizational non p=0.005 p0005 005 (p=0.005 p<0.00 p0002 002 p=0.002 respectively. respectively respectively) r=0.31 r031 r 31 (r=0.31 r=0.36 r036 36 (r=0.36 (p<0.001 OR=6.58, OR658 OR OR=6.58 6 58 OR=6.58) OR=1.37, OR137 OR=1.37 OR=1.37) nonpractitioners practitioners OR6 OR=6 48 Conclusions males 20 p00 p≤0.0 (p≤0.05 3 ±1. (±1.8 5.4 (5.4 p000 p=0.00 00 (p=0.001 p004 p=0.04 04 (p=0.046 p001 p=0.01 01 (p=0.011 (p=0.00 p<0.0 r=0.3 r03 (r=0.3 (p<0.00 OR65 OR=6.5 OR13 OR=1.3 OR= p0 p≤0. (p≤0.0 ±1 (±1. 5. (5. p=0.0 (p=0.04 (p=0.01 (p=0.0 p<0. r=0. r0 (r=0. (p<0.0 OR1 OR=1. p≤0 (p≤0. ± (±1 (5 p=0. (p=0. p<0 r=0 (r=0 (p<0. OR=1 p≤ (p≤0 (± ( p=0 (p=0 p< r= (r= (p<0 (p≤ p= (p= (r (p< (p

Worldwide, millions of people suffer from neurological and psychiatric conditions, such as schizophrenia, depression, and neurodegenerative diseases. These conditions are often linked to hyperactivity of monoamine oxidase B (MAO-B) in the brain, and inhibiting this enzyme can reduce oxidative stress, stabilize neurotransmitter levels, and alleviate symptoms. In this context, a pharmacophoric model was created using PharmaGist with 31 hits extracted from BindingDB to enable a pharmacophoric-based search of potential MAO-B inhibitors in ZincPharmer’s chemical space, followed by the building of 10 conformers for each molecule in the software OMEGA, screening for structural and electrostatic similarity to safinamide using ROCS (Rapid overlay of chemical structures) and EON (Electrostatic similarity for lead-hopping), respectively. In addition, the molecular docking with Gold using the score function was performed to rank the ligands with the highest probabilities of affinity to MAO-B and then discriminate those with suitable physical chemical, pharmacokinetic, and toxicological features using the tools QikProp, SwissADME, and DEREK. Four potential ligands with selective MAO-B inhibitor properties were identified, which show promise as future therapeutic agents for MAO-B-related disorders. Worldwide schizophrenia depression diseases MAOB MAO (MAO-B brain stress levels symptoms context 3 pharmacophoricbased based ZincPharmers ZincPharmer s space 1 OMEGA Rapid structures Electrostatic leadhopping, leadhopping lead hopping , lead-hopping) respectively addition pharmacokinetic QikProp SwissADME DEREK identified MAOBrelated related disorders lead-hopping

ABSTRACT Purpose: This study aimed to assess grating visual acuity and functional vision in children with congenital Zika syndrome. Methods: Initial and final grating visual acuity was measured using Teller acuity cards. Cerebral vision impairment standardized tests were used to assess functional vision. Patients were referred to the early visual intervention program for visually disabled children. Neuroimaging was performed. Results: In this study, 10 children were included with an age range of 1-37 months. Eight patients presented with macular atrophic scars. Neuroimaging revealed microcephaly and cerebral abnormalities in all patients. Low vision and cerebral vision impairment characteristics were observed in all children. The final grating visual acuity in this group varied from 3.00 to 0.81 logMAR. Conclusions: The grating visual acuity test revealed low vision in all children with congenital Zika syndrome. Functional vision evaluation revealed cerebral vision impairment characteristics in all patients, who were referred to the early visual intervention program. Visual acuity improved in six children. Purpose syndrome Methods cards performed Results 1 137 37 1-3 months scars 300 3 00 3.0 081 0 81 0.8 logMAR Conclusions 13 1- 30 3. 08 8 0.

RESUMO Objetivo: Examinar a associação entre o tempo de tela autorreportado e os sintomas de estresse, ansiedade e depressão em adolescentes. Métodos: Foi realizado estudo com delineamento transversal com 982 adolescentes entre 12-15 anos, matriculados na rede pública de ensino da cidade de Jacarezinho (PR). Para mensurar o tempo de tela, os adolescentes responderam à pergunta: “Considerando um dia típico, quanto tempo você passa assistindo TV, jogando videogame, usando computador ou smartphone?”. O questionário DASS-21 (versão curta) foi utilizado para avaliar os sintomas de depressão, ansiedade e estresse. Análises brutas e ajustadas (idade, sexo e nível de escolaridade materna) entre tempo de tela e indicadores de saúde mental foram realizadas por meio do modelo de regressão linear generalizado, com distribuição de Poisson, adotando a significância de p<0,05. Resultados: Maiores sintomas depressivos foram observados em adolescentes com tempo de tela de 4–6 horas/dia (RP 1,35, IC95% 1,13–1,61) e ≥6 horas/dia (RP 1,88, IC95% 1,62–2,19) quando comparados com seus pares com ≤2 horas/dia. O mesmo foi observado para os sintomas de ansiedade com tempo de tela de 4–6 horas/dia (RP 1,23, IC95% 1,04–1,46) e ≥6 horas/dia (RP 1,50, IC95% 1,28–1,77); e estresse, com 4–6 horas/dia (RP 1,25, IC95% 1,08–1,44) e ≥6 horas/dia (RP 1,49, IC95% 1,30–1,71), também comparados com seus pares com ≤2 horas/dia. Conclusões: O tempo de tela foi associado positivamente com os sintomas de depressão, ansiedade e estresse em adolescentes. Atenção especial deve ser dada àqueles que passam mais de quatro horas por dia em frente a uma tela. Objetivo Métodos 98 1215 12 15 12-1 anos PR. PR . (PR) pergunta Considerando típico TV videogame smartphone. smartphone smartphone?” DASS21 DASS 21 DASS-2 versão curta idade, idade (idade materna generalizado Poisson p005 p 0 05 p<0,05 Resultados 46 4 6 4– horasdia RP 135 1 35 1,35 IC95 IC 1,13–1,61 113161 13 61 ≥ 188 88 1,88 1,62–2,19 162219 62 2 19 ≤ 123 23 1,23 1,04–1,46 104146 04 150 50 1,50 1,28–1,77 128177 28 77 1,28–1,77) 125 25 1,25 1,08–1,44 108144 08 44 149 49 1,49 1,30–1,71, 130171 1,30–1,71 , 30 71 1,30–1,71) Conclusões 9 121 12- (PR smartphone? DASS2 DASS- p00 p<0,0 3 1,3 IC9 1,13–1,6 11316 18 8 1,8 1,62–2,1 16221 1,2 1,04–1,4 10414 5 1,5 1,28–1,7 12817 7 1,08–1,4 10814 14 1,4 13017 1,30–1,7 p0 p<0, 1, 1,13–1, 1131 1,62–2, 1622 1,04–1, 1041 1,28–1, 1281 1,08–1, 1081 1301 1,30–1, p<0 1,13–1 113 1,62–2 162 1,04–1 104 1,28–1 128 1,08–1 108 130 1,30–1 p< 1,13– 11 1,62– 16 1,04– 10 1,28– 1,08– 1,30– 1,13 1,62 1,04 1,28 1,08 1,30 1,1 1,6 1,0

ABSTRACT Objective: To examine the associations between self-reported screen time and symptoms of stress, anxiety, and depression in adolescents. Methods: A cross-sectional study was conducted with 982 adolescents aged between 12 and 15 years, enrolled in public schools in Jacarezinho (PR), Brazil. Screen time was assessed by the question “Considering a typical day, how much time do you spend watching TV, playing videogame, using computer or smartphone?” The DASS-21 questionnaire (short form) was used to assess symptoms of depression, anxiety, and stress. Crude and adjusted analyses (age, sex, and maternal level of education) between screen time and mental disorders symptoms were performed using general linear regression models, with Poisson distribution, with significance level at p<0.05. Results: Higher depressive symptoms were observed in adolescents who reported screen time of 4–6 hours/day (PR 1.35, 95%CI 1.13–1.61) and ≥6 hours/day (PR 1.88, 95%CI 1.62–2.19), compared with their pairs with <2 hours/day. The same was observed for anxiety symptoms with screen time of 4–6 hours/day (PR 1.23, 95%CI 1.04–1.46) and ≥6 hours/day (PR 1.50, 95%CI 1.28–1.77); and stress, with 4–6 hours/day (PR 1.25, 95%CI 1.08–1.44) and ≥6 hours/day (PR 1.49, 95%CI 1.30–1.71), also compared with their pairs with <2 hours/day. Conclusions: Screen time was positively associated with depressive, anxiety, and stress symptoms in adolescents. Special attention should be given to those who spend more than four hours a day in front of a screen. Objective selfreported self Methods crosssectional cross sectional 98 1 years PR, PR , (PR) Brazil Considering TV videogame smartphone smartphone? DASS21 DASS 21 DASS-2 short form age, age (age sex education models distribution p005 p 0 05 p<0.05 Results 46 4 6 4– hoursday 135 35 1.35 95CI CI 95 1.13–1.61 113161 13 61 ≥ 188 88 1.88 1.62–2.19, 162219 1.62–2.19 62 2 19 1.62–2.19) < 123 23 1.23 1.04–1.46 104146 04 150 50 1.50 1.28–1.77 128177 28 77 1.28–1.77) 125 25 1.25 1.08–1.44 108144 08 44 149 49 1.49 1.30–1.71, 130171 1.30–1.71 30 71 1.30–1.71) Conclusions 9 DASS2 DASS- p00 p<0.0 3 1.3 1.13–1.6 11316 18 8 1.8 16221 1.62–2.1 1.2 1.04–1.4 10414 5 1.5 1.28–1.7 12817 7 1.08–1.4 10814 14 1.4 13017 1.30–1.7 p0 p<0. 1. 1.13–1. 1131 1622 1.62–2. 1.04–1. 1041 1.28–1. 1281 1.08–1. 1081 1301 1.30–1. p<0 1.13–1 113 162 1.62–2 1.04–1 104 1.28–1 128 1.08–1 108 130 1.30–1 p< 1.13– 11 16 1.62– 1.04– 10 1.28– 1.08– 1.30– 1.13 1.62 1.04 1.28 1.08 1.30 1.1 1.6 1.0

ABSTRACT A young woman presented at our clinic with sudden visual loss in the right eye, recurrent vertigo, and right-sided tinnitus. We performed a complete ophthalmological evaluation. This revealed effects of the condition on the small arterioles of the peripheral retina. Susac syndrome is characterized by the clinical triad of retinal arteriolar occlusions, cochleovestibular manifestations, and encephalopathy (which can be identified by neuroimaging abnormalities). Early diagnosis and immunosuppressive therapy improved the patient's visual acuity and the remission of her other symptoms. Hemi-central retinal artery occlusion is an atypical neuro-ophthalmological finding in this disease. However, its identification as a sign of Susac syndrome may facilitate timely diagnosis and accurate treatment. eye vertigo rightsided sided tinnitus evaluation retina occlusions manifestations which abnormalities. abnormalities . abnormalities) patients patient s symptoms Hemicentral Hemi central neuroophthalmological neuro disease However treatment

The inhibition of the fatty acid amide hydrolase (FAAH), an endocannabinoid system component, emerged as a potentially new therapeutic target for a range of clinical disorders such as acute and chronic pain. Some α-ketoheterocycle derivatives demonstrated interesting analgesic and anti-inflammatory activities in vitro. Ligand-Based Drug Design techniques such as knowledge graph convolutional networks (kGCN) and hologram quantitative structure-activity relationship (HQSAR) using α-ketoheterocycle derivatives from five different datasets were generated to discover the relation between the chemical structures and the inhibition activity. Meanwhile, structure-based drug design simulations as interaction fields (MIF), molecular docking, and ligand sites studies (LSI) from FAAH were performed using Autogrid software and FTmap/FTsite servers. The results of both studies were merged to propose predictive models. The resulting kGCN model demonstrated adequate accuracy area under the curve by receiver operating characteristic (AUC-ROC 0.7922). From contribution maps of the Ligand-Based Drug Design (LBDD) models and the generated probes using MIF and LSI, it was observed that the oxazole ring, the ketone group, and the apolar chain present in the structures of the inhibitors are important, besides the evidence of the Cys269 and Val270 residues importance for the potential interaction, confirmed by carried docking studies. These fragments and structural information can be used to carry out new FAAH potential inhibitors studies and report kGCN as an accurate classification technique. FAAH, , (FAAH) component pain αketoheterocycle α ketoheterocycle antiinflammatory anti inflammatory vitro LigandBased Ligand Based (kGCN structureactivity structure activity HQSAR (HQSAR Meanwhile structurebased based MIF, (MIF) LSI (LSI FTmapFTsite FTmap FTsite servers AUCROC AUC ROC 0.7922. 07922 0.7922 . 0 7922 0.7922) LBDD (LBDD ring group important Cys Cys26 Val Val27 technique (FAAH (MIF 0792 0.792 792 Cys2 Val2 079 0.79 79 07 0.7 7 0.

ABSTRACT Introduction Personality disorders are an underdiagnosed entity and lead to high absenteeism and low productivity. Patients with histrionic personality disorder display intense emotion, attention seeking behaviour and manipulation. Clinical case report This is a case report of a 52-year-old woman, working as a hospital operational assistant, with a history of histrionic PD, major depression and fibromyalgia. In an Occupational Medicine examination after sick leave, she reports worsening of depressive symptoms and intensification of pain complaints, presenting apparent motor and cognitive slowing. Return to work was initially authorized, however, after two days, a new examination is requested by her superior, who is unable to find a suitable position for the employee. After further clinical observation and considering the history and medical reports, she is considered temporarily unfit to perform any role. Discussion/Conclusion It is important to highlight the challenge of Occupational Health in the professional reintegration of employees with psychiatric pathology. Constant updating and consolidation of knowledge in Mental Health are fundamental.

RESUMO Introdução As perturbações da personalidade são uma entidade subdiagnosticada e condicionam elevado absentismo e baixa produtividade. Pacientes com perturbação da personalidade histriónica caraterizam-se pelo seu dramatismo, emoções intensas, procura de atenção e tentativa de manipulação. Caso clínico Os autores descrevem o caso de uma mulher de 52 anos, a trabalhar como assistente operacional hospitalar, com antecedentes de perturbação da personalidade histriónica, depressão major e fibromialgia. Refere, em exame de Medicina do Trabalho após certificado de incapacidade temporária, agravamento dos sintomas depressivos e intensificação das queixas álgicas, apresentando aparente lentificação motora e cognitiva. É inicialmente autorizado o regresso ao trabalho mas, dois dias depois, é pedida nova consulta pela chefia, por não conseguir encontrar um posto adequado à colaboradora. Após nova observação clínica e tendo em conta os antecedentes e os relatórios médicos, é considerada temporariamente inapta para o desempenho de qualquer função. Discussão/Conclusão É importante realçar o desafio da Saúde Ocupacional na reintegração profissional de colaboradores com patologia psiquiátrica sendo essencial, para isso, a constante atualização e consolidação de conhecimentos na área da Saúde Mental.

ABSTRACT Blastic plasmacytoid dendritic cell neoplasia (BCDPN) is a rare and generally aggressive hematological malignancy, which requires early recognition. Below, the clinical course of a 72-year-old patient with NCDPB is described, whose most relevant findings included the presence of skin lesions, organomegaly, and bone marrow infiltration. After the diagnosis, systemic chemotherapy was indicated, with a good response; however, after 2 months the lesions recurred and the patient died. In this disease it is necessary to establish the differential diagnosis with lymphoproliferative disorders, lymphoid and acute myeloid leukemias, with the morphological analysis of the neoplastic cells being an important aspect for adequate diagnostic guidance.

RESUMEN La neoplasia de células dendríticas plasmocitoides blásticas (NCDPB) es una malignidad hematológica poco frecuente y generalmente agresiva, por lo cual se requiere su reconocimiento precoz. A continuación, se describe el curso clínico de una paciente de 72 años con NCDPB, en cuyos hallazgos más relevantes destacó la presencia de lesiones cutáneas, organomegalias, infiltración de la médula ósea. Posterior al diagnóstico se indicó quimioterapia sistémica, con buena respuesta, no obstante, a los 2 meses presentó recidiva de lesiones y la paciente falleció. En esta enfermedad es necesario establecer el diagnóstico diferencial con trastornos linfoproliferativos, leucemias linfoides y mieloides agudas, constituyendo el análisis morfológico de las células neoplásicas un aspecto importante para una adecuada orientación diagnóstica.

Resumen El objetivo de esta investigación fue analizar la relación entre la presencia de trastornos emocionales y el acoso escolar en los estudiantes de sexto a noveno grado de las instituciones educativas públicas de la ciudad de Floridablanca (Colombia). El diseño del estudio fue cuantitativo correlacional. Los instrumentos utilizados fueron la prueba de tamizaje cyberbullying y el Sistema de Evaluación de Niños y Adolescentes (SENA). Se evaluaron 76 menores que cumplen el rol de víctima o agresor, y los resultados obtenidos indicaron que un alto porcentaje de los involucrados en el acoso escolar como víctimas o agresores cara a cara o en línea presentan desajustes emocionales. Los datos descriptivos muestran que en Floridablanca (Colombia) aún hay fracciones de acoso escolar por debajo de la prevalencia internacional; sin embargo, existe una alta proporción de estudiantes en riesgo de asumir algún rol en el acoso escolar. Se concluyó que la Psicología es una disciplina científica que aporta herramientas para abordar los trastornos emocionales adscritos al acoso escolar. Que deben recibir tratamiento psicológico todos los involucrados en el acoso escolar en cualquiera de sus roles. Esta investigación puede considerarse como insumo para futuros trabajos que pretendan formular acciones de intervención para el acoso escolar y el trabajo de los trastornos emocionales qu e genera este problema.

Abstract The main goal for this research was to analyze the relationship between emotional disorders and bullying in schoolchildren. Participants were recruited from sixth to ninth grade in public schools from Floridablanca, Colombia. The design method was quantitative and correlational. We administered an online test called Cyberbullying to detect students involved in bullying and cyberbullying and emotional disorders were assessed using the test Sistema de Evaluación de Niños y Adolescentes (SENA). Participants were 76 schoolchildren with high scores as victims and/or aggressors. Results show a high percentage of schoolchildren involved in bullying and cyberbullying either as victims and/or aggressors that are suffering from emotional problems. Descriptive data also shows that Floridablanca still maintains a lower prevalence of bullying compared to international standards, but there’s a high risk for children getting involved in these behaviors. This research can be taken as an input for future work that intends to formulate intervention actions, both for school acoso and for the work of the emotional disorders that this problem generates.

Abstract Type 2 Diabetes Mellitus (T2DM) is a set of metabolic disorders that increase the risk of multisystemic diseases. In Mexico, Clinical Practice Guidelines (CPG) have been proposed for the healthcare of people with T2DM, from prevention to rehabilitation. However, although these guidelines emphasize the active participation of patients in their treatment to enhance treatment adherence, the necessary information on the procedures has not been provided. Therefore, the aim of this paper is to propose Human-Centered Design Thinking (HCDP) as a strategy for this purpose. The steps that constitute this methodology are described, as well as the results found in the international literature. The coherence of the HCDP with Mexican CPG recommendations is discussed, as is the importance of the methodological clarity provided by this model to improve treatment adherence in people with T2DM.

Resumen La diabetes mellitus tipo 2 (DMT2) es un conjunto de desórdenes metabólicos que aumenta el riesgo de afecciones multisistémicas. En México se han propuesto Guías de Práctica Clínica (GPC) para la atención de la salud en personas con DMT2, que van desde la prevención hasta la rehabilitación. Sin embargo, a pesar de enfatizar la participación activa de los pacientes en sus tratamientos para mejorar la adherencia al tratamiento, no cuenta con procedimientos claros. Por ello, el objetivo de este trabajo es proponer el pensamiento de diseño centrado en la persona (PDCP) como una estrategia para esta meta. Se describen los pasos que integran esta metodología, así como los resultados observados en la literatura internacional. Se discute la coherencia del PDCP con las recomendaciones de las GPC mexicanas, y la importancia de la claridad metodológica que brinda este modelo para mejorar la adherencia al tratamiento en personas con DMT2.

Resumen: La Enfermedad de Von Willebrand adquirida (EVW adquirida) es un trastorno hemorrágico adquirido poco frecuente, con características clínicas y de laboratorio similares a la Enfermedad de Von Willebrand congénita. Asociándose con enfermedades hemato-oncológicas, autoinmunes, cardiovasculares y tumores sólidos. Las gammapatías monoclonales constituyen un grupo heterogéneo de trastornos caracterizados por la proliferación de linfocitos B en los últimos estadios madurativos o células plasmáticas que preservan la capacidad de producir una inmunoglobulina (Ig) monoclonal o alguno de sus componentes. Como consecuencia, se produce la aparición de una paraproteína o componente M (CM) en suero y/o orina que estará formado por la misma cadena pesada o ligera, y por regiones variables idénticas. Se presenta el caso de una mujer de 57 años, que se presenta con un síndrome hemorragíparo, alteración de la crasis en su vía intrínseca, donde se diagnostica EVW adq secundaria a Mieloma Múltiple (MM) con CM IgM 5,9 g/dl. El tratamiento tuvo como objetivos detener el sangrado, prevenir complicaciones y abordar precozmente la patología hemato-oncológica causante. Para su abordaje requirió la realización de recambios plasmáticos terapéuticos (RPT) que tuvieron un rol de acción terapéutica temprana y eficaz con excelente tolerancia. Ante el diagnóstico se inició rápidamente poliquimioterapia siendo ésta una paciente candidata a trasplante de progenitores hematopoyéticos. El objetivo de la presentación de este caso clínico es destacar la importancia de un correcto y oportuno diagnóstico ante la sospecha clínica de una coagulopatía secundaria a una enfermedad hemato-oncológica subyacente. Por lo que hacemos énfasis en el abordaje multidisciplinario.

Resumo: A doença de von Willebrand adquirida (EVW acq, AVWS) é um distúrbio hemorrágico adquirido raro com características clínicas e laboratoriais semelhantes à doença de von Willebrand congênita. Associado a doenças hemato-oncológicas, autoimunes, cardiovasculares e tumores sólidos. As gamopatias monoclonais constituem um grupo heterogêneo de distúrbios caracterizados pela proliferação de linfócitos B nos últimos estágios de maturação ou plasmócitos que preservam a capacidade de produzir uma imunoglobulina monoclonal (Ig) ou um de seus componentes. Como consequência, ocorre o aparecimento de uma paraproteína ou componente M (CM) no soro e/ou na urina, que serão formados pela mesma cadeia pesada ou leve, e por regiões variáveis idênticas. Apresentamos o caso de uma mulher de 57 anos, que apresentava um síndroma hemorrágico, alteração da crase na sua via intrínseca, onde é diagnosticada Doença de Von Willebrand Adquirida secundária a Mieloma Múltiplo. O tratamento visava estancar o sangramento, prevenir complicações e abordar prontamente a patologia hemato-oncológica subjacente. Para sua abordagem, exigiu a realização de plasmaférese terapêutica que teve papel de ação terapêutica precoce e efetiva com excelente tolerância. Diante do diagnóstico, rapidamente foi iniciada poliquimioterapia, sendo este paciente candidato a transplante de células-tronco hematopoiéticas. O objetivo da apresentação deste caso clínico é realçar a importância de um diagnóstico correto e atempado face à suspeita clínica de uma coagulopatia secundária a uma doença hemato-oncológica subjacente. Portanto, enfatizamos a abordagem multidisciplinar.

Abstract: Acquired von Willebrand disease (AVWS) is a rare acquired bleeding disorder with clinical and laboratory features similar to congenital von Willebrand disease. Associated with hemato-oncological, autoimmune, cardiovascular diseases and solid tumors. Monoclonal gammopathies constitute a heterogeneous group of disorders characterized by the proliferation of B lymphocytes in the last stages of maturation or plasma cells that preserve the capacity to produce a monoclonal immunoglobulin (Ig) or one of its components. As a consequence, the appearance of a paraprotein or M component (CM) occurs in serum and/or urine, which will be formed by the same heavy or light chain, and by identical variable regions. We present the case of a 57-year-old woman, who presented with a hemorrhagic parous syndrome, alteration of the crasis in its intrinsic way, where Acquired Von Willebrand Disease secondary to Multiple Myeloma is diagnosed. Treatment was aimed at stopping the bleeding, preventing complications, and promptly addressing the underlying hemato-oncological pathology. For its approach, it required the performance of therapeutic plasma exchanges that had a role of early and effective therapeutic action with excellent tolerance. Given the diagnosis, polychemotherapy was quickly started, this patient being a candidate for hematopoietic stem cell transplantation. The objective of presenting this clinical case is to highlight the importance of a correct and timely diagnosis in the face of clinical suspicion of a coagulopathy secondary to an underlying hemato-oncological disease. Therefore, we emphasize the multidisciplinary approach.

Resumen Objetivo: caracterizar sociodemográficamente pacientes que padecen trastornos del estado de ánimo en Institución Prestadora de Servicios (IPS) de salud mental en Montería, departamento de Córdoba - Colombia, correlacionando este diagnóstico con variables de interés. Materiales y métodos: estudio descriptivo, retrospectivo-longitudinal, que correlacionó variables sociodemográficas con trastornos del estado de ánimo en 729 pacientes hospitalizados en una IPS, procedentes de municipios del departamento de Córdoba, en el período 2012- 2021-I. Resultados: hombres con edad promedio de 23 años presentaron mayor frecuencia de trastornos del estado de ánimo n=689 que mujeres n= 40; en su mayoría procedentes de municipios como Montería, Puerto Libertador, Valencia, Tierralta y Canalete; siendo Montería el municipio con mayor población y menor prevalencia; factores como lugar de procedencia, falta de apoyo familiar y estrés fueron quienes incidieron en recaídas, registrándose disminución en hospitalización de estos pacientes durante la pandemia COVID-19. Conclusión: existe correlación entre variables sociodemográficas como lugar de procedencia del departamento de Córdoba, falta de apoyo familiar y estrés como determinantes para la ocurrencia del diagnóstico de trastornos del estado de ánimo, en pacientes que proceden de municipios caracterizados por niveles de violencia alto y medio, baja cobertura educativa y pobreza multifuncional en población vulnerable.

ABSTRACT Objective : To sociodemographically characterize patients with Mood Disorders in a Mental Health Institution in Montería, Córdoba - Colombia, and correlate this diagnosis with variables of interest. Materials and Methods: This descriptive, retrospective-longitudinal study correlated sociodemographic variables with Mood Disorders in 729 hospitalized patients in an Institution of Mental Health, originating from municipalities in the department of Córdoba, during the period 2012-2021. Results: Men with an average age of 23 years presented a higher frequency of Mood Disorders (n=689) compared to women (n=40). The majority of patients originated from municipalities such as Montería, Puerto Libertador, Valencia, Tierralta, and Canalete. Montería, being the municipality with the largest population, showed a lower prevalence. Factors such as place of origin, lack of family support, and stress influenced relapses, with a decrease in hospitalizations of these patients during the COVID-19 pandemic. Conclusion: There is a correlation between sociodemographic variables such as the place of origin in the department of Córdoba, lack of family support, and stress as determinants for the occurrence of Mood Disorders diagnosis in patients from municipalities characterized by high and medium levels of violence, low educational coverage, and multifunctional poverty in vulnerable populations.

Resumo Introdução: O objetivo deste estudo foi investigar o papel do fenofibrato, um agonista do receptor ativado por proliferadores de peroxissoma-α, na lesão renal induzida por obesidade (lipotoxicidade) em camundongos submetidos à uninefrectomia. Métodos: Camundongos C57BL/6 foram submetidos a uninefrectomia e cirurgias simuladas (sham) e alimentados com dietas normocalóricas ou rica em gordura. Após 10 semanas, os camundongos obesos receberam fenofibrato a 0,02% por 10 semanas. Avaliamos função e morfologia renal, bem como níveis de mediadores inflamatórios e fibróticos e marcadores do metabolismo lipídico. Resultados: Camundongos alimentados com dieta rica em gordura desenvolveram obesidade e hiperlipidemia características, com subsequente acúmulo de lipídios e danos renais, incluindo expansão mesangial, fibrose intersticial, inflamação e proteinúria. Essas alterações foram maiores em camundongos obesos uninefrectomizados do que em camundongos obesos sham. O tratamento com fenofibrato preveniu hiperlipidemia e lesões glomerulares, reduziu o acúmulo de lipídios, melhorou a disfunção renal e atenuou a inflamação e fibrose renal. Além disso, o tratamento com fenofibrato reduziu a expressão no tecido renal do inibidor do ativador do plasminogênio-1, da proteína quimiotática de monócitos-1 e a expressão local do fator de crescimento de fibroblastos-21. Conclusão: A ativação do receptor ativado por proliferadores de peroxissoma-α pelo fenofibrato, com subsequente lipólise, atenuou lesões glomerulares e tubulointersticiais induzidas por lipotoxicidade renal, protegendo, assim, os rins de camundongos uninefrectomizados contra lesões induzidas por obesidade. Os achados do estudo sugerem uma via na ação farmacológica do fenofibrato, fornecendo insights sobre os mecanismos envolvidos no dano renal causado pela obesidade em doadores renais. Introdução peroxissomaα, peroxissomaα peroxissoma α, α (lipotoxicidade Métodos C57BL6 CBL C57BL 6 C BL C57BL/ sham (sham 1 semanas 002 0 02 0,02 lipídico Resultados características renais mesangial intersticial proteinúria disso plasminogênio1, plasminogênio1 plasminogênio 1, plasminogênio-1 monócitos1 monócitos monócitos- fibroblastos21. fibroblastos21 fibroblastos 21. 21 fibroblastos-21 Conclusão lipólise protegendo assim 00 0,0 plasminogênio- fibroblastos2 2 fibroblastos-2 0, fibroblastos-

Abstract Introduction: The objective of this study was to investigate the role of fenofibrate, a peroxisome proliferator-activated receptor-α agonist, in obesity-induced kidney damage (lipotoxicity) in mice with uninephrectomy. Methods: C57BL/6 mice underwent uninephrectomy and sham surgeries and were fed normocaloric or high-fat diets. After 10 weeks, obese mice were administered 0.02% fenofibrate for 10 weeks. Kidney function and morphology were evaluated, as well as levels of inflammatory and fibrotic mediators and lipid metabolism markers. Results: High-fat diet-fed mice developed characteristic obesity and hyperlipidemia, with subsequent renal lipid accumulation and damage, including mesangial expansion, interstitial fibrosis, inflammation, and proteinuria. These changes were greater in obese uninephrectomy mice than in obese sham mice. Fenofibrate treatment prevented hyperlipidemia and glomerular lesions, lowered lipid accumulation, ameliorated renal dysfunction, and attenuated inflammation and renal fibrosis. Furthermore, fenofibrate treatment downregulated renal tissue expression of plasminogen activator inhibitor-1, monocyte chemoattractant protein-1, and local expression of fibroblast growth factor-21. Conclusion: Peroxisome proliferator-activated receptor-α activation by fenofibrate, with subsequent lipolysis, attenuated glomerular and tubulointerstitial lesions induced by renal lipotoxicity, thus protecting the kidneys of uninephrectomy mice from obesity-induced lesions. The study findings suggest a pathway in the pharmacological action of fenofibrate, providing insight into the mechanisms involved in kidney damage caused by obesity in kidney donors. Introduction proliferatoractivated proliferator activated receptorα receptor α agonist obesityinduced lipotoxicity (lipotoxicity Methods C57BL6 CBL C57BL 6 C BL C57BL/ highfat high fat diets 1 weeks 002 0 02 0.02 evaluated markers Results Highfat High dietfed diet expansion fibrosis proteinuria dysfunction Furthermore inhibitor1, inhibitor1 inhibitor 1, inhibitor-1 protein1, protein1 protein protein-1 factor21. factor21 factor 21. 21 factor-21 Conclusion lipolysis donors 00 0.0 inhibitor- protein- factor2 2 factor-2 0. factor-

Resumen La seguridad de los psicofármacos durante el embarazo es un tema crucial en la práctica clínica. En esta revisión, se hace un breve recorrido sobre los cambios en el embarazo que impactan en la farmacodinamia de los medicamentos, además, se analizan los principales grupos farmacológicos en psiquiatría y sus efectos durante el embarazo. Se identifican tres períodos críticos durante el embarazo. El período de las primeras dos semanas se asocia con un mayor riesgo de aborto espontáneo. El período de la segunda a la décima semana es el más riesgoso, ya que pueden ocurrir alteraciones teratogénicas que afectan el desarrollo fetal. El período posterior a la décima semana se caracteriza por alteraciones en el crecimiento y desarrollo funcional del feto, pero suelen ser menos graves. Los antidepresivos, especialmente los inhibidores selectivos de la receptación de serotonina (ISRS) y los antipsicóticos de segunda generación se consideran los más seguros, pero estos últimos pueden estar asociados con síndrome metabólico, cardiopatías congénitas y trastornos del neurodesarrollo. El litio se ha asociado con efectos teratogénicos y malformaciones cardíacas, mientras que el valproato está relacionado con defectos congénitos importantes. Las benzodiacepinas pueden tener efectos tóxicos y causar síndrome de abstinencia en el recién nacido. La seguridad de los psicofármacos durante el embarazo requiere una evaluación individualizada de los beneficios y riesgos. Aunque algunos grupos de psicofármacos se consideran relativamente seguros, es necesario tener precaución y considerar las posibles complicaciones asociadas con su uso durante el embarazo.

Abstract: The safety of psychoactive drugs during pregnancy is a crucial issue in clinical practice. In this review, a brief overview of the changes in pregnancy that impact the pharmacodynamics of drugs is made; in addition, the main pharmacological groups in psychiatry and their effects during pregnancy are analyzed. Three critical periods during pregnancy are identified. The period of the first two weeks is associated with an increased risk of miscarriage. The period from the second to the tenth week is the most at risk , since teratogenic effects that affect fetal development can take place. The period after the tenth week is characterized by alterations in fetal growth and functional development , however ,less severe defects. Antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), and second-generation antipsychotics are considered the safest, but the latter may be associated with metabolic syndrome, congenital heart disease, and neurodevelopmental disorders. Lithium has been associated with teratogenic effects and cardiac malformations, while valproate is associated with major birth defects. Benzodiazepines can have toxic effects and cause Neonatal Withdrawal Syndrome . The safety of psychotropic drugs during pregnancy requires an individualized assesment of the benefits and risks. Although some groups of psychiatric drugs are considered relatively safe, caution is needed when considering the potential complications associated with their use during pregnancy.