The training of Chemistry teachers in Brazil has been researched for a few decades and studies point out to training gaps that reverberate in teaching, especially in basic education. One of the contents covered in this step and which is part of the high school curriculum is radioactivity, which is related, among other things, to radiological and radioactive accidents that occur around the world. Thus, this research sought to investigate how the training provided to Chemistry undergraduates in the state of Goiás is in relation to the subject of radioactivity, since in 1987 a radiological accident occurred in Goiânia with a Cesium 137 source. This is a qualitative research, data were collected via questionnaire and the analytical technique used was discursive textual analysis (ATD). The results showed that due importance was not given to the radiological accident, since there is evidence of training gaps in relation to the topic of radioactivity in Chemistry degree courses in the state of Goiás, where the accident occurred, and the contents on radioactivity are either not addressed, or the approach is superficial. This fact directly impacts the teacher’s performance in basic education, when working on this content with their students. teaching education related things world Thus 198 13 source ATD. ATD . (ATD) addressed superficial teacher s students 19 1 (ATD

This study presents a solution to solid waste problems, focusing on spent lithium-ion batteries (LiBs) and iron ore tailings (IOT) from the Mariana environmental accident in Brazil. The approach involves the production CoFe2O4 from LiBs and IOT, which serves as a catalyst for solar photo-Fenton reactions for methylene blue (MB) decolorization and as an electrochemical sensor for ascorbic acid (AA) detection. Chemical analysis showed recycling potential, with 45.22 ± 0.22% m m−1 Co from LiBs and 14.9 ± 1.5% m m−1 Fe from IOT, determined by inductively coupled plasma atomic emission spectroscopy (ICP OES) and flame atomic absorption spectrometry (FAAS). The sol-gel synthesized CoFe2O4 exhibited a crystallite size of 51.9 ± 1.3 nm and agglomerated crystal clusters. Recycled-CoFe2O4 exhibited a 98.1% MB decolorization efficiency in 60 min under solar irradiation and remained above 92.3% in all 7 reuse cycles. The electrochemical sensor exhibited a coefficient of determination of 0.9987, a sensitivity of 3.352 ± 0.0428 μA mol L−1, and a limit of detection of 0.5511 µM in the concentration range of 1.96 to 23.08 mmol L−1 for AA detection. This study demonstrates the potential of recycled-CoFe2O4 in an environmentally friendly dye removal and as an electrochemical sensor, offering sustainable waste management and resource utilization with solar energy. problems lithiumion lithium ion (LiBs IOT (IOT Brazil CoFeO CoFe O CoFe2O photoFenton photo Fenton (MB (AA 4522 45 22 45.2 022 0 0.22 m1 1 m− 149 14 9 14. 15 5 1.5 ICP OES FAAS. FAAS . (FAAS) solgel sol gel 519 51 51. 13 3 1. clusters RecycledCoFe2O4 RecycledCoFeO Recycled Recycled-CoFe2O 981 98 98.1 6 923 92 92.3 cycles 09987 9987 0.9987 3352 352 3.35 00428 0428 0.042 L1 L 05511 5511 0.551 196 96 1.9 2308 23 08 23.0 L− recycledCoFe2O4 recycledCoFeO recycled recycled-CoFe2O energy 452 4 2 45. 02 0.2 (FAAS RecycledCoFe RecycledCoFe2O 98. 92. 0998 998 0.998 335 35 3.3 0042 042 0.04 0551 551 0.55 19 230 23. recycledCoFe recycledCoFe2O 0. 099 99 0.99 33 3. 004 04 0.0 055 55 0.5 09 0.9 00 05

INTRODUCTION: The rising prevalence of stroke in sub-Saharan Africa necessitates the exploration of the role of occupational therapy in rehabilitation of stroke. In the southern African country of South Africa, occupational therapy aligns with healthcare policies and laws, and this article presents a review of synthesized evidence of occupational therapy intervention in stroke care and rehabilitation. METHOD: Rapid review methodology was used to develop a research question about cerebrovascular accident - intervention by occupational therapists., The Cochrane Library and MEDLINE databases were searched for relevant articles published between 2018 and 2023. Twenty four articles met the inclusion criteria and were analysed according to quantitative and qualitative parameters. RESULTS: Evidence of occupational therapy intervention with post-stroke upper limb impairment was found in 37,5% of articles. Occupational therapy for global improvement in function, cognitive rehabilitation, balance, social participation, work, and leisure comprised 45,8% of articles, and one article each reported evidence for occupational therapy addressing ADL and caregiver interventions. CONCLUSION: Evidence from the past five years reflect diverse occupational therapy interventions with clients with stroke. Gaps in recent evidence remain in relation to context-specific interventions, especially from low- and middle-income countries. IMPLICATIONS FOR PRACTICE Occupational therapists adopt a holistic approach to stroke rehabilitation, tailoring interventions to address the multifaceted needs and goals of individual stroke survivors. The effectiveness of individualised, occupation-based approaches across various domains are highlighted. • Therapists stay informed and up to date about emerging technologies and evidence-based practice to enhance their effectiveness in stroke rehabilitation. • This review provides evidence of the prevalence of upper limb impairments post-stroke, which will enable therapists to be well-versed in the diverse intervention approaches for upper limb rehabilitation as outlined in the literature reviewed, including technologies like Brain Computer Interface, Mental Practice, Mirror Therapy, and Action Observation Therapy. • Occupational therapy is vital in addressing cognitive impairments in stroke survivors, and practitioners can apply the evidence provided on interventions such as Virtual Reality and computer-assisted cognitive rehabilitation that have shown promise in improving cognition and ADL.

Resumen Introducción: Se presenta el caso clínico de un varón de 15 años con fracturas de huesos cortos del pie derecho como consecuencia de un accidente de tránsito. Tras 24 h de evolución, ingresa con disnea, desaturación, pico febril objetivo y posterior desarrollo de insuficiencia respiratoria. Ante la sospecha clínica de síndrome de embolia grasa, se solicita una angiotomografía pulmonar que confirma el diagnóstico. Se trata de una entidad inusual en pacientes con este tipo de fractura. El tratamiento inicial consistió en vigilancia estrecha en la unidad de cuidados intensivos, medidas de soporte con oxígeno suplementario, terapia respiratoria y manejo quirúrgico de las fracturas. La evolución clínica del paciente fue adecuada y el cuadro respiratorio se resolvió por completo. Conclusiones: El síndrome de embolia grasa secundario a fracturas de huesos cortos es un cuadro infrecuente; por lo tanto, es preciso tener un alto grado de sospecha diagnóstica, no solo en los escenarios más comunes, sino también en este tipo de contextos inusuales y retadores, que permita su identificación temprana y, de esta forma, implementar un manejo oportuno y generar un impacto favorable en los desenlaces clínicos y en la disminución del riesgo de secuelas a largo plazo.

Abstract Introduction: We present the clinical case of a 15-year-old male who sustained fractures to the short bones of his right foot as a result of a traffic accident. After 24 hours of evolution, he was admitted for dyspnea, desaturation, an objective febrile peak, and the development of respiratory failure. Given the clinical suspicion of fat embolism syndrome, pulmonary angiotomography was requested, which confirmed the diagnosis. This is a rare finding in patients with this type of fracture. The initial treatment included close monitoring in the intensive care unit, supportive measures such as supplemental oxygen, respiratory therapy, and surgical fracture management. The patient’s clinical progression was adequate, and the respiratory condition resolved completely. Conclusion: Fat embolism syndrome resulting from short bone fractures is a rare condition; therefore, it is necessary to have a high level of diagnostic suspicion, not only in the most common scenarios, but also in these unusual and challenging contexts, which allows for its early detection and, as a result, timely management, which has a positive impact on clinical outcomes and reduces the risk of long-term sequelae.

ABSTRACT Introduction: Musculoskeletal injuries related to work are extremely common, often resulting from workplace accidents. The knowledge of occupational diseases and injuries by the Occupational Health Physician is crucial for Occupational Medicine. This clinical case describes a 37-year-old male patient who sought Emergency Services due to a fall from stairs with right knee trauma involving hyperflexion during work. The diagnosis confirmed a complete rupture of the patellar tendon. With this clinical case, it was made a review of the literature about occupational and personal risk factors for patellar tendon rupture; as to investigate whether the literature describes any sequelae of the injury that may result in work limitations. Methods: A non-systematic literature review was conducted using the PubMed database with the keywords "Patellar tendon; knee injury; outcome; patellar tendon repair." Two articles not included in this filter were added for their relevance to the topic. Out of 56 articles published as systematic reviews and classic reviews between 2002 and 2022, a total of 23 articles were selected through the reading of abstracts. Exclusion criteria included bilateral rupture of the patellar tendon, studies exclusively focused on patellar tendon rupture in a sports context, and approaches to new surgical techniques. After reading these bibliographic sources, seven were used in the discussion of this clinical case. Results: Patellar tendon rupture is an uncommon and disabling injury with a higher incidence in men under 40 years old. In cases of total tendon rupture, surgical intervention is necessary to restore the extensor mechanism's functionality. Various authors have described potential predisposing conditions for patellar tendon rupture, such as the use of corticosteroids and fluoroquinolones, diabetes, rheumatic disease, Lyme disease and microtrauma. Most described cases are sports-related injuries. The relationship with occupational risk factors is not clear, except for professional athletes. Repetitive microtrauma is one of the main causes of patellar tendinopathy, which can lead to patellar tendon rupture and is defined as "overuse pathology," present in professions such as floor installers. Conclusion: Occupational medicine plays a relevant role in reintegrating workers after a workplace accident. Understanding the epidemiology, identifying injury mechanisms, treatment and prognosis of this pathology is important not only for preventing future workplace accidents but also for adapting the worker's return to their job.

RESUMO Introdução: As lesões músculo-esqueléticas ligadas ao trabalho são extremamente frequentes e muitas decorrentes dos acidentes laborais. O conhecimento das doenças e lesões provadas em contexto ocupacional é importante para a Medicina do Trabalho. Na descrição deste caso clínico apresenta-se um trabalhador de 37 anos, sexo masculino, que recorre ao Serviço de Urgência por queda de escadas com traumatismo do joelho direito com mecanismo de hiperflexão durante o trabalho. Após confirmação de diagnóstico de rotura total do tendão rotuliano. Com este caso clínico pretende-se rever na literatura a existência de fatores de risco ocupacionais e pessoais para esta situação clínica; bem como sequelas que possam configurar limitações na capacidade de trabalho. Métodos: Foi realizada a revisão de literatura não sistemática recorrendo a base de dados de artigos PubMed com as palavras-chave “Patellar tendon; knee injury; outcome; patellar tendon repair”. Foram incluídos dois artigos extra, pela sua relevância para o tema. Dos 56 estudos publicados como revisão sistemática e revisão, publicados entre 2002 e 2022, foram selecionados por leitura do resumo 23 documentos. Os critérios de exclusão foram rutura bilateral do rotuliano, estudos que dirigidos exclusivamente a rutura do rotuliano em contexto desportivo e abordagens a novas técnicas cirúrgicas. Após leitura destas fontes bibliográficas foram usadas sete na discussão deste caso clínico. Resultados: A rotura do tendão rotuliano é uma lesão incomum e incapacitante com maior incidência em homens com idade inferior a 40 anos. Nos casos de rotura total do tendão, a intervenção cirúrgica é necessária para restaurar a funcionalidade do mecanismo extensor. Diferentes autores descreveram a possível predisposição a condições para rotura do tendão rotuliano como o uso de corticosteroides e fluoroquina, diabetes, doença reumática, doença de Lume e o microtrauma. A maioria dos casos descritos são lesões desportivas. A relação com fatores de risco ocupacionais não é clara, com exceção dos atletas profissionais. O microtrauma repetitivo é uma das principais causas de tendinopatia patelar, que pode levar a rotura do rotuliano e que é definida como “patologia de uso excessivo”, que pode estar presente em profissões como assentadores de pavimento. Conclusão: A medicina do trabalho tem um papel relevante na reintegração dos trabalhadores após em caso de acidente no local de trabalho. Conhecer a epidemiologia, identificar os mecanismos de lesão, tratamento e prognóstico desta patologia é importante, não só para atuar na prevenção de futuros acidentes de trabalho, mas também para adaptar o retorno do trabalhador ao seu posto de trabalho.

ABSTRACT Introduction/framework/objectives Most professionals working in Occupational Health and Safety have some notions regarding the distribution of Occupational Accidents versus gender, however, not all have had the opportunity to consult reasonably up-to-date data on this subject. The aim of this review was to clearly summarize not only some articles that addressed this subject, but also to have access to national and European statistical data. Methodology This is a Bibliographic Review, initiated through a search carried out in May 2023 in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. The websites of Pordata and the National Institute of Statistics were also consulted. Content There are anatomical and physiological differences between genders, namely body size and shape, musculature and metabolism, which can modulate certain occupational issues, such as choosing and staying in certain jobs. Incidentally, in the same section of work, sometimes both genders take on different tasks and/or perform them in different ways. 98.8% of accidents in absolute numbers occur in males, as this is obviously much more prevalent in the industrial and construction sectors, areas where there is a higher accident rate. Discussion and Conclusions Accidents at work are more frequent and serious among men, not only due to the type of tasks that exist in positions predominantly assumed by this gender, but also due to the personality and influence of society and culture, which generally encourages more in this context to need to defy danger and/or be more acceptable not following the rules. Adherence to the proposed Safety measures varies with the Perception of Risk and the influence of the work team, management and society. As more of this global interference is taken into account, the greater the ability of the Occupational Health and Safety team to mitigate the incidence and severity of Occupational Accidents and thus obtain a safer workplace, and these measures must be different between the male and female sexes.

RESUMO Introdução/enquadramento/objetivos A generalidade dos profissionais a exercer na Saúde e Segurança Ocupacionais tem algumas noções relativas à distribuição dos Acidentes Laborais versus sexo, contudo, nem todos terão tido oportunidade de consultar dados razoavelmente atualizados sobre esse assunto. Pretendeu-se com esta revisão resumir de forma clara, não só alguns artigos que abordassem este assunto, como também ter acesso a dados estatísticos nacionais e europeus nesta área. Metodologia Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em maio de 2023 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Foram também consultados os sites da Pordata e do Instituto Nacional de Estatística. Conteúdo Existem diferenças anátomo-fisiológicas entre os géneros, nomeadamente tamanho e formato corporal, musculatura e metabolização, que podem modular determinadas questões ocupacionais, como a escolha e permanência em alguns postos laborais. Aliás, na mesma secção de trabalho, por vezes os dois géneros assumem tarefas diferentes e/ou executam-nas de formas diversas. Em números absolutos, 98,8% dos acidentes ocorrem no sexo masculino, por este ser obviamente muito mais prevalente nos setores industrial e da construção, áreas essas onde existe uma maior sinistralidade. Discussão e Conclusões Os acidentes de trabalho são mais frequentes e graves no sexo masculino, não só devido ao tipo de tarefas que existem nos postos assumidos predominantemente por este género, mas também devido à personalidade e influência da sociedade e cultura que, geralmente, incentiva mais neste contexto a necessidade de desafiar o perigo e/ou ser mais aceitável não cumprir as regras. A adesão às medidas de Segurança propostas varia com a Perceção de Risco e a influência da equipa de trabalho, chefia e sociedade. Quanto mais esta globalidade de interferências for levada em conta, maior a capacidade da equipa de Saúde e Segurança Ocupacionais para atenuar a incidência e gravidade dos Acidentes Laborais e assim se obter um local de trabalho mais seguro, sendo que essas medidas deverão ser distintas entre os sexos masculino e feminino.

ABSTRACT Introduction: Overactive bladder is characterized by overactivity of the detrusor and causes urge urinary incontinence. Accidents at work have a negative impact on the health of workers and consequently on the productivity of companies and the global economy. The worker and his/her family members are entitled to compensation for damage resulting from it. The responsibility for the repair and other charges arising from accidents at work lies with the employer, who is obliged to transfer it to entities legally authorized for this purpose (insurance companies). Case Report: In this clinical case, an accident at work is described in a 57-year-old woman, an operational assistant at a public health institution. The victim suffered a fall on a wet floor, which resulted in a rupture of the adductor muscles of the thighs, with aggravation of a pre-existing pathology (surgically corrected stress urinary incontinence). A few years after the accident, the victim underwent a new urogynecological surgical intervention at the insurance company, with worsening of existing stress incontinence and emergence of urge urinary incontinence, having developed, in this context, overactive bladder. Discussion/Conclusion: In this case report, the insurance company recognized the causal link between the accident at work and the injuries that developed. The consequences of this accident go beyond the work sphere, with an impact on the quality of life, leisure and sexual dimension of the worker. The reparation of damage by work accidents in Portugal focuses essentially on the loss of earning capacity. Occupational health services play a key role both in the prevention of accidents at work and in the follow-up of victims after returning to work. Occupational physicians and insurance companies play a key role in professional reintegration, so their communication and bonding should be strengthened.

RESUMO Introdução: A bexiga hiperativa caracteriza-se por hiperatividade do detrusor e ocasiona incontinência urinária de urgência. Os acidentes de trabalho têm um impacto negativo na saúde dos trabalhadores e consequentemente na produtividade das empresas e economia global. O trabalhador e os seus familiares têm direito à reparação dos danos emergentes. A responsabilidade pela reparação e demais encargos decorrentes cabe ao empregador, que é obrigado a transferi-la para entidades legalmente autorizadas para o efeito (seguradoras). Caso Clínico: Neste caso clínico descreve-se um acidente laboral numa trabalhadora de 57 anos, assistente operacional de uma instituição pública de saúde. A sinistrada sofreu queda em piso molhado, que resultou em rotura dos músculos adutores das coxas, com agravamento de patologia pré-existente (incontinência urinária de esforço corrigida cirurgicamente). Alguns anos após o acidente, a sinistrada foi submetida a nova intervenção cirúrgica uro-ginecológica na seguradora, com agravamento da incontinência de esforço já existente e surgimento de incontinência urinária de urgência, tendo desenvolvido, nesse contexto, bexiga hiperativa. Discussão/Conclusão: No caso clínico em questão, foi reconhecido pela companhia de seguros o nexo de causalidade entre o sinistro ocorrido e as lesões desenvolvidas. As consequências ultrapassam a esfera laboral, com impacto na qualidade de vida, lazer e dimensão sexual da trabalhadora. A reparação por acidentes de trabalho em Portugal incide essencialmente na perda da capacidade de ganho. Os serviços de saúde ocupacional têm um papel fundamental tanto na prevenção dos acidentes, como no acompanhamento dos sinistrados após regresso ao trabalho. O médico do trabalho e as companhias de seguro têm um papel fundamental na reintegração profissional, pelo que a sua comunicação e vínculo devem ser reforçados.

Abstract Objective: The aim of this study was to estimate whether the consumption of anticoagulants was associated with a difference in the frequency of thrombosis of any site, major bleeding and mortality, in adults with both diseases. Method: A retrospective cohort study was carried out in four high complexity centers. Patients older than 18 years with CKD on hemodialysis and non-valvular AF, with an indication for anticoagulation (CHA2DS2VASc ≥ 2), were included. The primary outcome was the occurrence of: major bleeding, thrombotic event (cerebrovascular accident, acute myocardial infarction or venous thromboembolic disease) or death. Adjustment for confounding variables was performed using logistic regression. Results: From 158 patients included, 61% (n = 97) received an anticoagulant. The main outcome was found in 84% of those who received anticoagulation and 70% of those who did not (OR: 2.12, 95%CI: 0.98-4.57; after the adjusted analysis OR: 2.13, 95%CI: 1.04-4.36). Separate outcomes were bleeding in 52% vs. 34% (OR: 2.03; 95%CI: 1.05-3.93), thrombosis in 35% vs. 34% (OR: 1.03; 95%CI: 0.52-2-01) and death in 46% vs. 41% (OR: 1.25; 95%CI: 0.65-2.38). Conclusions: The results of this study suggest an increased risk of bleeding in patients with AF and CKD on hemodialysis receiving anticoagulation, without a decrease in the risk of thrombotic events or all-cause mortality.

Resumen Objetivo: El objetivo de este estudio fue estimar si el uso de anticoagulantes se asociaba con una diferencia en la frecuencia de trombosis de cualquier sitio, hemorragia mayor y mortalidad en adultos con coexistencia de ambas patologías. Método: Se realizó un estudio de cohorte retrospectivo en cuatro centros de alta complejidad. Se incluyeron mayores de 18 años con ERC en hemodiálisis y FA no valvular, con indicación de anticoagulación (CHA2DS2VASc ≥ 2). El desenlace primario fue la ocurrencia de sangrado mayor, evento trombótico (accidente vascular cerebral, infarto agudo al miocardio o enfermedad tromboembólica venosa) o muerte. Se realizó ajuste por variables de confusión por regresión logística. Resultados: De los 158 pacientes incluidos, el 61% (n = 97) recibieron anticoagulante. El desenlace principal se encontró en el 84% de quienes recibieron anticoagulación y en el 70% de quienes no la recibieron (OR: 2.12, IC95%: 0.98-4.57; luego del ajuste OR: 2.13, IC95%: 1.04-4.36). De los desenlaces mayores se presentaron sangrado en el 52% vs. el 34% (OR: 2.03; IC95%: 1.05-3.93), trombosis en el 35% vs. el 34% (OR: 1.03; IC95%: 0.52-2.01) y muerte en el 46% vs. el 41% (OR: 1.25; IC95%: 0.65-2.38). Conclusiones: Los resultados de este estudio sugieren un incremento en el riesgo de sangrado en los pacientes con FA y ERC en hemodiálisis que reciben anticoagulación, sin disminución del riesgo de eventos trombóticos ni de muerte.

ABSTRACT This comprehensive study focuses on occupational health and safety in the construction sector, analyzing working conditions, accident prevention and training effectiveness. Employing a mixed approach with structured surveys, it reveals varied perceptions among employees on occupational safety, highlighting the importance of improving the provision of Personal Protective Equipment. Significant correlations are identified, such as the association between receiving adequate equipment and increased health and safety awareness. Despite safety training, some employees do not experience a significant improvement in their perception of occupational safety. The findings highlight the need for specific interventions to strengthen safety culture, improve communication of policies and procedures, and ensure the effectiveness of occupational health and safety training. These findings support the urgency of implementing preventive measures and comprehensive strategies to promote safe and healthy work environments in the construction industry.

RESUMEN Este estudio se centra en la seguridad y salud laboral en el sector de la construcción, analizando condiciones laborales, prevención de accidentes y eficacia de la formación. Empleando un enfoque mixto con encuestas estructuradas, se revelan percepciones variadas entre los empleados sobre la seguridad laboral, destacando la importancia de mejorar la provisión de equipos de protección personal. Se identifican correlaciones, como la asociación entre recibir equipo adecuado y una mayor conciencia de salud y seguridad. A pesar de la formación en seguridad, algunos empleados no experimentan una mejora relevante en su percepción de seguridad laboral. Las conclusiones resaltan la necesidad de intervenciones específicas para fortalecer la cultura de seguridad, mejorar la comunicación de políticas y procedimientos, y garantizar la efectividad de la formación en salud y seguridad laboral. Estos hallazgos respaldan la necesidad de implementar medidas preventivas y estrategias integrales para promover ambientes laborales seguros y saludables en la industria de la construcción.

RESUMEN Introducción: La herida es una pérdida de continuidad de la piel o mucosa producida por algún agente físico o químico. Una herida es “compleja” cuando por su extensión, localización, profundidad o exposición de elementos nobles, necesita para su curación una terapéutica especial. Este es el caso de heridas con compromiso tisular que afecta a estructuras como músculos, fascias, tendones, huesos, vasos sanguíneos, nervios o las lesiones de lenta evolución como úlceras o escaras. Objetivos: Determinar el método de reconstrucción más utilizado en el manejo terapéutico de las heridas complejas del tercio distal de la pierna en los pacientes atendidos en el Hospital de Trauma y en la Unidad de Cirugía Plástica de la FCM - UNA. Materiales y métodos: Estudio de diseño observacional, tipo de estudio descriptivo y retrospectivo. Fueron incluidos pacientes de ambos sexos, mayores de edad, con heridas complejas en el tercio distal de la pierna, atendidos en el Hospital de Trauma y en la Unidad de Cirugía Plástica de la FCM - UNA, durante el periodo 2010 al 2019. Resultados: Se incluyó a 112 pacientes de los cuales el 80,36 % fue hombres y el 19,64 % mujeres. Las edades estaban comprendidas entre los 18 y los 73 años y una media de 33,8 ± 14 años. La edad más frecuente fue 18 años. La mediana de edad es de 30 años, lo que implica que la mitad de la muestra tuvo por lo menos dicha edad. En cuanto a la procedencia, el 41,07 % era del interior, el 30,36 % del departamento Central y el 28,57 % restante de Asunción. En cuanto al mecanismo de la lesión, se puede observar que el mecanismo más frecuente fue el accidente de tráfico, seguido por caída de altura, en un gran porcentaje. En cuanto a la evolución y complicaciones se puede ver que 92 individuos, o sea 82 % de los pacientes no tuvo ninguna evolución negativa o complicaciones. Lo más común fue la infección con 1,9% de prevalencia, la pérdida parcial del colgajo o piel representan el 2,4%, dehiscencia de la sutura el 0,9 %, hematoma 0,6 % y pérdida total del colgajo 0,54 %. En cuanto al tratamiento aplicado, se debe tener en cuenta que los pacientes pudieron haber recibido más de un tratamiento por lo que el tamaño de la muestra se refiere a las visitas. El tratamiento más frecuente fue el colgajo sural con 28,57%, tutor externo con el 20,19%, injerto de piel 16,46%, toillete 12,73% y colgajo fascio - cutáneo en 6,21%. Conclusión: La gran mayoría de los casos tratados corresponde a algún tipo de accidente de tránsito. Se necesita de un equipo multidisciplinario: ortopedistas, cirujanos plásticos, cirujanos vasculares, fisioterapeutas, etc. en trabajo coordinado para tratar estas graves lesiones de forma a obtener resultados favorables. Para la cobertura de la pierna traumatizada, con exposición ósea, recurrimos a los colgajos musculares, en el 1/3 proximal el gemelo, en el 1/3 medio el sóleo. Para la cobertura del 1/3 distal de la pierna utilizamos el colgajo neuro-veno-fascio-cutáneo (sural) a pedículo distal.

ABSTRACT Introduction: The wound is a loss of continuity of the skin or mucosa produced by some physical or chemical agent. A wound is “complex” when due to its extension, location, depth, exposure of noble elements, it requires special therapy to heal. This is the case of wounds with tissue involvement that affects structures such as muscles, fascia, tendons, bones, blood vessels, nerves, or slowly evolving lesions such as ulcers or bedsores. Objectives: Determine the reconstruction method most used in the therapeutic management of complex wounds of the distal third of the leg in patients treated at the Trauma Hospital and the Plastic Surgery Unit of the FCM - UNA. Materials and methods: Observational, descriptive, and temporally retrospective study. Patients of both sexes, of legal age, with complex wounds in the distal third of the leg, treated at the Trauma Hospital and in the Plastic Surgery Unit of the FCM - UNA, during the period 2010 to 2019, were included. Results: 112 patients were included, of which 80.36% are men and 19.64% are women. The ages range from 18 to 73 years and an average of 33.8 ± 14 years. The most common age was 18 years. The median age is 30 years, which implies that half of the sample is at least that age. Regarding origin, 41.07% are from the interior, 30.36% from the Central department and the remaining 28.57% from Asunción. Regarding the mechanism of injury, the most frequent mechanism was a traffic accident, followed by a fall from a height, in a large percentage. Regarding the evolution and complications, 92, that is, 82% of the patients do not have any negative evolution or complications. The most common was infection with 1.9%, partial loss of the flap or skin represented 2.4%, suture dehiscence with 0.9%, hematoma 0.6%, and total loss of the flap 0.54. %. Regarding the treatment applied, it must be considered that patients may have received more than one treatment, so the sample size refers to visits. The most frequent treatment was the sural flap with 28.57%, external tutor with 20.19%, skin graft 16.46%, toilette 12.73% and fasciocutaneous flap in 6.21%. Conclusion: Most cases treated correspond to some type of traffic accident. A multidisciplinary team is needed: orthopedists, plastic surgeons, vascular surgeons, physiotherapists, etc. in coordinated work to treat these serious injuries to obtain favorable results. To cover the traumatized leg, with bone exposure, we resort to muscle flaps. In the proximal 1/3, the gastrocnemius. In the middle 1/3, the soleus. To cover the distal 1/3 of the leg we used the neuro-veno-fascio-cutaneous (sural) flap to the distal pedicle.

RESUMEN La salud ocupacional y entornos laborales saludables son activos esenciales para el desarrollo personal y socioeconómico. En esta investigación, se aborda la importancia de un entorno de trabajo saludable, destacando su influencia en la salud individual y colectiva. El estudio busca evaluar el entorno laboral en Balcomad S.A., empleando encuestas y entrevistas para recopilar datos cuantitativos y cualitativos sobre la salud y bienestar de los empleados. Los resultados obtenidos revelan que la empresa parece fomentar prácticas saludables en el lugar de trabajo y ha creado un ambiente laboral en el que la colaboración y el apoyo mutuo son valorados. Se sugiere que la empresa focalice esfuerzos en promover prácticas saludables fuera del trabajo para complementar las iniciativas internas y mejorar la prevención de accidentes y reducción del ausentismo relacionado con el trabajo.

ABSTRACT Occupational health and healthy work environments are essential assets for personal and socioeconomic development. In this research, the importance of a healthy work environment is addressed, highlighting its influence on individual and collective health. The study seeks to evaluate the work environment at Balcomad S.A., using surveys and interviews to collect quantitative and qualitative data on the health and well-being of employees. The results obtained reveal that the company appears to promote healthy practices in the workplace and has created a work environment in which collaboration and mutual support are valued. It is suggested that the company focus efforts on promoting healthy practices outside of work to complement internal initiatives and improve accident prevention and reduction of work-related absenteeism.

ABSTRACT Background: Ophidic accident is a neglected disease that affects tropical countries. Latin America is the second region after Africa, with the most cases worldwide. Local lesions accompany its clinical course up to systemic affectations such as renal, hematological, and neurological lesions. Cardiac complications are rare, especially in patients who do not have cardiovascular risk factors. There are reports of acute myocardial infarction, but there is little information about heart failure due to Bothrops spp. Case report: We present the case of a 25-year-old man without cardiovascular risk factors who was admitted to the intensive care unit and developed heart failure with cardiogenic shock and multi-organ failure secondary to a snake bite. Conclusions: Although the characteristic clinical course of a bothropic ophidian accident and its systemic manifestations are mainly related to coagulation abnormalities, there are cardiovascular complications within its clinical presentation that, although rare, if not detected promptly and not adequately managed, are associated with high morbidity and mortality.

RESUMEN Antecedentes: El accidente ofídico es una enfermedad desatendida que afecta a los países tropicales. América Latina es la segunda región después de África, con mayor número de casos a nivel mundial. Su curso clínico incluye lesiones locales hasta afectaciones sistémicas como lesiones renales, hematológicas y neurológicas. Las complicaciones cardiacas son raras, especialmente en pacientes que no tienen factores de riesgo cardiovascular. Hay reportes de infarto agudo de miocardio, pero existe poca información sobre la insuficiencia cardíaca debida a Bothrops spp. Reporte de caso: Presentamos el caso de un hombre de 25 años sin factores de riesgo cardiovascular que fue admitido en la unidad de cuidados intensivos y desarrolló insuficiencia cardíaca con choque cardiogénico y fallo multiorgánico secundario a una mordedura de serpiente. Conclusiones: Aunque el curso clínico característico de un accidente ofídico bothrópico y sus manifestaciones sistémicas están principalmente relacionadas con anomalías de la coagulación, hay complicaciones cardiovasculares dentro de su presentación clínica que, aunque raras, si no se detectan prontamente y no se manejan adecuadamente, están asociadas con alta morbilidad y mortalidad.

ABSTRACT The main objective of the research was to determine the relationship between emotional intelligence and workplace accidents among the employees of a financial institution in 2019 given the high rate of workplace accidents due to personal factors. A sample of 70 employees was selected and the abbreviated Emotional Quotient Inventory (Bar-On EQ-i) was administered to them. Additionally, workplace accident investigation reports were reviewed to identify the main personal factors that caused workplace accidents. The study found a significant relationship between emotional intelligence and workplace accidents, with a rho value of −0.51. This shows an average negative correlation between emotional intelligence and workplace accidents, meaning that the variables are related to each other in an inversely proportional manner. In other words, the lower the level of emotional intelligence, the higher the number of workplace accidents.

RESUMEN El objetivo general de la investigación es determinar la relación entre la inteligencia emocional y los accidentes de trabajo de los colaboradores de una entidad financiera en el año 2019, debido al alto índice de accidentes de trabajo registrados por factores personales en dicha entidad. Se seleccionó una muestra de 70 colaboradores y se les administró el Inventario de Inteligencia Emocional de Bar-On ICE abreviado. Asimismo, se revisaron los informes de investigación de accidentes de trabajo para identificar los principales factores personales que causaron los accidentes de trabajo. Se determinó que existe una relación significativa entre la inteligencia emocional y los accidentes de trabajo con un valor de rho = −0.51, lo que se interpreta como una correlación negativa media entre la inteligencia emocional y los accidentes de trabajo. Por lo tanto, las variables se relacionan entre sí de manera inversamente proporcional, es decir, cuanto menor sea el nivel de inteligencia emocional, mayor será el número de accidentes de trabajo.

SUMMARY BACKGROUND: Cerebrovascular accident (or stroke) and ischemic heart disease are the the major causes of death in the world. It is estimated that about 85% of strokes are ischemic in origin. Reperfusion therapy in the acute phase of ischemic stroke with a recombinant human tissue plasminogen activator is effective, but some factors influence the success of this treatment. OBJECTIVE: The aim of this study was to evaluate clinical aspects and possible determinants for reperfusion after venous thrombolysis. METHODS: This is a retrospective, cross-sectional, observational study based on a review of hospital records of inpatients diagnosed with ischemic stroke treated with intravenous thrombolysis, the main outcome being reperfusion or not. RESULTS: Data from this study revealed a predominance of females in the group of reperfused patients and males in the non-reperfused group, both maintaining moderate severity on the National Institutes of Health Stroke Scale and admission without statistical significance (p>0.18). In addition, the mean admission severity score was 13.2 for the group of reperfused patients and 14.2 for those not reperfused, and the mean ejection fraction of both groups was within normal functionality, with a mean of 0.50 for reperfused patients and 0.62 for non-reperfused patients. CONCLUSION: We found an association between successful venous chemical thrombolysis reperfusion and lower mortality in patients with acute stroke.