Resumen La investigación tuvo como objetivo comprender las experiencias alrededor de la sexualidad desde la teoría de los holones en un grupo de mujeres diagnosticadas con cáncer ginecológico en la ciudad de Pereira, Colombia. Se implementó un diseño cualitativo y fenomenológico, con la participación de seis mujeres entre 30 y 60 años, a quienes se aplicaron entrevistas semiestructuradas explorando los holones de reproductividad, género, erotismo y vinculación afectiva interpersonal. Las entrevistas fueron transcritas y analizadas de forma manual, mediante codificación abierta y axial para identificar categorías emergentes. En los discursos de las mujeres se evidenciaron elementos relacionados a los holones de la sexualidad. En el holón de reproductividad, se encontró una resignificación del rol reproductivo como madres; en el holón de género, se presentaron actitudes positivas hacia el cuerpo y amenazas a la identidad de género por causa de los cambios provocados por la enfermedad; en el holón de erotismo, las mujeres relataron experiencias sexuales marcadas por el dolor y el apoyo erótico de la pareja; y en el holón de vinculación afectiva interpersonal, se evidenciaron situaciones de estabilidad conyugal, separación temporal con la pareja y sostenimiento de vínculos abusivos durante el proceso de tratamiento oncológico. Estos hallazgos muestran una amplia reconfiguración integral de la sexualidad femenina en cada uno de los holones y realizan un aporte significativo a la comprensión de las subjetividades de las mujeres en el proceso de afrontar el cáncer ginecológico. Se recomienda realizar nuevas investigaciones con mayor cantidad de participantes y en otras regiones de Colombia.

Abstract The research aimed to understand the experiences around sexuality, from the holon theory, in a group of women diagnosed with gynecological cancer from Pereira, Colombia. A qualitative and phenomenological design was carried out, with the participation of six women between 30 and 60 years of age, to whom semi-structured interviews were applied, exploring the holons of reproductivity, gender, eroticism and interpersonal affective bonding. The interviews were transcribed and analyzed manually, using open and axial coding to identify emerging categories. In the women's discourses, elements related to the holons of sexuality were evident. In the holon of reproductivity, a resignification of the reproductive role as mothers was found; in the holon of gender, positive attitudes towards their bodies and threats to gender identity due to the changes caused by the disease were presented; in the holon of eroticism, women reported sexual experiences characterized by pain and erotic support from their partners; and in the holon of affective interpersonal bonding, they reported situations of marital stability, temporary separation from their partners and abusive ties during the process of cancer treatment. These findings show a comprehensive reconfiguration of female sexuality in each of the holons and make a significant contribution to the understanding of women's subjectivities in the process of coping with gynecological cancer. Further research with a larger number of participants and in other regions of Colombia is recommended.

Abstract This study analyzes the life stories of eight young people living with vertically transmitted HIV in order to understand their perceptions marked by secrecy and silence regarding their experiences with the virus. Conducted at a specialized outpatient clinic in Rio de Janeiro, the study adopted circle dance, a Complementary and Integrative Health Practice, as a care tool. Using a qualitative approach and Life History as a data collection method, the focus was to understand the youth’s experiences related to the disease and the crucial aspects of their lives. Three girls and five boys participated in the study, all aware of their diagnosis. The principal emerging themes included family dynamics, school environment connection, challenges in treatment adherence, age at the time of diagnosis disclosure, and time elapsed since then. Analyzing these young people’s narratives allowed us to explore individual and social aspects of their experiences, revealing their similarities and differences. The circle dance workshops provided a playful space for expressing emotions and feelings through body movements, expanding young people’s perspectives on the future. virus Janeiro Practice tool method youths youth s lives dynamics connection adherence disclosure then peoples differences movements future

Resumo Este estudo analisa as histórias de vida de oito jovens vivendo com HIV por transmissão vertical, visando compreender suas percepções marcadas pelo segredo e silêncio sobre suas vivências com o vírus. Realizado em ambulatório especializado no Rio de Janeiro, o estudo adotou como ferramenta de cuidado a dança circular, considerada uma Prática Integrativa e Complementar em Saúde. Utilizando abordagem qualitativa e a História de Vida como método de coleta, o foco foi compreender as experiências dos jovens, não apenas relacionadas à doença, mas também a aspectos cruciais de suas vidas. Participaram do estudo três meninas e cinco meninos, todos cientes de seu diagnóstico. Os principais temas emergentes incluíram dinâmica familiar, conexão com o ambiente escolar, desafios na adesão ao tratamento, idade no momento da revelação do diagnóstico e tempo decorrido desde então. A análise das narrativas desses jovens, permitiu explorar aspectos individuais e sociais da experiência, revelando similaridades e diferenças entre eles. As oficinas de dança circular ofereceram um espaço lúdico para a expressão de emoções e sentimentos por meio dos movimentos corporais, ampliando as perspectivas dos jovens em relação ao futuro. vertical vírus Janeiro Saúde coleta doença vidas meninos familiar escolar tratamento então experiência eles corporais futuro

HIV/AIDS remains one of the world's most significant public health and economic challenges, with approximately 36 million people currently living with the disease. Considerable progress has been made to reduce the impact of HIV/AIDS in the past years through successful multiple HIV/AIDS prevention and treatment interventions. However, barriers such as lack of engagement, limited availability of early HIV-infection detection tools, high rates of HIV/sexually transmitted infections (STIs), barriers to access antiretroviral therapy, lack of innovative resource optimisation and distribution strategies, and poor prevention services for vulnerable populations still exist and substantially affect the attainment of the UNAIDS 95-95-95 targets. A rapid review was conducted from 24 October 2022 to 5 November 2022. Literature searches were conducted in different prominent and reputable electronic database repositories including PubMed, Google Scholar, Science Direct, Scopus, Web of Science, IEEE Xplore, and Springer. The study used various search keywords to search for relevant publications. From a list of collected publications, researchers used inclusion and exclusion criteria to screen and select relevant papers for inclusion in this review. This study unpacks emerging opportunities that can be explored by applying machine learning techniques to further knowledge and understanding about HIV service design, prediction, implementation, and evaluation. Therefore, there is a need to explore innovative and more effective analytic strategies including machine learning approaches to understand and improve HIV service design, planning, implementation, and evaluation to strengthen HIV/AIDS prevention, treatment, and awareness strategies.

Abstract Sodium-glucose cotransporter 2 inhibitors (SGLT2i), originally developed as innovative antihyperglycemic agents, have demonstrated significant benefits in improving metabolic markers and protecting the kidneys and heart in patients with or without type 2 diabetes mellitus. The mechanisms behind these unexpected cardiorenal benefits cannot be attributed solely to improved glycemic control. Recent data suggest that metabolic reprogramming plays a role in the development of cardiorenal metabolic disease. Despite the effectiveness of SGLT2i in the management of chronic kidney disease (CKD)-related comorbidities in adults, their use in the pediatric population remains to be validated. The challenge in pediatric CKD lies in the imbalance between the metabolic needs of a growing child and the declining functional capacity of a failing kidney. Developing strategies to address modifiable factors in the progression of kidney disease is critical given the extended lifespan of the pediatric population. SGLT2i have emerged as innovative candidates for the treatment of CKD in children. By improving renal hemodynamic adaptation and mitigating overall CKD complications, these agents have the potential to be a novel therapeutic option for pediatric patients. This review will focus on the current understanding of how SGLT2i may provide cardiorenal protection.

Resumo Os inibidores do cotransportador 2 de sódio e glicose (SGLT2), inicialmente considerados medicamentos antihiperglicémicos inovadores, demonstraram benefícios significativos na melhoria dos marcadores metabólicos e na proteção renal e cardíaca em doentes com ou sem diabetes mellitus tipo 2. Estas vantagens cardiorenais inesperadas não podem ser atribuídas exclusivamente ao controle glicémico melhorado. Dados recentes sugerem que a reprogramação metabólica desempenha um papel no desenvolvimento de doenças metabólicas cardiorenais. Apesar da eficácia dos inibidores do SGLT2 no tratamento de comorbilidades associadas à doença renal crónica (DRC) em adultos, o seu uso na população pediátrica aguarda validação. O desafio na DRC pediátrica reside no desequilíbrio entre as necessidades metabólicas da criança em crescimento e a capacidade funcional diminuída do rim em falência. Face à expectativa de vida prolongada da população pediátrica, é fundamental o desenvolvimento de estratégias dirigidas a fatores modificáveis na progressão da DRC. Os inibidores do SGLT2 surgem como candidatos inovadores para o tratamento da DRC em crianças. Ao melhorar a adaptação hemodinâmica renal e mitigar as complicações gerais da DRC, estes agentes afiguram-se como uma potencial nova abordagem terapêutica para doentes pediátricos. Esta revisão incidirá no entendimento atual de como os inibidores do SGLT2 podem conferir proteção cardiorrenal.

Abstract: The Internet of Things (IoT) has the potential to revolutionize healthcare by enabling remote patient monitoring, personalized care and disease prevention. In Ecuador, research on IoT in the healthcare field is rapidly expanding. However, there’s a need for a clearer understanding of the current state of this research. This study examines the contributions of Ecuadorian authors in this field through their publications in two globally impactful bibliographic databases. The methodology employed is a systematic review using the PRISMA statement, resulting in a final stage comprising 23 articles. These publications encompass system proposals, prototypes, and reviews with applications in areas such as epidemiology, cardiology and nursing. The recurrent mention of patient information privacy is a challenge in implementing IoT-based healthcare systems. The conclusions emphasize that future work perspectives should address the challenges identified, considering the growing trend of publications from Ecuadorian authors.

Resumen: El Internet de las Cosas (IoT) tiene el potencial de revolucionar la atención médica al permitir la monitorización remota de pacientes, atención personalizada y prevención de enfermedades. En Ecuador, la investigación sobre IoT en el campo de la salud está expandiéndose rápidamente. Sin embargo, es necesario tener una comprensión más clara del estado actual de esta investigación. Es así como el presente trabajo analiza las contribuciones de los autores ecuatorianos en este campo, a través de sus publicaciones en dos bases de datos bibliográficas de impacto global. La metodología empleada es una revisión sistemática utilizando la declaración PRISMA, lo que resulta en una etapa final con 23 artículos. Las publicaciones abarcan propuestas de sistemas, prototipos y revisiones con aplicaciones en áreas como epidemiología, cardiología y enfermería. Se destaca la mención recurrente de la privacidad de la información del paciente como un desafío en la implementación de sistemas de atención médica basados en IoT. En las conclusiones se enfatiza que las perspectivas de trabajo futuro deben abordar los desafíos expuestos, teniendo en cuenta la creciente tendencia de publicaciones de autores ecuatorianos.

ABSTRACT Introduction: the identification of epidemiological and clinical factors related to early mortality allows us to draw up strategies and perfect action protocols and quality of care in Intermediate Care Units. Objective: to identify the epidemiological and clinical factors related to early mortality in patients treated in the Intermediate Care Unit. Methods: an observational, analytical, cross-sectional study was carried out at the “Arnaldo Milián Castro” Hospital between October 2019 and October 2022. All deaths (348) in the Intermediate Care Unit in the analyzed period were studied. Documentary analysis of medical records and descriptive and inferential, bivariate and multivariate statistics were used. Results: older adult patients increased the possibility of dying early 1.5 times and those with white skin three times, the latter with an 80% occurrence in this study. Patients with septic shock were six times more likely to die, those diagnosed with out-of-hospital bronchopneumonia five times more likely, and those with ischemic stroke, exacerbated respiratory disease, or decompensated heart failure four times more likely, respectively. Conclusions: early mortality was more frequent in individuals with white skin and age over 60 years; the emerging Intensive Care Unit as the place of origin and the history of high blood pressure, upper digestive bleeding, ischemic heart disease and diabetes mellitus predominated. The diagnosis at admission of upper digestive bleeding and intraventricular hemorrhage was more closely related to early mortality, and septic shock and multiple organ dysfunction were determining complications as well.

RESUMEN Introducción: la identificación de factores epidemiológicos y clínicos relacionados con la mortalidad precoz permite trazar estrategias y perfeccionar los protocolos de actuación y la calidad asistencial en Unidades de Cuidados Intermedios. Objetivo: identificar los factores epidemiológicos y clínicos relacionados con la mortalidad precoz en pacientes atendidos en la Unidad de Cuidados Intermedios. Métodos: se realizó un estudio observacional, analítico, transversal en el Hospital “Arnaldo Milián Castro” entre octubre de 2019 a octubre de 2022. Fueron estudiados todos los fallecidos (348) en la Unidad de Cuidados Intermedios en el período analizado. Se utilizaron el análisis documental de historias clínicas y la estadística descriptiva e inferencial, bivariada y multivariada. Resultados: los pacientes adultos mayores incrementaron la posibilidad de morir precozmente 1,5 veces y los de piel blanca tres veces, éstos últimos con un 80% de ocurrencia en este estudio. Los pacientes con choque séptico tuvieron seis veces más posibilidad de morir, los diagnosticados con bronconeumonía extrahospitalaria cinco veces y con accidente cerebrovascular isquémico, enfermedad respiratoria agudizada o insuficiencia cardíaca descompensada cuatro veces, respectivamente. Conclusiones: la mortalidad precoz fue más frecuente en los individuos con piel blanca y edad superior a los 60 años; la Unidad de Cuidados Intensivos emergentes como lugar de procedencia y los antecedentes de hipertensión arterial, sangrado digestivo alto, cardiopatía isquémica y diabetes mellitus predominaron. El diagnóstico al ingreso de sangrado digestivo alto y la hemorragia intraventricular guardaron mayor relación con la mortalidad precoz, así como fue determinante como complicación el choque séptico y la disfunción múltiple de órganos.

Abstract Diseases caused by free-living amoebae are opportunistic infections that can have a fatal course. They can cause very serious disseminated conditions with involvement of the central nervous system such as granulomatous amoebic encephalitis. This infection has become more common in Latin America, although its recognition is late due to the similarity with other pathological conditions or because it is unusual to include it in the differential diagnosis. We report a fatal case of granulomatous amoebic encephalitis due to Balamuthia mandrillaris in a 10-year-old girl. We highlight the severity of the brain involvement and the lack of validated schemes for its treatment. Today in the world this infection is considered an emerging disease, influenced by climate change, which calls for being attentive to its presence.

Resumen Las enfermedades causadas por amebas de vida libre son infecciones oportunistas que pueden tener un curso fatal. Pueden producir afecciones diseminadas graves con compromiso del sistema nervioso central, como la encefalitis amebiana granulomatosa. Esta infección es cada vez más frecuente en América Latina, aunque se reconocen tardíamente debido a la similitud con otras patologías o porque es inusual incluirla en el diagnóstico diferencial. Comunicamos un caso fatal de una encefalitis amebiana granulomatosa por Balamuthia mandrillaris en una niña de 10 años. Destacamos la gravedad de la afectación cerebral y la falta de esquemas antimicrobianos validados para su tratamiento. Hoy en el mundo esta infección es considerada una enfermedad emergente, influenciada por el cambio climático, lo que llama a estar atentos a su presencia.

RESUMEN Fundamento la infección por SARS-CoV-2 es la enfermedad emergente más importante del presente siglo. En dicho contexto, el Grupo de las Industrias Biotecnológica y Farmacéutica Cubanas (BioCubaFarma) creó alternativas terapéuticas para combatir la COVID-19, entre ellas el uso de Jusvinza, la cual forma parte del protocolo utilizado en el país. Objetivo determinar la resolutividad terapéutica de Jusvinza en pacientes confirmados de COVID-19. Métodos se realizó un estudio descriptivo, durante el periodo de enero a septiembre de 2021, en el Hospital Militar Dr. Joaquín Castillo Duany, de Santiago de Cuba. El universo estuvo constituido por 166 confirmados de COVID-19, a quienes se administró Jusvinza. Se analizaron algunas variables clínicas (estado clínico, enfermedades no transmisibles asociadas, progresión clínica), epidemiológicas (edad, sexo) y farmacológicas (resolutividad, duración en días). Se utilizó una planilla de vaciamiento de datos, los cuales fueron tomados de las historias clínicas. Resultados la morbimortalidad por COVID-19 fue superior en el sexo masculino, asociado a comorbilidades y edad mayor de 60 años; el sexo femenino resultó el de mayor resolutividad al tratamiento con Jusvinza (71,7 %), la cual incrementó su porcentaje en ausencia de enfermedades crónicas no transmisibles asociadas (81,4 %). Los pacientes de alto riesgo fueron los de más baja mortalidad (15,8 %). Conclusiones la resolutividad en pacientes confirmados de COVID-19 tratados con Jusvinza fue más elevada en casos de alto riesgo que en graves y críticos.

ABSTRACT Foundation SARS-CoV-2 infection is the most important emerging disease of this century. In this context, the Cuban Biotechnology and Pharmaceutical Industries Group (BioCubaFarma) created therapeutic alternatives to combat COVID-19, including the use of Jusvinza, which is part of the protocol used in the country. Objective to determine the Jusvinza therapeutic resolution in confirmed COVID-19 patients. Methods a descriptive study carried out from January to September 2021, at the Dr. Joaquín Castillo Duany Military Hospital, in Santiago de Cuba. The universe consisted of 166 confirmed COVID-19 cases, to whom Jusvinza was administered. Some clinical variables (clinical status, associated non-communicable diseases, clinical progression), epidemiological (age, sex) and pharmacological (resolving, duration in days) were analyzed. A data extraction form was used, which was taken from the medical records. Results morbidity and mortality from COVID-19 was higher in males, related to comorbidities and age over 60 years; The female sex was the one with the greatest response to treatment with Jusvinza (71.7%), which increased its percentage in the absence of associated chronic non-communicable diseases (81.4%). High-risk patients had the lowest mortality (15.8%). Conclusions resolution in confirmed COVID-19 patients treated with Jusvinza was higher in high-risk cases than in severe and critical cases.

RESUMO Objetivos. Descrever as características e os desfechos dos casos de COVID-19 na Jamaica e explorar os fatores de risco associados à COVID-19 grave de 9 de março a 31 de dezembro de 2020. Métodos. Análise transversal de dados de vigilância nacional usando casos confirmados de COVID-19 na Jamaica. As definições de caso confirmado, gravidade da doença e morte foram baseadas nas recomendações da Organização Mundial da Saúde. Foram usados testes de qui-quadrado e exato de Fisher para determinar a associação com os desfechos. Modelos de regressão logística foram usados para determinar os preditores de COVID-19 grave. Resultados. Esta análise incluiu 12.169 casos de COVID-19 (idade mediana: 36 anos; 6 744 do sexo feminino [55,4%]), dos quais 512 casos (4,2%) apresentaram doença grave; desses, 318 pacientes (62,1%) morreram (idade mediana ao morrer: 71,5 anos). A doença grave estava associada a ser do sexo masculino (razão de chances [RC]: 1,4; intervalo de confiança de 95% [IC 95%]: 1,2–1,7) e ter 40 anos ou mais de idade (RC: 6,5; IC 95%: 5,1–8,2). A morte por COVID-19 também estava associada a ser sexo masculino (RC: 1,4; IC 95%: 1,1–1,7), ter 40 anos ou mais (RC: 17,9; IC 95%: 11,6–27,7) e estar na Região Sanitária Oeste em comparação com a Região Sanitária Sudeste (RC: 1,7; IC 95%: 1,2–2,3). Conclusões. Os achados desta análise transversal indicam que a probabilidade de casos confirmados de COVID-19 na Jamaica era maior em indivíduos do sexo feminino e mais jovens, ao passo que as mortes por COVID-19 ocorreram com mais frequência em indivíduos do sexo masculino e mais velhos. Há um risco maior de resultados desfavoráveis em relação à COVID-19 a partir dos 40 anos, e indivíduos do sexo masculino são desproporcionalmente mais afetados. A morte por COVID-19 também variou de acordo com a região geográfica. Essas evidências podem ser úteis para outros países com cenários semelhantes e para os formuladores de políticas encarregados de manejar surtos e gerenciar a saúde.

RESUMEN Objetivos. Describir las características y los resultados de los casos de COVID-19 en Jamaica y explorar los factores de riesgo asociados a la COVID-19 grave desde el 9 de marzo hasta el 31 de diciembre del 2020. Métodos. Se realizó un análisis transversal de datos nacionales de vigilancia a partir de los casos confirmados de COVID-19 en Jamaica. Las definiciones de caso confirmado, gravedad de la enfermedad y muerte se basaron en las directrices de la Organización Mundial de la Salud. Para determinar la asociación con los criterios de valoración se utilizó la prueba de χ2 y la prueba exacta de Fisher. Se usaron modelos de regresión logística para determinar los factores predictivos de la COVID-19 grave. Resultados. Se incluyeron en el análisis 12 169 casos de COVID-19 (mediana de edad, 36 años; 6 744 mujeres [55,4%]), de los que 512 (4,2%) fueron de enfermedad grave. De estos pacientes, 318 (62,1%) fallecieron (mediana de edad al morir, 71,5 años). Se observó una asociación de la enfermedad grave con el sexo masculino (OR de 1,4; IC del 95 %, 1,2-1,7) y con la edad igual o superior a 40 años (OR de 6,5; IC del 95 %, 5,1-8,2). La muerte por COVID-19 también mostró una asociación con el sexo masculino (OR de 1,4; IC del 95%, 1,1-1,7), con la edad igual o superior a 40 años (OR de 17,9; IC del 95%, 11,6-27,7) y con la Región de Atención de Salud Occidental en comparación con la Sudoriental (OR de 1,7; IC del 95%, 1,2-2,3). Conclusiones. Los resultados de este análisis transversal indican que los casos confirmados de COVID-19 en Jamaica correspondieron una mayor probabilidad a mujeres y personas más jóvenes, mientras que las muertes por COVID-19 fueron más frecuentes en varones y personas de mayor edad. Hay un mayor riesgo de evolución desfavorable de la COVID-19 a partir de los 40 años, que afecta de manera desproporcionada a los varones. Las muertes por COVID-19 también variaron según la región geográfica. Esta evidencia podría ser de utilidad para otros países con entornos similares y para los responsables de la formulación de políticas en materia de gestión de brotes y salud.

ABSTRACT Objectives. To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020. Methods. A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19. Results. This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3). Conclusions. The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.

ABSTRACT Background: Chikungunya fever is an emerging global infection transmitted by Aedes mosquitoes that manifests as an acute febrile illness with joint pain and can lead to chronic arthritis. The mechanism underlying chronic joint damage remains unclear; however, chronic chikungunya arthritis shares similarities with rheumatoid arthritis. Disease-modifying antirheumatic drugs have revolutionized rheumatoid arthritis treatment by preventing joint damage. However, the role of these therapies in chronic chikungunya arthritis has not been determined. We conducted a systematic review to evaluate the burden of joint structural damage in chronic chikungunya arthritis to help to define the role of disease-modifying therapy in this disease. Methods: This systematic review included retrospective and prospective studies, trials, and case reports evaluating joint damage caused by chikungunya virus. Various databases were searched without any date or language restrictions. Study selection was conducted independently by two researchers, and data were extracted from the articles selected. Results: A total of 108 studies were initially evaluated, with 8 meeting the inclusion criteria. Longitudinal studies have reported persistent joint pain from chikungunya infection and the progression of radiographic joint damage up to 13 years post-infection. Joint imaging revealed synovial inflammation, bone erosion, and cartilage destruction in patients with chronic chikungunya arthritis. Conclusions: Few studies have addressed chikungunya-induced joint damage, limiting our understanding of chronic chikungunya arthritis. Nevertheless, chronic chikungunya arthritis has similarities to rheumatoid arthritis. The success of early disease-modifying antirheumatic drug therapy in rheumatoid arthritis underscores the need for comprehensive research on its role in chikungunya arthritis. Background unclear however Diseasemodifying Disease modifying However determined diseasemodifying disease Methods trials virus restrictions researchers selected Results 10 evaluated criteria 1 postinfection. postinfection post infection. post-infection inflammation erosion Conclusions chikungunyainduced induced Nevertheless

Abstract Cardiovascular disease (CVD) remains the leading cause of death in women. This review will address the known disparities in cardiovascular care concerning diagnosing and treating of heart disease in Latin American (LA) women. Gender-specific differences regarding the incidence, treatment, and outcomes of common cardiovascular pathology are increasingly recognized. Today, we identify that women have cardiovascular risk factors (CRFs), specifying the traditional, emerging, unique, or sex-specific determinants and the social and biological determinants that play a leading role in the prevention of CVD. The purpose of this article is to review the literature on cardiovascular disease in LA women, focusing on ischemic heart disease (IHD), valve disease (VD), heart failure, and cardiac rehabilitation (CR), where disparities continue to affect outcomes. Understanding the unique cardiovascular risk profile and barriers to optimal treatment outcomes in women is imperative to eliminate the current disparities in CVD. CVD (CVD (LA Genderspecific Gender specific incidence recognized Today CRFs, CRFs , (CRFs) traditional emerging sexspecific sex IHD, IHD (IHD) VD, VD (VD) failure CR, CR (CR) (CRFs (IHD (VD (CR

Abstract Objectives The emergence of the coronavirus disease 2019 (COVID-19) pandemic and subsequent lockdowns and social distancing measures adopted worldwide raised questions about the possible health effects of human social isolation. Methods We conducted a systematic review on PubMed, Scopus, and Embase electronic databases using terms related to human social isolation – defined as the isolation of an individual from regular routines and usual social contact – and psychological stress, searching for simulated or naturalistic isolation environments. We present the main results, as well as the validity and limitations of each model. PROSPERO registry number: CRD42021241880. Results Despite the diversity of contexts reviewed, some outcomes almost ubiquitously relate to psychological stress, i.e., longer periods, expectation of a longer period, confinement, lack of social interaction, and support. Based on the results, and considering that most studies were not designed for the purpose of understanding isolation itself, we propose a group of recommendations for future experimental or naturalistic research on the topic. Conclusion Evidence on the impact of different situations in which individuals are subjected to social isolation can assist in development of directed preventive strategies to support people under similar circumstances. Such strategies might increase the general public’s compliance with social distancing as a non-pharmacological intervention for emerging infectious diseases. 201 COVID19 COVID 19 (COVID-19 PubMed Scopus stress environments results model number CRD42021241880 CRD reviewed ie i e i.e. periods period confinement interaction itself topic circumstances publics public s nonpharmacological non pharmacological diseases 20 COVID1 1 (COVID-1 CRD4202124188 i.e 2 (COVID- CRD420212418 (COVID CRD42021241 CRD4202124 CRD420212 CRD42021 CRD4202 CRD420 CRD42 CRD4

ABSTRACT Streptococcus suis has been widely reported as a pathogen in animals, especially pigs. In terms of human health implications, it has been characterized as a zoonosis associated with the consumption of pork products and occupational exposure, particularly in Southeast Asian countries. Here, we present a rare case of human S. suis infection in Brazil, diagnosed in an older adult swine farmer, a small rural producer residing in the semi-arid region of Bahia, Brazil. animals pigs implications exposure countries Here S Brazil farmer semiarid semi arid Bahia

ABSTRACT BACKGROUND AND OBJECTIVES: Sickle cell disease is considered the most common hereditary disorder in Brazil. The chronic pain resulting from some complications of sickle cell disease is still poorly understood, inadequately described, and under-researched. This study aimed to characterize chronic pain in individuals with sickle cell disease, evaluate its treatment, and discuss the importance of studying it as a distinct pathology. METHODS: A cross-sectional study based on comparative analysis between two associations of sickle cell disease patients, one in Brazil and the other in France. The Pain Detect Questionnaire was used to assess neuropathic pain, and Odds Ratio was used to evaluate the strength of the association between opioid use and the recurrence of chronic painful crises. RESULTS: In Brazil, the Pain Detect questionnaire revealed that 55% of patients had a probable neuropathic component, 23% negative, and 22% uncertain. In France, the application resulted in 51% for probable presence, 29% for negative, and 20% for uncertain. All patients reported constant pain. As for the frequent use of opioids, the results were 62% in Brazil and 32% in France. The Odds Ratio calculation results were: OR 15.14 (95% CI = 4.777- 41.4, p < 0.0001) in Brazil; and OR 7.5 (95% CI = 2.121- 25.74, p = 0.0013) in France. CONCLUSION: While it is commonly believed that pain in sickle cell disease is primarily related to somatic and visceral tissue damage after vaso-occlusive events, this study indicated emerging evidence of neuropathic processes involved. Thus, there should be a significant concern about the management of chronic pain and particularly opioid dependence in Brazil. OBJECTIVES understood described underresearched. underresearched under researched. researched under-researched treatment pathology METHODS crosssectional cross sectional France crises RESULTS 55 component 23 negative 22 uncertain 51 presence 29 20 opioids 62 32 1514 15 14 15.1 95% 95 (95 4.777 4777 4 777 414 41 41.4 0.0001 00001 0 0001 75 7 5 7. 2.121 2121 2 121 2574 25 74 25.74 0.0013 00013 0013 CONCLUSION vasoocclusive vaso occlusive events involved Thus 6 3 151 1 15. 9 (9 4.77 477 77 41. 0.000 0000 000 2.12 212 12 257 25.7 0.001 001 ( 4.7 47 0.00 00 2.1 21 25. 4. 0.0 2. 0.

RESUMO JUSTIFICATIVA E OBJETIVOS: Dentre as alterações hereditárias, a doença falciforme é considerada a mais comum no Brasil. A dor crônica decorrente de suas complicações ainda é mal compreendida, inadequadamente descrita e pouco pesquisada. O presente estudo teve como finalidade caracterizar a dor crônica em indivíduos com doença falciforme, avaliar o seu tratamento e discutir a importância de seu estudo como uma doença em si. METODOS: Estudo transversal, baseado na análise comparativa entre duas associações de indivíduos acometidos pela doença falciforme, com sede no Brasil e na França. Foi aplicado o questionário Pain Detect para avaliação da dor neuropática e a Odds Ratio para avaliar a intensidade de associação entre o uso de opioides e a recorrência de crises álgicas de cunho crônico. RESULTADOS: O questionário Pain Detect apontou que no Brasil 55% de pacientes da doença calciforme apresentam componente neuropático provável, 23% negativo e 22% incerto. Na França, os resultaram foram de 51% para componente provável, 29% negativo e 20% incerto. Dos acometidos pela doença, 100% relataram dores constantes, sendo que fizeram uso frequente de opioides 62% no Brasil e 32% na França. O cálculo do Odds Ratio apontou os seguintes resultados: OR 15,14 (IC 95% = 4,777- 41,4, p < 0,0001) no Brasil; e OR 7,5 (IC 95% = 2,121- 25,74, p = 0,0013) na França. CONCLUSÃO: Embora haja uma crença de que a dor na doença falciforme seja primariamente relacionada à lesão tecidual a nível somático e visceral após os eventos vasoclusivos, o estudo apontou evidências emergentes de processos neuropáticos envolvidos. Assim, deve haver uma preocupação quanto ao manejo da dor crônica e em especial à dependência química pelos opioides no Brasil. OBJETIVOS hereditárias compreendida pesquisada si METODOS transversal França crônico RESULTADOS 55 provável 23 22 incerto 51 29 20 100 constantes 62 32 resultados 1514 15 14 15,1 IC 95 4,777 4777 4 777 414 41 41,4 0,0001 00001 0 0001 75 7 5 7, 2,121 2121 2 121 2574 25 74 25,74 0,0013 00013 0013 CONCLUSÃO vasoclusivos envolvidos Assim 10 6 3 151 1 15, 9 4,77 477 77 41, 0,000 0000 000 2,12 212 12 257 25,7 0,001 001 4,7 47 0,00 00 2,1 21 25, 4, 0,0 2, 0,

Abstract Visceral Crisis (VC) in breast cancer is a critical scenario when the burden of metastatic disease results in rapid deterioration of organ functions. There are no widely accepted objective clinical criteria for the definition of VC, and different studies have reported diverse clinical conditions such as visceral crises. Diagnosis of VC is associated with a dismal prognosis and the management of this condition is currently based on limited retrospective evidence and expert opinions. International guidelines have recommended cytotoxic polychemotherapy in the management of VC, to achieve rapid symptomatic control and preserve organ function. Nevertheless, in the case of hormone receptor-positive breast cancer, the role of chemotherapy as the treatment of choice for VC has been recently questioned, since endocrine therapy plus CDK4/6 inhibitors yielded similar response rates, with better quality of life. For HER2-positive and triple-negative breast cancer, combined chemotherapy (plus HER2-directed therapy for HER2-positive) remains a standard option for VC, but novel effective drugs such as antibody-drug conjugates are emerging and their role in the VC context shall soon be elucidated. This review aims to critically discuss the definition, prognosis, management, and future directions regarding the visceral crisis in metastatic breast cancer. (VC functions crises opinions function Nevertheless receptorpositive receptor positive questioned CDK46 CDK CDK4 6 CDK4/ rates life HER2positive HERpositive HER2 HER triplenegative triple negative HER2directed HERdirected directed antibodydrug antibody drug elucidated