Protium ovatum Eng. Burseraceae is an endemic species in Brazil used in traditional medicine. This study investigated the chemical variation and the in vitro antioxidant and antimicrobial properties of dichloromethane soluble fraction of hydrolate (DSFH) from leaves of P. ovatum collected from five different vegetation physiognomies within the Cerrado Goiano. The region was characterized based on the DSFH chemical composition by gas chromatography coupled to mass spectrometry (GC-MS) analysis. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) were performed to compare the different DSFHs from five Savannah regions in Brazil. The DSFHs from the Cerrado stricto sensu (CSS), Mata de Galeria (MG) and Cerradão (C) regions were grouped in the negative part of PC1, showing high similarity. Samples from the C and MG regions showed antioxidant activity of IC50 = 0.98 and 0.78 mg mL-1, respectively, and 0.250 mg mL-1 of butylated hydroxytoluene (positive control). DSFH from different regions exhibited antifungal activity against Candida albicans. The results show that the chemical composition and the biological activity of DSFHs can be affected according to the area of collection. Eng medicine (DSFH P Goiano GCMS GC MS (GC-MS PCA (PCA HCA (HCA CSS, CSS , (CSS) (MG (C PC1 PC similarity IC IC5 098 0 98 0.9 078 78 0.7 mL1, mL1 mL 1, 1 respectively 0250 250 0.25 mL- positive control. control . control) albicans collection (CSS 09 9 0. 07 7 025 25 0.2 02 2

Palicourea tomentosa (Aubl.) Borhidi (Rubiaceae, Palicoureeae), earlier classified as Psychotria poeppigiana Müll. Arg., is used in folk medicine for a variety of diseases. Biological studies on the plant describes their vasorelaxant, antiplasmodial, antitumoural and anticholinesterase activities. To expand the knowledge on the chemical and biological potential of this species, in this work, phytochemical and dereplication studies, as well as antimicrobial and anticholinesterase evaluation of Palicourea tomentosa were carried out. Phytochemical investigation deals with the isolation of lutein (1), a mixture of dehydrovomifoliol (2) and megastigma-4,7-dien-3-one (3), loliolide (4), 5,13-epoxy-9-hydroxy-megastigma-7-en,3-one (5), vomifoliol (6), asperuloside (7), 3-O-p-coumaroylquinic acid (8), and a mixture of the pyrrolizidinoindoline alkaloids hodgkinsine (9), chimonanthine (10) and psychotriasine (11). The ultra-high performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC HRMS/MS) based on molecular networking dereplication of dichloromethane fraction led to putative identification of other two megastigmanes, one terpene lactone and three carotenoids, besides seven triterpenes and four indole alkaloids. The dichloromethane, ethyl acetate and hydromethanol fractions of P. tomentosa were able to inhibit Candida albicans with minimum inhibitory concentrations (MICs) of 125, 250 and 125 µg mL-1, respectively. The methanol crude extract, dichloromethane and alkaloid fractions inhibited selectively the butyrilcholinesterase (BuChE) at percentages of 63.09, 60.39 and 56.22%, respectively. Aubl. Aubl (Aubl. Rubiaceae, Rubiaceae (Rubiaceae Palicoureeae, Palicoureeae , Palicoureeae) Müll Arg Arg. diseases vasorelaxant antiplasmodial activities species work out 1, 1 (1) 2 (2 megastigma4,7dien3one megastigma47dien3one megastigmadienone megastigma 4,7 dien 3 4 7 3, (3) 4, (4) 5,13epoxy9hydroxymegastigma7en,3one 513epoxy9hydroxymegastigma7en3one epoxyhydroxymegastigmaenone 5,13 epoxy 9 hydroxy en,3 5 13 en 5, (5) 6, 6 (6) 7, (7) 3Opcoumaroylquinic Opcoumaroylquinic O p coumaroylquinic 8, 8 (8) 9, (9) 10 (10 11. 11 . (11) ultrahigh ultra high highresolution resolution UHPLC HRMS/MS HRMSMS HRMS MS megastigmanes carotenoids P MICs (MICs 25 12 mL1, mL1 mL mL-1 respectively extract BuChE (BuChE 6309 63 09 63.09 6039 60 39 60.3 5622 56 22 56.22% (Aubl (1 ( megastigma4 7dien3one 47 (3 (4 13epoxy9hydroxymegastigma7en 3one hydroxymegastigma 513 5,1 en3 en, (5 (6 (7 (8 (9 (11 mL- 630 0 63.0 603 60. 562 56.22 dienone epoxyhydroxymegastigmaen 51 63. 56.2 56.

Alfred Schaeffer (1879-1957) was a German chemist who arrived in Minas Gerais in 1911 hired by the state government to organize the state health service in its newly established capital. He directed the Laboratory of Chemical Analysis of the State, and his analytical methods in dairy and mineral waters became a reference in Brazil. He also became professor of Chemistry at the new Faculty of Medicine of Belo Horizonte and founded the Chemistry Institute of the Engineering School in that city, influencing several students who became important names in Brazilian science. In addition, he was responsible for the assembly and technical coordination of pioneering industries in the dairy and wood distillation sector in the city of Santos Dumont. Later he assumed the post of technical director of Merck, also in Minas Gerais. Moving to Rio de Janeiro, he assumed a chair at the Technical School, working in teaching and research, and remained active even after retiring, publishing in important scientific journals. 18791957 1879 1957 (1879-1957 191 capital State Brazil science addition Dumont Merck Janeiro research retiring journals 1879195 187 195 (1879-195 19 187919 18 (1879-19 1 18791 (1879-1 (1879- (1879 (187 (18 (1 (

RESUMO Objetivo: Identificar e caracterizar a população de casos pediátricos encaminhados para o nosso centro de oxigenoterapia hiperbárica. Métodos: Estudo retrospetivo e observacional, que incluiu doentes pediátricos tratados com oxigenoterapia hiperbárica, de 2006 a 2021, no centro de referência de medicina hiperbárica do norte de Portugal. As variáveis de interesse foram extraídas dos processos clínicos eletrônicos. Resultados: O nosso estudo incluiu 134 casos. Os motivos de encaminhamento mais frequentes foram intoxicação por monóxido de carbono (n=59) e surdez súbita neurossensorial (n=41). Em 75 casos (56%) o tratamento foi iniciado em contexto de urgência. Os sintomas de apresentação à admissão variaram entre os diferentes casos, sendo os mais frequentes cefaleias e náuseas/vômitos. No que diz respeito à intoxicação por monóxido de carbono, as fontes mais comuns foram o aquecedor, lareira/braseiro e caldeira. Com relação aos efeitos adversos, foram identificados um caso de intoxicação por oxigênio e quatro casos de barotrauma do ouvido médio. Conclusões: A causa mais frequente de encaminhamento foi a intoxicação por monóxido de carbono. Todos os pacientes evoluíram favoravelmente e foram registrados poucos efeitos adversos, o que enfatiza a segurança desta terapia. Uma vez que a maioria dos pediatras pode não estar informada sobre os potenciais benefícios da oxigenoterapia hiperbárica, é de extrema importância promovê-los para que esta técnica seja cada vez mais implementada. Objetivo Métodos observacional 200 2021 Portugal eletrônicos Resultados 13 n=59 n59 n 59 (n=59 n=41. n41 n=41 . 41 (n=41) 7 56% 56 (56% urgência náuseasvômitos náuseas vômitos náuseas/vômitos aquecedor lareirabraseiro lareira braseiro caldeira adversos médio Conclusões terapia promovêlos promovê los implementada 20 202 1 n=5 n5 5 (n=5 n4 n=4 4 (n=41 (56 2 n= (n= (n=4 (5 (n (

ABSTRACT Objective: To identify and characterize the population of Pediatric patients referred to our hyperbaric oxygen therapy center. Methods: Retrospective and observational study, including pediatric patients treated with hyperbaric oxygen therapy, from 2006 to 2021, at the hyperbaric medicine reference center in the north of Portugal. Variables of interest were extracted from electronic medical records. Results: Our study included 134 patients. The most frequent reasons for referral were carbon monoxide poisoning (n=59) and sudden sensorineural hearing loss (n=41). In 75 cases (56%), treatment was initiated in an urgent context. Symptom presentation at Emergency Department varied among patients, the most frequent being headache and nausea/vomiting. Concerning carbon monoxide poisoning, the most common sources were water heater, fireplace/brazier, and boiler. Regarding adverse effects, it was identified one case of intoxication by oxygen and four cases of middle ear barotrauma. Conclusions: The most frequent cause for referral was carbon monoxide poisoning. All patients evolved favorably, with few side effects being reported, emphasizing the safety of this therapy. While most pediatricians may not be aware of the potential benefits arising with hyperbaric oxygen therapy, it is of upmost importance to promote them, so that this technique is increasingly implemented. Objective Methods 200 2021 Portugal records Results 13 n=59 n59 n 59 (n=59 n=41. n41 n=41 . 41 (n=41) 7 56%, 56 56% , (56%) context nauseavomiting nausea vomiting nausea/vomiting heater fireplacebrazier fireplace brazier fireplace/brazier boiler barotrauma Conclusions favorably reported them implemented 20 202 1 n=5 n5 5 (n=5 n4 n=4 4 (n=41 (56% 2 n= (n= (n=4 (56 (n (5 (

ABSTRACT: Anatomy teaching has been changing over the years, introducing technological methods especially after the pandemic period. An ongoing debate revolves around whether exclusive reliance on technology for anatomy classes, as opposed to traditional methods and face-to-face instruction, enhances knowledge acquisition. This study analyzed the knowledge perception of students from various semesters throughout the Veterinary Medicine course, comparing students who only had online classes with those who had face-to-face classes in Gross Anatomy of Domestic Animals. For this purpose, a questionnaire was distributed for voluntary and anonymous completion, and the responses were subsequently analyzed statistically. The results indicated that 11.5% of the students who took Anatomy remotely failed to apply the knowledge in other subjects, while no face-to-face learning student reported the same. Most students, both remote and face-to-face groups, remember the subject but review the content frequently. Regarding theoretical knowledge, the online group (80.8%) understood better as the course progressed, compared to 59.6% of the face-to-face group. The connection between Anatomy and other subjects was more highlighted by the face-to-face group (30.8%) compared to the online group (15.4%). Both groups agree that physical contact with anatomical specimens is essential; however, some believe that initial exposure through 3D images or photographs is feasible. We concluded based on this preliminary study that the initial interactions with the Anatomy field should include diversified pedagogical techniques with empathetic communication. The use of modern technological resources are allies in the teaching-learning process. Furthermore, after abstracting the contents, technology alone can effectively maintain and update anatomical knowledge. ABSTRACT years period facetoface face instruction acquisition Animals purpose completion statistically 115 11 5 11.5 same frequently 80.8% 808 80 8 (80.8% progressed 596 59 6 59.6 30.8% 308 30 (30.8% 15.4%. 154 15.4% . 15 4 (15.4%) essential however D feasible communication teachinglearning process Furthermore contents 1 11. 80.8 (80.8 59. 30.8 3 (30.8 15.4 (15.4% 80. (80. 30. (30. 15. (15.4 (80 (30 (15. (8 (3 (15 ( (1

RESUMO: O ensino de anatomia vem se modificando ao longo dos anos, introduzindo métodos tecnológicos, principalmente após o período pandêmico. Questiona-se o uso exclusivo da tecnologia em comparação aos métodos tradicionais de dissecação e aulas teóricas presenciais no que diz respeito à aquisição de conhecimento. Este artigo analisou a percepção de conhecimento de alunos de diversos semestres do curso de Medicina Veterinária, comparando alunos que tiveram aulas apenas online com aqueles que tiveram aulas presenciais de Anatomia Descritiva dos Animais Domésticos. Para tanto, questões foram enviadas por meio de formulário, com preenchimento voluntário e anônimo, e posteriormente analisadas estatisticamente. Os resultados indicam que 11,5% dos alunos que cursaram a disciplina remotamente falharam na aplicação dos conhecimentos em outras disciplinas, enquanto nenhum aluno do ensino presencial relatou o mesmo. A maioria dos alunos, tanto dos grupos remotos quanto dos presenciais, lembram-se do assunto, mas revisam o conteúdo com frequência. Em relação ao conhecimento teórico, o grupo online (80,8%) compreendeu melhor à medida que o curso avançava, comparado a 59,6% do grupo presencial. A ligação entre Anatomia e outras disciplinas foi mais destacada pelo grupo presencial (30,8%) em comparação ao online (15,4%). Ambos os grupos concordam que o contacto físico com peças anatômicas é essencial, mas alguns consideram possível ter um primeiro contacto com imagens ou fotografias 3D. Baseado nesse estudo preliminar, conclui-se que as interações iniciais com a área de Anatomia devem incluir técnicas pedagógicas diversificadas com comunicação empática. A utilização de recursos tecnológicos modernos é um aliado do processo de ensino-aprendizagem, e após a abstração dos conteúdos é possível o uso singular da tecnologia na manutenção e atualização do conhecimento anatômico. RESUMO anos pandêmico Questionase Questiona Veterinária Domésticos formulário anônimo estatisticamente 115 11 5 11,5 mesmo lembramse lembram assunto frequência teórico 80,8% 808 80 8 (80,8% avançava 596 59 6 59,6 30,8% 308 30 (30,8% 15,4%. 154 15,4% . 15 4 (15,4%) essencial 3D D preliminar concluise conclui empática ensinoaprendizagem, ensinoaprendizagem aprendizagem, aprendizagem ensino-aprendizagem anatômico 1 11, 80,8 (80,8 59, 30,8 3 (30,8 15,4 (15,4% 80, (80, 30, (30, 15, (15,4 (80 (30 (15, (8 (3 (15 ( (1

RESUMO A doença renal crônica (DRC) representa um dos principais problemas de saúde pública da atualidade. A dosagem da creatinina sérica e a estimativa da taxa de filtração glomerular (TFG) são as principais ferramentas para avaliação da função renal. Para a estimativa da TFG, existem diversas equações, sendo a mais recomendada a CKD-EPI (Chronic Kidney Disease – Epidemiology). Existem ainda algumas controvérsias com relação à dosagem da creatinina sérica e da estimativa da TFG, uma vez que vários fatores podem interferir nesse processo. Uma importante mudança recente foi a retirada da correção por raça das equações para estimativa da TFG, que superestimavam a função renal, e consequentemente retardavam a implementação de tratamentos como diálise e transplante renal. Neste documento de consenso da Sociedade Brasileira de Nefrologia e Sociedade Brasileira de Patologia Clínica e Medicina Laboratorial são revisados os principais conceitos relacionados à avaliação da função renal, possíveis controvérsias existentes e recomendações para a estimativa da TFG na prática clínica. DRC (DRC atualidade (TFG CKDEPI CKD EPI Chronic Epidemiology. Epidemiology . Epidemiology) processo clínica

ABSTRACT Chronic kidney disease (CKD) represents one of today’s main public health problems. Serum creatinine measurement and estimation of the glomerular filtration rate (GFR) are the main tools for evaluating renal function. There are several equations to estimate GFR, and CKD-EPI equation (Chronic Kidney Disease – Epidemiology) is the most recommended one. There are still some controversies regarding serum creatinine measurement and GFR estimation, since several factors can interfere in this process. An important recent change was the removal of the correction for race from the equations for estimating GFR, which overestimated kidney function, and consequently delayed the implementation of treatments such as dialysis and kidney transplantation. In this consensus document from the Brazilian Societies of Nephrology and Clinical Pathology and Laboratory Medicine, the main concepts related to the assessment of renal function are reviewed, as well as possible existing controversies and recommendations for estimating GFR in clinical practice. CKD (CKD todays today s problems (GFR CKDEPI EPI Epidemiology process transplantation Medicine reviewed practice

ABSTRACT Introduction Obstructive azoospermia occurs when there is a blockage in the male reproductive tract, leading to a complete absence of sperm in the ejaculate. It constitutes around 40% of all cases of azoospermia (1, 2). Blockages in the male reproductive tract can arise from either congenital or acquired factors, affecting various segments such as the epididymis, vas deferens, and ejaculatory ducts (3). Examples of congenital causes encompass conditions like congenital bilateral absence of the vas deferens and unexplained epididymal blockages (4). Acquired instances of obstructive azoospermia may result from factors like vasectomy, infections, trauma, or unintentional injuries caused by medical procedures (5). This complex condition affecting male fertility, presents two main treatment options: microsurgical reconstruction and surgical extraction of sperm followed by in vitro fertilization (IVF). Microsurgical reconstruction proves to be the most cost-effective option for treating obstructive azoospermia when compared with assisted reproductive techniques (6, 7). However, success rates of reconstruction defined by patency are as high as 99% for vasovasostomy (VV) but decline to around 65% if vasoepididymostomy (VE) is required (8, 9). Thus, continued refinement in technique is necessary in order to attempt to improve patency for patients undergoing VE. In this video, we show a comprehensive demonstration of microsurgical VE, highlighting the innovative epididymal occlusion stitch. The goal of this innovative surgical technique is to improve outcomes for VE. Materials and Methods The patient is a 39-year-old male diagnosed with obstructive azoospermia who presents for surgical reconstruction via VE. His partner is a 37-years-old female with regular menstrual cycles. The comprehensive clinical data encompasses a range of factors, including FSH levels, results from semen analysis, and outcomes from testicular sperm aspiration. This thorough exploration aims to provide a thorough understanding of our innovative surgical technique and its application in addressing complex cases of obstructive azoospermia. Results The procedure was started on the right, the vas deferens was identified and transected. The abdominal side of the vas was intubated and a vasogram performed, there was no obstruction. There was no fluid visible from the testicular side of the vas for analysis, thus we proceeded with VE. Upon inspection of the epididymis dilated tubules were identified. After selecting a tubule for VE, two 10-0 nylon sutures were placed, and it was incised. Upon inspection of the fluid motile sperm was identified. After VE, we performed a novel epididymal occlusion stitch technique. This was completed distal to the anastomosis by placing a 7-0 prolene through the tunica of the epididymis from the medial to lateral side. This stitch was then tightened down with the goal to largely occlude the epididymis so that sperm will preferentially travel through the anastomosis. The steps were then repeated on the left. At 3-month follow up, the patient had no change in testicular size as compared with preoperative size (18cc), he had no testicular or incisional discomfort, and on semen analysis he had presence of motile sperm. After 3 months post-surgery, the patient had motile sperm seen on semen analysis. Discussion The introduction of a novel epididymal occlusion stitch demonstrates a targeted strategy to enhance the success of microscopic VE. Encouragingly, a 3-month post-surgery follow-up reveals the presence of motile sperm, reinforcing the potential efficacy of our approach. This is promising given the historical lower patency, delayed time to patency, and higher delayed failure rates that patients who require VE experience (10). In total, 40% of all azoospermia cases can be attributed to obstruction. The conventional treatments for obstructive azoospermia involve microsurgical reconstruction and surgical sperm retrieval followed by IVF. While microsurgical reconstruction has proven to be economically viable, the quest for enhanced success rates has led to the exploration of innovative techniques. Historically, the evolution of VV and VE procedures, initially performed in the early 20th century, laid the foundation for contemporary microsurgical approaches (11). Notably, the microscopic VV demonstrated significant improvements in patency rates and natural pregnancy likelihood, as evidenced by the seminal Vasovastomy Study Group study in 1991 (8). In contemporary literature, success rates particularly for VE remain unchanged for the past three decades since the original published success rates by the Vasectomy Reversal Study Group (12). VE is associated with a longer time to patency as well with patients taking 2.8 to 6.6 months to have sperm return to ejaculate as compared to 1.7 to 4.3 months for those undergoing VV. Additionally, of those patients who successfully have sperm return to the ejaculate after VE up to 50% will have delayed failure compared to 12% for those undergoing VV who are patent. Finally, of those who experience delayed failure after undergoing VE it usually occurs earlier with studies reporting as early as 6 months post-operatively (20). Given the lack of improvement and significantly worsened outcomes with VE further surgical refinement is a constant goal for surgeons performing this procedure. Conclusion: In conclusion, this video is both a demonstration and a call to action for commitment to surgical innovation. We aim to raise the bar in VE success rates, ultimately bringing tangible benefits to patients and contributing to the ongoing evolution of reproductive medicine. The novel epididymal occlusion stitch emerges as a beacon of progress, promising not only enhanced safety but also potential reductions in patency time. Surgical excellence and methodological refinement, as exemplified in this video, lay the foundation for a future where male reproductive surgery continues to break new ground. 40 1, 1 (1 2. 2 . 2) 3. (3) 4. 4 (4) vasectomy infections trauma 5. 5 (5) fertility options IVF (IVF) costeffective cost effective 6, (6 7. 7 7) However 99 (VV 65 (VE 8, 8 (8 9. 9 9) Thus 39yearold yearold 39 year old 37yearsold yearsold 37 years cycles levels aspiration right transected obstruction 100 10 0 10- placed incised 70 7- left 3month month 18cc, 18cc cc , (18cc) discomfort postsurgery, postsurgery post surgery, Encouragingly followup approach 10. (10) total viable Historically th century 11. 11 (11) Notably likelihood 199 8. (8) literature 12. 12 (12) 28 66 6. 17 1. 43 Additionally 50 patent Finally postoperatively operatively 20. 20 (20) Conclusion conclusion innovation medicine progress ground ( (3 (4 (5 (IVF (18cc (10 (11 19 (12 (20 (2

ABSTRACT Erectile dysfunction is observed in about 50% of men. It has been found that diabetes mellitus increases its prevalence to 19-86.3%, necessitating attention to a therapeutic strategy. Among the available treatment methods, intracavernosal injections of mesenchymal stem cells have proven to be particularly effective. Objective The purpose of study is to assess and analyse the effectiveness of their use in the treatment of erectile dysfunction in patients with diabetes mellitus. Materials and Methods The literature search was conducted using systematic methods and analysis in databases such as Web of Science, Scopus, PubMed, Elsevier, and Springer, with 41 sources included for further review. Results The study highlights microangiopathic and neuropathic links as key factors in erectile dysfunction development in diabetic patients, stemming from endothelial dysfunction and conductivity disturbances. Mesenchymal stem cell therapy from bone marrow, adipose tissue, and umbilical cord mitigates pathogenic impact through regenerative and anti-apoptotic effects. Due to this, most studies indicate high efficacy of the treatment and rapid therapeutic action through intracavernosal administration. Some studies suggest an increase in the body’s receptor sensitivity to other drugs, such as sildenafil. Conclusion From the perspective of further research on this issue, standardising the preparation of stem cells and the treatment method using a large sample size is essential to introduce such a method as an extremely promising therapy for this delicate issue in men into practical medicine. The practical value of the study lies in the systematisation of information on different sources of mesenchymal stem cells for treating erectile dysfunction. 50 1986.3%, 19863 19 86.3%, 86 3 19-86.3% strategy effective Science Scopus PubMed Elsevier Springer 4 review disturbances marrow tissue antiapoptotic anti apoptotic effects administration bodys body s drugs sildenafil medicine 5 1986 1986.3% 1 863 86.3% 8 19-86.3 198 1986.3 86.3 19-86. 1986. 86. 19-86 19-8 19-

Resumen El presente estudio examina la forma en que algunas empresas responden al daño reputacional causado por una crisis. A través del análisis cualitativo de una compañía colombiana de medicina natural enfrentando un evento disruptivo que amenazaba su producto insignia y negocio, el estudio de caso explora la respuesta de la empresa ante sospechas mediáticas de manipulación de un producto fitoterapéutico. Los hallazgos revelan inconsistencias significativas en las respuestas organizacionales de la empresa, así como las repercusiones de dichas inconsistencias en los stakeholders y la industria. Este estudio arroja luz sobre el uso estratégico de respuestas desvinculadas de la realidad en escenarios de crisis para proteger la reputación. Además, destaca que la empresa analizada se apartó de las estrategias establecidas en teoría para la gestión de crisis. La empresa no empleó la estrategia consistente en ‘tomar la iniciativa’ al no revelar proactivamente la crisis. Además, priorizó respuestas instrumentales sobre consideraciones normativas o éticas. El análisis de las desviaciones identificadas de los principios establecidos de gestión de crisis resalta aún más la importancia de los hallazgos de este trabajo y sus implicaciones teóricas y prácticas para el desarrollo de estrategias de comunicación de crisis más efectivas basadas en la búsqueda de la verdad.

Abstract This study examines how businesses respond to reputational damage caused by reputation crises. Drawing on the qualitative analysis of a Colombian natural medicine company facing a disruptive event that threatened its flagship product and business, the case study explores the company’s response to media suspicions of tampering with a phytotherapeutic product. The findings reveal significant inconsistencies in the firm’s organizational responses and their repercussions on stakeholders and the industry. This study sheds light on the strategic use of responses detached from reality in crisis scenarios to protect reputation. In addition, the study highlights that the analyzed company deviated from established crisis management strategies outlined in theory. The company did not implement the ‘steal the thunder’ approach, as it failed to proactively disclose the crisis. Moreover, the company prioritized instrumental responses over normative or ethical considerations. The analysis of the identified deviations from established crisis management principles further emphasizes the importance of the work’s findings and their theoretical and practical implications for developing more effective crisis communication strategies grounded in truth-seeking.

Resumen. En este artículo interpreto las cuatro primeras secciones de Humano, demasiado humano I para argumentar que la filosofía de Nietzsche tiene pretensiones diagnósticas y terapéuticas. En el primer apartado, se muestra que dicha filosofía es psicológica. En el segundo apartado se ilustra la psicología descriptiva de la filosofía de Nietzsche, la cual señala que las doctrinas metafísicas descansan sobre malentendidos psicológicos y que los sentimientos y representaciones considerados “superiores” se basan en motivos egoístas y errores de la razón. En el tercer apartado se defiende que la filosofía de Nietzsche también es médica e intelectualista: su indagación sobre la psicología humana le permite, primero, diagnosticar dos tipos de enfermedad, una causada por el conocimiento científico (la enfermedad existencial) y otra causada por las doctrinas metafísicas (la enfermedad nerviosa), y segundo, curar ambos tipos de enfermedades al eliminar, con el mismo conocimiento científico, sus causas.

Abstract. In this paper, I interpret the first four sections of Human, All Too Human I to argue that Nietzsche’s philosophy has diagnostic and therapeutic ambitions. In the first section, I show that his philosophy is psychological. In the second section, I illustrate the descriptive psychology of Nietzsche’s philosophy, for which metaphysical doctrines rest on psychological misunderstandings and highly valued sensations and conceptions are based on selfish motives and mistakes of reason. In the third section, I argue that Nietzsche’s philosophy is also medical and intellectualist: his inquiry into human psychology allows him, first, to diagnose two types of illnesses, one caused by scientific knowledge (existential illness) and the other caused by metaphysical doctrines (nervous illness), and second, to cure both types of diseases by eliminating their causes with this same scientific knowledge.

Resumen. El juicio clínico se ha convertido en un tópico capital para la filosofía de la medicina y la profesión médica desde los sesenta. Tras el desarrollo de la medicina basada en la evidencia en los noventa, se espera una mayor sensibilidad en el juicio clínico frente a las necesidades y preferencias de los pacientes ante las amenazas de enfoques positivistas, que, se considera, descuidan la individualidad. Este artículo aborda este problema a la luz de una filosofía de la medicina más sensible a los componentes históricos de la epistemología, la ontología y la ética. Se dirige la mirada al siglo XIX para dilucidar las tensiones en torno al lugar de los conocimientos médicos y la apuesta por dotar al juicio clínico de nuevos métodos para la mejora profesional. Este retorno al pasado ayuda a comprender las transformaciones actuales del campo de la medicina, especialmente en cuanto a cómo ayudan a constituir nuevos tipos de pacientes, nuevos tipos de ethos profesional y nuevas formas de relación entre dichos actores.

Abstract. Clinical judgement has become a central topic in both medicine and the philosophy since the 1960s. With the development of evidence-based medicine in the 1990s, clinical judgment is expected to be more sensitive to the needs and preferences of patients in the face of threats from positivist approaches that are considered to neglect individuality. This paper addresses this problem in the light of a philosophy of medicine that is more sensitive to the historical components of epistemology, ontology, and ethics. The analysis is directed to the 19th century in order to elucidate the tensions about the place of medical knowledge and the commitment, for the sake of professional improvement, to provide clinical judgment with new methods. This trip to the past is useful to understand the current transformations in the field of medicine, especially the way in which they help constitute new types of patients, new types of professional ethos, and new forms of relationship between these actors.

Resumo Política do orgulho gay na Argentina surgiu nas décadas de 1960 e 1970 no contexto das tensões entre os discursos médico e criminológico sobre a homossexualidade, que propunham, respectivamente, que a homossexualidade era uma imoralidade que deveria ser punida criminalmente ou uma doença que poderia ser tratada. Conclui-se que diante do aumento da violência policial, as bichas, homossexuais e transexuais se apropriam taticamente do discurso médico, identificando-se como doentes e aliando-se aos médicos em suas tentativas de descriminalizar a inversão sexual. Depois, no contexto do clima de modernização cultural, eles usarão as pretensões de objetividade científica da medicina para exigir a despatologização da homossexualidade, abandonando o discurso da vitimização, narrando suas experiências como alegres e questionando suas bases a partir da categoria do orgulho. Se baseia na análise historiográfica de um extenso corpus de imprensa de massa, material político-organizacional, tratados médicos e documentos em primeira pessoa.

Resumen Los orígenes de la política del orgullo gay en Argentina pueden rastrearse en las décadas de 1960 y 1970. En este periodo, mientras la criminología sostenía que la homosexualidad era un delito que debía ser castigado penalmente, la medicina afirmaba que era una enfermedad a tratar. Frente al aumento de la violencia policial, “maricas”, homosexuales y transexuales se apropiaron tácticamente del discurso médico y se identificaron como enfermos/as en sus intentos por descriminalizar la inversión sexual. Luego, en el marco del clima de modernización cultural, usaron las pretensiones de objetividad científica de la medicina para exigir la despatologización. En ese momento, abandonaron el discurso de la victimización, comenzaron a narrar sus experiencias como gozosas y a interpelar a sus bases desde la categoría del “orgullo”. La investigación se basó en el análisis historiográfico de un extenso corpus de prensa, material político-organizacional, tratados médicos y penitenciarios y documentos en primera persona.

Abstract The emergence of gay pride politics in Argentina takes places in the 1960s and 1970s in the context of the tensions between medical and criminological discourses on homosexuality, which respectively proposed that homosexuality was an immorality that should be criminally punished or an illness that could be treated. The conclusion is that, faced with an increase in police violence, maricas, gay men and transgender people tactically appropriated medical discourses, identifying themselves as sick and allying with medical doctors in their attempts to decriminalize sexual inversion. Then, in the context of the climate of cultural modernization, they would use the pretensions of scientific objectivity of medicine to demand the de-pathologization of homosexuality, abandoning the discourse of victimization, narrating their experiences as joyful, and mobilizing their base through the category of pride. The paper is based on the historiographic analysis of an extensive corpus of mass-circulation press, political organizations' material, medical treatises and first-person documents.

ABSCTRACT Introduction: Prostate neoplasia is the second most diagnosed cancer in men, having well established risk factors such as advanced age, familial and ethnic susceptibility. Recently, the association with environmental or lifestyle factors has been investigated, opening the possibility of certain occupational risk factors being associated with a higher incidence of this disease. Although controversial, as it does not necessarily imply a malignant etiology, prostate-specific antigen remains the mainstay in screening for this disease. Case report: This is the case of a 60-year-old surgeon with 36 years of professional history, including shift and night-work. As part of the health surveillance carried out by Occupational Medicine, he underwent complementary diagnostic tests and an increase in prostate-specific antigen was detected, culminating in a biopsy which ultimately confirmed the diagnosis of prostate adenocarcinoma. Discussion/Conclusion: Shift work, and particularly night work, has been investigated as a possible carcinogen and is currently classified by the International Agency for Research on Cancer as "probably carcinogenic to humans". Given the growing evidence linking certain occupational factors with this and other neoplasms, it may be sensible to include cancer screening in workers' health surveillance protocols, in some sectors. In the case presented, the inclusion of prostate-specific antigen measurement in the complementary tests requested by Occupational Medicine allowed for a timely diagnosis, with detection and treatment of the disease at an early stage.

RESUMO Introdução: A neoplasia da próstata é a segunda mais comummente diagnosticada no sexo masculino, destacando-se como fatores de risco bem estabelecidos a idade avançada, a suscetibilidade familiar e étnica. Recentemente, a associação a fatores ambientais ou de estilo de vida tem vindo a ser investigada, abrindo a possibilidade à associação de fatores de risco ocupacionais com uma maior incidência desta patologia. Apesar de controverso por não significar necessariamente a existência de patologia maligna, o antigénio específico da próstata mantém-se como o pilar no rastreio desta doença. Descrição do caso: Trata-se do caso de um cirurgião de 60 anos, com 36 anos desta atividade profissional, realizando trabalho por turnos e trabalho noturno. No âmbito da vigilância da saúde realizada pela Saúde Ocupacional, é submetido a exames complementares de diagnóstico, detetando-se um aumento do antigénio específico da próstata, que culmina na realização de biópsia, confirmando o diagnóstico de adenocarcinoma da próstata. Discussão/Conclusão: O trabalho por turnos e, particularmente, o trabalho noturno, tem vindo a ser investigado como possivelmente carcinogénico, estando, atualmente, classificado pela Agência Internacional para a Investigação em Cancro como “provavelmente carcinogénico para humanos”. Tendo em conta a crescente evidência relacionando fatores ocupacionais com esta e outras neoplasias, poderá fazer sentido incluir rastreios oncológicos nos protocolos de vigilância da saúde dos trabalhadores, em alguns setores. No caso apresentado, a inclusão da medição de antigénio específico da próstata nos exames complementares pedidos pela Saúde Ocupacional permitiu um diagnóstico atempado, com deteção e tratamento da doença numa fase precoce.

ABSTRACT Introduction: Every year more than 2.3 million cases of breast cancer are registered, making it the most common type of cancer among adults. The association between breast cancer and occupational factors is an issue that has been studied in the literature since the beginning of the 18th century. Technological developments have allowed a more in-depth study of the relationship between breast cancer and occupational factors such as exposure to chemicals, pesticides, metals and also sources of exposure to ionising and non-ionising radiation.The aim of the present literature review is to complete an update on the scientific knowledge about the relationship between occupational exposure to ionising radiation in healthcare workers and the development of breast cancer. Methodology: A research was carried using Medline with the PubMed search engine and Elsevier with the Science Direct search engine. The search words used were a combination of breast cancer, occupational exposure, ionizing radiation and healthcare workers. A research was also carried out in Revista Portuguesa de Saúde Ocupacional, using the terms “Breast Cancer” and “Ionizing Radiation”. Discussion/Conclusions: Current literature is not unanimous about the specific clinical and pathological features of breast cancer possibly linked to occupational settings. Healthcare professionals such as radiology technicians, nurses, orthopaedic surgeons and interventional cardiologists are especially vulnerable to this type of exposure, particularly to ionising radiation. However, some studies have pointed to a difficulty in establishing a causal relationship between these factors due to the number of variables involved, such as the duration and intensity of exposure and the influence of other risk factors. Changes in equipment, procedures and protective measures have resulted in lower doses in recent years, which means that the risk of breast cancer is low at current levels of occupational exposure to ionizing radiation.

RESUMO Introdução: Todos os anos são registados mais de 2,3 milhões de casos de cancro da mama, o que o torna o tipo cancro mais comum entre os adultos. A associação entre o cancro da mama e fatores ocupacionais é uma questão que tem vindo a ser estudada na literatura desde o início do século XVIII. Os desenvolvimentos tecnológicos permitiram um estudo mais aprofundado sobre a relação entre o cancro da mama e os fatores profissionais como a exposição a produtos químicos, pesticidas, metais e também fontes de exposição a radiação ionizante e não ionizante. O objetivo da presente revisão de literatura é incidir na relação entre a exposição ocupacional a radiação ionizante em trabalhadores da saúde e o desenvolvimento de cancro da mama. Metodologia: Foi efetuada uma pesquisa na Medline, com o motor de busca PubMed e na Elsevier, com o motor de busca Science Direct. As palavras de pesquisa usadas foram uma combinação dos termos breast cancer, occupational exposure, ionizing radiation e healthcare workers. Foi também realizada pesquisa na Revista Portuguesa de Saúde Ocupacional utilizando os termos “Cancro de mama” e “Radiação Ionizante”. Discussão/Conclusão: A literatura atual não é unânime quanto às características clínicas e patológicas específicas do cancro da mama possivelmente ligadas a contextos profissionais. Os profissionais de saúde, tais como técnicos de radiologia, enfermeiros, cirurgiões ortopédicos e cardiologistas de intervenção são especialmente vulneráveis a este tipo de exposição, nomeadamente à radiação ionizante. No entanto, alguns estudos apontaram para uma dificuldade em estabelecer uma relação causal entre estes fatores e o desenvolvimento de doença devido ao número de variáveis envolvidas, tais como a duração e intensidade da exposição e à influência de outros fatores de risco. As mudanças no equipamento, procedimentos e medidas de proteção resultaram em doses mais baixas nos anos mais recentes, o que significa que o risco de cancro da mama é baixo nos níveis atuais de exposição profissional à radiação ionizante.

ABSTRACT Introduction: Although most individuals recover after acute infection by SARS-CoV-2, others may suffer from persistent symptoms with potential medium and long-term consequences on the performance of activities and participation, with possible implications for their fitness for work. Objective: To analyze the persistence of symptoms twelve months after SARS-CoV-2 infection, and the perception of the performance level in activities and participation in life situations, of workers in a company of the industrial sector in the Aveiro Region. Methodology: An observational study, developed in an Occupational Health Service of an industrial company in the region of Aveiro, including workers with positive SARS-COV-2 RT-PCR/TRAg test, between October/2020-January/2022. After signaling the infection, the Occupational Health Team applied a questionnaire collecting sociodemographic variables, a list of common symptoms during the acute phase of infection by SARS-COV-2, and the perceived functionality assessed by the Portuguese version of WHODAS 2.0-PT12 (where '12 points' means the most functionality). At twelve months, they filled out another list of persistent symptoms after SARS-CoV-2 infection and again WHODAS 2.0-PT12. Data analysis included descriptive statistics and univariate and multivariate linear regression. The analysis was conducted with the software JASP 0.16.3. Results: Eighty-five workers were infected with SARS-CoV-2, with a mean age of 36.1± 9.8years, 77.7% were male, 36.7% had higher education and 17.7% reported at least one chronic condition. At twelve months, thirty workers (35.3%) reported persistent symptoms, with fatigue (27.7%) and arthralgia (14.4%) being the most mentioned. The mean WHODAS 2.0 in the two evaluation moments was 19.2±8.0 vs 15.7±5.0. Significant associations between WHODAS 2.0 items and persistent symptoms of fatigue, headache, cough, myalgia, arthralgia, and previous chronic disease were found. Conclusions: Persistent symptoms twelve months after acute SARS-CoV-2 infection have repercussions on workers' self-perception of performance in some activities and participation in life situations. The occupational health team can implement continuous surveillance of the infected worker's health, assess the presence of persistent symptoms of this infection, and implement an individualized rehabilitation program, which minimizes the impact of the persistence of symptoms on their work performance, and in activities and participation in life situations.

RESUMO Introdução: Embora a maioria dos indivíduos recupere após a infeção aguda por SARS-CoV-2, outros podem apresentar sintomas persistentes com potenciais consequências a médio e longo prazo no desempenho de atividades e participação, com eventuais implicações na sua aptidão para o trabalho. Objetivo: Analisar a persistência de sintomas aos doze meses após infeção por SARS-CoV-2 e perceção do nível de desempenho em atividades e participação em situações de vida de trabalhadores do setor industrial numa empresa da Região de Aveiro. Metodologia: Estudo observacional, desenvolvido num Serviço de Saúde Ocupacional de uma empresa industrial da região de Aveiro, incluindo trabalhadores com teste SARS-COV-2 RT-PCR/TRAg positivo, entre outubro/2020-janeiro/2022. Após sinalização da infeção, a Equipa de Saúde Ocupacional aplicou um questionário recolhendo as variáveis sociodemográficas, uma lista de sintomas comuns durante a fase aguda da infeção por SARS-COV-2 e a funcionalidade percebida avaliada pela versão portuguesa da WHODAS 2.0-PT12 (onde '12 pontos' significa a maior funcionalidade). Aos doze meses, preencheram outra lista de sintomas persistentes após a infeção por SARS-CoV-2 e novamente a WHODAS 2.0-PT12. A análise dos dados incluiu estatística descritiva e regressão logística univariada e multivariada. A condução da análise foi realizada com o software JASP 0,16.3. Resultados: Oitenta e cinco trabalhadores encontravam-se infetados com SARS-CoV-2, com idade média de 36,1±9,8anos, 77,7% eram do sexo masculino, 36,7% possuíam escolaridade superior e 17,7% relataram pelo menos uma condição crónica. Aos doze meses, trinta trabalhadores (35,3%) relataram sintomas persistentes, sendo a fadiga (27,7%) e artralgia (14,4%) os mais mencionados. A média da WHODAS 2.0 nos dois momentos de avaliação foi 19,2±8,0 vs 15,7±5,0. Foram encontradas associações significativas entre os itens da WHODAS 2.0 e os sintomas persistentes fadiga, cefaleia, tosse, mialgia, artralgia e doença crónica prévia. Conclusões: Os sintomas persistentes doze meses após a infeção aguda por SARS-CoV-2 têm repercussão na autoperceção do desempenho em algumas atividades e participação em situações de vida dos trabalhadores. A equipa de saúde ocupacional deve realizar a vigilância contínua da saúde do trabalhador infetado, avaliando a presença de sintomas persistentes desta infeção e poderá implementar um programa de intervenção individualizado, que minimize o impacto da persistência dos sintomas no seu desempenho laboral, assim como, em atividades e participação em situações de vida.