ABSTRACT Purpose: To evaluate the effect of upper eyelid ptosis repairwith Muller muscle-conjunctival resection on meibomian gland function and ocular surface parameters. Methods: Thirty-eight patients who underwent ptosis repair with Muller muscle-conjunctival resection were retrospectively reviewed. Meibomian gland loss, Ocular Surface Disease Index OXFORD score, meiboscore, and noninvasive keratograph break-up time were measured preoperatively and at 1st, 3rd, and 6th months postoperatively. Results: Noninvasive keratograph break-up time values decreased significantly at 1st and 3rd months postoperatively compared to the preoperative level, but were similar to the preoperative level at 6th months postoperatively (p<0.001 and p=0.628, respectively). Ocular surface disease index, OXFORD score, meibomian gland loss, and meiboscore values increased significantly in the 1st and 3rd postoperative months compared to the preoperative period, but these values decreased to preoperative levels in the 6th postoperative month (p<0.001 and p>0.05, respectively). Conclusion: There is a transient deterioration in meibography findings and OSDI score in the early postoperative period afterMuller muscle-conjunctival resection. Patients undergoing Muller muscle-conjunctival resection may require topical lubricants, especially in the first 3 postoperative months. Purpose muscleconjunctival muscle conjunctival parameters Methods Thirtyeight Thirty eight reviewed loss breakup break up st rd th Results p<0.001 p0001 p 0 001 (p<0.00 p0628 628 p=0.628 respectively. respectively . respectively) index p005 05 p>0.05 Conclusion lubricants p<0.00 p000 00 (p<0.0 p062 62 p=0.62 p00 p>0.0 p<0.0 (p<0. p06 6 p=0.6 p0 p>0. p<0. (p<0 p=0. p>0 p<0 (p< p=0 p> p< (p p=

RESUMO Objetivo: Avaliar a funcionalidade e fatores associados em crianças e adolescentes com osteogênese imperfeita (OI). Métodos: Estudo transversal com 30 crianças e adolescentes com OI. Foram avaliados prontuários médicos, uso de bisfosfonatos, características socioeconômicas, dinamometria de preensão palmar, equilíbrio, hipermobilidade articular, nível de deambulação e escores do Pediatric Evaluation of Disability Inventory - Computer Adaptative Test (PEDI-CAT). Os dados foram apresentados em média e desvio padrão e comparados por teste t por Mann-Whitney, enquanto os categóricos foram apresentados em frequência e comparados pelo teste exato de Fisher. Análises intragrupos foram realizadas por análise de covariância (ANCOVA) ou Teste de Wilcoxon para postos sinalizados. O teste Tau-b de Kendall foi usado para correlações. Resultados: A idade variou de 6 a 18 anos. A amostra foi dividida em dois grupos de acordo com a gravidade da doença. Casos moderados/graves (n=10) apresentaram menor estatura e força muscular comparadas às dos leves (n=20). Fraqueza muscular foi observada em todos os casos de OI quando comparados à população normal. Não houve diferença nos domínios do PEDI-CAT com exceção do domínio mobilidade. Houve correlação entre o número de fraturas, tipo de OI, peso e equilíbrio e o domínio mobilidade; e entre os domínios Atividades Diárias e Mobilidade e Responsabilidade e Social/cognitivo do PEDI-CAT. Conclusões: Nossos achados sugerem que crianças com OI moderada/severa podem atingir o mesmo nível de funcionalidade que crianças com a forma leve. Fraturas podem ter grande influência no nível de funcionalidade e o tratamento deve enfocar a prevenção e a reabilitação desses eventos. Objetivo . (OI) Métodos 3 médicos bisfosfonatos socioeconômicas palmar articular PEDICAT. PEDICAT PEDI CAT (PEDI-CAT) MannWhitney, MannWhitney Mann Whitney, Whitney Mann-Whitney Fisher ANCOVA (ANCOVA sinalizados Taub Tau b correlações Resultados 1 anos doença moderadosgraves moderados graves n=10 n10 n 10 (n=10 n=20. n20 n=20 20 (n=20) normal mobilidade fraturas Socialcognitivo Social cognitivo CAT. Conclusões moderadasevera moderada severa leve eventos (OI (PEDI-CAT n=1 n1 (n=1 n2 n=2 2 (n=20 n= (n= (n=2 (n

ABSTRACT Objective: The aim of this study was to evaluate the functioning and associated factors in children and adolescents with osteogenesis imperfecta (OI). Methods: This is a cross-sectional study conducted on 30 children and adolescents with OI. Medical records, use of bisphosphonates, socioeconomic status, handgrip strength, balance, joint hypermobility, ambulatory level, and the Pediatric Evaluation of Disability Inventory—Computer Adaptative Test (PEDI-CAT) scores were assessed. Data is presented as mean and standard deviation and Student’s t-test or Mann–Whitney U test. Categorical data is presented as frequency and analyzed using Fisher’s exact test. Within-group analyses were conducted using ANCOVA or Wilcoxon signed-rank test. Correlations used Kendall’s Tau-b test. Results: The participants involved in this study were 6–18 years old. The sample was separated into two groups according to disease severity. The moderate/severe OI group (n=10) presented a lower height and muscular strength than the mild group (n=20). Muscle weakness was observed in all participants with OI when compared with the normal population. No differences were observed between the groups in the PEDI-CAT scores except for the mobility domain. There were correlations between the PEDI-CAT mobility domain and the number of fractures, OI type, weight, and balance; there was also a correlation between the PEDI-CAT daily activities, mobility, responsibility, and social/cognitive domains. Conclusions: The findings suggest that children with moderate/severe forms of OI can achieve the same function levels as children with mild OI. Fractures can have a major influence on the functional level, and treatment should focus on the prevention and rehabilitation of these events when they occur. Objective . (OI) Methods crosssectional cross sectional 3 records bisphosphonates status balance hypermobility level InventoryComputer Inventory Computer PEDICAT PEDI CAT (PEDI-CAT assessed Students Student s ttest t test MannWhitney Mann Whitney Fishers Fisher Withingroup Within signedrank signed rank Kendalls Kendall Taub Tau b Results 618 6 18 6–1 old severity moderatesevere moderate severe n=10 n10 n 10 (n=10 n=20. n20 n=20 20 (n=20) population fractures type weight activities responsibility socialcognitive social cognitive domains Conclusions occur (OI 61 1 6– n=1 n1 (n=1 n2 n=2 2 (n=20 n= (n= (n=2 (n

RESUMO Objetivo: analisar possíveis impactos à saúde geral, mental e auditiva de trabalhadores da enfermagem acometidos pelo vírus da COVID-19. Métodos: estudo exploratório, transversal, realizado com profissionais da enfermagem de um hospital público da região Sul do Brasil, que responderam a um questionário sobre sintomas gerais e auditivos após a infecção pela COVID-19 e o Oldenburg Burnout Inventory (OLBI). A análise estatística foi realizada com a aplicação do teste do Qui-quadrado de independência, do teste ANOVA com pós-teste de Tukey e da Correlação Linear de Pearson, com p-valor em 5%. Resultados: participaram 52 trabalhadores (17 enfermeiros, 30 técnicos, cinco auxiliares). Os sintomas de cefaleia, perda do olfato e do paladar, cansaço e dores musculares foram referidos por mais de 75% dos trabalhadores; 80,8% ou já estão classificados com burnout (40,4%) ou já apresentam escores altos para exaustão ou para distanciamento do trabalho (40,4%), havendo correlação com os sintomas tosse (p = 0,0327) e febre (p=0,0235); 44,23% apresentaram sintomas auditivos, sendo a tontura/vertigem referida por 34,6% e zumbido por 13,5%, embora sem correlação com os níveis de burnout (p=0.4250). Conclusão: houve impactos na saúde geral, mental e auditiva dos trabalhadores da enfermagem que foram diagnosticados com COVID-19, principalmente tosse e febre, burnout, zumbido e tontura. Objetivo geral COVID19. COVID19 COVID 19. 19 Métodos exploratório transversal Brasil COVID-1 OLBI. OLBI . (OLBI) Quiquadrado Qui quadrado independência pósteste pós Pearson pvalor p valor 5 5% Resultados 17 (1 enfermeiros 3 técnicos auxiliares. auxiliares auxiliares) cefaleia paladar 75 808 80 8 80,8 40,4% 404 40 4 (40,4% 40,4%, , 0,0327 00327 0 0327 p=0,0235 p00235 0235 (p=0,0235) 4423 44 23 44,23 tonturavertigem tontura vertigem 346 34 6 34,6 135 13 13,5% p=0.4250. p04250 p=0.4250 4250 (p=0.4250) Conclusão COVID19, 19, COVID1 1 COVID- (OLBI ( 7 80, 40,4 (40,4 0,032 0032 032 p=0,023 p0023 023 (p=0,0235 442 2 44,2 34, 13,5 p0425 p=0.425 425 (p=0.4250 40, (40, 0,03 003 03 p=0,02 p002 02 (p=0,023 44, 13, p042 p=0.42 42 (p=0.425 (40 0,0 00 p=0,0 p00 (p=0,02 p04 p=0.4 (p=0.42 (4 0, p=0, p0 (p=0,0 p=0. (p=0.4 p=0 (p=0, (p=0. p= (p=0 (p=

ABSTRACT Purpose: to analyze possible impacts on the general, mental and hearing health of nursing workers affected by the COVID-19 virus. Methods: an exploratory, cross-sectional study, carried out with nursing professionals from a public hospital in Southern Brazil, who answered a questionnaire on general and auditory symptoms after COVID-19 infection, and the Oldenburg Burnout Inventory (OLBI). Statistical analysis was performed using the Chi-square test of independence, the ANOVA test with Tukey's post-test and Pearson's Linear Correlation, with a p-value of 5%. Results: 52 workers participated (17 nurses, 30 technicians, five aides). The symptoms of headache, loss of smell and taste, fatigue and muscle pain were reported by more than 75% of workers; 80.8% either had already been classified as burnout (40.4%) or featured high scores for exhaustion or work disengagement (40.4%), with a correlation with the symptoms of cough (p=0.0327) and fever (p=0.0235); 44.23% had auditory symptoms, with dizziness/vertigo reported by 34.6% and tinnitus by 13.5%, although without correlation with burnout levels (p=0.4250). Conclusion: there were impacts on the general, mental and hearing health of nursing workers who were diagnosed with COVID-19, mainly cough and fever, burnout, tinnitus and dizziness. Purpose COVID19 COVID 19 COVID-1 virus Methods exploratory crosssectional cross sectional study Brazil infection OLBI. OLBI . (OLBI) Chisquare Chi square independence Tukeys Tukey s posttest post Pearsons Pearson Correlation pvalue p value 5 5% Results 17 (1 nurses 3 technicians aides. aides aides) headache taste 75 808 80 8 80.8 40.4% 404 40 4 (40.4% 40.4%, , p=0.0327 p00327 0 0327 (p=0.0327 p=0.0235 p00235 0235 (p=0.0235) 4423 44 23 44.23 dizzinessvertigo dizziness vertigo 346 34 6 34.6 135 13 13.5% p=0.4250. p04250 p=0.4250 4250 (p=0.4250) Conclusion COVID19, 19, COVID1 1 COVID- (OLBI ( 7 80. 40.4 (40.4 p=0.032 p0032 032 (p=0.032 p=0.023 p0023 023 (p=0.0235 442 2 44.2 34. 13.5 p0425 p=0.425 425 (p=0.4250 40. (40. p=0.03 p003 03 (p=0.03 p=0.02 p002 02 (p=0.023 44. 13. p042 p=0.42 42 (p=0.425 (40 p=0.0 p00 (p=0.0 (p=0.02 p04 p=0.4 (p=0.42 (4 p=0. p0 (p=0. (p=0.4 p=0 (p=0 p= (p= (p

Anabolic steroids are often consumed by both amateur and professional sports practitioners with the aim of improving their performance and for the rapid gain of muscle mass. Nandrolone is one of the main steroids consumed and is, frequently, acquired illegally or from dubious sources, and this raises serious concerns regarding the quality of the products. This work sought to qualitatively and quantitatively evaluates oily, nandrolone-based anabolic steroids confiscated by the Federal Police Department, in the triple border (Paraguay-Brazil-Argentina, PY-BR-AR). For the quantitative study, we conducted a methodological validation analysis based on the application of solvent extraction and GC-MS (gas chromatography-mass spectrometry). A total of 40 samples of nandrolone steroids (as described on the label) were thoroughly investigated. The results obtained showed that 90% of the samples analyzed contained the active ingredient but 67.5% of these samples exhibited concentrations below the values indicated on the label; these products are thus considered to be of low quality and their consumption may pose serious risks to the consumers. The findings of this study point to the importance of enforcing regulatory controls on the sale of anabolic steroids with a view to inhibiting the consumption of counterfeit drugs that can pose serious risks to the health of consumers. mass frequently sources oily nandrolonebased Department ParaguayBrazilArgentina, ParaguayBrazilArgentina Paraguay Brazil Argentina, Argentina (Paraguay-Brazil-Argentina PYBRAR. PYBRAR PY BR AR . PY-BR-AR) GCMS GC MS gas chromatographymass chromatography spectrometry. spectrometry spectrometry) 4 as label investigated 90 675 67 5 67.5 consumers PY-BR-AR 9 6 67.

Resumo Enquadramento: O contexto de ensino clínico e a vivência da pandemia COVID-19 são potencialmente stressores e/ou ansiogénicos em estudantes de enfermagem. Objetivo: Avaliar a eficácia do programa “Aprender a Relaxar” na redução do stresse e ansiedade em estudantes de enfermagem. Metodologia: Estudo pré-experimental, longitudinal, com amostra de sete estudantes seguidos na consulta de ansiedade. Concebido e implementado Programa “Aprender a Relaxar” baseado nas técnicas de respiração diafragmática e relaxamento muscular progressivo, com oito sessões, em cinco semanas. Avaliação inicial, final e follow-up utilizada Escala de Perceção de Stresse e Questionário de Autoavaliação de Ansiedade de Zung. Resultados: Redução dos níveis de stresse entre avaliação inicial e avaliação final (p = 0,069) e diminuição significativa entre avaliação inicial e follow-up (p = 0,033). Diminuição significativa da ansiedade entre avaliação inicial e avaliação final (p = 0,033) e entre avaliação inicial e follow-up (p = 0,006). Conclusão: Programa demonstrou efeito positivo na gestão do stresse, autocontrolo da ansiedade e sintomatologia associada, sendo um recurso terapêutico útil na intervenção com estudantes de enfermagem.

Abstract Background: Clinical placements and the COVID-19 pandemic are experiences that cause stress and anxiety in nursing students. Objective: To assess the effectiveness of the ‘‘Learning to Relax’’ (Aprender a relaxar) program in reducing stress and anxiety in nursing students. Methodology: A pre-experimental, longitudinal study was conducted with seven students who sought an anxiety consultation. The ‘‘Learning to Relax’’ program was designed based on diaphragmatic breathing and progressive muscle relaxation techniques and implemented in eight sessions during five weeks. The evaluation was conducted at baseline, endline, and follow-up using the Perceived Stress Scale and the Zung Self-Rating Anxiety Scale. Results: Stress levels were lower between baseline and endline (p = 0.069) and significantly lower between baseline and follow-up (p = 0.033). There was a significant decrease in anxiety between baseline and endline (p = 0.033) and between baseline and follow-up (p = 0.006). Conclusion: Program had a positive impact on managing stress, anxiety, and associated symptoms. It is therefore a therapeutic resource for interventions with nursing students.

Resumen Marco contextual: El contexto de la enseñanza clínica y la experiencia de la pandemia de COVID-19 son factores potencialmente estresantes y/o ansiógenos para los estudiantes de enfermería. Objetivo: Evaluar la eficacia del programa “Aprender a Relajarse” para reducir el estrés y la ansiedad en estudiantes de enfermería. Metodología: Estudio longitudinal preexperimental con una muestra de siete estudiantes a los que se les hizo un seguimiento en la clínica de ansiedad. Diseño y aplicación del programa “Aprender a Relajarse”, basado en técnicas de respiración diafragmática y relajación muscular progresiva, con ocho sesiones a lo largo de cinco semanas. Evaluación inicial, final y de seguimiento mediante la Escala de Percepción del Estrés y el Cuestionario de Autoevaluación de la Ansiedad de Zung. Resultados: Reducción de los niveles de estrés entre la evaluación inicial y la final (p = 0,069) y disminución significativa entre la evaluación inicial y el follow-up (p = 0,033). Disminución significativa de la ansiedad entre la evaluación inicial y la final (p = 0,033) y entre la evaluación inicial y el follow-up (p = 0,006). Conclusión: Programa mostró un efecto positivo sobre la gestión del estrés, el autocontrol de la ansiedad y los síntomas asociados, lo que lo convierte en un recurso terapéutico útil para la intervención con estudiantes de enfermería.

Resumen Aunque no es muy común, en los últimos 20 años se ha observado un aumento significativo en los reportes de rotura del pectoral mayor, normalmente asociado a la práctica de actividad física en la que se produce una contracción intensa y/o al uso de cargas pesadas ejerciendo resistencia sobre el mismo. el músculo. En este caso clínico tenemos un paciente de 51 años que refiere dolor en el pecho derecho y en el brazo derecho durante 3 días después de intentar arreglar el manillar de su motocicleta. Presentó asimetría de pectorales, pérdida de fuerza en miembro superior derecho, dificultad de movimiento y hematoma. La resonancia magnética demostró rotura completa de la unión miotendinosa del pectoral mayor, con tendinopatía con fisuras de inserción e intrasustancial del infraespinoso y tendinopatía con rotura parcial del tendón subescapular. Un médico ortopédico recomendó seguimiento con el uso de medicación analgésica.

Resumo Apesar de não muito frequente, nos últimos 20 anos, houve um aumento significativo dos relatos sobre rotura do peitoral maior, normalmente associadas à prática de atividade física em que ocorre contração intensa e/ou uso de cargas pesadas exercendo resistência sobre o músculo. Neste relato de caso temos um paciente de 51 anos referindo dor no tórax à direita e no braço direito há 3 dias após tentar consertar o guidão da moto. Apresentava assimetria dos peitorais, perda de força do membro superior direito, dificuldade de movimentação e hematoma. A ressonância magnética demonstrou rotura completa da junção miotendínea do peitoral maior, com tendinopatia com fissuras insercionais e intrasubstanciais infraespinhal e tendinopatia com rotura parcial do tendão subescapular. Foi indicado por médico ortopedista o acompanhamento com o uso de medicação analgésica.

Abstract Although not very common, in the last 20 years, there has been a significant increase in reports of rupture of the pectoralis major, normally associated with the practice of physical activity in which intense contraction occurs and/or the use of heavy loads exerting resistance on the muscle. In this case report we have a 51-year-old patient reporting pain in his right chest and right arm for 3 days after trying to fix his motorcycle's handlebars. He had asymmetry of the pectorals, loss of strength in the right upper limb, difficulty moving and hematoma. Magnetic resonance imaging demonstrated complete rupture of the myotendinous junction of the pectoralis major, with tendinopathy with insertional and intrasubstantial infraspinatus fissures and tendinopathy with partial rupture of the subscapularis tendon. An orthopedic doctor recommended follow-up with the use of analgesic medication.

ABSTRACT Colombia is the ninth largest producer of dragon fruit in the world and the department of Boyacá is the largest with 440 hectares planted. Bacterial phytopathogens can cause pitahaya fruit losses and low yields by producing stem soft rot. This research aimed to study and identified possible agents of bacterial diseases of pitahaya in Boyacá, Colombia. Thirteen farms in the region were selected to take 20 samples by means of a targeted and random sampling of stem and fruit tissues with soft rot symptoms in the early stages of the disease. A process of microbiological isolation, biochemical and molecular taxonomic identification of the isolated bacteria. The 16s rRNA gene sequences of the V2-V5 region were edited by removing the primers, assembling and obtaining the consensus sequence of the primers 1100R-337F and 800R -518F. The phylogenetic analysis was performed by BLAST at NCBI, using the "Classifier" and "SeqMatch" tools from the RDP website, and phylogenetic trees were created by multiple alignment using the MUSCLE algorithm and the Tamura Nei distance method was performed. Signs like blisters and mucilaginous fluids, symptoms like yellow and brown chlorotic spots, soft rot, and liquefaction were identified, and possible vectors like flies and ants were report. Twenty-five bacterial morphotypes were identified classifieds in 4 phyla, 9 families and 13 genera. The analysis of the 16S rRNA gene sequences of the bacterial strains showed a 98 to 100% identity with Enterobacter cloacae, Pectobacterium carotovora and Paenibacillus glucanolyticus, reported in other studies as causing the soft rot of the pitahaya stem and fruit. New species were reported as possible pathogenic bacteria of pitahaya: Pantoea cypripedii, Kluyvera intermedia and Klebsiella oxytoca. Infectivity assays did not have positive results. The microbiota identified in the stages of the necrotrophic phase or final stage of soft rot of the stem belong to the genera Achromobacter, Sphingobacterium, Pseudomonas, Klebsiella, Paenibacillus, Bacillus, Stenotrophomonas and Microbacterium. In the fly Leptoglossus zonatus associated with the crop were identified Pseudomonas fulva and Lysinibacillus fusiformis were identified. This is also the first official report of a complex of possible phytopathogen bacteria of the order Enterobacterales (Enterobacteriacea, Erwiniaceae and Pectobacteriaceae family) in symptoms by bacterial disease on pitahaya Colombian crops. Identification of the bacteria in a pathogenic system can guide chemical and biological control practices in order to increase the productive and export potential of exotic and orphan crops from small local farmings.

RESUMEN Colombia es el noveno productor de pitahaya amarilla en el mundo y el Departamento de Boyacá es el mayor productor con 440 hectáreas plantadas. Los fitopatógenos bacterianos pueden causar pérdidas de frutos de pitahaya y bajos rendimientos al producir la pudrición blanda de los tallos. El objetivo de esta investigación fue estudiar e identificar posibles agentes de enfermedades bacterianas de la pitahaya en Boyacá, Colombia. Trece (13) fincas de la región fueron seleccionadas para la toma de 20 muestras mediante un muestreo dirigido y al azar de tejidos de tallo y frutos con síntomas de pudrición blanda en estadios iniciales de la enfermedad. Se realizó un proceso de aislamiento microbiológico, identificación bioquímica y taxonómica molecular de las bacterias aisladas. Las secuencias del gen ARNr 16s de la región V2-V5 fueron editadas mediante la eliminación de los primers, ensamblaje y obtención de la secuencia consenso de los primers 1100R-337F y 800R -518F. El análisis filogenético fue hecho por BLAST en el NCBI, por las herramientas "Classifier" y "SeqMatch", del sitio Web del RDP y se realizaron árboles filogenéticos mediante alineamiento múltiple usando el algoritmo MUSCLE y el método de distancias de Tamura Nei. Se registraron signos como ampollas y fluidos mucilaginosos, síntomas como manchas cloróticas amarillas y marrones, pudrición blanda y licuefacción, y se reportaron posibles vectores como moscas y hormigas. Veinticinco (25) morfotipos de bacterias fueron clasificados en 4 filos, 8 familias y 13 géneros. El análisis de las secuencias del gen ARNr 16S de las cepas bacterianas mostró una identidad del 98 al 100% con Enterobacter cloacae, Pectobacterium carotovora y Paenibacillus glucanolyticus, reportados en otros estudios como causantes de la pudrición blanda del tallo y fruto de pitahaya. Se reportaron nuevas especies como posibles bacterias patógenas de pitahaya: Pantoea cypripedii, Kluyvera intermedia y Klebsiella oxytoca. Los ensayos de infectividad no arrojaron resultados positivos. La microbiota identificada en los estadios de la fase necrotrofa o final de la pudrición blanda del tallo podría estar conformada por los géneros Achromobacter, Sphingobacterium, Pseudomonas, Klebsiella, Paenibacillus, Bacillus, Stenotrophomonas y Microbacterium. En la mosca Leptoglossus zonatus asociada al cultivo se identificó Pseudomonas fulva y Lysinibacillus fusiformis. Este es el primer registro oficial de un complejo de posibles bacterias fitopatógenas del orden Enterobacterales (familia Enterobacteriaceae, Erwiniaceae y Pectobacteriaceae) en síntomas por enfermedad bacteriana en cultivos colombianos de pitahaya. La identificación de las bacterias de un pato-sistema puede orientar las prácticas de control químico y biológico con el fin de incrementar el potencial productivo y de exportación de los cultivos exóticos y huérfanos de las pequeñas fincas locales.

ABSTRACT Introduction: Approximately 10% of patients with dengue present with neurological disorders during or after infection. Dengue virus infection can present with three neurologic presentations: 1) acute non-specific neurologic symptoms, 2) acute encephalitis or focal neurologic symptoms, and 3) post-infectious neurologic complications. The present study is a report of a series of five laboratory-confirmed cases of neurologic dengue. The aim is to report a series of cases of neurological manifestations associated with dengue virus infection and their clinical features. Methodology: This is a presentation of a series of five cases of neurologic dengue confirmed by laboratory tests. Results: Of the series of cases, two patients presented with lower limb weakness, two had altered consciousness and another patient had right hemibody weakness associated with dysarthria. All had a positive serologic diagnosis of dengue fever by antiviral antibodies. One patient developed an immune-mediated neurological syndrome, another patient had muscle dysfunction, and three patients developed encephalitis. Conclusion: Neurological disorders associated with DENV should be suspected in any patient presenting with acute non-specific neurological symptoms, acute encephalitis, focal neurological symptoms with evidence of positivity for DENV, or presenting with neurological complications during the convalescent phase due to this virus.

RESUMEN Introducción: Alrededor del 10% de los pacientes con dengue presentan alteraciones neurológicas durante o después de la infección. La infección por el virus del dengue se puede presentar con tres cuadros neurológicos: 1) síntomas neurológicos agudos no específicos, 2) encefalitis aguda o síntomas neurológicos focales y 3) complicaciones neurológicas post infecciosas. El presente estudio es un reporte de una serie de cinco casos de dengue neurológico confirmados por pruebas de laboratorio. El objetivo es reportar una serie de casos de manifestaciones neurológicas asociadas a la infección por el virus de dengue y sus características clínicas. Metodología: Se trata de la presentación de una serie de cinco casos de dengue neurológico confirmados por pruebas de laboratorio. Resultados: De la serie de casos, dos pacientes cursaron con debilidad de miembros inferiores, dos tuvieron alteración de conciencia y otro paciente presentó debilidad en hemicuerpo derecho asociado a disartria. Todos ellos con el diagnóstico serológico positivo, a través de anticuerpos anti-virus, del dengue. Una paciente desarrolló Síndrome neurológico mediado por inmunidad, otro paciente sufrió disfunción muscular y tres pacientes desarrollaron encefalitis. Conclusión: Los trastornos neurológicos asociadas al DENV deben ser motivo de sospecha en todo paciente que presente síntomas neurológicos agudos no específicos, encefalitis aguda, síntomas neurológicos focales con evidencia de positividad para DENV, o que presente complicaciones neurológicas durante la fase de convalecencia por este virus.

ABSTRACT Introduction: The introduction of Single-Port (SP) platform opened the field to new surgical options, allowing to perform major urological robot-assisted procedures extraperitoneally and with a supine patient positioning (1–3). Nevertheless, a comprehensive description of different supine access options is still lacking (4–6). In this light, we provided a step-by-step guide of SP extraperitoneal supine access options also exploring preliminary surgical outcomes. Materials and methods: Transvesical access was performed by a transversal incision 3cm above the pubic bone, after the anterior abdominal sheet incision, the bladder was insufflated with a flexible cystoscope and the detrusor muscle was incised at the level of the bladder dome. Similarly, the extraperitoneal access was carried out with a 4cm incision above the pubic bone, once visualized the preperitoneal space the prevesical fat was gently spread. The Low Anterior Access was performed with a 3cm incision at the McBurney point, the abdominal muscles were then spread. A gentle dissection was used laterally to develop the retroperitoneal space. Results: Overall, sixteen different procedures were performed with supine extraperitoneal access on 623 consecutive patients. No intraoperative conversions occurred. The median access time was 16 (IQR 12-21), 11 (IQR 7-14) and 14 (IQR 10-18) minutes in case of transvesical, extraperitoneal and low anterior access, respectively. Notably, 81.5 % of patients were discharged on the same day with a postoperative opioid free rate of 73%. Conclusion: The Atlas provides a comprehensive step-by-step guide to successfully perform all major urological SP procedures extraperitoneally and with supine patient positioning. Introduction SinglePort Single Port (SP robotassisted robot assisted 1–3. 13 1–3 . 1 3 (1–3) Nevertheless 4–6. 46 4–6 4 6 (4–6) light stepbystep step outcomes methods cm bone dome Similarly spread point Results Overall 62 occurred IQR 1221, 1221 12 21 , 12-21) 714 7 7-14 1018 10 18 10-18 transvesical respectively Notably 815 81 5 81. 73 73% Conclusion 1– (1–3 4– (4–6 122 2 12-21 71 7-1 101 10-1 8 (1– (4– 12-2 7- 10- (1 (4 12- (

ABSTRACT Objectives: To evaluate the safety and effectiveness of robot-assisted radical cystectomy (RARC), laparoscopic radical cystectomy (LRC), and open radical cystectomy (ORC) in bladder cancer. Methods: A literature search for network meta-analysis was conducted using international databases up to February 29, 2024. Outcomes of interest included baseline characteristics, perioperative outcomes and oncological outcomes. Results: Forty articles were finally selected for inclusion in the network meta-analysis. Both LRC and RARC were associated with longer operative time, smaller amount of estimated blood loss, lower transfusion rate, shorter time to regular diet, fewer incidences of complications, and fewer positive surgical margin compared to ORC. LRC had a shorter time to flatus than ORC, while no difference between RARC and ORC was observed. Considering lymph node yield, there were no differences among LRC, RARC and ORC. In addition, there were statistically significant lower transfusion rates (OR=-0.15, 95% CI=-0.47 to 0.17), fewer overall complication rates (OR=-0.39, 95% CI=-0.79 to 0.00), fewer minor complication rates (OR=-0.23, 95% CI=-0.48 to 0.02), fewer major complication rates (OR=-0.23, 95% CI=-0.68 to 0.21), fewer positive surgical margin rates (OR=0.22, 95% CI=-0.27 to 0.68) in RARC group compared with LRC group. Conclusion: LRC and RARC could be considered as a feasible and safe alternative to ORC for bladder cancer. Notably, compared with LRC, RARC may benefit from significantly lower transfusion rates, fewer complications and lower positive surgical margin rates. These data thus showed that RARC might improve the management of patients with muscle invasive or high-risk non-muscle invasive bladder cancer. Objectives robotassisted robot assisted RARC, , (RARC) (LRC) (ORC cancer Methods metaanalysis meta analysis 29 2024 characteristics Results metaanalysis. analysis. loss rate diet observed yield addition OR=0.15, OR015 OR OR= 0.15, 0 15 (OR=-0.15 95 CI=0.47 CI047 CI CI= 0.47 47 CI=-0.4 0.17, 017 0.17 17 0.17) OR=0.39, OR039 0.39, 39 (OR=-0.39 CI=0.79 CI079 0.79 79 CI=-0.7 0.00, 000 0.00 00 0.00) OR=0.23, OR023 0.23, 23 (OR=-0.23 CI=0.48 CI048 0.48 48 0.02, 002 0.02 02 0.02) CI=0.68 CI068 0.68 68 CI=-0.6 0.21, 021 0.21 21 0.21) OR=0.22, OR022 22 (OR=0.22 CI=0.27 CI027 0.27 27 CI=-0.2 068 Conclusion Notably highrisk high risk nonmuscle non (RARC (LRC 2 202 OR=0.15 OR01 015 0.15 1 (OR=-0.1 9 CI=0.4 CI04 047 0.4 4 CI=-0. 01 0.1 OR=0.39 OR03 039 0.39 3 (OR=-0.3 CI=0.7 CI07 079 0.7 7 0.0 OR=0.23 OR02 023 0.23 (OR=-0.2 048 CI=0.6 CI06 0.6 6 0.2 OR=0.22 (OR=0.2 CI=0.2 CI02 027 06 20 OR=0.1 OR0 (OR=-0. CI=0. CI0 04 0. CI=-0 OR=0.3 03 0.3 07 OR=0.2 (OR=0. OR=0. (OR=-0 CI=0 CI=- (OR=0 OR=0 (OR=- (OR= (OR

Resumo Introdução: O processo de desnutrição-inflamação é uma das principais causas de morbimortalidade em pacientes com DRC, influenciando a qualidade de vida. O objetivo deste estudo foi identificar o estado inflamatório e nutricional de idosos em hemodiálise (HD) e sua associação com qualidade de vida. Métodos: Estudo realizado em serviços de saúde de três cidades diferentes. O Escore de Desnutrição-Inflamação (MIS, por sua sigla em inglês) foi utilizado para avaliar estado inflamatório e nutricional, com medidas antropométricas, estado proteico, massa magra e funcionalidade. A qualidade de vida foi avaliada com KDQOL-SFTM. Os dados foram analisados utilizando análise multivariada e modelo de Poisson para avaliar fatores que aumentaram o risco de desenvolver desnutrição e inflamação. Resultados: O MIS identificou prevalência de 52,2% de desnutrição e inflamação na população. Na análise univariada, a maioria dos domínios do KDQOL-SFTM apresentou escores maiores para idosos nutridos. Medidas antropométricas associadas à massa muscular e funcionalidade foram menores em idosos desnutridos. A modelagem multivariada revelou maior risco nutricional de 50,6% para mulheres e idosos pois o risco de desnutrição aumentou em 2,4% para cada ano adicional de vida e em 0,4% para cada mês adicional de HD. Maior circunferência muscular do braço (CMB) e maior albumina sérica foram fatores de redução da desnutrição em 4,6% e 34,7%, respectivamente. Conclusão: Demonstrou-se que albumina sérica mais elevada e CMB preservada são bons indicadores de melhor estado nutricional. Maior MIS foi associado a pior qualidade de vida, idade mais avançada, menor renda e escolaridade, maior tempo em diálise e presença de comorbidades. Introdução desnutriçãoinflamação DRC HD (HD Métodos diferentes DesnutriçãoInflamação Desnutrição Inflamação MIS, (MIS inglês proteico KDQOLSFTM. KDQOLSFTM KDQOL SFTM. SFTM Resultados 522 52 2 52,2 população univariada nutridos desnutridos 506 50 6 50,6 24 4 2,4 04 0 0,4 (CMB 46 4,6 347 34 7 34,7% respectivamente Conclusão Demonstrouse Demonstrou se avançada escolaridade comorbidades 5 52, 50, 2, 0, 4, 3 34,7 34,

Abstract Introduction: The malnutrition-inflammation process is one of the main causes of morbidity and mortality in patients with chronic kidney disease (CKD), influencing quality of life. The aim of this study was to identify the inflammatory and nutritional status of elderly hemodialysis (HD) and its association with quality of life. Methods: This study was carried out in health services in three different cities. The Malnutrition-Inflammation Score (MIS) was used to assess the inflammatory and nutritional status, with anthropometric measurements, protein status, lean mass and function. The quality of life was assessed using KDQOL-SFTM. Data were analyzed using multivariate analysis and the Poisson model to evaluate the factors that increased the risk of developing malnutrition and inflammation. Results: The MIS identified a 52.2% prevalence of malnutrition and inflammation in the population. In univariate analysis, most KDQOL-SFTM domains presented higher scores for nourished elderly. Anthropometric measures associated with muscle mass and functionality were lower in the malnourished elderly. Multivariate modeling revealed a higher nutritional risk of 50.6% for women and older age, since with each additional year of life the risk of malnutrition increased by 2.4% and by 0.4% with each additional month on HD. Greater arm muscle circumference (AMC) and higher serum albumin were factors for reducing malnutrition by 4.6% and 34.7%, respectively. Conclusion: Higher serum albumin and preserved AMC have been shown to be good indicators of better nutritional status. Higher MIS was associated with poorer quality of life, older age, lower income and education, longer time on dialysis, and presence of comorbidities. Introduction malnutritioninflammation CKD, CKD , (CKD) HD (HD Methods cities MalnutritionInflammation Malnutrition Inflammation (MIS measurements function KDQOLSFTM. KDQOLSFTM KDQOL SFTM. SFTM Results 522 52 2 52.2 population 506 50 6 50.6 age 24 4 2.4 04 0 0.4 (AMC 46 4.6 347 34 7 34.7% respectively Conclusion education dialysis comorbidities (CKD 5 52. 50. 2. 0. 4. 3 34.7 34.

Resumen El objetivo principal de este manuscrito es brindar una perspectiva funcional del examen físico de mano. Por lo que se recopiló de fuentes bibliográficas y la experiencia de los autores los puntos clave que se consideran necesarios para hacer un abordaje funcional de la mano, ya que es una estructura anatómica con una muy relevante para la funcionalidad, se comenta que representa el 33% de la funcionalidad de una extremidad superior, para esto es de relevancia conocer el cómo abordarla con base en la funcionalidad, por eso es indispensable la evaluación de la mano y los dedos haciendo énfasis su movilidad realizando mediciones cuantitativas y cualitativas como el uso de índices de movilidad y el uso de un goniómetro de dedos, la medición de la fuerza puede ser medida de las mismas maneras con el uso del examen manual muscular y dinamometría de mano respectivamente y así tener en cuenta los conceptos biomecánicos como lo son el uso de palancas. Por estas cuestiones es necesario implementar una valoración de mano y dedos enfocada a la funcionalidad, teniendo presente los factores que podrían modificar la exploración y así poder reportar una valoración más orientada a las deficiencias y necesidades del paciente.

Abstract The primary goal of this manuscript is to provide a functional perspective the physical examination of the hand. Therefore, the key points that are considered necessary for a functional approach to the hand have been compiled from bibliographic sources and the experience of the authors. Since it is an anatomical structure with high relevance for functionality, it is commented that it represents 33 % of the functionality of an upper extremity, for this it is relevant to know how to approach it based on the functionality, which is why the evaluation of the hand and fingers is essential, emphasizing their mobility, performing quantitative and qualitative measurements such as the use of indices of mobility and the use of a finger goniometer, the measurement of force can be measured in the same ways with the use of manual muscle examination and hand dynamometry, respectively, and thus consider biomechanical concepts such as the use of levers . For these reasons, it is necessary to carry out an assessment of the hand and fingers focused on functionality, keeping in mind the factors that could modify the examination and thus be able to report an assessment more oriented to the patient&apos;s deficiencies and needs.

SUMMARY: The aim of the study is to investigate the differences in body composition between differently trained men and women. This research included 159 participants (84 male and 75 female) divided into 5 groups according to activity level: PI - physically inactive, PA - physically active, SP - strength and power athletes, EA - endurance athletes, TS - team sports athletes. The testing procedure of measuring body composition was carried out by the use of bioelectrical impedance analysis (BIA, InBody 720). Of the statistical analysis, ANOVA and MANOVA were used. The results showed that there is a significant difference in body composition parameters between differently trained men and women (p = 0.000; F = 2.470; η2 = 0.356, on average). Both in groups of men and women the biggest differences were observed between PI, EA and other groups (F = from 9.656 to -1.673, p = from 0.000 to 0.043; F = from 10.966 to 1.073, p = from 0.000 to 0.050, respectively). The results showed that every physical activity is beneficial from the aspect of body composition status and that the most crucial factor in improving body composition status is the regularity of physical activity. It has been shown that regular physical activity leads to a decrease in muscle fat and an increase in muscle mass and protein. Also, it has been shown that practicing a physical activity typical for endurance sports has the most significant positive impact on body composition status and leads to a significant decrease in body fat mass.

RESUMEN: El objetivo del estudio fue investigar las diferencias en la composición corporal entre hombres y mujeres con entrenamiento diferente. Esta investigación incluyó a 159 participantes (84 hombres y 75 mujeres) divididos en 5 grupos según el nivel de actividad: FI - físicamente inactivos, FA - físicamente activos, FP - atletas de fuerza-potencia, AR - atletas de resistencia, DE - atletas de deportes de equipo. El procedimiento de prueba para medir la composición corporal se llevó a cabo mediante el análisis de impedancia bioeléctrica (BIA, InBody 720). Para el análisis estadístico se utilizaron ANOVA y MANOVA. Los resultados mostraron que existe una diferencia significativa en los parámetros de composición corporal entre hombres y mujeres con entrenamiento diferente (p = 0,000; F = 2,470; η2 = 0,356, en promedio). Tanto en los grupos de hombres como en los de mujeres las mayores diferencias se observaron entre FI, AR y otros grupos (F = de 9,656 a -1,673, p = de 0,000 a 0,043; F = de 10,966 a 1,073, p = de 0,000 a 0,050, respectivamente). Los resultados mostraron que toda actividad física es beneficiosa desde el punto de vista del estado de la composición corporal y que el factor más crucial para mejorar el estado de la composición corporal es la regularidad de la actividad física. Se ha demostrado que la actividad física regular provoca una disminución de la grasa muscular y un aumento de la masa muscular y las proteínas. Además, se ha demostrado que la práctica de una actividad física típica de los deportes de resistencia tiene el impacto positivo más significativo en el estado de la composición corporal y conduce a una disminución significativa de la masa grasa corporal.

Abstract Objective To compare the phase angle (PhA) through bioelectrical impedance (BIA) of children with intestinal failure (IF) using prolonged parenteral nutrition (PN) followed by an Intestinal Rehabilitation Program, with a control group. Methods Children under 10 years of age with IF using prolonged PN for >60 days (study group) were included. The control group consisted of healthy children without chronic pathologies, matched by sex and age. Anthropometric parameters evaluated were: weight, height, weight/age z-score (W/A), height/age z-score (H/A), BMI, BMI/A z-score, arm circumference, triceps skinfold, subscapular skinfold, mid-arm muscle circumference. BIA parameters were resistance (R), reactance (Xc), and phase angle (PhA). Results Twenty-eight children were included in the study group, median (IQR) age was 11 (8-27) months, 53.6 % were male. In the control group, 28 children were included, median (IQR) age was 12.5 (8-24.7) months, 50 % were male. Children from the study group had W/A z-scores and H/A z-scores significantly lower than controls. There was no significant difference between PhA in the study group and controls, [median (IQR) 4.3° (3.8;4.6) vs 4.0° (3.8;5.4) respectively, p = 0.980]. Prematurity was significantly higher in the study group than in the controls, but there was no significant correlation between gestational age at birth and PhA of the children from the study group. Conclusion Children with IF using prolonged PN showed lower W/A and H/A compared to the control group, but without significant difference between the PhA of children with IF compared to controls. (PhA (BIA (IF (PN Program 1 60 >6 pathologies weight height weightage zscore z score W/A, WA , W A (W/A) heightage H/A, HA H (H/A) BMI BMIA zscore, score, circumference skinfold midarm mid R, R (R) Xc, Xc (Xc) PhA. . Twentyeight Twenty eight IQR (IQR 827 8 27 (8-27 months 536 53 6 53. male 2 125 12 5 12. 824.7 8247 24.7 24 7 (8-24.7 zscores scores controls 43 4 3 4.3 3.84.6 3846 3.8 4.6 (3.8;4.6 40 0 4.0 3.85.4 3854 5.4 (3.8;5.4 respectively 0.980. 0980 0.980 980 0.980] > (W/A (H/A (R (Xc 82 (8-2 824 824. 247 24. (8-24. 4. 84 3.84. 384 38 3. 46 (3.8;4. 85 3.85. 385 54 5. (3.8;5. 098 0.98 98 (8- (8-24 3.84 (3.8;4 3.85 (3.8;5 09 0.9 9 (8 (3.8; 0. ( (3.8 (3. (3

SUMMARY: The aim of this study was to determine the effects 12 weeks Step aerobics program on anthropometric characteristics and body composition in young females. A total of 94 female participants were randomly divided in two groups. The E group subsample consisted of 44 participants (20±0.4 years), who had three Step aerobics program trainings per week and the C group subsample consisted of 50 participants (20±0.6 years), who did not take part in any organized exercise program and only conducted their regular daily activities. The following measurements were used: Body height, body weight, waist size, abdomen skinfold, back skinfold, upper arm skinfold, upper leg skinfold, body fat percentage and muscle mass percentage. Upon the Step aerobics program implementation, there was a body fat reduction by 4.9 % and waist size by 7.7 %, while the muscle mass was increased by 9.4 %. Above mentioned skinfolds showed a reduction (p>0.05) at the final measurement compared to the initial one - abdomen by 25 %, upper leg by 23.7 %, back by 15.7 % and upper arm by 3.5 %. Likewise, there was a body fat percentage reduction by 2.1 % and BMI by 6.4 %. Based on the obtained results, we can conclude that the Step aerobics training is efficient in reducing subcutaneous fat tissue and viscelar fat, as well as in increasing muscle mass.

RESUMEN: El objetivo de este estudio fue determinar los efectos de un programa aeróbico Step de 12 semanas sobre las características antropométricas y la composición corporal en mujeres jóvenes. Un total de 94 mujeres participantes fueron divididas aleatoriamente en dos grupos. La submuestra del grupo E estuvo compuesta por 44 participantes (20 ± 0,4 años), que realizaron tres entrenamientos del programa aeróbico Step por semana y la submuestra del grupo C estuvo compuesta por 50 participantes (20 ± 0,6 años), que no participaron en ningún programa de ejercicio organizado y sólo realizaron sus actividades diarias habituales. Se utilizaron las siguientes mediciones: altura corporal, peso corporal, tamaño de cintura, pliegue cutáneo del abdomen, pliegue cutáneo de la espalda, pliegue cutáneo de la parte superior del brazo, pliegue cutáneo de la parte superior de la pierna, porcentaje de grasa corporal y porcentaje de masa muscular. Al implementar el programa aeróbico Step, hubo una reducción de la grasa corporal de un 4,9 % y del tamaño de la cintura de un 7,7 %, mientras que la masa muscular aumentó un 9,4 %. Los pliegues cutáneos mencionados anteriormente mostraron una reducción (p>0,05) en la medición final en comparación con la inicial: abdomen en un 25 %, parte superior de la pierna en un 23,7 %, espalda en un 15,7 % y parte superior del brazo en un 3,5 %. Asimismo, hubo una reducción del porcentaje de grasa corporal del 2,1 % y del IMC del 6,4 %. Con base en los resultados obtenidos, podemos concluir que el entrenamiento aeróbico Step es eficaz para reducir el tejido adiposo subcutáneo y la grasa visceral, así como para aumentar la masa muscular.