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

ABSTRACT: This study assessed the efficacy of magnesium sulfate and ketamine hydrochloride in reducing the demand for propofol, remifentanil, and postoperative rescue analgesia in cats undergoing elective ovariohysterectomy. Thirty cats were premedicated with acepromazine (0.05 mg/kg) and morphine (0.3 mg/kg) intramuscularly and induced to unconsciousness with propofol for orotracheal intubation. The continuous infusion (CI) of propofol and remifentanil were started and animals and were randomly allocated into three groups: the magnesium sulfate group (MG) received one bolus (50 mg/kg) and CI (80 mg/kg/h) of magnesium sulfate; the ketamine group (KG) received bolus (0.5 mg/kg) and CI (1.8 mg/kg/h) of ketamine hydrochloride; the control group (CG) received bolus and CI of 0.9% saline solution. Cardiovascular and respiratory functions, extubation time, and rescue postoperative scores were assessed and data were described with a significance level of 95% (P < 0.05). The infusion period of treatments was 21.5 ± 3.4 and 21.0 ± 2.4 minutes in the KG and MG, respectively (P = 0.194). The infusion rates of remifentanil (P = 0.336) and propofol (P = 0.716) were similar between groups. Analysis of the postoperative pain scales revealed no significant intergroup differences in rescue frequency, rescue score, and time to the first rescue analgesia. In conclusion, the proposed protocols were safe and effective, yet it is noteworthy that both magnesium sulfate and ketamine failed to demonstrate significant additional postoperative analgesic or adjuvant anesthetic effects. ABSTRACT ovariohysterectomy 0.05 005 0 05 (0.0 mg/kg mgkg mg kg 0.3 03 3 (0. intubation (CI groups MG (MG 50 (5 80 (8 mg/kg/h mgkgh h (KG 0.5 5 1.8 18 1 8 (1. CG (CG 09 9 0.9 solution functions 95 P 0.05. . 0.05) 215 21 21. 34 4 3. 210 24 2 2. 0.194. 0194 0.194 194 0.194) 0.336 0336 336 0.716 0716 716 frequency score conclusion effective effects 0.0 00 0. (0 ( 1. (1 019 0.19 19 0.33 033 33 0.71 071 71 01 0.1 0.7 07 7

RESUMO: Objetivou-se avaliar a eficácia do sulfato de magnésio e cetamina em reduzir o requerimento de propofol, remifentanil e o resgate analgésico pós-operatório de gatas submetidas à ovariohisterectomia eletiva. Trinta gatas foram pré-medicadas com acepromazina (0,05 mg/kg) e morfina (0,3 mg/kg), intramuscular, e induzidas a inconsciência com propofol para intubação orotraqueal. As infusões contínuas (IC) de propofol e remifentanil foram iniciadas e os animais foram aleatoriamente alocados em três grupos: grupo sulfato de magnésio (MG) que recebeu bolus (50 mg/kg) e IC (80 mg/kg) de sulfato de magnésio; grupo cetamina (KG) que recebeu bolus (0,5 mg/kg) e IC (1,8 mg/kg/h) de cetamina; grupo controle (CG) que recebeu bolus e IC de solução salina 0,9%. As funções cardiovasculares e respiratórias, o tempo de extubação e a pontuação de resgate pós-operatório foram registrados e descritos com nível de significância de 95% (P < 0.05). O tempo de infusão dos tratamentos foi de 21,5 ± 3,4 e 21,0 ± 2,4 minutos no KG e MG, respectivamente (P = 0.194). As taxas de infusões de remifentanil (P = 0.336) e propofol (P = 0.716) foram similares entre grupos. Na análise de dor pós-operatória as escalas não demonstraram diferenças entre grupos quanto a número de resgates, pontuação de resgate ou tempo para o primeiro resgate. Em conclusão, os protocolos propostos foram seguros e efetivos. Contudo, o sulfato de magnésio e cetamina não demonstraram analgesia pós-operatória adicional ou efeitos adjuvantes anestésicos significativos. RESUMO Objetivouse Objetivou se pósoperatório pós operatório eletiva prémedicadas pré medicadas 0,05 005 0 05 (0,0 mg/kg mgkg mg kg 0,3 03 3 (0, mg/kg, , intramuscular orotraqueal (IC MG (MG 50 (5 80 (8 (KG 0,5 5 1,8 18 1 8 (1, mg/kg/h mgkgh h CG (CG 09 9 0,9% respiratórias 95 P 0.05. 0.05 . 0.05) 215 21 21, 34 4 3, 210 24 2 2, 0.194. 0194 0.194 194 0.194) 0.336 0336 336 0.716 0716 716 pósoperatória operatória resgates conclusão efetivos Contudo significativos 0,0 00 0, (0 ( 1, (1 0,9 0.0 019 0.19 19 0.33 033 33 0.71 071 71 0. 01 0.1 0.3 0.7 07 7

Resumo Analisou-se a viabilidade técnica e ambiental da Erythrina poeppigiana para produzir compensados com os adesivos: fenol-formaldeído (FF); uréia-formaldeído (UF) e poliuretano à base de mamona (PU). Avaliou-se as propriedades física e mecânica: densidade aparente, teor de umidade, absorção de água, inchamento em espessura, resistência ao cisalhamento e flexão estática. Os testes apontaram a viabilidade da eritrina para produção de compensados não estruturais. A avaliação ambiental, através dos indicadores, quantificação da energia embutida e emissão de CO 2 e, demonstrou que os pain compensado produzido com adesivo PU teve melhor desempenho que os painéis com FF e UF. O tratamento T1 (FF) apresentou maior energia embutida, o T2 (UF) a maior emissão de CO 2 e. A viabilidade técnica e ambiental da eritrina para produzir compensados pode promover o desenvolvimento socioeconômico regional, ambientalmente sustentável, com vantagens em relação aos compensados estrangeiros, bem como ao desempenho ambiental. Analisouse Analisou se adesivos fenolformaldeído fenol formaldeído uréiaformaldeído uréia UF (UF PU. . (PU) Avaliouse Avaliou mecânica aparente umidade água espessura estática estruturais indicadores T (FF regional sustentável estrangeiros (PU

Abstract The study analyzed the technical and environmental feasibility of using Erythrina poeppigiana to produce plywood with different adhesives: phenol-formaldehyde (PF), urea-formaldehyde (UF), and castor oil-based polyurethane (PUA). The physical and mechanical properties of the plywood were evaluated, including apparent density, moisture content, water absorption, thickness swelling, shear resistance, and static bending. Tests proved erythrina’s suitability for non-structural plywood production. The environmental impact of the production process was also evaluated, using embedded energy and CO2e emissions as indicators. The results showed that plywood produced with PU adhesive had better environmental performance compared to panels with FF and UF adhesives. T1 treatment (PF) had the highest embodied energy, while T2 (UF) had the highest CO2e emission. Overall, the study suggests that using erythrina to produce plywood can be a viable option for promoting regional socioeconomic development while also being environmentally sustainable and presents an advantage over foreign plywood in terms of environmental performance. adhesives phenolformaldehyde phenol formaldehyde PF, PF , ureaformaldehyde urea UF, oilbased oil based PUA. PUA . (PUA) evaluated density content absorption swelling resistance bending erythrinas s nonstructural non structural COe CO e indicators T (PF (UF emission Overall (PUA

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 Shoulder trauma is one of the most common pathologies in traumatology; it can range from soft-tissue trauma to fractures. Dislocations are common and generate damage to internal structures that predispose to new dislocation events and chronic pain. In this paper, an image review will be performed of the different pathologies that can occur in traumatic and non-traumatic dislocations. Glenohumeral instability has many forms of presentation and the radiologist plays an important role in the diagnosis.

Resumen El trauma del hombro es una de las patologías más comunes en traumatología, se pueden presentar desde trauma de tejidos blandos hasta fracturas. Las luxaciones son comunes y generan daños de estructuras internas que predisponen a nuevos eventos de luxación y dolor crónico. En este trabajo se realizará una revisión por imagen de las diferentes patologías que pueden ocurrir en las luxaciones traumáticas y no traumáticas. La inestabilidad glenohumeral tiene muchas formas de presentación y el radiólogo juega un papel importante en el diagnóstico.

Resumo O complexo da esclerose tuberosa (CET) é uma doença autossômica dominante caracterizada pelo desenvolvimento de hamartomas no sistema nervoso central, coração, pele, pulmões e rins e outras manifestações, incluindo convulsões, tubérculos corticais, linhas de migração radial, autismo e deficiência cognitiva. A doença está associada a variantes patogênicas nos genes TSC1 ou TSC2, resultando na hiperativação da via mTOR, um importante regulador do crescimento e metabolismo celular. Consequentemente, a hiperativação da via mTOR leva à proliferação anormal do tecido e ao desenvolvimento de tumores sólidos. O envolvimento renal no CET é caracterizado pelo desenvolvimento de lesões císticas, carcinoma de células renais e angiomiolipomas renais, que podem progredir e causar dor, sangramento e perda da função renal. Nos últimos anos, houve uma mudança notável na abordagem terapêutica do CET, especialmente no tratamento das manifestações renais. Os inibidores de mTOR surgiram como a principal opção terapêutica, enquanto intervenções cirúrgicas como nefrectomia e embolização são reservadas principalmente para complicações que não respondem ao tratamento clínico, como hemorragia renal grave. Esta revisão se concentra nas principais características clínicas do CET, nos mecanismos subjacentes ao envolvimento renal, nos recentes avanços na terapia para lesões renais e nas perspectivas futuras. (CET central coração pele convulsões corticais radial cognitiva TSC TSC2 celular Consequentemente sólidos císticas dor anos clínico grave futuras

Abstract Tuberous sclerosis complex (TSC) is an autosomal dominant disease characterized by the development of hamartomas in the central nervous system, heart, skin, lungs, and kidneys and other manifestations including seizures, cortical tubers, radial migration lines, autism and cognitive disability. The disease is associated with pathogenic variants in the TSC1 or TSC2 genes, resulting in the hyperactivation of the mTOR pathway, a key regulator of cell growth and metabolism. Consequently, the hyperactivation of the mTOR pathway leads to abnormal tissue proliferation and the development of solid tumors. Kidney involvement in TSC is characterized by the development of cystic lesions, renal cell carcinoma and renal angiomyolipomas, which may progress and cause pain, bleeding, and loss of kidney function. Over the past years, there has been a notable shift in the therapeutic approach to TSC, particularly in addressing renal manifestations. mTOR inhibitors have emerged as the primary therapeutic option, whereas surgical interventions like nephrectomy and embolization being reserved primarily for complications unresponsive to clinical treatment, such as severe renal hemorrhage. This review focuses on the main clinical characteristics of TSC, the mechanisms underlying kidney involvement, the recent advances in therapy for kidney lesions, and the future perspectives. (TSC system heart skin lungs seizures tubers lines disability genes metabolism Consequently tumors lesions angiomyolipomas pain bleeding function years option treatment hemorrhage perspectives

Abstract Introduction Eagle syndrome is a rare and an often misdiagnosed entity in otorhinolaryngology. Objective To determine the efficacy of the surgical treatment for Eagle syndrome. Methods The present prospective study included 25 patients who presented with complaints of pain in the throat, ear, and neck, as well as difficulty and/or pain while swallowing; they were assessed for Eagle syndrome. As per patient profile, we performed a clinical assessments along with orthopantomograms (OPGs), three-dimensional computed tomography (3D CT) scans, and cone beam computed tomography (CBCT). Pain was assessed pre- and postoperatively through the Numerical Rating Scale-11 (NRS-11), whose score ranges from 0 to 10. Microscopic tonsillo-styloidectomy was performed in cases in which the conservative treatment failed to relieve pain. Results The mean age of the entire study population was of 36.08 ± 7.19 years, and the male-to-female ratio was of 1.08:1. Referred otalgia was the commonest (44%) complaint. Radiologically, out of 25 patients, 20 patients presented elongated styloid processes. The longest symptomatic styloid process measured radiographically was of 64.7 mm while the shortest was of 28.2 mm. Out of 20 patients, 12 underwent surgery. The postoperative pain assessment through the NRS-11 was performed on day 0 (3.83 ± 0.83), day 7 (1.5 ± 0.52), week 4 (0.5 ± 0.52), and week 12 (0.41 ± 0.51). By 12 weeks, 7 patients were symptom-free, while 5 patients still reported mild pain. Conclusion Eagle syndrome associated with an elongated styloid process is not a rarity, but it often goes undiagnosed. Microscopic tonsillo-styloidectomy shows excellent results in the management of patients with Eagle syndrome. otorhinolaryngology 2 throat ear neck andor or swallowing profile OPGs, OPGs , (OPGs) threedimensional three dimensional 3D D CT scans CBCT. CBCT . (CBCT) pre Scale11 Scale 11 Scale-1 NRS11, NRS11 NRS (NRS-11) 10 tonsillostyloidectomy tonsillo styloidectomy 3608 36 08 36.0 719 19 7.1 years maletofemale male female 1.081. 1081 1.08 1. 1 1.08:1 44% 44 (44% complaint Radiologically processes 647 64 64. 282 28 28. surgery NRS-1 3.83 383 3 83 (3.8 0.83, 083 0.83 0.83) 1.5 15 (1. 0.52, 052 0.52 52 0.52) 0.5 05 (0. 0.41 041 41 (0.4 0.51. 051 0.51 51 0.51) weeks symptomfree, symptomfree symptom free, free symptom-free rarity undiagnosed (OPGs (CBCT Scale1 Scale- NRS1 (NRS-11 360 36. 71 7. 081 1.081 108 1.0 1.08: (44 6 NRS- 3.8 38 8 (3. 0.8 (1 0. (0 0.4 04 (NRS-1 (4 3. (3 ( (NRS- (NRS

Abstract Introduction Tonsillectomy is one of the most common operations performed by otorhinolaryngology surgeons worldwide; however, the insufficient quality of the postoperative pain management and effective posttonsillectomy pain relief remain a clinical dilemma. Objective To evaluate the efficacy of applying bismuth iodine paraffin paste (BIPP) to the dissected fossa as an adjuvant therapy for a better outcome in terms of posttonsillectomy pain management and due to its wound healing properties. Methods The present is a prospective randomized control pilot study with 44 patients aged > 7 years who underwent tonsillectomy. The patients were divided into two groups: the control group and the group that had BIPP applied to the dissected tonsillar fossa. The visual analogue scale score and the post-onsillectomy percentage of tonsillar fossa epithelization were recorded and evaluated. Results Both subjectively and objectively, there a was statistically significant pain-relieving effect in the BIPP group within the first 5 postoperative days (p < 0.05). From postoperative day 3 onward, the dissected area of the tonsillar fossa healed significantly faster in the BIPP group compared with the control group, and it became stable on day 14. Conclusion The topical application of BIPP showed a better pain-relieving effect, it was safe, and hastened wound healing after tonsillectomy. worldwide however dilemma (BIPP properties 4 tonsillectomy groups postonsillectomy post onsillectomy evaluated objectively painrelieving relieving p 0.05. 005 0.05 . 0 05 0.05) onward 14 safe 00 0.0 1 0.

Abstract Introduction Submandibular gland fistula (SGF) is a rare subset of salivary gland fistulas. It is seldom tough to diagnose them prior to surgical exploration, and it is often clinically confused with close differentials. An early diagnosis based on pertinent clinical features and focused radiological findings can be pivotal in optimal management and help prevent recurrence and avoid unnecessary investigations/interventions. Objective To review articles that discuss SGF and provide vital etiological, clinical, and imaging features of this rare entity that can aid in early clinical diagnosis. Data Synthesis An extensive review involving PubMed and Google Scholar and reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Conclusion Submandibular gland fistula is a rare entity. It can be confused with close differentials, including branchial fistulas, if not thoroughly examined. Discharge from fistulae along with submandibular pain/tenderness and/or swelling are important diagnostic clues. A history of trauma, nodule at the site of discharge, prior submandibular disease/calculi, or discharge aggravated with food further increases a clinical suspicion. Optimal radiological investigation looking for calculi/foreign body and delineating the fistula tract is vital to affirm a diagnosis. Gland with fistula excision is a commonly advocated treatment of choice with no reports of recurrence, although conservative management and gland preserving surgery have also reported a favorable prognosis. (SGF fistulas exploration differentials investigationsinterventions investigations interventions investigations/interventions etiological MetaAnalyses Meta Analyses PRISMA (PRISMA standards examined paintenderness pain tenderness andor clues trauma diseasecalculi disease calculi disease/calculi suspicion calculiforeign foreign prognosis

Abstract Chronic ulcers significantly affect the quality of life of patients and impose a high cost on the healthcare system. The therapeutic management should be comprehensive, taking into consideration the etiological diagnosis of the wound and the characteristics of the wound bed when deciding on a therapeutic proposal appropriate to the healing phase, correcting factors that delay healing. During the epithelialization phase, repair techniques with grafts are recommended to shorten re-epithelialization time, improve the quality of scar tissue, and achieve adequate pain management. Currently, due to the reported benefits of skin appendages, the technique of follicular unit auto-grafting obtained with a scalp punch is among the chosen strategies for wound repair. This is a minimally invasive, outpatient practice, whose technique has advantages over the donor site, patients recovery and well-being. system comprehensive phase reepithelialization re time tissue Currently appendages autografting auto grafting invasive practice site wellbeing. wellbeing well being. being well-being

Abstract Background Neurofibromatosis type 1 (NF1) is a rare genetic disorder with a wide range of clinical manifestations, notably neurocutaneous features, that can lead to emotional and physical consequences. Objectives This study assessed the influence of sociodemographic factors and clinical features of the disease on the quality of life of Brazilian individuals with NF1. Methods This is a descriptive cross-sectional study. Data were collected from 101 individuals with NF1 using the Brazilian version of the Impact of NF1 on Quality of Life Questionnaire (INF1-QoL), a form with information on sociodemographic characteristics, and an NF1 visibility self-evaluation scale. The relationship between variables was evaluated through statistical testing, and the significance level was defined as 0.05. Results The study included 101 adults with NF1 aged 18 to 59 years, with a mean age of 35.54 years (±9.63) and a female predominance (n = 84, 83.17%). The mean total INF1-QoL score was 10.62 (±5.63), with a median of 10, minimum value of 0, and maximum of 31 points. Two characteristics of the participants were significantly associated with the quality of life: educational level (p = 0.003) and familial history of NF1 (p = 0.019). There was a statistically significant correlation between the INF1-QoL score and the degree of disease visibility (rho = 0.218; p = 0.028). Study limitations Cross-sectional study, conducted with a convenience sample and using self-reported measures. Conclusions The findings support the significant impact of NF1 on quality of life. The authors recommend multidisciplinary follow-up for patients, with adherence to anticipatory clinical care measures, adequate pain control, psychological assistance, and genetic counseling. NF (NF1 manifestations consequences crosssectional cross sectional 10 INF1QoL, INF1QoL INFQoL INF1 QoL , INF (INF1-QoL) selfevaluation self evaluation scale testing 005 0 05 0.05 5 3554 35 54 35.5 ±9.63 963 9 63 (±9.63 n 84 83.17%. 8317 83.17% . 83 17 83.17%) 1062 62 10.6 ±5.63, 563 ±5.63 (±5.63) 3 points 0.003 0003 003 0.019. 0019 0.019 019 0.019) rho 0.218 0218 218 0.028. 0028 0.028 028 0.028) Crosssectional Cross selfreported reported measures followup follow up patients control assistance counseling (NF (INF1-QoL 00 0.0 355 35. ±9.6 96 6 (±9.6 8 831 83.17 106 10. 56 ±5.6 (±5.63 0.00 000 001 0.01 01 0.21 021 21 002 0.02 02 0. ±9. (±9. 83.1 ±5. (±5.6 0.2 2 ±9 (±9 83. ±5 (±5. ± (± (±5 (

RESUMO Neste artigo nos propomos a pensar a implantação do SIAT II Acolher Helvétia, durante a chamada Operação Caronte, como parte de uma lógica de atuação governamental na Cracolândia explicitada pela primeira vez na operação Dor e Sofrimento. Ancorados na experiência pregressa dos autores em pesquisas de campo na região, realizamos uma ampla pesquisa bibliográfica e documental que nos permitiu verificar que as ações dos governos estadual e municipal passaram a assumir um caráter militarizado de dispersão e concentração dos usuários de crack. No intuito inicial de ocupar serviços públicos subutilizados, essas ações acabaram por estabelecer ali uma situação de guerra generalizada. Concluímos que as ações do município e do governo do estado em torno da Operação Caronte mantiveram a principal tendência da atuação governamental na Cracolândia: a de tornar insuportáveis as condições de vida nas ruas e, ao provocar dor e sofrimento, expulsar os usuários de crack pela imposição do tratamento baseado na abstinência. Helvétia Sofrimento região subutilizados generalizada sofrimento abstinência

ABSTRACT In this article, we propose to think about the implementation of SIAT II Acolher Helvétia, during the so-called Operation Caronte, as part of a logic of government action in Cracolândia explained by the first time in Operation Dor e Sofrimento. Anchored in the authors’ previous experience in field research in the region, we carried out an extensive bibliographical and documentary research that allowed us to verify that the actions of state and municipal governments began to assume a militarized character of dispersion and concentration of crack users. With the initial intention of occupying underutilized public services, these actions ended up establishing a situation of generalized war there. We conclude that the actions of the municipality and state government around Operation Caronte maintained the main tendency of government action in Cracolândia: to make living conditions on the streets unbearable and, by causing pain and suffering, expel crack users by imposing abstinence-based treatment. article Helvétia socalled so called Sofrimento authors region services there suffering abstinencebased abstinence based treatment

RESUMEN Introducción: el riesgo de aparición del infarto agudo de miocardio está relacionada con varias comorbilidades, muchas de las cuales son prevenibles y tratables. El infarto agudo de miocardio tiene un impacto relevante en términos de mortalidad y número de hospitalizaciones. Objetivos: determinar las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Metodología: el diseño del estudio fue observacional, descriptivo de corte transversal, sobre las características clínica-epidemiológicas del infarto agudo de miocardio con elevación del segmento ST en pacientes mayores de edad atendidos en el Centro Médico Nacional-Hospital Nacional, durante el periodo 2021-2023. Resultados: se analizaron 102 expedientes de pacientes con diagnóstico de infarto agudo de miocardio con elevación del segmento ST con una media de 64 ± 12 años; el 68 % (n = 69) correspondió al sexo masculino, con una edad promedio de 62 años, y en relación a las mujeres el promedio fue de 64 años. El motivo de consulta principal fue el dolor precordial y la cara miocárdica más afectada de acuerdo con el electrocardiograma inicial fue la cara anteroseptal. La mortalidad intrahospitalaria fue del 16 %, el 68 % correspondió a varones. La comorbilidad más frecuente fue la hipertensión arterial. Conclusión: La hipertensión arterial es la patología más prevalente. Asimismo, son habituales la obesidad, el tabaquismo y la diabetes mellitus. Las comorbilidades están en relación directa con la edad y prevalecen en mayores de 60 años. El infarto agudo de miocardio con elevación del segmento ST es más frecuente en el sexo masculino.

ABSTRACT Introduction: the risk of acute myocardial infarction is related to several comorbidities, many of which are preventable and treatable. Acute myocardial infarction has a relevant impact in terms of mortality and number of hospitalizations. Objectives: the design of the study was observational, descriptive, cross-sectional, on the clinical characteristics of ST-segment elevation myocardial infarction, in adult patients treated at the Centro Médico Nacional-Hospital Nacional, during the period 2021-2023. Methodology: the design of the study was observational, descriptive, cross-sectional, on the clinical-epidemiological characteristics of acute myocardial infarction with ST segment elevation in adult patients treated at the National Medical Center-National Hospital, during the period 2021-2023. Results: 102 records of patients with a diagnosis of ST-segment elevation myocardial infarction with a mean age of 64 ± 12 years were analyzed; 68 % (n = 69) were male, with an average age of 62 years, and in relation to women the average was 64 years. The main reason for consultation was precordial pain and the most affected myocardial aspect according to the initial electrocardiogram was the anteroseptal aspect. In-hospital mortality was 16 %, 68 % of which were men. The most frequent comorbidity was arterial hypertension. Conclusion: high blood pressure is the most prevalent pathology. Likewise, obesity, smoking and diabetes mellitus are common. Comorbidities are directly related to age and prevail in those over 60 years of age. ST-segment elevation myocardial infarction is more common in males.

RESUMEN La subluxación atlantoaxial es la lesión más frecuente en la columna cervical causada por la artritis reumatoidea. Se manifiesta por rigidez de nuca, dolor cervical y déficit neurológico. El diagnóstico se realiza con tomografía computarizada e imágenes de resonancia magnética. El intervalo atlanto dental anterior mayor a 5mm indica inestabilidad atlantoaxial, el intervalo atlanto dental posterior menor a 14mm advierte riesgo neurológico. Las indicaciones más frecuentes de cirugía son: dolor cervical severo, inestabilidad y síntomas de mielopatía. Cuando existe compresión medular es necesaria la descompresión cervical alta sea por vía posterior o por vía anterior (odontoidectomía endonasal versus transoral). La línea rinopalatina nos indicará la factibilidad de una odontoidectomía endonasal endoscópica (OEE). El objetivo de la presentación del presente caso es compartir nuestra experiencia con la primera odontoidectomía endonasal endoscópica realizada en nuestro país y fomentar la utilización de la técnica. La cirugía fue realizada en un paciente con cuadriparesia espástica por subluxación atlantoaxial por artritis reumatoidea y que presentó excelente evolución pos operatoria, con recuperación casi completa. La OEE es una técnica operatoria mínimamente invasiva, ideal para pacientes con múltiples comorbilidades y que ofrece de buenos a excelentes resultados.

ABSTRACT Atlantoaxial subluxation is the most common injury to the cervical spine caused by rheumatoid arthritis. It is manifested by neck stiffness, neck pain and neurological deficit. Diagnosis is made with computed tomography and magnetic resonance imaging. The anterior dental atlanto interval greater than 5mm indicates atlantoaxial instability, the posterior dental atlanto interval less than 14mm warns of neurological risk. The most frequent indications for surgery are: severe neck pain, instability and symptoms of myelopathy. When there is spinal cord compression, upper cervical decompression is necessary, either via a posterior or anterior approach (endonasal versus transoral odontoidectomy). The rhinopalatine line will indicate the feasibility of an endoscopic endonasal odontoidectomy (EEO). The objective of the presentation of this case is to share our experience with the first endoscopic endonasal odontoidectomy performed in our country and to promote the use of the technique. The surgery was performed on a patient with spastic quadriparesis due to atlantoaxial subluxation due to rheumatoid arthritis and who presented excellent postoperative evolution, with almost complete recovery. EEO is a minimally invasive surgical technique, ideal for patients with multiple comorbidities and offering good to excellent results.

Abstract Objective: Ovarian torsion (OT) represents a severe gynecological emergency in female pediatric patients, necessitating immediate surgical intervention to prevent ovarian ischemia and preserve fertility. Prompt diagnosis is, therefore, paramount. This retrospective study set out to assess the utility of combined clinical, ultrasound, and laboratory features in diagnosing OT. Methods: The authors included 326 female pediatric patients aged under 14 years who underwent surgical confirmation of OT over a five-year period. Logistic regression analysis was employed to pinpoint factors linked with OT, and the authors compared clinical presentation, laboratory results, and ultrasound characteristics between patients with OT (OT group) and without OT (N-OT group). The authors conducted receiver operating characteristic (ROC) curve analysis to gauge the predictive capacity of the combined features. Results: Among 326, OTwas confirmed in 24.23 % (79 cases) of the patients. The OT group had a higher incidence of prenatal ovarian masses than the N-OT (22 cases versus 7 cases) (p < 0.0001). Similarly, the authors observed significant differences in the presence of lower abdominal pain, suspected torsion on transabdominal ultrasound, and a high neutrophil-lymphocyte ratio (NLR > 3) between the OTand non-OT groups (p < 0.05). Furthermore, when these parameters were combined, the resulting area under the curve (AUC) was 0.868, demonstrating their potential utility in OT diagnosis. Conclusion: This study demonstrates a prediction model integrating clinical, laboratory, and ultrasound findings that can support the preoperative diagnosis of ovarian torsion, thereby enhancing diagnostic precision and improving patient management. Future prospective studies should concentrate on developing clinical predictive models for OTin pediatric patients. Objective fertility is therefore paramount Methods 32 1 fiveyear five year period presentation results NOT N group. . ROC (ROC Results 2423 24 23 24.2 79 (7 22 (2 p 0.0001. 00001 0.0001 0 0001 0.0001) Similarly pain neutrophillymphocyte neutrophil lymphocyte NLR 3 nonOT non 0.05. 005 0.05 05 0.05) Furthermore AUC (AUC 0868 868 0.868 Conclusion management 242 2 24. ( 0000 0.000 000 00 0.0 086 86 0.86 0.00 0. 08 8 0.8