RESUMO Objetivo: Descrever as características epidemiológicas de pacientes pediátricos com doença falciforme (DF) e avaliar o uso de plantas medicinais concomitantemente ao tratamento medicamentoso. Métodos: Realizou-se revisão de prontuários de pacientes pediátricos de uma instituição pública com nível de atendimento terciário; o critério de seleção foi ser criança ou adolescente com DF em acompanhamento pediátrico neste ambulatório. Nos prontuários dos pacientes selecionados foi procurado o registro do uso de plantas com finalidades medicinais. Resultados: Foram revisados 154 prontuários (100% dos pacientes ativos desse ambulatório): 99 crianças e 55 adolescentes. O genótipo predominante foi SS (58,4%), seguido do SC (29,2%). O uso de ao menos uma medicação para a DF foi relatada em 95,5% dos prontuários. Em 70,1% dos prontuários havia o relato do uso de plantas medicinais, em 276 citações, sendo 64 plantas citadas ao todo; destas, seis espécies foram citadas para o tratamento da doença de base (DF), sendo “ora-pro-nobis” (Pereskia aculeata) a principal. Das 276 citações de plantas medicinais nos prontuários, 60,5% incluíram o uso de plantas medicinais em sintomas gripais e/ou COVID-19 (tanto prevenção quanto tratamento), sendo relatadas 35 para este uso, exclusivamente ou não. Essa foi a principal finalidade de uso encontrada nos prontuários dos pacientes, seguida do uso para sintomas de dor (14,2% das citações). Conclusões: Notou-se que a maioria dos pacientes avaliados faz uso da medicina convencional, aliada à tradicional/ complementar/ alternativa, o que leva à necessidade de mais estudos nessas áreas, especialmente na pediatria, visando principalmente à segurança do paciente. Objetivo (DF medicamentoso Métodos Realizouse Realizou se terciário ambulatório Resultados 15 100% 100 (100 ambulatório) 9 5 adolescentes 58,4%, 584 58,4% , 58 4 (58,4%) 29,2%. 292 29,2% . 29 2 (29,2%) 955 95 95,5 701 70 1 70,1 27 6 todo destas DF, orapronobis ora pro nobis “ora-pro-nobis Pereskia aculeata 605 60 60,5 eou COVID19 COVID 19 COVID-1 tanto tratamento, tratamento) 3 não 14,2% 142 14 (14,2 citações. citações) Conclusões Notouse Notou convencional tradicional complementar alternativa áreas pediatria paciente 10 (10 58,4 (58,4% 29,2 (29,2% 95, 7 70, 60, COVID1 COVID- 14,2 (14, (1 58, (58,4 29, (29,2 14, (14 ( (58, (29, (58 (29 (5 (2

ABSTRACT Objective: The aim of this study was to describe the epidemiological characteristics of pediatric patients with sickle cell disease (SCD) and evaluate the use of medicinal plants in these patients concomitantly with their drug treatment. Methods: This is a review of the medical records of pediatric patients at a public institution with tertiary care. The selection criterion was to be a child or adolescent with SCD undergoing pediatric follow-up at this outpatient clinic. In the medical records of the patients selected, records of the use of plants for medicinal purposes were sought. Results: In total, 154 records (100% of total active patients followed in this clinic) were reviewed: 99 children and 55 adolescents. The predominant genotype was SS (58.4%), followed by SC (29.2%). The use of at least one medication for SCD was reported in 95.5% of the medical records. The use of medicinal plants was reported by 70.1% of patients, with 276 citations in the medical records referring to 64 different types of plants. Six plants were used for the treatment of SCD, the main one being Lemonvine/Ora-pro-nóbis (Pereskia aculeata). The use of medicinal plants was reported for flu-like symptoms and/or COVID-19 (both for prevention and treatment) by 60.5% of the citations, with 35 different plants reported for this use, exclusively or not. This use was followed by pain symptoms (14.2% of citations). Conclusions: The majority of patients in this study use both conventional and traditional/complementary/alternative medicine, highlighting the need for more studies in the area, with a special focus on patient safety. Objective (SCD Methods care followup follow up clinic selected sought Results 15 100% 100 (100 reviewed 9 5 adolescents 58.4%, 584 58.4% , 58 4 (58.4%) 29.2%. 292 29.2% . 29 2 (29.2%) 955 95 95.5 701 70 1 70.1 27 6 Lemonvine/Orapronóbis LemonvineOrapronóbis Lemonvine/Ora pro nóbis Lemonvine Ora Pereskia aculeata. aculeata aculeata) flulike flu like andor COVID19 COVID 19 COVID-1 605 60 60.5 3 not 14.2% 142 14 (14.2 citations. citations) Conclusions traditionalcomplementaryalternative traditional complementary alternative medicine area safety 10 (10 58.4 (58.4% 29.2 (29.2% 95. 7 70. Orapronóbis LemonvineOra COVID1 COVID- 60. 14.2 (14. (1 58. (58.4 29. (29.2 14. (14 ( (58. (29. (58 (29 (5 (2

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

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

ABSTRACT: Acute abdomen cases are among the most prevalent and challenging illnesses in equine medicine. The diagnosis includes anamnesis and detailed clinical evaluation of the patient, allowing the gathering of several important information and, additionally, the use of complementary exams helps to define the diagnosis and prognosis of each case. This research applied the multiple correspondence analysis (MCA) in data referring to clinical examination information and outcome of horses with colic referred to a hospital in Rio Grande do Sul, Brazil. Fifty eight horses were included in the analysis and, it was possible to identify significant differences between the groups, survivors and non-survivors. Related to clinical signs, non-survivor cases are distinguished by severe pain, lack of motility, mucosal alteration, capillary refill time greater than 2sec, heart rate more than 48bpm and presence of nasogastric reflux. As complementary exams, hematocrits and blood lactate demonstrate significative difference among the groups. The cardiovascular parameters, including heart rate, mucosal color and capillary refill time, were the variables with the greatest contribution to discriminate animals that non-survive from those that were discharged. Thus, clinical evaluation should not be underestimated and complementary exams should be used in conjunction to seek a better prognosis. The MCA allowed to visualize the data and predict the outcome of the patients. ABSTRACT medicine patient additionally case (MCA Sul Brazil groups nonsurvivors. nonsurvivors non survivors. non-survivors signs nonsurvivor survivor pain motility alteration 2sec sec bpm reflux parameters nonsurvive survive discharged Thus patients

RESUMO: Os casos de abdome agudo estão entre as doenças mais prevalentes e desafiadoras na medicina equina. O diagnóstico inclui a realização de anamnese e avaliação clínica detalhada do paciente, permitindo a coleta de diversas informações importantes e, adicionalmente, a utilização de exames complementares ajuda a definir o diagnóstico e prognóstico de cada caso. O objetivo principal deste trabalho foi aplicar a análise de correspondência múltipla (ACM) em dados referentes ao exame clínico e desfecho de cavalos com cólica encaminhados para um hospital no Rio Grande do Sul, Brasil. Foram incluídos 58 cavalos na análise e foi possível identificar diferenças significativas entre os grupos, sobreviventes e não sobreviventes. Relacionado aos sinais clínicos, os casos de óbito distinguem-se por dor intensa, falta de motilidade, alteração da mucosa, tempo de preenchimento capilar maior que 2seg., frequência cardíaca maior que 48bpm e presença de refluxo nasogástrico. Como exames complementares, o hematócrito e o lactato sanguíneo demonstraram diferença significativa entre os grupos. Os parâmetros cardiovasculares, como batimento cardíaco, coloração de mucosas e tempo de preenchimento capilar, foram as variáveis com maior contribuição para diferenciar animais que não sobreviveram dos que receberam alta hospitalar. Assim, a avaliação clínica não deve ser subestimada e os exames complementares devem ser utilizados em conjunto para buscar um melhor prognóstico. A ACM permitiu visualizar os dados e prever o desfecho dos pacientes. RESUMO equina paciente adicionalmente caso (ACM Sul Brasil 5 grupos clínicos distinguemse distinguem se intensa motilidade mucosa 2seg seg 2seg. bpm nasogástrico cardiovasculares cardíaco hospitalar Assim pacientes

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.

Resumen Marco contextual: El dolor torácico agudo (DTA) es un síntoma frecuente en las personas con síndrome coronario agudo (SCA) que a menudo requiere atención de urgencias. Objetivo: Conocer el tiempo de respuesta prehospitalaria y el papel del enfermero de la ambulancia de soporte vital inmediato en casos de DTA en personas con posible SCA en dos distritos del norte de Portugal. Metodología: Estudio observacional, analítico, transversal, retrospectivo, cuantitativo, con una muestra de 75 casos. Resultados: Se registraron tiempos totales de respuesta prehospitalaria largos, superiores a 95 minutos en ambos distritos, y en infarto agudo de miocardio con elevación del segmento ST (EAMCSST), con tiempos medios de 131 ± 22,23 minutos, seguido del 10,66% de la muestra total. Los enfermeros utilizaron el protocolo de dolor torácico en la mayoría de los casos (98,7%), realizaron electrocardiogramas (97,3%) y contribuyeron a la mejoría de los síntomas (72%). Conclusión: El enfermero es fundamental para diagnosticar y controlar los síntomas, pero los tiempos de respuesta, sobre todo en el IAMCEST, superan los recomendados para el procedimiento de elección, la angioplastia.

Resumo Enquadramento: A dor torácica aguda (DTA) é um sintoma comum na pessoa com síndrome coronária aguda (SCA) que requer frequentemente cuidados de emergência. Objetivo: Conhecer o tempo de resposta pré-hospitalar e a atuação do enfermeiro da ambulância suporte imediato de vida nas ocorrências de DTA, na pessoa com suspeita de SCA, relativamente a dois distritos do interior norte de Portugal. Metodologia: Estudo observacional, analítico transversal, retrospetivo, de cariz quantitativo, numa amostra de 75 ocorrências. Resultados: Verificaram-se tempos totais longos na resposta pré-hospitalar, ultrapassando os 95 minutos em ambos os distritos e, no enfarte agudo miocárdio com elevação do segmento ST (EAMCSST), apresentando tempos médios de 131 ± 22,23 minutos, sucedido em 10,66% da amostra total. Os enfermeiros utilizaram o protocolo da dor torácica na generalidade das ocorrências (98,7%), realizaram eletrocardiograma (97,3%) e contribuíram para a melhoria dos sintomas (72%). Conclusão: O enfermeiro é essencial no diagnóstico e controlo da sintomatologia, mas os tempos de resposta, particularmente no EAMCSST, ultrapassam o recomendado para a realização do procedimento de eleição, a angioplastia.

Abstract Background: Acute chest pain (ACP) is a common symptom in patients with acute coronary syndrome (ACS) that often requires emergency care. Objective: Examine the out-of-hospital response time and the role of immediate life support nurses in the presence of ACP in patients with suspected ACS, in two districts in the interior north of Portugal. Methodology: Observational, analytical, cross-sectional, retrospective, quantitative study with a sample of 75 occurrences. Results: Total out-of-hospital response times were high, exceeding 95 minutes in both districts. In ST-elevation myocardial infarction (STEMI), total mean times were 131 ± 22.23 minutes, which occurred in 10.66% of the total sample. The nurses used the chest pain protocol in the majority of occurrences (98.7%), performed electrocardiogram (97.3%), and contributed to symptom improvement (72%). Conclusion: Although the nurse’s role is crucial for establishing the diagnosis and managing symptoms, the response times, especially in STEMI cases, exceed the recommended time for the procedure of choice (angioplasty).

ABSTRACT Introduction Personality disorders are an underdiagnosed entity and lead to high absenteeism and low productivity. Patients with histrionic personality disorder display intense emotion, attention seeking behaviour and manipulation. Clinical case report This is a case report of a 52-year-old woman, working as a hospital operational assistant, with a history of histrionic PD, major depression and fibromyalgia. In an Occupational Medicine examination after sick leave, she reports worsening of depressive symptoms and intensification of pain complaints, presenting apparent motor and cognitive slowing. Return to work was initially authorized, however, after two days, a new examination is requested by her superior, who is unable to find a suitable position for the employee. After further clinical observation and considering the history and medical reports, she is considered temporarily unfit to perform any role. Discussion/Conclusion It is important to highlight the challenge of Occupational Health in the professional reintegration of employees with psychiatric pathology. Constant updating and consolidation of knowledge in Mental Health are fundamental.

RESUMO Introdução As perturbações da personalidade são uma entidade subdiagnosticada e condicionam elevado absentismo e baixa produtividade. Pacientes com perturbação da personalidade histriónica caraterizam-se pelo seu dramatismo, emoções intensas, procura de atenção e tentativa de manipulação. Caso clínico Os autores descrevem o caso de uma mulher de 52 anos, a trabalhar como assistente operacional hospitalar, com antecedentes de perturbação da personalidade histriónica, depressão major e fibromialgia. Refere, em exame de Medicina do Trabalho após certificado de incapacidade temporária, agravamento dos sintomas depressivos e intensificação das queixas álgicas, apresentando aparente lentificação motora e cognitiva. É inicialmente autorizado o regresso ao trabalho mas, dois dias depois, é pedida nova consulta pela chefia, por não conseguir encontrar um posto adequado à colaboradora. Após nova observação clínica e tendo em conta os antecedentes e os relatórios médicos, é considerada temporariamente inapta para o desempenho de qualquer função. Discussão/Conclusão É importante realçar o desafio da Saúde Ocupacional na reintegração profissional de colaboradores com patologia psiquiátrica sendo essencial, para isso, a constante atualização e consolidação de conhecimentos na área da Saúde Mental.

Abstract Introduction: The initial treatment of stenosing tenosynovitis is usually conservative. When there is no good response, it must be resolved by surgically releasing the A1 pulley, traditionally with open release (OR). However, there is the alternative of ultrasound-guided percutaneous A1 pulley release (UPAR), which has shown similar results. Objective: To evaluate the effectiveness and costs of UPAR compared to OR at our center. Method: A retrospective study was carried out in patients undergoing UPAR. Information on pain scale, mechanical symptoms (Quinnell grades), and disability (QuickDASH) was obtained before and after the procedure. The costs of UPAR and OR alternatives were evaluated. Results: A statistically significant improvement in pain, mechanical symptoms and disability was observed after the procedure. No complications were reported. UPAR was found to be 63% less expensive than the most economical OR alternative. Conclusion: UPAR is a safe and effective alternative to treat “trigger finger or thumb”, with low costs and a shorter recovery period compared to OR. UPAR should be considered as the initial treatment when other options have not been successful.

Resumen Introducción: El tratamiento inicial de la tenosinovitis estenosante suele ser conservador. Cuando no hay buena respuesta debe resolverse liberando quirúrgicamente la polea A1, tradicionalmente con liberación abierta (LA), sin embargo, existe la alternativa de la liberación percutánea de la polea A1 guiada por ultrasonido (LPAUS), que ha mostrado similares resultados. Objetivo: Evaluar la eficacia y costos de LPAUS en comparación con la LA en nuestro centro. Método: Se llevó a cabo un estudio retrospectivo en pacientes sometidos a LPAUS. Se obtuvo información sobre escala del dolor, síntomas mecánicos (grados de Quinnell) y discapacidad (QuickDASH) antes y después del procedimiento. Se evaluaron los costos de este y las alternativas de LA. Resultados: Se observó una mejora estadísticamente significativa en dolor, síntomas mecánicos y discapacidad después del procedimiento. No se informaron complicaciones. La LPAUS resultó ser un 63% menos costosa que la alternativa de LA más económica. Conclusión: La LPAUS es una alternativa segura y efectiva para tratar el «dedo o pulgar en gatillo», con bajos costos y un periodo de recuperación más corto en comparación con la LA. La LPAUS se debe considerar como tratamiento inicial cuando otras opciones no han tenido éxito.

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

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

Abstract This article analyzes abortion experiences with misoprostol during the first decade of the 21st century in Argentina, before the legalization of the practice and the publication of the World Health Organization manuals on medication dosage. Based on in-depth interviews with women who underwent medical abortions during those years, we inquire about the mechanisms of information circulation and clandestine purchase of the drug. In addition, the article delves into experiences on the use of medication, confidence in the procedure, and the pain felt by these women from the theoretical perspective of the sociology of emotions. Among the most relevant findings is that women build networks and links to overcome the problems surrounding the practice of abortion because of the difficulty of obtaining the medication in the context of legality and illegality and the lack of information about the procedure itself and to develop a reliable method based on their own experiences.

Resumen En el presente artículo se analizan experiencias de aborto con misoprostol durante la primera década del siglo XXI en Argentina, antes de la legalización de la práctica y de la publicación de los manuales de la Organización Mundial de la Salud respecto a la posología de la medicación. A partir de entrevistas en profundidad a mujeres que se practicaron abortos medicamentosos en esos años, se indaga acerca de los mecanismos de circulación de información y de compra clandestina de la droga. Además, se ahonda en las experiencias sobre el uso de la medicación, la confianza en el procedimiento y el dolor sentido por estas mujeres desde la perspectiva teórica de la sociología de las emociones. Entre los hallazgos más relevantes se encuentra la constatación de que las mujeres construyeron sus redes y vínculos para sortear los problemas en torno a la práctica del aborto, tanto por la dificultad de conseguir la medicación en el marco de la legalidad e ilegalidad como por la falta de información sobre el procedimiento en sí mismo y la construcción de un método confiable a partir de sus propias experiencias.

Resumen: Introducción: La pérdida de un ser querido se construye como una experiencia humana inevitable, que genera una vivencia emocional que impacta tanto al individuo que experimenta la pérdida como a su entorno. Objetivo: Investigar la relación entre los procesos de duelo anticipado y las alteraciones en la participación ocupacional de quienes fueron cuidadoras principales informales de personas con enfermedad terminal en la Región Metropolitana de Chile. Método: Enfoque cualitativo con 7 entrevistas semiestructuradas individuales a cuidadoras adultas en el sur y poniente de la región. Resultados: Fueron categorizadas experiencias y subjetividades que expresan la importancia que las mujeres atribuyen al cuidado de sus familiares, con una escasa demostración emocional durante esta etapa. Además, emergen categorías como rutinas y roles, donde muchas mujeres priorizan el cuidado; redes de apoyo, con relatos frecuentes sobre la falta de ayuda y herramientas más allá de lo económico; y áreas de ocupación afectadas, predominantemente el descanso y sueño, aunque también se menciona el autocuidado y la participación social. Conclusión: Si bien el proceso de duelo anticipado genera dolor y desgaste propio, es el cuidado informal lo que genera cambios en la participación y calidad de vida de las mujeres cuidadoras.

Resumo: Introdução: A perda de um ente querido é construída como uma experiência humana inevitável, que gera uma vivência emocional que afeta tanto o indivíduo que experimenta a perda quanto seu entorno. Objetivo: investigar a relação entre os processos de luto antecipado e as alterações na participação ocupacional daquelas que foram cuidadoras primárias informais de pessoas com doença terminal na Região Metropolitana do Chile. Método: abordagem qualitativa com 7 entrevistas individuais semiestruturadas com cuidadoras adultas no sul e oeste da região. Resultados: Foram categorizadas experiências e subjetividades que expressam a importância que as mulheres atribuem ao cuidado de seus familiares, com uma escassa demonstração emocional durante essa etapa. Além disso, surgem categorias como rotinas e papéis, em que muitas mulheres priorizam o cuidado; redes de apoio, com relatos frequentes sobre a falta de ajuda e ferramentas além das econômicas; e áreas de ocupação afetadas, predominantemente o descanso e o sono, embora o autocuidado e a participação social também sejam mencionados. Conclusão: Embora o processo de luto antecipado gere dor e desgaste próprio, é o cuidado informal que gera mudanças na participação e na qualidade de vida das mulheres cuidadoras.

Abstract: Introduction: The loss of a loved one is constructed as an inevitable human experience, which generates an emotional experience that impacts both the individual experiencing the loss and his or her environment. Objective: To investigate the relationship between anticipated grief processes and alterations in the occupational participation of informal primary caregivers of terminally ill persons in the Metropolitan Region of Chile. Method: Qualitative approach with 7 individual semi-structured interviews with adult caregivers in the south and west of the region. Results: Experiences and subjectivities were categorized that express the importance that women attribute to the care of their relatives, with little emotional demonstration during this stage. In addition, categories such as routines and roles emerge, where many women prioritize caregiving; support networks, with frequent reports on the lack of help and tools beyond the economic; and areas of occupation affected, predominantly rest and sleep, although self-care and social participation are also mentioned. Conclusion: Although the process of anticipatory grief generates pain and self-exhaustion, it is informal caregiving that generates changes in the participation and quality of life of women caregivers.

ABSTRACT Objective: To describe the evidence of Platelet Rich Plasma (PRP), Stem cells therapy (SCT) and Extracorporeal shockwave therapy (ESWL) for the treatment of Peyronies disease (PD), including information from the main urological society guidelines. Materials and Methods: A literature review of PubMed articles published between 2000 and 2023 was conducted, utilizing keywords such as "Peyronie's Disease", "Penile curvature", "Platelet Rich Plasma", "Stem cells", and "Extracorporeal shockwave therapy". Only full-text articles in English were included, excluding case reports and opinions. Results: A considerable number of clinical trials were conducted using PRP penile injections for therapy of PD, showing reduction of curvature, plaque size and improvement in quality of life. Preclinical studies in rats have shown the potential benefit of adipose-derived stem cells, with improvements in erectile function and fibrosis. Human studies with mesenchymal stem cells demonstrated promising results, with reduction of curvature and plaque size. ESWL effects on PD were investigated in randomized clinical trials and demonstrated no significant impact in curvature or plaque size, but reasonable effect on pain control. Conclusion: Restorative therapies has emerged as an innovative treatment option for PD and the results from current studies appear to be promising and demonstrated good safety profile. Unfortunately, due to scarce evidence, PRP and SCT are still considered experimental by American Urological Association (AUA) and European Association of Urology (EAU) guidelines. ESWT is recommended, by the same guidelines, for pain control only. More high-quality studies with long-term follow-up outcomes are needed to evaluate efficacy and reproducibility of those therapies. Objective PRP, , (PRP) (SCT (ESWL (PD) guidelines Methods 200 202 Peyronie s Disease, Disease Disease" Penile curvature" Plasma, Plasma" cells" therapy. . therapy" fulltext full text included opinions Results life adiposederived adipose derived fibrosis Conclusion profile Unfortunately AUA (AUA EAU (EAU recommended only highquality high longterm long term followup follow up (PRP (PD 20 2

RESUMEN ¿Por qué no se soluciona la crisis carcelaria en Ecuador? Esta pregunta lleva a explorar la problemática penitenciaria desde sus orígenes hasta llegar al contexto ecuatoriano actual. El objetivo es reflexionar y demostrar que las prisiones y la privación de libertad han mantenido la misma dinámica desde sus orígenes, causando sufrimiento y dolor a los reclusos, en contraposición a la finalidad resocializadora de la pena; el contexto actual demuestra que la gestión penitenciaria no ha evolucionado, pese al desarrollo científico y normativo de esta rama. El enfoque cualitativo y socio-jurídico son la base de la investigación porque a través del diseño narrativo se describe de forma secuencial la historia del sistema penitenciario, el avance normativo y se compara con la realidad social; es decir, se hace un acercamiento del derecho a la sociedad a través de la revisión documental de fuentes secundarias. En definitiva, se concluye que no existe la voluntad política del Estado para abordar el problema de forma técnica y con el personal especializado, tal como sugiere la doctrina; al contrario, la crisis carcelaria en Ecuador tiene un tinte anacrónico, deshumanizante y alejado de la finalidad de la pena; es decir, no hay rehabilitación ni resocialización.

ABSTRACT Why is the prison crisis in Ecuador not solved? is the question that leads us to explore the penitentiary problem from its origins to the current Ecuadorian context. The objective is to reflect and demonstrate that prisons and deprivation of liberty have maintained the same dynamic since their origins, causing suffering and pain to inmates, in contrast to the resocializing purpose of punishment; The current context shows that prison management has not evolved, despite the scientific and regulatory development of this branch. The qualitative and socio-legal approach is the basis of the research because through the narrative design the history of the penitentiary system, the regulatory advance, and are compared with social reality are sequentially described; That is, an approach to the right to society is made through the documentary review of secondary sources. In short, it is concluded that there is no political will of the State to address the problem technically and with specialized personnel as suggested by the doctrine; on the contrary, the prison crisis in Ecuador has an anachronistic, dehumanizing tone and is far from the purpose of the sorrow; That is, there is no rehabilitation or resocialization.

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 Introduction: Research has shown the importance of differentiating Attention Deficit Hyperactivity Disorder (ADHD) from subjective complaints of attention difficulties. In both cases, there is a clinical manifestation that differentially affects women and men. This study assessed the potential relationships among Behavioural and Emotional Symptoms, ADHD Diagnosis, Attentional Complaints, and Sex in Young Adults between 18 and 25 years of age. Method: Using a cross-sectional design, we examined the relationships across three groups (diagnosed with ADHD, attentional complaints, and controls) in a sample of 232 participants (Meanage = 20.38 years, SDage = 1.81 years; 52% women). We employed the Adult ADHD Self Report Scale and the Toulouse Pieron Test to classify participants among groups; for measures of behavioural/emotional symptoms using the Minnesota Multiphasic Personality Inventory-2 - Restructured Form (MMPI-2-RF), through High-Order and Somatic/Cognitive Scales. Results: Multivariate Analysis of Variance (MANOVA) revealed a significant relationship between group membership and the MMPI-2-RF variables after controlling for sex (p < 0.01). Post hoc tests indicated group differences across all variables except for Head Pain Complaints. Additionally, comparisons between men and women revealed significant differences in Behavioural and Emotional Dysfunction, and Gastro-Intestinal Complaints. Conclusion: The findings highlight the importance of making a diagnosis that is not only based on a list of symptoms and signs but also takes into account differences in sex, emotional/behavioural alterations, and associated connections to increased rumination in young adults, which may influence self-assessment bias and contribute to overestimation or underestimation of ADHD symptomatology.

Resumen Introducción: Las investigaciones han demostrado la importancia de diferenciar el trastorno por déficit de atención con hiperactividad (TDAH) de las quejas subjetivas de dificultades de atención. En ambos casos existe una manifestación clínica que afecta diferencialmente a mujeres y hombres. Este estudio evaluó las posibles relaciones entre los síntomas conductuales y emocionales, el diagnóstico de TDAH, las quejas atencionales y el sexo en adultos jóvenes de entre 18 y 25 años. Método: Utilizando un diseño transversal, examinamos las relaciones entre tres grupos (diagnosticados con TDAH, quejas atencionales y controles) en una muestra de 232 participantes (Mediaedad = 20.38 años, DEedad = 1.81 años; 52 % mujeres). Empleamos la escala de Autoinforme de TDAH en Adultos y la prueba Toulouse Pieron para clasificar a los participantes entre grupos; para medidas de síntomas conductuales/emocionales utilizamos el inventario multifásico de personalidad de Minnesota-2 - Forma reestructurada (MMPI-2-RF), por medio de las escalas de Alto Orden y las Somáticas/ Cognitivas. Resultados: El análisis multivariado de varianza (Manova) mostró una relación significativa entre el grupo y las variables del MMPI-2-RF después de controlar el sexo (p < 0.01). Las pruebas post hoc indicaron diferencias entre grupos en todas las variables, excepto en quejas de dolor de cabeza. Además, las comparaciones entre hombres y mujeres revelaron diferencias significativas en la disfunción conductual y emocional y en las quejas gastrointestinales. Conclusión: Los hallazgos resaltan la importancia de realizar un diagnóstico que no se base únicamente en una lista de síntomas y signos, sino que también tenga en cuenta las diferencias de sexo, las alteraciones emocionales/conductuales y las conexiones asociadas con una mayor rumiación en adultos jóvenes, lo cual puede influir en el sesgo de autoevaluación y contribuir a una sobreestimación o subestimación de la sintomatología del TDAH.