Abstract Sexual satisfaction is expressed as an evaluation to gauge the level of enjoyment in one’s sexual life. Studies of the sexuality of the LGBTIQ population have been limited, as this group grapples with taboos, repression, and social stigma, which impact various aspects of their lives, including health and sexual satisfaction. This study investigates the unidimensional scale of sexual satisfaction in the LGBTIQ population in Ecuador, We analyze how this scale is affected when compared to different sociodemographic variables. We utilized a quantitative, descriptive, correlational, and prospective methodology, applying a questionnaire to 625 residents of Ecuador to gather sociodemographic data and the Sexual Satisfaction Index (SSI). The results on the unidimensional scale of sexual satisfaction are as follows: 33% of respondents report sexual satisfaction, while 60.5% experience sexual dissatisfaction, and 6.6% undergo a severe stress experience. There is less sexual dissatisfaction among individuals living in Quito, males, homosexuals, those with a higher level of education, and Afro-Americans, with a P value < 0,005 that is statistically significant. A negative value of sexual satisfaction is observed in the studied population, emphasizing the need for further investigation into the causes and factors influencing sexual dissatisfaction. This will help us understand their needs and provide support in a safe and respectful environment due to ongoing discrimination.

Resumen La satisfacción sexual se expresa como una evaluación, para manifestar el nivel de agrado a la vida sexual. Los estudios en la sexualidad de la población LGBTIQ han sido poco profundizados, grupos rodeados de tabúes, víctimas de una represión y condenas sociales; afectando las diferentes dimensiones de la salud, como la satisfacción sexual. Este trabajo investiga la escala unidimensional de la satisfacción sexual en la población LGBTIQ Ecuador. Se analiza cómo esta escala es afectada al correlacionarse con las diferentes variables sociodemográficas. Se utiliza una metodología cuantitativa, correlacional descriptiva y prospectiva. Se aplica: cuestionario a 625 personas residentes en Ecuador con recogida de datos sociodemográficos, Índice de Satisfacción Sexual (ISS). Los resultados de la escala unidimensional de satisfacción sexual muestran que el 33 % de la población tiene satisfacción sexual, el 60,5 % experimenta insatisfacción sexual y un 6,6 % reporta una experiencia severa de estrés en esta área. Se observa una menor insatisfacción sexual en los residentes de la ciudad de Quito, en hombres, en personas homosexuales, en aquellos con un nivel educativo más alto y en individuos afrodescendientes, con un valor de p < 0,005, lo que indica una significancia estadística. Estos resultados reflejan un nivel negativo de satisfacción sexual en la población estudiada. Por lo tanto, se hace necesario continuar investigando la satisfacción sexual para comprender las causas y los factores que inciden en la insatisfacción sexual. Es crucial visibilizar las necesidades y los apoyos que requiere esta comunidad en un entorno seguro y respetuoso, especialmente considerando los constantes actos de discriminación que enfrentan.

Abstract This article evaluates the influence of implementing the Multisectoral Strategy Barrio Seguro (EMBS) on the inhabitants of the Manzanares neighbourhood in the district of Huacho in Peru. Since 2017, this public policy of the Ministry of Interior seeks to intervene in the security conditions and safe coexistence of certain territories that report high crime rates. This quantitative research surveyed 353 people to establish that, in 49.2% of cases, the EMBS has had inadequate influence. Although not a significant impact, the policy meets certain expectations that suggests that robust institutions, greater trust in the authorities, and organic participation of civil society could enhance its effects. The study recommends assessing the EMBS experience in other neighbourhoods and cities. It also proposes the application of qualitative studies that provide tools for building the idea of citizen security.

Resumen Este artículo evalúa la influencia de la aplicación Estrategia Multisectorial Barrio Seguro (EMBS) sobre los habitantes del barrio Manzanares en el distrito de Huacho en Perú. Esta es una política pública del Ministerio del Interior que, desde 2017, busca intervenir las condiciones de seguridad y convivencia pacífica de ciertos territorios que reportan altas tasas de criminalidad. Esta investigación de enfoque cuantitativo encuestó a 353 personas para establecer que en el 49,2 % de los casos la EMBS ha tenido una influencia regular. Si bien no es una influencia significativa, la política colma ciertas expectativas y su efecto podría potenciarse con una institucionalidad más fuerte, mayor confianza hacia las autoridades y participación orgánica de la sociedad civil. El estudio recomienda que la experiencia de la EMBS pueda evaluarse en otros barrios y ciudades. Se propone, además, que se apliquen estudios cualitativos que den cuenta de una aproximación a la construcción de la idea de la seguridad ciudadana.

ABSTRACT The research work presents the conclusions of the analysis of the use of electrical energy as a resource in businesses classified as micro and small that are located in the city of San Lorenzo and registered in the same municipality. The general objective was established to “Analyze the effectiveness of electricity consumption in MSMEs in San Lorenzo and its relationship with the Green Economy in 2023”, research related to Sustainable Development Goal No. 8 Decent Work and Economic Growth that promotes inclusive and sustained economic growth as a strategy to drive progress, create decent jobs for all and improve living standards. This research had a qualitative-quantitative approach. The main results obtained were the following, 62% of the MSMEs in the city of San Lorenzo present some criterion of effectiveness in relation to the use of electrical energy, 78% of the MSMEs affirm that the quality of the supply in the electrical service It is poor and not safe. 86% of microentrepreneurs responded that electricity consumption is part of the cost of their products or services, 71% affirm that the rate for electricity consumption can be improved for the benefit of MSMEs. 65% maintain that the use of electrical energy has a direct effect on their costs and 91% of MSMEs affirm that they can use electrical energy more efficiently and rationally.

RESUMEN El trabajo de investigación presenta las conclusiones del análisis del aprovechamiento en la utilización de la energía eléctrica como recurso en los negocios tipificados como micro y pequeños que se encuentran situados en la ciudad de San Lorenzo y catastrados en el mismo municipio. Se estableció como objetivo general “Analizar la efectividad del consumo de energía eléctrica en las mipymes de San Lorenzo y su relación con la Economía verde en el año 2023”, investigación relacionada a el Objetivo de Desarrollo Sustentable N° 8 Trabajo Decente y Crecimiento Económico que promueve un crecimiento económico inclusivo y sostenido como estrategia para impulsar el progreso, crear empleos decentes para todos y mejorar los estándares de vida. Esta investigación fue de enfoque cuali-cuantitativo. Los principales resultados obtenidos fueron los siguientes, el 62% de las mipymes de la ciudad de San Lorenzo presentan algún criterio de efectividad en relación a la utilización de energía eléctrica, el 78% de las mipymes afirman que la calidad del suministro en el servicio eléctrico es deficiente y no seguro. El 86% de los microemprendedores respondieron que el consumo de energía eléctrica forma parte del costo de sus productos o servicios, el 71% afirma que la tarifa por el consumo de energía eléctrica puede ser mejorada en provecho de las mipymes. Un 65% sostiene que la utilización de la energía eléctrica tiene un efecto directo en sus costos y un 91% de las mi pymes afirman que pueden utilizar en forma más eficiente y racional la energía eléctrica.

Abstract: Corn drying reduces the moisture content present in the grain to levels that allow safe storage. This process requires a large amount of energy, which is why, if not applied correctly, it can affect the quality of the product to be dried, in addition to representing important costs in the operation of the drying plants. The objective of this research is to analyze the corn drying systems used in Canton Quevedo, Province of Los Ríos. In order to achieve the objective, field visits were made to the area under study, considering factors related to the technology used and the corn harvesting period, as well as, characteristics of the coastal region of Ecuador. It was determined that stationary or fixed bed drying is the drying system widely used for corn drying, which uses subsidized liquefied petroleum gas as fuel for its operation. The moisture content of the corn received at the drying plants is above 30% in the two harvesting periods of the product, a situation that has an impact on processing times and product quality. The fuel demand for drying an average mass of product of 60.2 tons, between the first harvest period, March - June, and the second period, September - November, presents a difference of 300.77 kg of LPG in relation to the first harvest, being the moisture content a key factor to take into account.

Resumen: El secado del maíz permite reducir el contenido de humedad presente en el grano a niveles que permitan un almacenamiento seguro. El objetivo de esta investigación permite analizar los sistemas de secado de maíz empleados en el Cantón Quevedo, Provincia de Los Ríos. Para alcanzar nuestro objetivo se realizaron visitas de campo en la zona objeto de estudio, por lo que se consideraron factores relacionados con la tecnología empleada y período de cosecha de maíz, características de la región costera del Ecuador. Se determinó que el secado estacionario o de lecho fijo es el sistema de secado ampliamente empleado para el secado de maíz, el cual emplea como combustible el gas licuado de petróleo subsidiado para su funcionamiento. La humedad de recibo de maíz en las plantas de secado presenta niveles de humedad por encima del 30 %, en los dos periodos de cosecha del producto, situación que repercute en los tiempos de proceso y en la calidad del producto. La demanda de combustible para secar una masa promedio de producto, 60,2 Ton, entre el primer período de cosecha que va de Marzo - Junio, y el segundo período, Septiembre - Noviembre, presenta una diferencia de 300,77 Kg de GLP con relación a la primera cosecha, siendo la humedad de recibo un factor clave a tomar en cuenta.

Abstract: This study presents a methodology to assess the feasibility of turning a conventional road infrastructure for the circulation of motorized vehicles into a sustainable mobility system through the incorporation of bicycle lane. The methodology includes five stages developed in two key moments: the collection and definition of parameters based on a literature review and, the analysis of selected road axes according to the study parameters: roadway section, bicycle lane slope and potentially benefited population. The assessment of the road infrastructure is based on six categories ranging from 1 to 0, where 1 represents the ideal situation and 0 the limit situation. The study will be carried out on the roads connecting the peri-urban sub-centers with the urban center, with the objective of promoting the safe use of bicycles as a means of transportation in an intermediate city in the Andes of Latin America, Cuenca in Ecuador. The study of the four proposed road axes indicates which road presents the optimal conditions for the incorporation of a bicycle lane in its current conditions.

Resumen: Este estudio presenta una metodología innovadora para evaluar la viabilidad de transformar la infraestructura vial convencional en Cuenca, Ecuador, en un sistema de movilidad sostenible mediante la inclusión de carriles para bicicletas. La metodología se compone de cinco etapas distribuidas en dos momentos clave: la recopilación y definición de parámetros, basados en una revisión bibliográfica exhaustiva, y el análisis de ejes viales seleccionados de acuerdo con los parámetros de estudio: sección de la calzada, pendiente de ciclovía y población potencialmente beneficiada. La valoración de la infraestructura vial se basa en una escala de seis categorías dende 1 representa la situación ideal y 0 la situación límite. Esta investigación se centra en las vías que conectan los subcentros periurbanos con el centro urbano, con el objetivo de fomentar el uso seguro de la bicicleta como medio de transporte en una ciudad intermedia de los Andes de América Latina, Cuenca en Ecuador. El análisis de los cuatro ejes viales propuestos revela la vía con las condiciones óptimas para la incorporación de una ciclovía en su estado actual.

Abstract Objective: To communicate the experience in an Andean country with the OcclutechTM Duct Occluder device for the closure of patent ductus arteriosus. Method: Observational, retrospective, cross-sectional study with basic statistical analysis. Period: December/2014 to December/2022. Data: medical chart, reports of catheterization. Results: Forty-six patients, female 71.3%, male 28.7%; age: 0.6-38 years-old (median [Me]: 5.2); weight: 6.3-60 kg (Me: 16.5). Origin: andean 91.3%, coast 8.7%. Types of patent ductus arteriosus: E 54.4%, A 32.6%, D 13%. Minimum ductal diameter: 1.8-11.8 mm (Me: 3.5). Mean pulmonary artery pressure prior to occlusion: 14-67 mmHg (Me: 27). Pulmonary vascular resistance index prior to occlusion: 0.28-4.9 WU/m2 (Me: 1.3). Six of them were classified as hypertensive patent ductus arteriosus. Occlusion rate: 47.8% immediate, 81% at 24 hours, 100% after six months. Fluoroscopy time: 2-13.8 minutes (Me: 4). Complications: a migrated device. Follow-up: 1-6.5 years. Conclusions: OcclutechTM Duct Occluder device was effective and safe for the closure of patent ductus arteriosus type E, A and D in low-altitude and high-altitude dwellers, whether they were children or adults, even when these ductus arteriosus were hypertensive.

Resumen Objetivo: Presentar la experiencia en un país andino con el dispositivo OcclutechTM Duct Occluder para el cierre del conducto arterioso persistente. Método: Estudio observacional, retrospectivo, de corte transversal con análisis estadístico básico. Periodo: diciembre/2014 a diciembre/2022. Datos: historia clínica, informes de laboratorio de cateterismo. Resultados: Cuarenta y seis pacientes; de sexo femenino 71.3%, de sexo masculino 28.7%; edad: 0.6-38 años (mediana [Me]: 5.2); peso: 6.3-60 kg (Me: 16.5). Procedencia: andina 91.3%, costa 8.7%. Tipos de conducto arterioso persistente: E 54.4%, A 32.6%, D 13%. Diámetro ductal mínimo: 1.8-11.8 mm (Me: 3.5). Presión media de la arteria pulmonar previo a la oclusión: 14-67 mmHg (Me: 27). Índice de resistencias vasculares pulmonares previo a la oclusión: 0.28-4.9 UW/m2 (Me: 1.3). Fueron catalogados como conductos arteriosos persistentes hipertensivos seis de ellos. Tasa de oclusión: inmediata el 47.8%, a las 24 horas el 81%, a los seis meses el 100%. Tiempo de fluoroscopia: 2-13.8 minutos (Me: 4). Complicaciones: un dispositivo migrado. Seguimiento: 1-6.5 años. Conclusiones: El dispositivo OcclutechTM Duct Occluder fue efectivo y seguro para el cierre de conducto arterioso persistente tipo E, A y D en habitantes de baja y alta altitud, ya sea que estos hubieran sido niños o adultos, incluso cuando estos conductos arteriosos fueron hipertensivos.

Resumo Introdução: O papel da endoscopia por cápsula na avaliação do intestino delgado encontra-se bem estabelecido, e as orientações atuais posicionam-na como um teste de primeira linha numa variedade de cenários clínicos. O advento das cápsulas de dupla câmara permitiu expandir a sua aplicação para a avaliação endoscópica da mucosa do cólon, oferecendo a oportunidade de um exame não invasivo de todo o intestino (endoscopia pan-entérica por cápsula, PCE). Sumário: Procedemos a uma revisão de vários aspectos do procedimento e preparação dos doentes para a PCE, bem como as aplicações clínicas atuais e as perspetivas futuras das cápsulas de dupla câmara. Na doença de Crohn não estenosante e não penetrante localizada ao intestino delgado e cólon, a PCE permite monitorizar a atividade da doença e avaliar a cicatrização da mucosa, um indicador importante da eficácia da terapêutica, com um rendimento de diagnóstico superior aos métodos convencionais, nomeadamente os exames imagiológicos ou a colonoscopia invasiva. Também na colite ulcerosa, as cápsulas de dupla câmara têm sido utilizadas para monitorizar a atividade da doença de forma não invasiva. Existem índices endoscópicos validados e especificamente concebidos para as cápsulas de dupla câmara, que permitem uma avaliação sistematizada e quantificação objetiva da atividade inflamatória. Na suspeita de hemorragia digestiva média ou baixa, alguns estudos exploratórios demonstraram a aplicabilidade e o elevado rendimento diagnóstico da PCE, podendo funcionar como um filtro de modo a permitir indicar quaisosdoentesquemaisirãobeneficiar de um procedimento invasivo subsequente, nomeadamente para arealizaçãodeprocedimentos hemostáticos dirigidos. A possibilidade de utilização da PCE é também discutida no contexto das síndromes de polipose com envolvimento simultâneo do intestino delgado e do cólon. Mensagens-chave: A PCE é um procedimento diagnóstico eficaz e seguro para avaliar diretamente a mucosa do intestino delgado e cólon. A sua aplicação tem vindo a expandir-se no contexto das Doenças Inflamatórias Intestinais e, mais recentemente, na suspeita de hemorragia digestiva média ou baixa. Existe a expectativa de que no futuro próximo possamos assistir a uma redução substancial da demanda por procedimentos endoscópicos invasivos, face à utilização crescente da PCE enquanto método de diagnóstico pan-intestinal não invasivo.

Abstract Background: The role of capsule endoscopy in the evaluation of the small bowel is well established, and current guidelines position it as a first-line test in a variety of clinical scenarios. The advent of double-headed capsules further enabled the endoscopic assessment of colonic mucosa and the opportunity for a one-step noninvasive examination of the entire bowel (panenteric capsule endoscopy [PCE]). Summary: We reviewed the technical procedure and preparation of patients for PCE, as well as its current clinical applications and future perspectives. In non-stricturing and non-penetrating Crohn’sdisease affecting the small bowel and colon, PCE monitors disease activity by assessing mucosal healing, a major treatment outcome, with a higher diagnostic yield than cross-sectional imaging or conventional colonoscopy. Also in ulcerative colitis, double-headed capsules have been used to monitor disease activity noninvasively. Currently, validated scoring systems have been specifically devised for these double-headed capsules and permit a standardized assessment of the inflammatory burden. In suspected mid-lower digestive bleeding, some exploratory studies have demonstrated the feasibility and high diagnostic yield of PCE, which may work as a filter indicating which patients may benefit of further invasive procedures, namely, for planned hemostatic procedures. The possibility of using PCE is also discussed in the context of polyposis syn-dromes with simultaneous involvement of the small intestine and colon. Key Messages: PCE is a feasible, effective, and safe diagnostic procedure to evaluate the small bowel and colon. It has been increasingly explored in the setting of inflammatory bowel diseases and, more recently, in suspected mid-lower digestive bleeding. PCE is expected to reduce the demand for invasive procedures and expand the scope of noninvasive intestinal evaluation in the coming future.

Resumen El objetivo del presente trabajo fue analizar los criterios de selección de pareja en relación al apego en adultos. Esta investigación fue cuantitativa, correlacional, de corte transversal, con 170 participantes, escogidos a través de un muestreo no probabilístico bola de nieve y discriminados con criterios de inclusión. Para la recolección de datos se utilizó la Escala de Selección de Pareja de Romero, la cual evalúa los criterios para la selección de pareja. Para determinar el apego se empleó el instrumento CAMIR. En los resultados de selección de pareja, se evidenció que en similitud y atractivo la mayoría de los participantes consideran de baja importancia, en aspectos no verbales y complementariedad la mayoría indican tener un nivel de importancia medio; los rasgos de personalidad y la satisfacción de necesidades tuvieron un nivel de importancia alta. En apego, la mayoría de los evaluados, muestran un tipo de apego seguro e inseguro preocupado. De la misma manera, la gran mayoría no presentó un tipo de apego inseguro evitativo e inseguro desorganizado. Se concluye que existió correlación entre estilos de apego y selección de pareja, evidenciándose en la correlación positiva entre el estilo de apego seguro con el criterio satisfacción de necesidades; el estilo de apego inseguro evitativo tuvo una correlación positiva con: el criterio similitud, atractivo físico, aspectos no verbales y rasgos de personalidad; por último, el estilo de apego inseguro preocupado mantuvo una correlación positiva con el criterio complementariedad.

Abstract This research aimed to analyze the partner selection criteria concerning attachment in adults. This research was quantitative, correlational, and cross-sectional, with 170 participants chosen through non-probabilistic snowball sampling and discriminated with inclusion criteria. The Romero Partner Selection Scale, which evaluates the criteria for partner selection, was used for data collection. The CAMIR instrument was used to determine attachment. In the results of partner selection, it was evident that in similarity and attractiveness, the majority of participants consider it to be of low importance; in non-verbal aspects and complementarity, the majority indicate having a medium level of importance; Personality traits and needs satisfaction had a high level of significance. In attachment, most of those evaluated show a type of secure and preoccupied insecure attachment. In the same way, the vast majority did not present a kind of avoidant and disorganized insecure attachment. It is concluded that there was a correlation between attachment styles and partner selection, evident in the positive correlation between the secure attachment style and the needs satisfaction criterion; the insecure-avoidant attachment style had a positive correlation with the similarity criterion, physical attractiveness, non-verbal aspects, and personality traits; Finally, the preoccupied insecure attachment style maintained a positive correlation with the complementarity criterion.

Resumo Objetivo: Revisar a eficácia e segurança do laser de picossegundo de neodímio dopado com ítrio, alumínio e granada (Nd:YAG) para a remoção de tatuagens cosméticas das sobrancelhas. Métodos: Esta foi uma revisão retrospectiva de janeiro de 2022 a agosto de 2023 de pacientes que se submeteram à remoção de tatuagens cosméticas das sobrancelhas com o laser de picossegundo Nd:YAG. Resultado: Um total de 24 pacientes foram incluídos na revisão. 70% dos pacientes foram classificados como “muito melhorados” (75-100% da tatuagem removida) e 30% foram classificados como “melhorados” (50-75% da tatuagem removida). O comprimento de onda de 1064 nm foi o primeiro utilizado em todos os casos. O número médio de sessões necessárias para obter resultados satisfatórios foi 3. Quatro pacientes tiveram uma mudança inesperada na cor principal das tatuagens das sobrancelhas após o primeiro tratamento, que foi tratada com sucesso com o comprimento de onda de 532 nm. Nenhum dos pacientes apresentou despigmentação, cicatrizes ou danos/descoloração dos pelos das sobrancelhas. Conclusão: O laser de picossegundo Nd:YAG é um tratamento eficaz e seguro para a remoção de tatuagens cosméticas das sobrancelhas.

Abstract Objective: To review the efficacy and safety of PS neodymium-doped yttrium aluminum garnet (Nd:YAG) laser for the removal of cosmetic tattoos of the eyebrows. Method: This was a retrospective review from January 2022 to August 2023 of patients who underwent cosmetic tattoo removal of the eyebrows with PS Nd:YAG laser. Results: A total of 24 patients were included in the review. 70% of patients were rated as “very much improved” (75-100% of the tattoo removed) and 30% of patients were rated “much improved” (50-75% of the tattoo removed). 1064-nm was the 1st wavelength used in all the cases. The average number of sessions required to obtain satisfactory results was 3. Four patients experienced unexpected change in their primary color of the eyebrow tattoos after the 1st treatment, which was successfully treated with 532-nm wavelength. None of the patients experienced dyspigmentation, scarring, or damage/bleaching of hairs of the eyebrows. Conclusion: PS Nd:YAG garnet laser is an effective and safe treatment for the removal of cosmetic tattoos of the eyebrows.

Abstract Office hysteroscopy is a safe and effective procedure for visualization and surgical approach of intracavitary diseases. Considered to be a standard technique, it allows to avoid risks and complications associated with patient’s hospitalization. Pain is one of the primary reasons for not completing the procedure, so that the concern with its reduction has been the subject of many studies. The purpose of this study was to describe an intracavitary anesthetic technique and demonstrate its effectiveness and safety in controlling pain during office hysteroscopy. This is a retrospective study with eight hundred fifty-nine patients who underwent office hysteroscopy at two specialized units. The total of patients was submitted to office hysteroscopy for diagnostic or surgical purpose. Those who reported pain during the procedure were offered anesthesia, which was immediately performed. By using an endoscopic needle, hysteroscopic anesthesia was administered in specific sites with precise application guidelines. After the hysteroscopy, the intensity of the patient’s pain during the procedure was assessed by a numeric survey, regardless of having received hysteroscopic anesthesia. The doctor responsible was also invited to rate patient’s reported pain reliability by a numeric scale. When using hysteroscopic anesthesia, office hysteroscopy was completed in 94.3% of the cases, however there were no significant differences regarding the number of completed procedures between those and the ones who didn't received. However, in women submitted to hysteroscopic anesthesia, the reduction in reported pain was significant, with a more noticeable effect in those who reported a higher pain score before the technique. There were no complications related to hysteroscopic anesthesia. Hysteroscopic anesthesia is an effective and safe method for pain control during office procedures and might be considered when performing this technique. Its use can provide a greater comfort to the patient and allows to avoid risks associated with the operating room.

Resumo A histeroscopia office é um procedimento seguro e eficaz para o diagnóstico e abordagem cirúrgica da patologia intracavitária. Sendo considerada o gold standard, permite evitar riscos e complicações associados à hospitalização de doentes. A dor frequentemente associada, é considerada uma das principais razões para o procedimento não ser concluído, pelo que a preocupação com a sua redução tem sido objecto de muitos estudos. O objectivo deste estudo foi descrever uma técnica anestésica intracavitária e demonstrar a sua eficácia e segurança no controlo da dor das pacientes durante a histeroscopia. Este é um estudo retrospectivo com oitocentas e cinquenta e nove pacientes submetidas a histeroscopia office em duas unidades especializadas. O total das pacientes foi submetida a uma histeroscopia diagnóstica ou terapêutica, sendo oferecida a anestesia histeroscópica de imediato a todas aquelas que reportaram dor. Utilizando uma agulha endoscópica, o fármaco anestésico foi administrado em locais específicos de acordo com guidelines precisas. Após a realização da histeroscopia, a intensidade da dor das pacientes foi registada de acordo com uma escala numérica, independentemente de terem ou não realizado anestesia histeroscópica. No final do procedimento o médico responsável avaliou subjectivamente a confiabilidade da avaliação da doente por meio de uma escala numérica. Quando utilizada, a anestesia histeroscópica permitiu concluir 94.3% dos procedimentos, não se verificando uma diferença significativa entre o número de procedimentos concluídos quando a mesma não era administrada. Contudo, nas mulheres que realizaram anestesia histeroscópica, a redução da dor foi significativa, com um efeito mais notório naquelas que apresentavam níveis de dor iniciais superiores. Não se registaram complicações decorrentes da técnica anestésica. A anestesia histeroscópica é uma técnica eficaz e segura no controlo da dor, devendo ser considerada a sua utilização em procedimentos de consultório. Esta permite um maior conforto, evitando os riscos associados à sua realização no bloco operatório.

Resumo: Introdução: O uso de prednisona e reabilitação musculoesquelética e respiratória foi descrito no tratamento de pacientes com COVID-19 grave ou crítico. O papel destas intervenções e o momento ideal para o seu início não estão claramente estabelecidos. Este trabalho mostra os resultados da Unidade de Reabilitação Hospitalar do Banco de Seguro del Estado que implementou um programa abrangente de reabilitação e uso de corticosteroides na fase subaguda de pacientes graves ou críticos pós-COVID-19, com uma abordagem sistematizada, trabalhando de forma interdisciplinar e centrada no paciente. São relatados os achados na admissão, a necessidade de oxigênio, a escala de Barthel, os padrões tomográficos, o uso de corticosteroides, a resposta ao tratamento e as complicações. Os resultados desta abordagem sobre variáveis clínicas, respiratórias e funcionais são descritos. Material e métodos: Estudo descritivo e retrospectivo de pacientes pós-COVID-19 que completaram reabilitação na Unidade de Reabilitação do Hospital Banco de Seguros del Estado (URHBSE) no período de abril a agosto de 2021. Os dados foram obtidos dos prontuários de pacientes com posterior análise estatísticas usando PRISM (v8.2.1). Resultados: 84 pacientes completaram o programa de reabilitação. No momento da admissão na URHBSE, 55% apresentavam dependência total ou grave da escala de Barthel. 48% não conseguiam se mover. 89,2% necessitaram oxigênio com saturação média de 90,3 ± 4,8. 25% dos pacientes foram internados necessitando máscara com reservatório. Todos os pacientes que ingressaram no programa estavam na fase subaguda da doença (4 a 12 semanas) e receberam um plano de reabilitação abrangente e individualizado. O objetivo era alcançar uma situação funcional semelhante à que apresentavam antes da COVID-19. O tempo de permanência na URHBSE foi de 23,5±13,8 dias. A tomografia de tórax de alta resolução (TCAR) foi realizada em 76 pacientes (90,5%); os resultados foram patológicos em 96,1%. O vidro fosco predominou em 49,3% deles, a consolidação em 8,23% e o padrão fibroso em 30,13%. Alterações tomográficas “atípicas” de danos pós-COVID (derrame pleural, nódulos cavitados, cavidades apicais, etc.) foram detectadas em 11,8% dos exames tomográficos. Aspergilose pulmonar foi encontrada em 2,6% dos pacientes e tromboembolismo pulmonar em 6,6%. 44 pacientes (52,3%) receberam prednisona. Em 63,4% a oferta de oxigênio foi suspensa nos primeiros 15 dias após o início da mesma. Encontramos associação entre o padrão tomográfico em vidro fosco e a suspensão precoce da oferta de oxigênio desde o início da administração da prednisona (p = 0,047). Apesar do alto grau de colonização, mesmo naqueles que usaram prednisona, não observamos infecções. Em relação às variáveis respiratórias, só temos dados sobre a presença de dispneia nos primeiros 35 pacientes; destes, 83% apresentavam dispneia na admissão, enquanto apenas 17% a apresentavam na alta (p< 0,0001). Observou-se também diferenças significativas na necessidade de O2 entre a admissão e a alta (p< 0,0001) e no grau de dependência medido pela escala de Barthel, com 55% dos pacientes apresentando dependência total ou grave na admissão e apenas 3,4% na alta. Conclusões: As intervenções realizadas na fase subaguda da doença foram associadas a melhorias significativas nas variáveis de interesse clínico. São necessários mais estudos para definir o papel e o momento exato do início dos corticosteroides e da reabilitação neste grupo de pacientes.

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Abstract: Introduction: In patients with severe or critical COVID-19, the use of prednisone and musculoskeletal and respiratory rehabilitation has been described. The role of these interventions and the optimal time for their initiation are not clearly established. This study presents the results of the Rehabilitation Unit of the Banco de Seguro del Estado Hospital, which implemented a comprehensive rehabilitation program and the use of corticosteroids in the subacute stage of patients with severe or critical post-COVID-19, with a systematic approach, working interdisciplinary and centered on the person being treated. Findings at admission, oxygen requirement, Barthel scale, tomographic patterns, use of corticosteroids, their response, and complications are reported. The results of this approach on clinical, respiratory, and functional variables are described. Method: Descriptive, retrospective study of post-COVID-19 patients who completed rehabilitation at the Rehabilitation Unit of the Banco de Seguros del Estado Hospital (URHBSE) in the period April-August 2021. Data obtained from review of medical records, statistical analysis with PRISM (v8.2.1). Results: Eighty-four patients completed the rehabilitation program. Upon admission to the URHBSE, 55% had total or severe dependence on the Barthel scale. Forty-eight percent were unable to walk. Eighty-nine-point two percent required oxygen, with a mean saturation of 90.3 ± 4.8. Twenty-five percent of patients were admitted requiring a reservoir mask. All patients who entered the program were in the subacute phase of the disease (4 to 12 weeks) and received a comprehensive and individualized rehabilitation plan. The objective was to achieve a functional situation similar to what they had before COVID-19. The length of stay at the URHBSE was 23.5 ± 13.8 days. A total of 76 patients (90.5%) underwent high-resolution chest tomography (HRCT), which was pathological in 96.1% of cases. The predominant findings were ground-glass opacity in 49.3% of cases, consolidation in 8.23%, and a fibrosis-like pattern in 30.13%. “Non-typical” post-COVID damage tomographic alterations were detected (pleural effusion, cavitary nodules, apical cavities, etc.) in 11.8% of the tomographies. In 2 patients (2.6%), pulmonary aspergillosis was found, and in 6.6%, pulmonary thromboembolism. Forty-four patients (52.3%) received prednisone. In 63.4% of cases, oxygen supplementation was discontinued within the first 15 days from the start of prednisone. We found an association between the ground-glass opacity tomographic pattern and early discontinuation of oxygen supplementation from the start of prednisone (p = 0.047). Despite the high degree of colonization, we did not observe infections by colonizing microorganisms, even in those who used prednisone. Comparing admission and discharge, statistically significant differences were found in the following parameters: degree of dyspnea, oxygen requirement (only one patient was discharged with oxygen), saturation, degree of instrumentation (tracheostomy, nasogastric tube, etc.), and the Barthel dependency scale. Regarding respiratory variables, we only have data on the presence of dyspnea in the first 35 patients. Of these, 83% had dyspnea at admission, while only 17% had it at discharge (p < 0.0001). There were also significant differences in the oxygen requirement between admission and discharge (p < 0.0001) and in the degree of dependency measured on the Barthel scale. Fifty-five percent of patients had total or severe dependence at admission, compared to only 3.4% at discharge. Conclusions: The interventions carried out in the subacute stage of the disease were associated with significant improvements in clinical variables of interest. More studies are needed to define the role and the exact timing of the initiation of corticosteroids and rehabilitation in this group of patients.

Abstract Background: ST-elevation myocardial infarction (STEMI) systems of care have reduced inter-hospital transfer times and facilitated timely reperfusion goals. Helicopters may be an option when land transportation is not feasible; however, the safety of air transport in patients with acute coronary syndrome (ACS) is a factor to consider. Objetives: The aim of this study was to evaluate the safety of helicopter transport for patients with ACS. Methods: Prospective, observational, and descriptive study including patients diagnosed with ACS within the STEMI network of a metropolitan city transferred by helicopter to a large cardiovascular center to undergo percutaneous coronary intervention. The primary outcome of the study was the incidence of air-travel-related complications defined as IV dislodgement, hypoxia, arrhythmia, angina, anxiety, bleeding, and hypothermia. Secondary outcomes included the individual components of the primary outcome. Results: A total of 106 patients were included in the study; the mean age was 54 years and 84.9% were male. The most frequent diagnosis was STEMI after successful fibrinolysis (51.8%), followed by STEMI with failed fibrinolysis (23.7%) and non-reperfused STEMI (9.4%). Five patients (4.7%) developed at least one complication: IV dislodgement (1.8%) and hypoxemia (1.8%) in two patients and an episode of angina during flight (0.9%). A flight altitude of > 10,000 ft was not associated with complications. Conclusions: The results of this study suggest that helicopter transportation is safe in patients undergoing acute coronary syndrome, despite the altitude of a metropolitan area.

Resumen Antecedentes: Los sistemas de atención de IAMCEST han reducido los tiempos de transferencia interhospitalaria y han facilitado las metas de reperfusión oportuna. Los helicópteros pueden ser una opción cuando el transporte terrestre no es factible; sin embargo, la seguridad del transporte aéreo en pacientes con síndrome coronario agudo (SICA) es un factor a considerar. Objetivos: Evaluar la seguridad del transporte en helicóptero para pacientes con SICA. Métodos: Estudio prospectivo, observacional, descriptivo. Se incluyeron pacientes con diagnóstico de SICA dentro de la red IAMCEST en metrópolis extensa, trasladados en helicóptero a un centro cardiovascular. El resultado primario del estudio fue la incidencia de complicaciones relacionadas con los viajes aéreos definidas cómo desalojo de catéter intravenoso, hipoxia, arritmia, angina, ansiedad, sangrado e hipotermia. Resultados: Total de 106 pacientes; la edad media fue de 54 años y 84,9% eran hombres. La altitud media de vuelo fue de 10,100 pies y la distancia media de vuelo fue de 50,0 km. El diagnóstico más frecuente fue IAMCEST tras fibrinolisis exitosa (51,8%), seguido de IAMCEST con fibrinolisis fallida (23,7%). Cinco pacientes (4,7%) desarrollaron una complicación: desalojo IV (1,8%) e hipoxemia (1,8%) en dos pacientes y un episodio de angina durante el vuelo (0,9%). Una altitud de vuelo mayor de 10,000 pies no se asoció a complicaciones. Conclusiones: Los resultados de este estudio sugieren que el transporte en helicóptero es seguro en pacientes con SICA, incluso en altitudes > 10,000 pies.

Abstract Background: Congenital heart disease poses a therapeutic challenge, specifically pulmonary valve stenosis. This has been treated for many years with invasive procedures and bioprostheses, which over time, become dysfunctional due to the accumulation of fibrous tissue and calcification. Objective: The aim of this study is to describe the use of endovascular management in the right ventricular outflow tract, as the beginning of an ongoing effot to improve pediatric outcomes in developing countries. Methods: Seven pediatric patients with endovascular management of the right outflow tract are presented. Three of them underwent surgical valvuloplasty with persistent pulmonary stenosis. They decided to insert a percutaneous transcatheter pulmonary valve (PPVI) with a Melody valve using the valve-in-valve technique, with 100% stenosis and no complications associated with the procedure. Results: Four patients with successful percutaneous valve implantation had different congenital heart diseases. In addition, the case of a patient in whom an intentional pulmonary valve fracture was performed, an innovative procedure in pediatric endovascular management in the country, is highlighted. Conclusions: The procedure was minimally invasive, safe, and effective. The IVPP technique could be a viable option in our country for managing failed primary valve implantations or even in native tracts.

Resumen Antecedentes: Las cardiopatías congénitas plantean un desafío terapéutico, específicamente la estenosis de la válvula pulmonar. Esta ha sido tratada durante muchos años con procedimientos invasivos e inserción de bioprótesis, que con el tiempo se vuelven disfuncionales y pueden reestenosarse por acumulación de tejido fibroso y calcificación. Debido a las complicaciones generadas por la injuria quirúrgica, se han descrito medidas menos invasivas para el manejo de la estenosis residual e inicial por medios endovasculares en adultos y más recientemente en población pediátrica. Objetivo: El objetivo de este reporte es describir la misma en el manejo endovascular del tracto de salida del ventrículo derecho, como el inicio de un trabajo continuo para la mejoría de los resultados pediátricos en países en vía de desarrollo. Métodos: Se presentan siete casos pediátricos de manejo endovascular del tracto de salida derecho; tres de ellos sometidos a valvuloplastia quirúrgica con persistencia de la estenosis pulmonar, por lo cual se decidió inserción percutánea de una válvula pulmonar (IVPP) transcatéter con válvula Melody utilizando la técnica valve-in-valve, con lo que se consiguió una resolución del 100% de la estenosis y no se presentó ningún tipo de complicación asociada al procedimiento. Resultados: En cuatro pacientes se logró una implantación exitosa de la válvula por vía percutánea en diferentes cardiopatías congénitas, siendo uno de ellos en tracto nativo; además, destaca el caso de un paciente en quien se realizó fractura intencional de la válvula pulmonar, procedimiento innovador en el manejo endovascular pediátrico en Colombia. Conclusiones: En estos pacientes el procedimiento resultó ser poco invasivo, seguro y efectivo. La técnica IVPP podría ser considerada una opción viable en Colombia (y en otros países en desarrollo) para el manejo de implantes valvulares primarios fallidos o incluso en tractos nativos.

ABSTRACT: The anchorage management in orthodontic treatments has been a constant challenge, the use of miniplates may be a viable solution to this query. The objective of this study was to determine the morphological differences in the area of insertion of orthodontic miniplates in the anterior and posterior mandibular regions, comparing them between age, sex, biotype and skeletal class. In this analysis 40 cone-beam records of patients were studied, bone thickness measurements were carried out, the sites that allowed the positioning of a miniplate were identified and compared between sex, age groups, biotype and skeletal class. Significant differences were observed between men and women at the anterior mandibular level, in men greater bone and cortical thicknesses were observed. No significant differences were observed between adult and young patients at the anterior mandibular level, but there were differences at the posterior mandibular level. The area 3 mm below the 2nd molar was not a reliable area for the insertion of mini plates, since many of the patients had no bone in that area. Miniplates are a safe anchoring resource which must be adapted to each patient.

RESUMEN: El manejo del anclaje en los tratamientos de ortodoncia ha sido un reto constante, por lo que la utilización de miniplacas aparece como un rescate a esta interrogante. Determinar las diferencias morfológicas en la zona de inserción de miniplacas ortodóncicas en las regiones anterior y posterior mandibular, comparandolas entre edad, sexo, biotipo y clase esqueletal. Se estudiaron 40 registros de cone-beam de pacientes y se realizaron mediciones de grosor del hueso, donde se identificaron los sitios que permitan posicionar una miniplaca y fueron comparados entre sexo, grupos etarios, biotipo y clase esqueletal. Se observó diferencias significativas entre hombres y mujeres a nivel anterior mandibular, en los hombres se observaron mayores grosores óseos y corticales. No se observaron diferencias significativas entre pacientes adultos y jóvenes a nivel anterior mandibular, pero sí hubo diferencias a nivel mandibular posterior. La zona 3 mm debajo del 2do molar no es una zona confiable para la inserción de mini placas, ya que muchos de los pacientes no presentaban hueso en esa zona. Las miniplacas son un recurso seguro de anclaje las cuales deben ser adaptadas a cada paciente.

Resumen Este trabajo intenta examinar el nivel de conocimiento financiero de los trabajadores de la industria turística en México a través de la Metodología de Ecuaciones Estructurales (SEM). El tipo de muestreo no es probabilístico por autodeterminación. Se aplica un cuestionario a 500 trabajadores, en 2023, de empresas mexicanas del sector turístico considerando los siguientes 7 temas: Inversión, ahorro, crédito, seguros, pensiones, etc. gastos y presupuestos. El SEM permite sacar a la luz el conocimiento financiero que los trabajadores encuestados tienen sobre estos temas. A partir de una estructura factorial obtenida del análisis confirmatorio, que presenta buena bondad de ajuste, ajuste estructural y parsimonía, los principales hallazgos son: 1) en términos de crédito, los trabajadores dan importancia a los requisitos solicitados por las instituciones financieras y consideran que son fáciles de interpretar y cumplir, 2) en términos de cuentas de fondos de jubilación, los trabajadores se sienten confiados en las instituciones que administran sus ahorros de jubilación y tienen claras las comisiones, 3) en términos de ahorro, los trabajadores perciben que las cuentas bancarias se han adaptado a sus necesidades, ya que los bancos se han vuelto muy flexibles en términos de requisitos de apertura y montos iniciales con información clara y completa de la cuenta, 4) en términos de inversión, los trabajadores apenas adquieren pagarés bancarios, y 5) en cuanto al seguro de vida, los trabajadores expresan la facilidad que existe para contratar un seguro, aunque el costo es limitado. Los resultados obtenidos tienen implicaciones prácticas para que el sector turístico continúe promoviendo el hábito de ahorro y el uso de servicios y productos financieros a los que el trabajador pueda tener acceso, ya que este conocimiento financiero se traduce en empleados más organizados en sus asuntos financieros.

Abstract This paper attempts to examine the level of financial knowledge of workers in the tourism industry in Mexico through the Structural Equations Methodology (SEM). The type of sampling is non-probabilistic by self-determination. A questionnaire is applied to 500 workers, in 2023, from Mexican companies in the tourism sector considering the following 7 issues: investment, savings, credit, insurance, pensions, expenses and budgets. The SEM allows bring to light the financial knowledge that the surveyed workers have about these issues. Based on a factor structure obtained from the confirmatory analysis, which presents good goodness of fit, structural adjustment, and parsimony, the main findings are: 1) in terms of credit, workers give importance to the requirements requested by financial institutions and consider that they are easy to interpret and comply with, 2) in terms of retirement fund accounts, workers feel confident in institutions that manage their retirement savings and are clear about commissions, 3) in terms of savings, workers perceive that bank accounts have been adapted to their needs since banks have become very flexible in terms of requirements for opening and initial amounts with clear and complete account information, 4) in terms of investment, workers hardly acquire bank promissory notes, and 5) regarding life insurance, workers express the ease that exists to contract insurance, although the cost is limited. The results obtained have practical implications for the tourism sector to continue promoting the habit of saving and the use of financial services and products to which the worker can have access, since this financial knowledge translates into more organized employees in their financial affairs.