Abstract This paper analyzes how private autonomy behaves in the context of economic compensation, particularly in relation to the principle of the protection of weaker spouse, which applies to this matter through the application of the article 3 of the Civil Marriage Act (LMC). The regulatory agreement on economic compensation can be reached either out of court-it must be recorded in a notarial deed- or in court -it takes the form of a settlement. In any case, the consent of the judge hearing the divorce case will always be required, as this is a legal requirement in Article 63 of the LMC. It is therefore a freedom of contract protected by the jurisdictional authority. Our opinion is that the approval process of this agreement includes a substantive review by the judge of it, who is vested with corrective powers over the content of the agreement, if he deems it inadequate. A conclusion like this is based on the classification of the agreement as a procedural legal transaction and on the analogical application -based on the principle of protection of the weaker spouse- of article 31 LMC, which provides the requirements for the regulatory agreement in the context of a judicial separation by mutual consent and which obliges the judge to complete or rectify the agreement if it is incomplete or insufficient. In order to achieve this, we proposed a double level of judicial control, as well as the need to protect not only the beneficiary spouse, but also the person obligated to pay the agreed compensation.

Resumen El trabajo tiene por objeto examinar cómo se comporta la autonomía privada en materia de compensación económica, particularmente en relación con el principio de protección del cónyuge más débil, que rige en esta materia por aplicación del artículo 3 de la Ley de Matrimonio Civil (LMC). Se sabe que el acuerdo regulador de compensación económica puede alcanzarse tanto fuera del juicio -debiendo constar en escritura pública- como dentro de él - adoptando la forma de un avenimiento-. En uno y otro caso, siempre se requerirá de la aprobación del juez que conoce del juicio de divorcio, según dispone el artículo 63 de la LMC. Se trata, entonces, de una libertad de pacto tutelada jurisdiccionalmente. La opinión de estos autores es que el trámite de aprobación de este acuerdo implica una revisión de fondo por parte del juez, quien está investido de facultades correctoras de su contenido, sí lo estima como insuficiente. Una conclusión como esta se construye sobre la calificación del acuerdo como negocio procesal y, además, a partir de la aplicación analógica -fundada en el principio de protección de cónyuge más débil- del artículo 31 de la LMC, que contempla los requisitos del acuerdo regulador en el caso de separación judicial de común acuerdo y que ordena al juez completarlo o corregirlo sí el convenio es incompleto o insuficiente. Para estos efectos, se propone un doble nivel de revisión judicial, así como la necesidad de protección no sólo al cónyuge beneficiario, sino también al obligado al pago de la compensación pactada.

ABSTRACT BACKGROUND: Specific types of violence such as intimate partner sexual violence and intimate partner homicide occur more frequently in rural areas. OBJECTIVE: This study aimed to systematically review the literature on the knowledge and attitudes of rural healthcare providers regarding cases of domestic violence against women. DESIGN AND SETTING: Systematic review developed at Universidade Federal de Uberlândia. METHODS: We conducted an electronic search of six databases, which only included observational studies, regardless of the year, language, or country of publication, except for studies that used secondary data and were exclusively qualitative. Two reviewers performed the selection, data extraction, and risk of bias assessment using a specific Joanna Briggs Institute tool. RESULTS: Six studies met the inclusion criteria. All the studies had a low risk of bias. Approximately 38% of these professionals identified injuries caused by violence in patients. When asked about knowing the correct attitude to take in cases of confirmed violence, between 12% and 64% of rural healthcare providers answered positively; most of them would refer to specialized institutions and promote victim empowerment and counseling. The number of professionals with an educational background in the field ranged from 16% to 98%. CONCLUSIONS: The evident disparity across studies shows that some professionals have suboptimal knowledge and require training to adopt the correct attitude when identifying female victims of domestic violence in clinical practice. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered in the Open Science Framework Database under the registration http://doi.org/10.17605/OSF.IO/B7Q6S. BACKGROUND areas OBJECTIVE women SETTING Uberlândia METHODS databases year language publication qualitative selection extraction tool RESULTS criteria 38 patients 12 64 positively counseling 16 98 98% CONCLUSIONS practice REGISTRATION http//doi.org/10.17605/OSF.IO/B7Q6S. httpdoiorg1017605OSFIOB7Q6S httpdoiorgOSFIOBQS http //doi.org/10.17605/OSF.IO/B7Q6S. doi org 10 17605 OSF IO B7Q6S B Q S http://doi.org/10.17605/OSF.IO/B7Q6S 3 1 6 9 http//doi.org/10.17605/OSF.IO/B7Q6S httpdoiorg OSFIOB doiorg1017605OSFIOB7Q6S doiorgOSFIOBQS //doi.org/10.17605/OSF.IO/B7Q6S 1760 BQS doiorg 176 17

SUMMARY OBJECTIVE: The aim of this study was to estimate the prevalence of influenza immunization in elderly people in Brazil in 2019. METHODS: This is a population-based cross-sectional study. The Brazilian individuals (≥60 years) who participated in the 2019 National Health Survey were included. The survey was conducted in permanent households in Brazil from August 2019 to March 2020. The prevalences of influenza vaccination and their respective confidence intervals (95%CI) were estimated according to sociodemographic characteristics and the diagnosis of chronic diseases. RESULTS: The prevalence of influenza vaccination was 72.4% (95%CI 71.5–73.2), with statistically significant differences observed between genders (p=0.001), age groups (p=0.001), and those living with a spouse/partner (p=0.002). Significant differences were found in groups with arterial hypertension (75.2%, p<0.001), diabetes (77.2%, p<0.001), and arthritis or rheumatism (75.5%, p<0.001). CONCLUSION: A global prevalence of influenza vaccination of 72.4% was estimated among elderly people in Brazil. OBJECTIVE METHODS populationbased population based crosssectional cross sectional ≥60 60 (≥6 years 201 included 2020 95%CI 95CI CI 95 diseases RESULTS 724 72 4 72.4 71.5–73.2, 715732 71.5–73.2 , 71 5 73 2 71.5–73.2) p=0.001, p0001 p p=0.001 0 001 (p=0.001) spousepartner spouse partner p=0.002. p0002 p=0.002 . 002 (p=0.002) 75.2%, 752 75 (75.2% p<0.001, p<0.001 p<0.001) 77.2%, 772 77 (77.2% 75.5%, 755 (75.5% p<0.001. CONCLUSION ≥6 6 (≥ 20 202 9 7 72. 71573 71.5–73. p000 p=0.00 00 (p=0.001 (p=0.002 75.2% (75.2 p<0.00 77.2% (77.2 75.5% (75.5 ≥ ( 7157 71.5–73 p00 p=0.0 (p=0.00 75.2 (75. p<0.0 77.2 (77. 75.5 715 71.5–7 p0 p=0. (p=0.0 75. (75 p<0. 77. (77 71.5– p=0 (p=0. (7 p<0 71.5 p= (p=0 p< 71. (p= (p

Abstract Background Sexual function plays a very important role in the sexual health of people, and the determination of their related factors reflects the importance of paying attention to sexual function in the cultural context. Objective The present study aimed to the role of sexual self-esteem, sexual desire, and sexual assertiveness in the female sexual function. Methods In this descriptive-analytical cross-sectional study, 592 married women of reproductive age referring to comprehensive health centers in Rasht city (North of Iran) and eligible for the inclusion criteria were selected by cluster random sampling. The data collection tools were demographic information form, Halbert’s Sexual Rights Questionnaires, Women’s Sexual Self-Esteem (short form), Halbert’s Sexual Desire, and Female Sexual Function Index. Data analysis was done with descriptive and inferential statistical tests at a significant level (p < 0.05). Results The mean and standard deviation of sexual assertiveness, sexual desire, and sexual self-esteem scores were 56.79 ± 18.24, 49.12 ± 26.04, and 98.52 ± 6.11, respectively. Sexual assertiveness (p < 0.01, r = 0.13), sexual desire (p < 0.001, r = 0.178), sexual self-esteem (p < 0.01, r = 0.34) of the participants with the total score, and all areas of female sexual function had a significant positive correlation. Conclusion Based on the findings, there is a direct and statistically significant relationship between sexual assertiveness, sexual desire, the adaptability of sexual self-esteem, and family income with sexual function in participants. However, the unemployment of the spouse had a negative effect on the female sexual function. people context selfesteem, selfesteem self esteem, esteem descriptiveanalytical analytical crosssectional cross sectional 59 North Iran sampling form Halberts Halbert s Questionnaires Womens Women SelfEsteem Self Esteem short , form) Desire Index p 0.05. 005 0.05 . 0 05 0.05) 5679 56 79 56.7 1824 18 24 18.24 4912 49 12 49.1 2604 26 04 26.04 9852 98 52 98.5 611 6 11 6.11 respectively 001 01 0.01 0.13, 013 0.13 13 0.13) 0001 0.001 0.178, 0178 0.178 178 0.178) 0.34 034 34 score correlation findings However 5 00 0.0 567 7 56. 182 1 2 18.2 491 4 49. 260 26.0 985 9 98. 61 6.1 0.1 000 0.00 017 0.17 17 0.3 03 3 0. 18. 26. 6.

The constitutional recognition of customary law in South Africa has opened a new conduit for the development of customary law. With the courts taking the lead in addressing customary law disputes, the interpretation of customary law has come with setbacks. This article argues that the development and reform strides made by the judicial and legislative institutions appear of modest benefit to the people they strive to protect, advance and regulate, especially during interpretation and reform. The article seeks to confront the judicial interpretation of customary law based on the recent High Court case of Sengadi v Tsambo. The court had to consider an application for four types of relief. The court deviated from the factual nature of customary law in relation to a spouse's burial rights when it concluded that a valid customary marriage and all the validity requirements outlined under the Recognition of Customary Marriages Act had been met. Indicating the factuality of customary law when it relates to marriage and its link to burial rights, "that a male descendant of the household belongs to his paternal family, his place and existence being one with his paternal roots. His right to belong to his paternal family is absolute and customary." The above ignored, yet crucial cultural practice informs the interpretation of customary law under the constitutional guise. The Constitution affirms the right to practise and observe one's culture. In Sengadi v Tsambo, to determine the burial rights of a spouse, the court employed a narrow and strict interpretation instead of interpreting the cultural practice of bridal integration against a holistic customary background. The article advocates for courts to adopt purposive interpretational approaches in reforming customary law. It emphasises for the consideration of the interpretational rules and theoretical frameworks proposed by legal scholars to reflect the factual nature of customary law. As the positivist approach to customary law undermines the pluralistic nature of the South African legal system. The article pioneers for the recognition of living customary law as holistic, and an integral normative system of indigenous people of South Africa, while taking into account the history and context of this legal system.

SUMMARY OBJECTIVE: The aim of this study was to compare pregnant women's perceptions of risk and pregnancy-specific stress levels. METHODS: This cross-sectional descriptive study was conducted with 410 healthy pregnant women at the city hospital located in the east of Turkey. Data were collected via Personal Information Form, Perception of Pregnancy Risk Questionnaire, and Pregnancy Stress Rating Scale. RESULTS: The pregnancy risk perception mean score was 2.43±1.82, and the pregnancy-specific stress mean score was 22.27±12.67. There is a statistically significant and strong positive correlation between the perception of pregnancy risk and pregnancy-specific stress level (p<0.01). Pregnant women's pregnancy risk perception decreased as the duration of marriage and the number of living children increased, and it increased as the gestational week increased (p<0.05). Pregnancy-specific stress decreased as the duration of marriage (p<0.001), the age of the spouse, the number of pregnancies, and the number of living children increased (p<0.01), and it increased as the gestational week increased (p<0.01). CONCLUSION: The pregnant women's perceptions of pregnancy risks and pregnancy-specific stress were low, but pregnancy-specific stresses increased as their perceptions of pregnancy risks increased. OBJECTIVE womens s pregnancyspecific specific levels METHODS crosssectional cross sectional 41 Turkey Form Questionnaire Scale RESULTS 243182 2 43 1 82 2.43±1.82 22271267 22 27 12 67 22.27±12.67 p<0.01. p001 p p<0.01 . 0 01 (p<0.01) p<0.05. p005 p<0.05 05 (p<0.05) Pregnancyspecific p<0.001, p0001 p<0.001 , 001 (p<0.001) spouse pregnancies p<0.01, CONCLUSION low 4 24318 8 2.43±1.8 2227126 6 22.27±12.6 p00 p<0.0 (p<0.01 (p<0.05 p000 p<0.00 00 (p<0.001 2431 2.43±1. 222712 22.27±12. p0 p<0. (p<0.0 (p<0.00 243 2.43±1 22271 22.27±12 p<0 (p<0. 24 2.43± 2227 22.27±1 p< (p<0 2.43 222 22.27± (p< 2.4 22.27 (p 2. 22.2 22.

Abstract The purpose of this research work was to analyze whether the registration of the declaration of a building at the expense of the social estate violates the property right of the spouse who owns the land in the Peruvian legal system. A qualitative design of dogmatic analytical type was used, through the review of norms, doctrine, pertinent jurisprudence and analysis of two relevant cases. The results highlight that there is a violation of the property right of the spouse owner of the land, due to an erroneous interpretation of the second paragraph of article 310 of the Civil Code. In conclusion, there is an urgent need for a legislative modification of the corresponding civil and registry regulations, in order to protect the right of ownership, recognized and guaranteed by the constitution and the civil system of a property that is already titled and qualified as one’s own.

Resumen El presente trabajo de investigación tuvo como objetivo, analizar si la inscripción de la declaratoria de edificación realizada a costa del caudal social vulnera el derecho de propiedad del cónyuge propietario del suelo en el ordenamiento jurídico peruano. Se usó un diseño cualitativo de tipo dogmática analítica, mediante la revisión de normas, doctrina, jurisprudencia pertinente y análisis de dos casos relevantes. Los resultados resaltan que, existe una vulneración al derecho de propiedad del cónyuge propietario del suelo, debido a una errónea interpretación que se realiza en el segundo párrafo del artículo 310 del Código Civil. En conclusión, surge la imperiosa necesidad de una modificación legislativa de la normativa civil y registral correspondiente, a fin de tutelar el derecho de propiedad, reconocido y garantizado por la constitución y el ordenamiento civil de un bien que ya viene titulado y calificado como propio.

SUMMARY OBJECTIVE: The aim of the study was to examine the relationship between social support, marital dissatisfaction, psychological factors, and health-promoting behaviors in pregnant women. METHODS: This cross-sectional study was conducted on 1,265 pregnant women who visited the outpatient clinic of a maternity hospital between May and August 2023. The Health Promotion Lifestyle-II Questionnaire was used to measure the healthy lifestyle behaviors of pregnant women. The mental health status of pregnant women was measured using the Depression Anxiety and Stress Scale-21. The Marital Disaffection Scale was used to assess the level of disaffection toward a spouse. Perceived social support was measured by the Multidimensional Perceived Social Support Scale. RESULTS: Pregnant women had a mean age of 26.46±5.09 years. Multivariate linear regression analysis revealed that there was a positive association between perceived social support and health-promoting behaviors. It was also found that marital disaffection was negatively associated with health-promoting behaviors (p<0.001). CONCLUSION: The present study suggests that stress, anxiety, depression, and marital disaffection are negatively associated with health-promoting lifestyle behaviors, while social support is positively associated with the adoption of health practices in pregnant women. Understanding the complex interplay between psychosocial factors and healthy behaviors is crucial to improving healthy behaviors in pregnant women. OBJECTIVE dissatisfaction healthpromoting promoting METHODS crosssectional cross sectional 1265 1 265 1,26 2023 LifestyleII Lifestyle II Scale21. Scale21 21. 21 Scale-21 spouse RESULTS 2646509 26 46 5 09 26.46±5.0 years p<0.001. p0001 p p<0.001 . 0 001 (p<0.001) CONCLUSION stress anxiety depression 126 1,2 202 Scale2 2 Scale-2 264650 4 26.46±5. p000 p<0.00 00 (p<0.001 12 1, 20 Scale- 26465 26.46±5 p00 p<0.0 (p<0.00 2646 26.46± p0 p<0. (p<0.0 264 26.46 p<0 (p<0. 26.4 p< (p<0 26. (p< (p

Abstract This article addresses the issue of violence against women in the context of the Covid-19 pandemic, problematizing the effectiveness of state interventions in the protection of women in cases of gender violence. The research hypothesis is that social isolation and the difficulties faced during the pandemic have intensified women's vulnerability, requiring greater government attention. The deductive method was used and, as a methodological procedure, a literature review was performed in repositories, such as Google Scholar, Scielo, and database of theses and dissertations with inclusion terms: violence against women; family violence; coronavirus; Covid-19; law 11.340 and protection of the State. The relevance of the present study lies in the fact that the vulnerability of women has greatly increased in the scenario of the global pandemic, since social isolation measures have contributed in various ways to worsen this situation, requiring even more attention from the government in the prevention and punishment of aggressors. It was possible to conclude through the present study that the pandemic has brought social and financial problems to millions of people around the world and that the social isolation imposed to reduce their risks, has aggravated female violence, whose cases of underreporting were even more evident by the difficulty of access to public transport, lack of foster care options and dependence on the spouse. The situation could be minimized with greater commitment from the State, more efficient communication, which could be done through social networks, and more measured actions by the Brazilian Judiciary in favor of the release and protection of bandits, who will fatally represent a greater risk of the occurrence of violence and femicide when they return to their companions.

Resumo O presente artigo aborda a questão da violência contra as mulheres no contexto da pandemia da Covid-19, problematizando a efetividade das intervenções estatais na proteção da mulher em casos de violência de gênero. A hipótese de pesquisa é que o isolamento social e as dificuldades enfrentadas durante a pandemia intensificaram a vulnerabilidade das mulheres, exigindo maior atenção do governo. Empregou-se o método dedutivo e como procedimento metodológico, foi realizada uma revisão de literatura em repositórios como Google Acadêmico, Scielo e banco de teses e dissertações com termos de inclusão: violência contra a mulher; violência familiar; coronavírus; covid-19; lei 11.340 e proteção do Estado. A relevância do presente estudo está no fato de que a vulnerabilidade da mulher aumentou muito no cenário da pandemia mundial, uma vez que medidas de isolamento social contribuíram de diversas maneiras para que esta situação se agravasse, requerendo ainda mais atenção por parte do governo na prevenção e punição dos agressores. Foi possível concluir através do presente estudo que a pandemia trouxe problemas sociais e de ordem financeira para milhões de pessoas em todo mundo, e que o isolamento social imposta como forma de reduzir os seus riscos, agravou a violência feminina, cujos casos de subnotificação ficaram ainda mais evidentes pela dificuldade de acesso aos transportes públicos, falta de opções de acolhimento e dependência do conjugue. A situação poderia ser minimizada com maior comprometimento do Estado, comunicação mais eficiente, a qual poderia ser feita através das redes sociais, e ações mais comedidas por parte do judiciário brasileiro em prol da soltura e proteção de bandidos, os quais fatalmente representarão maior risco da ocorrência de violência e feminicídio ao voltarem para suas companheiras.

Resumo A viuvez é o “estado de uma pessoa depois da morte de seu cônjuge”. É considerada como um dos eventos de vida não normativos, de mais difícil manejo, particularmente em pessoas idosas, dado o conjunto de demandas emocionais, sociais e comportamentais que acarreta. Este estudo teve o objetivo de identificar as variáveis de saúde e/ou psicossociais relacionadas a viuvez em idosos. Foi realizada uma revisão integrativa da literatura por meio de busca nas bases de dados AgeLine, BVS, PsycoInfo, Pubmed e Scielo. Foram selecionados estudos publicados no idioma inglês, espanhol e português, com idosos de 60 anos ou mais, transversais ou longitudinais que incluíram descrições e detalhamentos sobre o processo de viuvez, como resultado primário e/ou secundário. Sintomas depressivos, suporte social, impacto das experiências prévias da relação marital no estado de viuvez, estado e/ou condição nutricional enquanto auto percepção de saúde, bem-estar psicológico, satisfação com a vida, religiosidade e espiritualidade podem atuar como fatores agravantes ou de proteção na viuvez.

Abstract Widowhood is “the state of a person after the death of his or her spouse”. It is considered one of the most difficult non-normative life events to manage, particularly in the elderly, given the set of emotional, social and behavioral demands that it entails. This study aimed to identify health and/or psychosocial variables related to widowhood in the elderly. An integrative literature review was carried out by searching the AgeLine, BVS, PsycoInfo, Pubmed and Scielo databases. Cross-sectional or longitudinal studies published in English, Spanish and Portuguese, with elderly aged 60 years and over, including descriptions and details about the widowhood process, as a primary and/or secondary result, were selected. Depressive symptoms, social support, impact of previous experiences of the marital relationship on the state of widowhood, nutritional state and/or condition as self-perception of health, psychological well-being, satisfaction with life, religiosity and spirituality can act as aggravating or debilitating factors. widowhood protection.

Abstract The aim is to determine the prevalence of sarcopenia components and associations with socioeconomic variables in older persons living in rural areas in the state of Ceará, Brazil. We conducted a cross-sectional study with 274 older adults. Muscle mass was assessed using muscle mass index (MMI), measured by bioelectrical impedance analysis and calf circumference. Muscle strength (MS) was assessed using the handgrip test. Physical performance was measured using the walk test to calculate gait speed (GS) and the timed up-and-go test. Probable sarcopenia was defined as the presence of low MS, while confirmed sarcopenia was defined as the presence of low MS and low MMI. Severe sarcopenia was defined as the presence of the latter two criteria and slow GS. We tested for associations between sociodemographic characteristics and lifestyle habits and the components of sarcopenia. The logistic regression produced the following results: i) prevalence of low MS was higher among men, individuals aged >69 years, and in those not working at the time of the study; ii) the prevalence of low MMI was higher in individuals aged >69 years, those not living with a spouse, and those with an inadequate level of physical activity; iii) the prevalence of slow GS was higher in individuals aged >69 years, those who had lived in rural areas for less than 30 years, and those not working at the time of the study. Ceará Brazil crosssectional cross sectional 27 adults MMI, , (MMI) circumference (MS (GS upandgo up go results i men 69 >6 years ii spouse activity iii 3 2 (MMI 6 >

Resumo O objetivo é estimar prevalência de componentes da sarcopenia e associações com variáveis socioeconômicas em idosos de população rural do Ceará. Estudo transversal com 274 idosos. Massa muscular foi determinada por Índice de Massa Muscular (IMM) por bioimpedância elétrica e por circunferência da panturrilha; força muscular (FM) por teste de preensão palmar; e desempenho físico por testes da caminhada (VC) e Timed-up-and-go. Provável sarcopenia foi caracterizada por diminuição da FM, sarcopenia quando associada a diminuição do IMM, e sarcopenia grave quando estes dois foram acompanhados de baixa VC. Foram estimadas associações entre condições sociodemográficas, hábitos de vida e componentes da sarcopenia. Na regressão logística, foi observada frequência mais elevada: i) no sexo masculino, idade>69 anos, e nos que não trabalham, entre os idosos com FM diminuída; ii) com idade>69 anos, nos que não moram com o cônjuge, e nos que não praticam atividade física num nível adequado, entre os idosos com IMM diminuído; iii) com idade>69 anos, nos que residem na zona rural há menos que 30 anos, e nos que não trabalham, entre os idosos com VC diminuída. Ceará 27 (IMM panturrilha (FM palmar (VC Timedupandgo. Timedupandgo Timed up and go. go Timed-up-and-go sociodemográficas logística elevada i masculino idade69 idade 69 idade>6 anos trabalham diminuída ii cônjuge adequado diminuído iii 3 2 idade6 6 idade>

Despite the enactment of the Recognition of Customary Marriages Act 120 of 1998 (the Recognition Act), many customary marriages remain unregistered. There are many reasons for non-registration. Since marriage certificates are associated with spousal benefits, people who do not expect such spousal benefits have no reason to register their marriage. These include the elderly and the widowed. The registration process is another reason for non-registration. Nevertheless, the difficulties that arise when a spouse does not have a registration certificate cannot be sustained. This article is motivation for mandatory registration of customary marriages. It briefly discusses the history of registration of customary marriages. It also studies the provisions of the Recognition Act in this regard. The difficulties that arise in the absence of a marriage certificate are also discussed. It recommends the use of traditional leaders, who receive a state salary, to facilitate the instantaneous registration of customary marriages. The benefits of involving traditional leaders are also discussed.

ABSTRACT Introduction: Adherence to treatment in chronic diseases is one of the most widely discussed topics in health psychology. Objective: To describe the therapeutic adherence and its association with psychosocial and clinical factors in people with primary hypothyroidism seen at the National Institute of Endocrinology in Havana. Material and Methods: Descriptive and cross-sectional study that included 63 subjects (56 women and 7 men) who attended the thyroid dysfunction consultation in the period July-December, 2019. Data were collected from the review of clinical histories, patients’ interviews, a questionnaire to evaluate the therapeutic adherence (MBG), and interviews to specialists. Results: In the population studied, total adherence to treatment was found in 42.9% of the patients, partial adherence in 46% of them, and no adherence was found in 11.1% of the cases; there was more adherence to pharmacological treatment than non-pharmacological treatment. Adherence was significantly associated with having spouse, coping styles, and disease control (p< 0,05). Conclusions: Partial adherence to treatment was predominant, followed by total adherence. The variable related to appropriate therapeutic adherence was significantly associated with the clinical control of primary hypothyroidism, which supports that people with adherence behavior have a much greater chance of having a successful therapeutic treatment.

RESUMEN Introducción: La adherencia al tratamiento en enfermedades crónicas es uno de los temas más abordados por la psicología de la salud. Objetivo: Describir la adherencia terapéutica de personas con hipotiroidismo primario y su asociación con factores psicosociales y clínicos atendidos en el Instituto Nacional de Endocrinología, La Habana. Material y Método: Estudio descriptivo transversal, que incluyó a las personas que asistieron a consulta de disfunciones tiroideas en el período comprendido de julio a diciembre 2019 (63 sujetos, 56 mujeres y 7 hombres). La recogida de datos se hizo a partir de la revisión de historias clínicas, entrevista a los pacientes, cuestionario de evaluación de la adherencia terapéutica (MBG) y entrevista a especialistas. Resultados: En la población estudiada se encontró adherencia total en 42,9 % de las personas, adherencia parcial en 46 % y no adherencia en 11,1 % de los casos; con mayor adherencia al tratamiento farmacológico que al no farmacológico. La adherencia se asoció significativamente a la tenencia de pareja, estilos de afrontamiento y control de la enfermedad con una p< 0,05. Conclusiones: La adherencia terapéutica adecuada resultó ser una variable vinculada de manera significativa con el control clínico del hipotiroidismo primario, lo que avala que las personas con un comportamiento adherente tienen más posibilidades de tener éxito terapéutico.

Resumen Presentamos el caso de una mujer de 38 años sin antecedentes personales relevantes, residente de Ciudad Autónoma de Buenos Aires, que consultó por fiebre, cefalea retroocular mialgias, ar tralgias y exantema maculopapular pruriginoso en dorso de manos y pies de 6 días de evolución. El laboratorio presentaba linfopenia, trombocitopenia grave y hepatitis anictérica. El cónyuge había cursado internación tres semanas antes por un cuadro de similares características sin diagnóstico etiológico. Posteriormente, la paciente evolucionó con metrorragia y petequias axilares asociados a fotofobia, somnolencia y temblor fino de la lengua, con líquido cefalorraquídeo normal, cumpliendo tratamiento con ceftriaxona 2 g/día intravenoso por 7 días. La tomografía computarizada de abdomen y pelvis evidenciaba un hematoma de pared abdominal izquierdo. Se derivaron muestras serológicas al Instituto Nacional de Enfermedades Virales Humanas Dr. Julio I. Maiztegui para virus dengue, leptospirosis y hantavirus con resultados no reactivos y RT-PCR de virus Junín que resultó positiva. Retrospectivamente se realizó el diagnóstico del cónyuge por detección de anticuerpos IgG para virus Junín por ELISA y prueba de neutralización. Ninguno de los dos casos presentaba un nexo epidemiológico claro. Nuestro objetivo es remarcar la importancia de la sospecha clínica fuera de áreas endémicas.

Abstract We present the case of a 38-year-old woman with no relevant medical history, resident of the City of Buenos Aires, who was admitted in hospital for presenting fever, retroocular headache, myalgia, arthralgia, and maculopapular pruritic rash on the back of the hands and feet of 6 days of evolution. Laboratory tests revealed lymphopenia, severe thrombocytopenia, and anicteric hepatitis. Her husband had been hospitalized three weeks earlier for a condition of similar characteristics without etiological diagnosis. Subsequently, it evolved with metrorrhagia and axillary petechiae associated with photophobia, drowsiness, and fine tremor of the tongue with normal cerebrospinal fluid, treated with intravenous ceftriaxone 2 g/day for 7 days. Computed tomography of abdomen and pelvis showed a left abdominal wall hematoma. Serological samples were sent to the National Institute of Human Viral Diseases Dr. Julio I. Maiztegui for dengue virus, leptospirosis and hantavirus with non-reactive results, and RT-PCR of Junín virus that was positive. Retrospectively, the spouse was diagnosed by detection of IgG antibodies to Junin virus by ELISA and neutralization tests. Neither of the two cases had a clear epidemiological link. Our aim is to highlight the importance of clinical suspicion outside of endemic areas.