Abstract This article discusses questions concerning the future of humanity in the face of threats to the health of populations, whose impact has been exacerbated in the course of inequalities in all parts of the world, pari passu with global development in the hegemonized model since last century. The COVID-19 pandemic is a good example that illustrates this dissonance between development and inequalities. Questions were formulated to be debated about the construction of the future of world society, based on the understanding of the evolutionary character of life on the planet vis-à-vis the evils that affect large contingents of the population and represent powerful risks for this evolutionary process. These questions call attention to the discussion around social participation in the definition and control of public policies, as opposed to the hegemony of private interests in the formulation and execution of these policies, both in the scenarios of each country and in the international context.

Resumo O artigo discute questões sobre o futuro da humanidade ante as ameaças que rondam a saúde das populações, cujo impacto vem se exacerbando no curso das desigualdades em todas as partes do mundo, pari passu o desenvolvimento global no modelo hegemonizado a partir do século passado. A pandemia de COVID-19 foi tomada como um caso que bem ilustra essa dessintonia entre desenvolvimento e desigualdades. Formulam-se perguntas a serem postas em debate sobre a construção do futuro da sociedade mundial, com base na acepção sobre o caráter evolucional da vida no planeta vis-à-vis os males que acometem grandes contingentes populacionais e representam poderosos riscos para esse processo evolutivo. São indagações que apontam para a discussão em torno da participação social na definição e no controle das políticas públicas, em contrapartida à hegemonia dos interesses privados na formulação e execução dessas políticas, tanto nos cenários de cada país como no contexto internacional.

A cardiomiopatia hipertrófica (CMH) é uma forma de doença do músculo cardíaco de causa genética, caracterizada pela hipertrofia das paredes ventriculares. O diagnóstico requer detecção por métodos de imagem (Ecocardiograma ou Ressonância Magnética Cardíaca) de qualquer segmento da parede do ventrículo esquerdo com espessura > 15 mm, sem outra causa provável. A análise genética permite identificar mutações de genes codificantes de diferentes estruturas do sarcômero responsáveis pelo desenvolvimento da CMH em cerca de 60% dos casos, permitindo o rastreio de familiares e aconselhamento genético, como parte importante do manejo dos pacientes e familiares. Vários conceitos sobre a CMH foram recentemente revistos, incluindo sua prevalência de 1 em 250 indivíduos, não sendo, portanto, uma doença rara, mas subdiagnosticada. A vasta maioria dos pacientes é assintomática. Naqueles sintomáticos, a obstrução do trato de saída do ventrículo esquerdo (OTSVE) é o principal distúrbio responsável pelos sintomas, devendo-se investigar a sua presença em todos os casos. Naqueles em que o ecocardiograma em repouso ou com Manobra de Valsalva não detecta gradiente intraventricular significativo (> 30 mmHg), devem ser submetidos à ecocardiografia com esforço físico para detecção da OTSVE.   Pacientes com sintomas limitantes e grave OTSVE, refratários ao uso de betabloqueadores e verapamil, devem receber terapias de redução septal ou uso de novas drogas inibidoras da miosina cardíaca. Por fim, os pacientes adequadamente identificados com risco aumentado de morta súbita podem receber medida profilática com implante de cardiodesfibrilador implantável (CDI).

La miocardiopatía hipertrófica (MCH) es una forma de enfermedad cardíaca de origen genético, caracterizada por el engrosamiento de las paredes ventriculares. El diagnóstico requiere la detección mediante métodos de imagen (Ecocardiograma o Resonancia Magnética Cardíaca) que muestren algún segmento de la pared ventricular izquierda con un grosor > 15 mm, sin otra causa probable. El análisis genético permite identificar mutaciones en genes que codifican diferentes estructuras del sarcómero responsables del desarrollo de la MCH en aproximadamente el 60% de los casos, lo que permite el tamizaje de familiares y el asesoramiento genético, como parte importante del manejo de pacientes y familiares. Varios conceptos sobre la MCH han sido revisados recientemente, incluida su prevalencia de 1 entre 250 individuos, por lo tanto, no es una enfermedad rara, sino subdiagnosticada. La gran mayoría de los pacientes son asintomáticos. En los casos sintomáticos, la obstrucción del tracto de salida ventricular izquierdo (TSVI) es el trastorno principal responsable de los síntomas, y su presencia debe investigarse en todos los casos. En aquellos en los que el ecocardiograma en reposo o la maniobra de Valsalva no detecta un gradiente intraventricular significativo (> 30 mmHg), deben someterse a ecocardiografía de esfuerzo para detectar la obstrucción del TSVI. Los pacientes con síntomas limitantes y obstrucción grave del TSVI, refractarios al uso de betabloqueantes y verapamilo, deben recibir terapias de reducción septal o usar nuevos medicamentos inhibidores de la miosina cardíaca. Finalmente, los pacientes adecuadamente identificados con un riesgo aumentado de muerte súbita pueden recibir medidas profilácticas con el implante de un cardioversor-desfibrilador implantable (CDI).

Hypertrophic cardiomyopathy (HCM) is a form of genetically caused heart muscle disease, characterized by the thickening of the ventricular walls. Diagnosis requires detection through imaging methods (Echocardiogram or Cardiac Magnetic Resonance) showing any segment of the left ventricular wall with a thickness > 15 mm, without any other probable cause. Genetic analysis allows the identification of mutations in genes encoding different structures of the sarcomere responsible for the development of HCM in about 60% of cases, enabling screening of family members and genetic counseling, as an important part of patient and family management. Several concepts about HCM have recently been reviewed, including its prevalence of 1 in 250 individuals, hence not a rare but rather underdiagnosed disease. The vast majority of patients are asymptomatic. In symptomatic cases, obstruction of the left ventricular outflow tract (LVOT) is the primary disorder responsible for symptoms, and its presence should be investigated in all cases. In those where resting echocardiogram or Valsalva maneuver does not detect significant intraventricular gradient (> 30 mmHg), they should undergo stress echocardiography to detect LVOT obstruction. Patients with limiting symptoms and severe LVOT obstruction, refractory to beta-blockers and verapamil, should receive septal reduction therapies or use new drugs inhibiting cardiac myosin. Finally, appropriately identified patients at increased risk of sudden death may receive prophylactic measure with implantable cardioverter-defibrillator (ICD) implantation.

Abstract A continuous increase in levels of atmospheric pollution and emission restrictions has forced scientists and engineers to adopt new strategies to improve and develop internal combustion engines. One strategy is based on the development of new simulation methodologies using computational fluid dynamic (CFD) techniques, proposed in the present article. In this study,the dynamic loop methodology with ANSYS Fluent code is proposed to perform the numerical simulation ofa four-stroke spark ignition engine. The complexity of the real case was first simplified with three-dimensional CAD geometry, which was then discretized in ANSYS Meshing, whereby a hybrid mesh was created using prismatic and tetrahedral elements. Simulations for in-cylinder analyses were performed in cold flow and employing common flow parameters, such as swirl and tumble. The mesh quality results were classified as good or excellent, being higher than 0.79 for orthogonal quality criteria and lower than 0.36 for skewness criteria. Turbulent effects were introduced concerning the opening and closing of the valves. It was found that the turbulence increases during the intake stroke up to 90°, and during the power stroke, wherein the of the piston bowl, had a great contributionthat can be seen from the swirl and tumble profile for the engine cycle. In the case of the turbulence intensity, a sharp increase was registered during the admission step up to 90°, at which point the turbulence intensity was 4.0. It canbe concluded that this is an innovative approach, capable of simulating the engine motion profile in cold flow.

ABSTRACT Introduction: the vision, the man's most reliable sense, plays an essential role in all spheres of life. It is a fundamental part of face- to- face social communication. Objective: to characterize the students with visual disabilities served by the "Jose Marti" Special School in Pinar del Rio province as Resource and Support Center, in the period from September 2022 to May 2023. Methods: observational, descriptive, cross - sectional study. The universe and the sample were formed of 37 students, coincident from a non-probabilistic intentional sampling and according to the exclusion and inclusion criteria. The medical records were reviewed taking into account the corresponding ethical considerations, and with the consent of the Center's management. Descriptive and inferential statistics were used to tabulate data. Results: in the sample, the ages between 10 to12 years predominated, the male sex 51,35 %, schooling at the primary level (32,43 %). Out of them, seven students were blind for 18,91 %, and 30 were of low vision for 81,08 %, while 54,05 classified as having slight low vision. Composite hyperopic astigmatism was the most common primary ametropia. The most commonly used optical aids were hypercorrections and manual magnifying glasses. The most used non-optical aids: lighting, lecterns, strong contrasts (black and white), and close -ups. Conclusions: it is gratifying to achieve that the students with visual disabilities moved with their peer group at the educational level that corresponds to them, with the resources and support necessary for their development taking into account their uniqueness.

RESUMEN Introducción: la visión, el sentido más fiable del hombre, posee un papel esencial en todas las esferas de la vida. Es parte fundamental en la comunicación social cara a cara. Objetivo: caracterizar los educandos con discapacidad visual atendidos por la Escuela Especial “José Martí” de la provincia de Pinar del Río como Centro de Recursos y Apoyo, en el período septiembre 2022 a mayo de 2023. Métodos: estudio observacional, descriptivo, de corte transversal. El universo y la muestra quedaron constituidos por 37 educandos coinciden a partir de un muestreo intencional no probabilístico y según los criterios de exclusión e inclusión. Se revisaron las historias clínicas teniendo presentes las consideraciones éticas correspondientes y con el consentimiento de la dirección del Centro. Se utilizó la estadística descriptiva e inferencial para realizar la tabulación de datos. Resultados: en la muestra predominaron las edades entre 10-12 años, el sexo masculino en el 51,35 %, escolaridad en el nivel primario (32,43 %). De ellos, siete educandos fueron ciegos para un 18,91 % y 30 baja visión para un 81,08 %, mientras 54,05 clasificó con baja visión ligera. El astigmatismo hipermetrópico compuesto fue la ametropía primaria más frecuente. Las ayudas ópticas más utilizadas fueron las hipercorrecciones y lupas manuales. Las ayudas no ópticas más empleadas: la iluminación, los atriles, contrastes fuertes (negro y blanco) y acercamientos. Conclusiones: es gratificante el logro de que los educandos con discapacidad visual transiten con su grupo de iguales en el nivel educativo que les corresponde con los recursos y apoyos necesarios para su desarrollo teniendo en cuenta su singularidad.

Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods:  A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.   Background: The concept introduced by enhanced recovery after surgery protocols modifies perioperative traditional care in digestive surgery. The integration of these modern recommendations components during the perioperative period are highly important to ensure less postoperative complications, reduced length of hospital stay and decreased surgical costs. Aims: The aim of this position paper is to emphasize the most important points of a multimodal perioperative care protocol. Methods:  A careful analysis of each recommendation of both ERAS and ACERTO protocols is presented, justifying its inclusion in the recommended multimodal care of digestive surgery patients. Results: Enhanced recovery programs (ERPs) such as ERAS and ACERTO protocols are a cornerstone in modern perioperative care. Nutritional therapy is highly important in digestive surgery and thus both preoperative and postoperative nutrition care are key to ensure less postoperative complications and to reduce the length of hospital stay. The concept of prehabilitation is another key element in ERPs. Management of crystalloid fluids in a perfect balance in vital. Fluid overload may delay the recovery of patients and increase postoperative complications. Abbreviation of preoperative fast for 2h before anesthesia is now accepted by various guidelines of both surgical and anesthesiology societies. Combined with early postoperative refeeding, these prescriptions are not only safe but can also enhance recovery of patients undergoing digestive procedures. Conclusions: This Brazilian College of Digestive Surgery position paper strongly emphasizes that the implementation of ERPs in digestive surgery represents a paradigm shift in perioperative care, transcending traditional practices and embracing an intelligent approach to patient well-being.

ABSTRACT Objective: To evaluate the level of COVID-19 risk perception (PCR-CV19) by returning to in-person classes and to analyze this perception with sociodemographic and health variables associated with such disease. Materials and methods: A cross-sectional and prospective study. The questionnaire was adapted to assess the PCR-CV19 among 532 university students. Moreover, an association analysis of the four dimensions of the PCR-CV19 (cognitive vulnerability, emotional vulnerability, risky-protective behaviors and severity) and the perception index was performed with sociodemographic and health variables. The following statistical methods were used: one-way analysis of variance (ANOVA), Shapiro-Wilk test for normality, Levene’s test for homogeneity of variances and Tukey’s honest significant difference or Games-Howell post hoc tests. These analyses were performed using the Jamovi statistical software, version 1.2.2. Results: A moderate level of PCR-CV19 was found, where the most relevant dimensions were risky-protective behaviors and severity. In addition, there was an association between the dimensions PCR-CV19 and perception index with the variables age, gender, alcohol consumption, physical and mental health indicators (anxiety and depression), and experiences with COVID-19. Cognitive vulnerability and emotional vulnerability were the most sensitive dimensions in the evaluation of the PCR-CV19. Conclusions: We continue to face constant risk conditions, thus making it necessary to maintain a surveillance scheme of the PCR-CV19 experienced by the population. In university students, cognitive vulnerability and emotional vulnerability were the most sensitive dimensions in the evaluation of PCR-CV19 and experiences with COVID-19 (illness or death). The fact that university students do not feel vulnerable and/or do not perceive the severity associated with COVID-19 transmission may affect their self-care behaviors. These results have key implications for public health; therefore, an intersectoral approach is required to have relevant information in order to face future pandemics.

RESUMEN Objetivo: Evaluar el nivel de percepción de riesgo de contagio de la COVID-19 frente al retorno a las clases presenciales y analizar esta percepción con variables sociodemográficas y de salud asociadas a esta enfermedad. Materiales y métodos: Estudio transversal y prospectivo. Se adaptó el cuestionario para evaluar la percepción de riesgo de contagio de la COVID-19 (PCR-CV19) en 532 universitarios. Además, se realizó un análisis de asociación de las cuatro dimensiones del PCR-CV19 (vulnerabilidad cognitiva, vulnerabilidad emocional, conductas de riesgo-protección y gravedad) y el índice de percepción con variables sociodemográficas y de salud. Se utilizaron técnicas estadísticas: análisis de varianza (ANOVA) de una vía (OneWay ANOVA), previa verificación de la prueba de normalidad Shapiro-Wilk y la prueba de Levene para la homogeneidad y la prueba post-hoc de Tukey o Ganes-Howell. Estos análisis se realizaron en el programa estadístico JAMOVI, versión 1.2.2. Resultados: Se evidenció un nivel moderado de percepción de riesgo de contagio, en donde las dimensiones de las conductas de riesgo-protección y gravedad se identificaron como las más relevantes; asimismo, se encontró asociación entre las dimensiones del PCR-CV19 y el índice de percepción con las variables edad, género, consumo de alcohol e indicadores de salud física y mental (ansiedad y depresión) y las experiencias vividas con la enfermedad de la COVID-19. Los aspectos de vulnerabilidad cognitiva y emocional fueron las dimensiones más sensibles en la evaluación de la percepción. Conclusiones: Seguimos enfrentando condiciones de riesgo que surgen de manera constante, lo que hace necesario mantener un esquema de vigilancia de la percepción de riesgo que experimenta la población. En los universitarios, los aspectos de vulnerabilidad cognitiva y emocional fueron las dimensiones más sensibles en la evaluación de la percepción del riesgo y las experiencias vividas con la COVID-19 (enfermedad o muerte). El hecho de que los universitarios no se sientan vulnerables y/o no perciban la gravedad asociada al contagio puede afectar sus conductas de autocuidado. Estos resultados tienen implicaciones claves para la salud pública, por lo que se requiere un abordaje intersectorial, con el objetivo de contar con información relevante para enfrentar futuras pandemias.

ABSTRACT BACKGROUND AND OBJECTIVES: The mechanisms underlying nociplastic pain, such as fibromyalgia (FM), are not fully understood, however, it is believed that altered sensory processing and pain modulation play prominent roles in the maintenance of nociplastic pain. The hypothesis is that changes in the primary somesthetic cortex (S1) contribute to the generalized pain character of FM. The objective of this study was to evaluate the involvement of the primary somesthetic cortex in humans with fibromyalgia, as well as to investigate possible associations between S1 changes and clinical signs and symptoms of FM. CONTENTS: For this integrative review, the following databases were used: Pubmed and Web of Science, including observational studies carried out in humans with FM. In total, 541 studies were identified and four were included. The majority of studies are case-control studies, published between 2016 and 2022. In total, data from 161 individuals were included in this review. It was identified that there are morphological changes, hyperactivation and increased functional connectivity between S1 and periaqueductal gray matter and between S1 and anterior cingulate cortex. CONCLUSION: Patients with FM present morphological changes and hyperactivation in S1, as well as increased functional connectivity between S1 and periaqueductal gray matter and S1 and limbic system. Furthermore, different bilateral somatotropic subregions (legs, chest, fingers, hands, face and back) showed reduced functional connectivity in patients with FM. These regions are often presented as “tender points” in FM.

RESUMO JUSTIFICATIVA E OBJETIVOS: Os mecanismos subjacentes à dor nociplástica, como a fibromialgia (FM), não são totalmente compreendidos, contudo acredita-se que o processamento sensorial e a modulação da dor alterados desempenham papéis proeminentes para a manutenção da dor nociplástica. Com a hipótese de que alterações no córtex somestésico primário (S1) contribuam para o caráter de dor generalizada da FM, o objetivo deste estudo foi avaliar o envolvimento do córtex somestésico primário em humanos com FM, bem como investigar possíveis associações entre alterações de S1 com sinais e sintomas clínicos da FM. CONTEÚDO: Para esta revisão integrativa, foram utilizadas as seguintes bases de dados: Pubmed e Web of Science, incluindo estudos observacionais realizados em humanos com FM. No total, 541 estudos foram identificados e quatro foram incluídos. A maioria dos estudos são do tipo caso-controle, publicados entre 2016 e 2022. Ao todo, dados de 161 indivíduos foram incluídos. Foi identificado que há alterações morfológicas, hiperativação e aumento da conectividade funcional entre S1 e substância cinzenta periaquedutal e entre S1 e córtex cingulado anterior. CONCLUSÃO: Pacientes com FM apresentam alterações morfológicas e hiperativação em S1, bem como aumento da conectividade funcional entre S1 e substância cinzenta periaquedutal e S1 e sistema límbico. Ademais, diferentes sub-regiões somatotrópicas bilaterais (pernas, tórax, dedos, mãos, face e costas) apresentaram redução da conectividade funcional em pacientes com FM. Essas regiões são frequentemente apresentadas como “tender points” na FM.

■ ABSTRACT Introduction: The aesthetic procedure market is growing exponentially in Brazil. This growth has aroused the interest of several professional categories. The decision to practice in the sector must consider the market opportunities in the location in which you intend to operate. However, the area lacks comparative analyses documenting probable regional differences in the country. The objective of the study is to describe market differences in aesthetic procedures between Brazilian states and regions. An index of potential cosmetic consumption (IPCC) is calculated for such a comparative analysis. Method: Cross-sectional study involving providers of nonsurgical aesthetic procedures in Brazil. Searches on Google Maps® were conducted using key terms, and telephone interviews were conducted to obtain information on professional categories, types of providers, and services offered. Positive predictive values were obtained for all search strategies and used to estimate the total number of providers. Population size and per capita income were considered to calculate the IPCCs for Brazilian states. Results: São Paulo, Minas Gerais, and Rio de Janeiro presented the highest IPCCs, being 524, 210, and 180, respectively. Roraima had an IPCC of 14, the lowest in the country. The Southeast Region presented, on average, the highest IPCC (242) among all Brazilian regions. Conclusion: Considering population size and income, the Southeast Region presents the greatest market opportunities for nonsurgical aesthetic procedures in Brazil. Our findings may be of interest to healthcare professionals and investors who work or intend to work in the sector.

■ RESUMO Introdução: O mercado de procedimento estéticos cresce exponencialmente no Brasil. Tal crescimento tem despertado o interesse de várias categorias profissionais. A decisão de praticar no setor deve considerar as oportunidades de mercado da localidade na qual se pretende atuar. Entretanto, a área carece de análises comparativas documentando prováveis diferenças regionais no país. O objetivo do estudo é descrever as diferenças de mercado em procedimentos estéticos entre os estados e regiões brasileiras. Um índice de potencial consumo de cosmiatria (IPCC) é calculado para tal análise comparativa. Método: Estudo transversal envolvendo prestadores de procedimentos estéticos não cirúrgicos no Brasil. Buscas no Google®-Google Maps® foram conduzidas usando termos-chave e entrevistas telefônicas realizadas para obter informações sobre categorias profissionais, tipo de provedores e serviços oferecidos. Valores preditivos positivos foram obtidos para todas as estratégias de busca e usados para estimar o número total de provedores. O tamanho da população e a renda per capita foram considerados para o cálculo dos IPCCs para os estados brasileiros. Resultados: São Paulo, Minas Gerais e Rio de Janeiro apresentaram os maiores IPCCs, sendo 524, 210 e 180, respectivamente. Roraima teve um IPCC de 14, o mais baixo do país. A Região Sudeste apresentou, em média, o maior IPCC (242) entre todas as regiões brasileiras. Conclusão: Considerando o tamanho da população e a renda, a Região Sudeste apresenta as maiores oportunidades de mercado em procedimentos estéticos não cirúrgicos no Brasil. Nossos achados podem ser de interesse para profissionais de saúde e investidores que atuam ou pretendem atuar no setor.

RESUMO Objetivo Descrever o perfil dos casos de mpox na cidade do Rio de Janeiro, entre junho e novembro de 2022. Métodos Estudo descritivo de dados secundários das fichas de notificação de mpox. Foram analisados dados socioeconômicos, clínicos e espaciais. Resultados Dos 928 casos, 93,7% foram do sexo masculino, 85,0% homem cisgênero, 65,6% homossexual, 41,8% entre 30 e 39 anos e 41,0% brancos. Apresentavam imunodepressão por doença 34,5%, e 41,9% informaram sorologia positiva prévia para vírus da imunodeficiência humana. Os sinais e sintomas mais prevalentes foram: lesões cutâneas (96,6%), especialmente com manifestações múltiplas (67,8%) e em região genital (46,1%), além de febre (58,3%), adenomegalia (43,3%) e cefaleia (38,7%). A maioria das notificações ocorreu na rede pública (81,3%) e na atenção hospitalar (51,3%). Conclusão O estudo revelou maior incidência de mpox entre homens cisgênero, autodeclarados de cor branca e homossexual. A maioria dos casos teve apresentação leve evoluindo para cura sem hospitalização.

ABSTRACT Objective To describe the profile of cases of mpox in the city of Rio de Janeiro between June and November 2022. Methods This was a descriptive study of secondary data obtained from mpox notification forms. Socioeconomic, clinical and spatial data were analyzed. Results Of the 928 cases, 93.7% were male, 85.0% cisgender male, 65.6% homosexual, 41.8% between 30 and 39 years old, and 41.0% were of White race/skin color. A total of 34.5% had immunosuppression due to illness, and 41.9% reported their HIV status as being positive. The most prevalent signs and symptoms were: skin lesions (96.6%), especially with multiple manifestations (67.8%) in the genital region (46.1%), in addition to fever (58.3%), adenomegaly (43.3%) and headache (38.7%). Most notifications occurred in public services (81.3%) and in hospital care (51.3%). Conclusion The study revealed high incidence of mpox, especially among young, cisgender and homosexual men. Most cases were mild, with genital lesions, progressing to cure without hospitalization. Person-to-person transmission was predominant.

RESUMEN Objetivo Describir el perfil de los casos de mpox en la ciudad de Río de Janeiro entre junio y noviembre de 2022. Métodos Estudio descriptivo de datos secundarios de los formularios de notificación de mpox. Se analizaron datos socioeconómicos, clínicos y espaciales. Resultados De los 928 casos, 93,7% eran hombres, 65,6% homosexuales, 41% blanca, y 41,8% de 30 a 39 años. Estaban inmunocomprometidos debido a una enfermedad 34,5%, y 41,9% reportaron serología positiva para virus de inmunodeficiencia humana. Signos y síntomas más prevalentes fueron: lesiones cutáneas (96,6%), con manifestaciones múltiples (67,8%) y en la región genital (46,1%), además de fiebre (58,3%), adenomegalia (43,3%) y cefalea (38,7%). Mayoría de las notificaciones ocurrieron en la red pública (81,3%) y atención hospitalaria (51,3%). Conclusión El estudio reveló alta incidencia de mpox, especialmente entre hombres jóvenes, cisgénero y homosexuales. Mayoría de los casos tuvieron una presentación leve, progresando hasta la curación sin hospitalización.

Abstract Changes in the interactions between agents involved in the value chain of the palm oil sector in the municipality of Tibú (Colombia) over the period 1985-2020 have resulted in a reduction in the indices of poverty, social inequality, and unemployment for the inhabitants of the region, which can be explained by a process of socio-technical transition. The main objective of this study is to analyze the factors that determined the success of this process from a multilevel perspective. Exploratory research was developed based on a case study analysis using semi-structured interviews of commercial and non-commercial agents in the sector and information collected from secondary sources. The results show that changes in the legal and regulatory framework established by the government, landscape transformation, and the transition from small farmers to medium entrepreneurs of the farms in the region were important factors revolutionizing the system and are encouraging the emergence of new alternative practices in the palm oil sector.

Resumen Los cambios en las formas de interactuar entre los diferentes agentes involucrados en la cadena de valor del sector de la palma de aceite en el municipio de Tibú (Colombia) durante el periodo 1985-2020 han dado como resultado una reducción en los índices de pobreza, desigualdad social y desempleo para los habitantes de la región, lo cual se explica por un proceso de transición sociotécnica. El objetivo principal de este estudio es analizar desde una perspectiva multinivel los factores que determinaron el éxito de este proceso. Para lograr este propósito, se desarrolló una investigación exploratoria basada en el análisis de un estudio de caso mediante entrevistas semiestructuradas aplicadas a agentes comerciales y no comerciales del sector, y la recopilación de información de fuentes secundarias. Los resultados muestran que los cambios en el marco jurídico y normativo establecidos por el gobierno, la transformación del paisaje y la transición de pequeños propietarios a medianos empresarios agrícolas en la región, fueron factores importantes para revolucionar el régimen y fomentar la aparición de nuevas prácticas alternativas en el sector del aceite de palma.

ABSTRACT Purpose: To compare the differences between the apparent and actual chord μ. Methods: In this prospective, comparative, non-randomized, and non-interventional study, imaging examinations using Pentacam and the HD Analyzer were performed in the same room under the same scotopic conditions. The inclusion criteria were patients aged 21-71 years, able to provide informed consent, myopia up to 4D, and anterior topographic astigmatism up to 1D. Patients using contact lenses, those with previous eye diseases or surgeries, corneal opacities, corneal tomographic changes, or suspected keratoconus were excluded. Results: Altogether, 116 eyes of 58 patients were analyzed. The patients’ mean age was 30.69 (±7.85) years. In the correlation analyses, Pearson’s correlation coefficient of 0.647 indicates a moderate positive linear relationship between apparent and actual chord μ. The mean actual and apparent chord μ were 226.21 ± 128.53 and 278.66 ± 123.90 μm, respectively, with a mean difference of 52.45 μm (p=0.01). The analysis of mean pupillary diameter resulted in 5.76 mm using the HD Analyzer and 3.31 mm using the Pentacam. Conclusions: We found a correlation between the two measurement devices, and even though we found considerable differences, both can be used in daily practice. Given their differences, we should respect their peculiarities as well.

RESUMO Objetivo: Comparar as diferenças entre a chord aparente μ e o chord real μ. Métodos: Estudo prospectivo, comparativo, não randomizado e não intervencionista. Os exames de imagem (Pentacam e HD Analyzer) foram realizados na mesma sala e nas mesmas condições escotópicas. Os critérios de inclusão foram idade de 21 a 71 anos; compreensão do termo de consentimento; miopia até 4D e astigmatismo topográfico anterior até 1D. Os critérios de exclusão foram usuários de lentes de contato; pacientes com doenças oculares prévias ou cirurgias; opacidades da córnea; a presença de alterações tomográficas da córnea ou suspeita de ceratocone. Resultados: Em nosso estudo foram analisados 116 olhos de 58 pacientes. A média de idade foi de 30,69 anos (± 7,85). Análises de correlação foram desenvolvidas e o coeficiente de correlação de Pearson (0,647) indica uma relação linear positiva moderada entre as variáveis. A média do chord μ real foi 226,21 ± 128,53 μm e a média do chord μ média foi 278,66 ± 123,90 μm, com diferença média de 52,45 μm (p=0,01). A análise do diâmetro pupilar médio apresentou: 5,76mm no HD Analyzer e 3,31mm no Pentacam. Conclusões: Entendemos a existência de uma diferença significativa entre os métodos e assim a medida de ambos os dispositivos com base em princípios diferentes devemos respeitar suas peculiaridades. Como encontramos correlação entre as duas medidas, acreditamos que ambas podem ser utilizadas na prática diária.

Abstract We report a case of chronic sclerosing sialoadenitis focusing on clinical, laboratory and histological aspects and perform a review of literature with discussion of multidisciplinary clinical approach to this pathology. Chronic sclerosing sialoadenitis is an uncommon, chronic inflammatory disease that has been recently included in the IgG4-associated diseases spectrum. This pathology simulates cervical neoplastic pathology, and its definitive diagnosis is difficult. Its etiology, treatment and evolution remain topics of scientific debate. uncommon IgG4associated IgGassociated IgG4 associated IgG spectrum difficult etiology debate

Resumo Reporta-se um caso clínico de sialoadenite esclerosante crónica focando aspetos clínicos, laboratoriais e histológicos, e realiza-se uma revisão da literatura com discussão da abordagem clínica multidisciplinar desta patologia. A sialoadenite esclerosante crónica é uma doença inflamatória crónica, incomum, que se integrou recentemente no espectro de doenças associadas à IgG4. Esta patologia simula patologia neoplásica cervical e o seu diagnóstico definitivo é difícil. A sua etiologia, tratamento e evolução são na atualidade temas de debate científico. Reportase Reporta clínicos histológicos realizase realiza incomum IgG4 IgG difícil etiologia científico

The publication Cardiovascular Statistics – Brazil aims to provide an annual compilation of data and research on the epidemiology of CVDs in Brazil.  The report integrates official statistics from the Brazilian Ministry of Health and other governmental entities alongside data from the GBD project, coordinated by the IHME at the University of Washington. Additionally, it incorporates data derived from various sources and scientific studies, including cohorts and registries, that relate to CVDs and their associated risk factors. This publication is intended for a wide range of individuals, including researchers, clinicians, patients, healthcare policymakers, media professionals, the general public, and other interested parties seeking extensive national data about heart disease and stroke.  Volunteer researchers from various Brazilian universities and research institutions carry out the project. The group is led by a five-member steering committee (ALPR, CAP, DCM, GMMO, and LCCB). The Brazilian Society of Cardiology fully supports this initiative, and the project receives collaborative support from the GBD Brazil Network and an International Committee (GAR, PP, and TAG) from both the IHME/University of Washington (GAR) and the World Heart Federation (PP and TAG). 

A publicação Estatística Cardiovascular – Brasil tem por objetivo fornecer uma compilação anual dos dados e das pesquisas sobre a epidemiologia das DCV no Brasil.  Este documento integra as estatísticas oficiais do Ministério da Saúde do Brasil e outras entidades governamentais ao lado de dados do projeto GBD, coordenado pelo IHME da Universidade de Washington. Além disso, incorpora dados derivados de várias fontes e estudos científicos, inclusive coortes e registros, relacionados às DCV e fatores de risco associados. Esta publicação destina-se a um público variado, incluindo pesquisadores, clínicos, pacientes, formuladores de políticas de saúde, profissionais da mídia, o público em geral e todos aqueles que buscam dados nacionais abrangentes sobre DCV e acidente vascular cerebral. Pesquisadores voluntários de várias universidades e instituições de pesquisa brasileiros realizaram este projeto. O grupo é liderado por um comitê diretivo com cinco membros (ALPR, CAP, DCM, GMMO e LCCB). A Sociedade Brasileira de Cardiologia apoia integralmente esta iniciativa e o projeto recebe colaboração da Rede GBD Brasil1 e do GBD International Committee (GAR, PP e TAG) do IHME/Universidade de Washington (GAR) e da World Heart Federation (PP e TAG). 

ABSTRACT The present article presents the outcomes of the normative research on the combat against the COVID-19 pandemic at the National Health Council (Conselho Nacional de Saúde - CNS) from February 2020 to March 2022. This is a documental, descriptive-analytical study, with qualitative approach, using the technical analysis of content. Seventy-seven acts were issued by the CNS Collegiate, there included 63 recommendations, 6 opinions, 5 motions, 2 technical notes and 1 resolution. Most part of the documents (59%) were worked out during the first year of the pandemic. Despite the Council’s performance when combating the COVID-19, non-binding acts may be highlighted, the CNS normative production concentrating in merely guidance recommendations.

RESUMO Este artigo apresenta os resultados de pesquisa normativa sobre o enfrentamento da pandemia de Covid-19, no Conselho Nacional de Saúde (CNS), entre os meses de fevereiro de 2020 e maio de 2022. Tratou-se de estudo documental, descritivo-analítico com abordagem qualitativa, utilizando-se de técnica de análise de conteúdo. Foram identificados 77 atos expedidos pelo colegiado do CNS, sendo 63 recomendações, 6 pareceres, 5 moções, 2 notas técnicas e 1 resolução, constatando-se que a maior parte dos documentos (59%) foi elaborada no primeiro ano da pandemia. A despeito da atuação do CNS no enfrentamento da Covid-19, destaca-se o uso de atos não vinculantes, concentrando-se a produção normativa do CNS em recomendações que têm caráter meramente orientadores.

Abstract (Objective) From 1988 to 2018, high school students in Costa Rica had to pass a final exam to graduate from high school and be eligible for public university education. In this context, students had to choose a national science test from the areas of physics, chemistry, and biology. Historically, chemistry was the least chosen (4-6 %) of those sciences. On the other hand, there is a need -at the national levelto increase interest in careers related to STEM (Sciences, technology, engineering, and mathematics). (Methodology) Under both premises, in 2016, the first national camp (called Quimi Camp) to promote scientific vocations was held to encourage high school students in Costa Rica to choose chemistry. Quimi Camp is an event supported by the OLCOQUIM National Chemistry Olympiad and the OLCOCI National Science Olympiad, which are in turn organized by the five Costa Rican State universities and the LANOTEC CENAT National Nanotechnology Laboratory at the National Center of High Technology, with the consent of the Ministry of Education (MEP) and the Ministry of Science, Innovation, Technology and Telecommunication (MICITT). The participating students made the final evaluation of this event. (Results) The results showed an excellent perception of the event regarding its organization and content. (Conclusions) Quimi Camp promoted students' vocation for science and engineering and positively influenced the selection of a University Career in STEM.

Resumen (Objetivo) Desde el año 1988 y hasta el año 2018, el estudiantado de secundaria en Costa Rica debía aprobar un examen final para graduarse de la escuela secundaria, y ser elegible para una educación universitaria pública. En ese contexto, cada estudiante debía elegir una prueba nacional de ciencias entre las áreas de física, química y biología. Históricamente, la química fue la menos elegida (4-6 %), entre esas ciencias. Por otro lado, existe la necesidad -a nivel nacional- de aumentar el interés en las carreras relacionadas con STEM (sciences, technology, engineering and mathematics). (Metodología) Desde ambas premisas, en el año 2016 se realizó el primer campamento nacional de promoción de vocaciones científicas en Costa Rica (denominado Quimi Camp) para promover la química entre estudiantes de secundaria. Quimi Camp es un evento amparado en las Olimpiadas Nacionales de Química OLCOQUIM y en las Olimpiadas Nacionales de Ciencias OLCOCI; los cuales son, a su vez, organizados por las 5 universidades estatales costarricenses y el Laboratorio Nacional de Nanotecnología LANOTEC del Centro Nacional de Alta Tecnología CENAT, con la venia de los entes de gobierno. El estudiantado participante realizó la evaluación final de este evento. (Resultados) Los resultados mostraron una excelente percepción del evento en cuanto a su organización y contenido. (Conclusiones) Quimi Camp impulsó la vocación de estudiantes por las ciencias y la ingeniería e influyó positivamente en la selección de una carrera universitaria en STEM.

Resumo (Objetivo) De 1988 a 2018, os alunos do ensino médio na Costa Rica deviam passar em uma prova final para se formar no ensino médio e se qualificar para uma educação universitária pública. Nesse contexto, cada aluno tinha de escolher um teste nacional de ciências das áreas da física, química e biologia. Historicamente, a química foi a menos escolhida (4-6%), entre essas ciências. Por outro lado, existe a necessidade em âmbito nacional de aumentar o interesse por carreiras relacionadas com STEM (ciências, tecnologia, engenharia e matemática). (Metodologia) Sob ambas as premissas, em 2016 foi realizado o primeiro acampamento nacional de promoção de vocações científicas na Costa Rica (denominado Quimi Camp) para promover a química entre alunos do ensino médio. O Quimi Camp é um evento contemplado pelas Olimpíadas Nacionais de Química da OLCOQUIM e Olimpíadas Nacionais de Ciências da OLCOCI; que por sua vez são organizados pelas 5 universidades estaduais da Costa Rica e pelo Laboratório Nacional de Nanotecnologia LANOTEC do Centro Nacional de Alta Tecnologia CENAT, com a permissão das entidades governamentais. Os alunos participantes fizeram a avaliação final deste evento. (Resultados) Os resultados mostraram uma excelente percepção do evento em termos de organização e conteúdo. (Conclusões) O Quimi Camp impulsionou a vocação dos alunos para ciências e engenharias e influenciou positivamente a escolha de uma Carreira Universitária em STEM.