Abstract Introduction: México has a high rate of teenage pregnancy, which symbolizes a risk to the health and socio-economic development of this group. The prevention of a second pregnancy at this stage is relevant to improve quality of life. Objective: To explore the social representations of prenatal contraceptive counseling based on the experiences and expectations of pregnant adolescents and health providers in a second level care hospital. Methodology: Qualitative study based on Serge Moscovici’s Social Representations Theory with ten primiparous adolescents in any quarter of pregnancy and seven health providers, adolescents without pregnancy condition were excluded. We used semi-structured interviews recorded and analyzed in their integrity through fluctuating reading by two researchers, the discourse of the proposed thematic axes was contrasted. Integrity, confidentiality, and autonomy were respected. Results: The realities represented by adolescents showed a need for knowledge, values, respect, kindness, and patience. Providers evoked paternalistic counseling, but with recognition of focused counseling and reproductive rights. Conclusion: More participants stated that the ideal time to receive counseling is during pregnancy, since pregnant adolescents expressed the need to receive information and have more time lapse between their pregnancies. The expectations of the Prenatal Contraceptive Counseling (CAP by its acronym in Spanish) differed in terms of values to give rise to a paternalistic attitude on the part of the health provider and the preference of adolescents for counseling based on respect, honesty, and trust, among others.

Abstrato Introdução: O México tem um alto índice de gravidez na adolescência, o que simboliza um risco para a saúde e o desenvolvimento socioeconômico desse grupo. A prevenção de uma segunda gravidez nesta fase é relevante para melhorar sua qualidade de vida. Objetivo: Explorar as representações sociais do aconselhamento contraceptivo pré-natal a partir das experiências e expectativas de gestantes adolescentes e profissionais de saúde em um segundo nível de atenção hospitalar. Metodologia: Estudo qualitativo baseado na Teoria das Representações Sociais de Serge Moscovici com dez adolescentes primíparas em qualquer trimestre da gravidez e sete profissionais de saúde; foram excluídas as adolescentes sem condições de gravidez. Foram utilizadas entrevistas semiestruturadas gravadas e analisadas em sua integridade por meio da leitura flutuante de dois pesquisadores, contrastando o discurso dos eixos temáticos propostos. Integridade, confidencialidade e autonomia foram respeitadas. Resultados: As realidades representadas pelos adolescentes mostraram necessidade de conhecimento, valores, respeito, gentileza e paciência. Os prestadores evocaram aconselhamento paternalista, más com reconhecimento de aconselhamento focado e direitos reprodutivos. Conclusão: Um número maior de participantes afirmou que o momento ideal para receber aconselhamento é durante a gravidez, pois as adolescentes grávidas expressaram a necessidade de receber informações e de ter mais tempo entre as gestações. As expectativas da aconselhamento contraceptivo pré-natal (CAP, na sigla em espanhol) diferiram quanto aos valores para dar lugar a uma atitude paternalista por parte do provedor de saúde e a preferência das adolescentes por uma assessoria baseada no respeito, honestidade, confiança, entre outros

Resumen Introducción: México presenta una tasa elevada de embarazo adolescente lo que simboliza un riesgo a la salud y desarrollo socioeconómico de este grupo. La prevención de un segundo embarazo en esta etapa es relevante para mejorar su calidad de vida. Objetivo: Explorar las representaciones sociales de la consejería anticonceptiva prenatal a partir de las experiencias y expectativas de adolescentes gestantes y proveedores de salud en un hospital de segundo nivel de atención. Metodología: Estudio cualitativo basado en la Teoría de las Representaciones Sociales de Serge Moscovici con diez adolescentes primíparas en cualquier trimestre de embarazo y siete proveedores de salud, se excluyeron adolescentes sin condición de embarazo. Se utilizó entrevista semiestructurada grabadas y analizadas en su integridad mediante lectura fluctuante realizada por dos investigadores, se contrastó el discurso de los ejes temáticos propuesto. Se respetó la integridad, confidencialidad y autonomía. Resultados: Las realidades representadas por las adolescentes mostraron necesidad de conocimientos, valores, respeto, amabilidad y paciencia. Los proveedores evocaron una consejería paternalista, pero con reconocimiento de una consejería focalizada y derechos reproductivos. Conclusión: Las experiencias similares de los participantes fueron que el momento ideal para recibir la consejería es durante el embarazo, en virtud de que las adolescentes embarazadas manifestaron necesidad de recibir información y espaciar sus embarazos. Las expectativas de la consejería anticonceptiva prenatal difirieron en los valores para dar lugar a una actitud paternalista por parte del proveedor de salud y la preferencia de las adolescentes por una consejería basada en el respeto, honestidad, confianza, entre otros.

Abstract Background Recently, it was demonstrated that allopurinol, a xanthine oxidase inhibitor, has cardiovascular and anti-ischaemic properties and may be a metabolic antianginal agent option.Objective: The objective of this study was to evaluate the antianginal effect of allopurinol as a third drug for patients with stable coronary artery disease (CAD). Methods This was a randomized clinical trial between 2018 and 2020 including patients with CAD who maintained angina despite initial optimization with beta-blockers and calcium channel blockers. The individuals were randomized 1:1 to 300 mg of allopurinol twice daily or 35 mg of trimetazidine twice daily. The main outcome was the difference in the angina frequency domain of the Seattle Angina Questionnaire (SAQ-AF). A probability (p) value < 0.05 was considered statistically significant. Results A hundred and eight patients were included in the randomization phase, with 54 (50%) in the allopurinol group and 54 (50%) in the trimetazidine group. Six (5.6%) individuals, 3 from each group, were lost to follow-up for the primary outcome. In the allopurinol and trimetazidine groups, the median SAQ-AF scores were 50 (30.0 to 70.0) and 50 (21.3 to 78.3), respectively. In both groups, the SAQ-AF score improved, but the median of the difference compared to baseline was lower in the allopurinol group (10 [0 to 30] versus 20 [10 to 40]; p < 0.001), as was the mean of the difference in the total SAQ score (12.8 ± 17.8 versus 21.2 ± 15.9; p = 0.014). Conclusion Both allopurinol and trimetazidine improved the control of angina symptoms; however, trimetazidine presented a greater gain compared to baseline. Brazilian Registry of Clinical Trials - Registration Number RBR-5kh98y Recently inhibitor antiischaemic anti ischaemic option.Objective optionObjective option Objective CAD. . (CAD) 201 202 betablockers beta blockers 11 1 1: 30 SAQAF. SAQAF AF (SAQ-AF) (p 005 0 05 0.0 significant phase 5 50% (50% 5.6% 56 6 (5.6% followup follow up groups 30.0 (30. 70.0 700 70 21.3 213 21 (21. 78.3, 783 78.3 , 78 78.3) respectively 10 (1 [ 2 [1 40 40] 0.001, 0001 0.001 001 0.001) 12.8 128 12 8 (12. 178 17 17. 212 21. 15.9 159 15 9 0.014. 0014 0.014 014 0.014) symptoms however RBR5kh98y RBRkhy RBR 5kh98y kh y (CAD (SAQ-AF 00 0. (50 5.6 (5.6 30. (30 70. 7 (21 78. ( 4 000 0.00 12. (12 15. 0.01 01 khy (5 5. (5. (3 (2

Resumo Fundamento Recentemente, foi demonstrado que o alopurinol, um inibidor da xantina oxidase, possui propriedades cardiovasculares e anti-isquêmicas e pode ser uma opção de agente antianginoso metabólico. Objetivo O objetivo do presente estudo foi avaliar o efeito antianginoso do alopurinol como terceiro medicamento para pacientes com doença arterial coronariana (DAC) estável. Métodos Trata-se de um ensaio clínico randomizado entre 2018 e 2020 incluindo pacientes com DAC que mantiveram angina apesar da otimização inicial com betabloqueadores e bloqueadores dos canais de cálcio. Os indivíduos foram randomizados 1:1 para 300 mg de alopurinol 2 vezes ao dia ou 35 mg de trimetazidina 2 vezes ao dia. O desfecho principal foi a diferença no domínio da frequência da angina do Questionário de Angina de Seattle (QAS-FA). Foram considerados estatisticamente significativos valores de probabilidade (p) < 0,05. Resultados Foram incluídos 108 pacientes na fase de randomização, com 54 (50%) no grupo alopurinol e 54 (50%) no grupo trimetazidina. Seis (5,6%) indivíduos, 3 de cada grupo, foram perdidos no seguimento para o desfecho primário. Nos grupos de alopurinol e trimetazidina, as pontuações medianas do QAS-FA foram 50 (30,0 a 70,0) e 50 (21,3 a 78,3), respectivamente. Em ambos os grupos, a pontuação do QAS-FA melhorou, mas a mediana da diferença em relação à linha de base foi menor no grupo alopurinol (10 [0 a 30] versus 20 [10 a 40]; p < 0,001), assim como a média da diferença na pontuação total do QAS (12,8 ± 17,8 versus 21,2 ± 15,9; p = 0,014). Conclusão Tanto o alopurinol quanto a trimetazidina melhoraram o controle dos sintomas de angina; no entanto, a trimetazidina apresentou um ganho maior em relação à linha de base. Registro Brasileiro de Ensaios Clínicos – Número de Registro RBR-5kh98y Recentemente oxidase antiisquêmicas anti isquêmicas metabólico (DAC estável Tratase Trata se 201 202 cálcio 11 1 1: 30 QASFA. QASFA FA . (QAS-FA) (p 005 0 05 0,05 10 randomização 5 50% (50% 5,6% 56 6 (5,6% primário 30,0 (30, 70,0 700 70 21,3 213 21 (21, 78,3, 783 78,3 , 78 78,3) respectivamente melhorou (1 [ [1 40 40] 0,001, 0001 0,001 001 0,001) 12,8 128 12 8 (12, 178 17 17, 212 21, 15,9 159 15 9 0,014. 0014 0,014 014 0,014) entanto RBR5kh98y RBRkhy RBR 5kh98y kh y (QAS-FA 00 0,0 (50 5,6 (5,6 30, (30 70, 7 (21 78, ( 4 000 0,00 12, (12 15, 0,01 01 khy 0, (5 5, (5, (3 (2

Abstract Introduction and Objectives: Oral food challenges (OFC) are the gold standard for the diagnosis of food allergy. The aim of this study was to characterize and analyze the OFCs performed in the Pediatric Department of the study hospital. Material and Methods: Retrospective analysis of all patients who underwent OFCs in the pediatric department of the study hospital from October 2016 to December 2021. All non-IgE-mediated reactions were excluded. Statistical analysis was performed using IBM Statistical Package for Social Sciences®. Results: A total of 301 OFCs were performed on a total of 172 patients during the study period. Most patients were preschool children (<6 years; 79.4%) and 40.1% had more than one OFC. The most frequently tested allergens were hen’s egg (26.2%), tree nuts (16.9%), and cow’s milk (16.7%). The positivity rate was 23.2%. Tests for milk and wheat were significantly associated with a positive result. The main reason for OFC testing was to establish a diagnosis (60.1%), but also to assess tolerance (25.6%) and to document the responsiveness threshold (14.3%). Most positive reactions were local/grade I (25.7%) or moderate/grade II (58.6%). Patients with a personal history of atopic comorbidities were more likely to have a positive test result (p=0.022), especially those with atopic dermatitis (p=0.022). Discussion and Conclusion: Most OFCs in this analysis were negative. Early recognition of food allergy resolution is essential to prevent unnecessary allergen avoidance. An increased risk of positive reactions to milk or wheat, or in the setting of a personal history of atopic dermatitis, should be considered.

Resumo Introdução e Objetivos: A prova de provocação oral é o gold standard para o diagnóstico de alergia alimentar. Este estudo pretendeu caracterizar e analisar as provas efetuadas no Serviço de Pediatria de um hospital de nível II. Material e Métodos: Estudo retrospetivo dos doentes submetidos a provas de provocação oral entre outubro 2016 e dezembro 2021 num hospital de nível II. As reações não mediadas por IgE foram excluídas. A análise estatística foi realizada através do software IBM Statistical Package for Social Sciences®. Resultados: Foram realizadas 301 provas num total de 172 doentes. A maioria dos doentes eram crianças com idade <6 anos (79,4%) e 40,1% realizou duas ou mais provas. Os alergénios mais frequentemente testados foram ovo (26,2%), frutos secos (16,9%) e leite de vaca (16,7%). Constatou-se que 23,2% das provas foram positivas. Verificou-se uma associação estatisticamente significativa entre as provas realizadas para o leite e trigo e a obtenção de um resultado positivo. Relativamente ao objetivo das provas, 60,1% destinavam-se a estabelecer o diagnóstico, 25,6% a avaliar a tolerância e 14,3% a documentar o limiar de reatividade. A maioria das reações positivas foram locais/grau I (25,7%) ou moderadas/grau II (58,6%). Foi identificada uma associação estatisticamente significativa entre antecedentes de atopia e um resultado positivo nas provas (p=0,022), particularmente antecedentes de dermatite atópica (p=0,022). Discussão: A maioria das provas realizadas foram negativas. O reconhecimento atempado da resolução de uma alergia alimentar permite suspender a evicção desnecessária de alergénios suspeitos. Deve ser considerado o risco acrescido de uma reação positiva com leite, trigo ou em contexto de antecedentes pessoais de dermatite atópica.

ABSTRACT Benthic cyanobacteria research in high mountain reservoirs remains limited, mainly due to their complexity and knowledge gaps that persist in relation to their ecology in tropical regions. This study aimed to explore the composition, diversity, and toxic potential of cyanobacterial in the upper sediment of two Colombian reservoirs. Our investigation involved multiple methodologies, such as germination experiments, that allowed us to assess the presence and viability of cyanobacteria in upper sediment samples, while the competitive ELISA assay allowed for the quantification of toxins within the cultures. The molecular analysis of Operational Taxonomic Units (OTUs) from subsamples of sediment cultures focused on evaluating cyanobacterial diversity and richness among prokaryotic phyla, and the Phylogenetic analysis of culturable cyanobacteria. Chlorophyll-a measurements confirmed the presence of viable populations in sediment cultures, while microscopic identification demonstrated the growth capacity of cyanobacteria from the orders Nostocales, Chroococcales, Oscillatoriales, and Synechococcales under controlled laboratory conditions. Despite low microcystin levels in culture, the prior detection of mcy genes in direct sediment samples suggests a possible toxic potential of cyanobacterial inhabiting the upper sediments. Community analysis, based on the OTUs abundance, revealed a notably diverse microbial community in both reservoir sediments, with a higher relative abundance of cyanobacteria compared to other prokaryotic phyla. These findings support the hypothesis that surface sediments play a fundamental role as a repository for cyanobacteria that may pose inherent risks to ecosystem health. In conclusion, this research underscores the necessity of further studies to achieve a holistic comprehension of benthic cyanobacteria dynamics in high-mountain tropical reservoirs.

RESUMEN Las investigaciones sobre cianobacterias bentónicas en reservorios de alta montaña en regiones tropicales aún son limitadas, debido a su complejidad y vacíos de conocimiento en relación con su ecología. Este estudio tuvo como objetivo explorar la composición, diversidad y potencial tóxico de estas cianobacterias en sedimentos superiores de dos embalses colombianos, empleando múltiples metodologías, como experimentos de germinación para evaluar su presencia y viabilidad en sedimentos, ensayos de ELISA competitivo para cuantificar toxinas en cultivo, análisis de Unidades Taxonómicas Operativas (OTUs) a partir de submuestras de los cultivos para evaluar su diversidad y riqueza entre los diferentes phylum procarióticos, y análisis filogenético de cianobacterias cultivables. Se confirmó la presencia de poblaciones viables de cianobacterias en los sedimentos mediante mediciones de clorofila-a y la identificación microscópica demostró su capacidad de crecimiento en condiciones controladas de laboratorio. A pesar de los bajos niveles de microcistina en cultivo, la detección previa de genes mcy en muestras directas de sedimento, sugiere un potencial tóxico en las cianobacterias presentes. El análisis de la comunidad reveló una notable diversidad microbiana en los sedimentos de ambos embalses, con una mayor abundancia relativa de cianobacterias en comparación con otros phylum procarióticos. Estos hallazgos respaldan la hipótesis de que los sedimentos superficiales desempeñan un papel fundamental como depósito de cianobacterias que pueden plantear riesgos inherentes a la salud del ecosistema. En conclusión, esta investigación subraya la necesidad de realizar más estudios para lograr una comprensión holística de la dinámica de las cianobacterias bentónicas en reservorios tropicales de alta montaña.

Abstract Sustainable agriculture allows the efficient use of natural resources, particularly water. This study aimed to compare the water footprint of the lettuce (Lactuca sativa L.) cultivation in two production systems: aquaponic and hydroponic, in order to understand its impact on water resources. Both production systems were established in a shade house in the state of Sonora, Mexico. The experiment was conducted from May 20 to July 29, 2020. The estimation of the WFtotal was calculated by adding the blue water footprints, consumption of water sheet in the development of the crop and of the inputs and materials used in each system (based on information from the scientific literature). The results indicated an average harvested lettuce weight of 0.056 kg (±0.005 kg) in the aquaponic system and 0.097 kg (±0.007 kg) in the hydroponic system. The statistical analysis was evaluated with the Student’s t-test with a significance level of 5%. The estimated BWFs were 0.2941 and 0.1721 m3 kg-1, the WFtotal were 2.6841 m3 kg-1 and 0.1821 m3 kg-1 for the aquaponic system and hydroponic system, respectively, for 19 plants in each system. The values of the WFtotal were high since they represent the sum of the blue water footprints and the WFinputs and materials. The results of this research confirmed the hypothesis proposed as the aquaponic system registered a greater water footprint. However, it is advisable to generate more knowledge on the subject.

Resumen La agricultura sostenible permite el uso eficiente de los recursos naturales, particularmente del agua. El objetivo de este trabajo fue comparar la huella hídrica del cultivo de lechuga (Lactuca sativa L.) en dos sistemas de producción: acuapónico e hidropónico, para conocer su impacto en los recursos hídricos. Ambos sistemas productivos se establecieron en una casa sombra en el estado de Sonora, México. El experimento se realizó del 20 de mayo al 29 de julio de 2020. La estimación de la HHtotal se calculó mediante la suma de las huellas hídricas azules, consumo de lámina de agua en el desarrollo del cultivo) y de los insumos y materiales utilizados en cada sistema (con base en información de la literatura científica). Los resultados indicaron un peso promedio de lechuga cosechada de 0.056 kg (±0.005 kg) en el sistema acuapónico y de 0.097 kg (±0.007 kg) en el sistema hidropónico. El análisis estadístico se evaluó con la prueba t de student con un nivel de significancia de 5%. Las HHA estimadas fueron 0.2941 y 0.1721 m3 kg-1, las HHtotal fueron 2.6841 m3 kg-1 y de 0.1821 m3 kg-1 para los sistema acuapónico y sistema hidropónico, respectivamente, para 19 plantas en cada sistema. Los valores de las HHtotal fueron elevados ya que representan la suma de las huellas hídricas azules y de la HHinsumos y materiales. Los resultados de esta investigación confirmaron la hipótesis planteada, al registrar una mayor huella hídrica el sistema acuapónico. Sin embargo, es conveniente generar mayor conocimiento en el tema.

Abstract Introduction. Although Chagas disease causes high levels of morbidity, the muscle function and tolerance to physical activity in Chagas disease patients are still not completely understood. Objective. To compare health-related fitness of patient groups with acute Chagas disease versus chronic Chagas disease. Materials and methods. We conducted a cross-sectional study involving 18 patients. The data were obtained from patient's records, and functional capacity was measured with the six-minute walk test, the peripheral muscle strength with handgrip strength, and respiratory muscle strength using the maximum inspiratory pressure and the maximum expiratory pressure. Results. The 18 patients were divided in two groups: acute Chagas disease (n=9) and chronic Chagas disease (n=9). The distance walked in the six-minute walk test was lower than the predicted distance walked in both groups (p < 0.0001). The maximum expiratory pressure was lower than the predicted one (p = 0.005), and statistically significant for chronic Chagas disease patients (p = 0.02). Heart rate increased faster in the chronic Chagas disease group within the first two minutes of the six-minute walk test (p = 0.04). The sixminute walk test in the acute Chagas disease group presented a strong correlation with peripheral muscle strength (p = 0.012) and maximum inspiratory pressure (p = 0.0142), while in the chronic Chagas disease group, only peripheral muscle strength and maximum inspiratory pressure were correlated (p = 0.0259). Conclusion. The results suggest lowered functional capacity and reduced respiratory and peripheral muscle strength in patients with Chagas disease, although no differences were observed between groups. The early increase in heart rate during exercise in the chronic Chagas disease group implies a greater myocardial overload.

Resumen Introducción. Aunque la enfermedad de Chagas causa gran morbilidad, la función muscular y la tolerancia a la actividad física de estos pacientes aún no se comprenden por completo. Objetivos. Comparar el estado físico relacionado con la salud de pacientes con enfermedad de Chagas aguda versus crónica de Chagas. Materiales y métodos. Se hizo un estudio transversal que incluyó 18 pacientes. La información se obtuvo de los registros de los pacientes. La capacidad funcional se evaluó con la prueba de la caminata de seis minutos, se determinó la fuerza de prensión manual para evaluar los músculos periféricos y se estableció la fuerza de los músculos respiratorios mediante presión inspiratoria máxima y la presión espiratoria máxima. Resultados. Se evaluaron 18 pacientes, nueve con enfermedad de Chagas aguda y nueve con enfermedad de Chagas crónica. La distancia recorrida en la prueba de caminata de seis minutos fue menor que la distancia recorrida predicha en ambos grupos (p < 0,0001). La presión espiratoria máxima fue más baja de lo previsto (forma aguda: p = 0,005; forma crónica: p = 0,02). La frecuencia cardíaca aumentó más rápido en el grupo con enfermedad de Chagas crónica dentro de los primeros dos minutos de la caminata (p = 0,04). La distancia recorrida en el grupo con la forma aguda se correlacionó con la fuerza de prensión manual (p = 0,01) y la presión inspiratoria máxima (p = 0,01). En el grupo con la enfermedad crónica, solo hubo correlación entre la fuerza de presión manual y la presión inspiratoria máxima (p = 0,02). Conclusiones. Los resultados sugirieren disminución de la capacidad funcional y de la fuerza muscular respiratoria y periférica, aunque sin diferencias entre ambos grupos. El aumento de la frecuencia cardiaca en el grupo con enfermedad de Chagas crónica sugiere una mayor sobrecarga miocárdica.

RESUMEN La problemática socioambiental que experimentan las zonas costeras, ha condicionado la aparición de algunas herramientas y enfoques de gestión ambiental para tratar de dar respuestas y soluciones interdisciplinares a ellas. El surgimiento del enfoque de Manejo Integrado de Zonas Costeras en la década del 70 del siglo XX y su posterior implementación por el mundo ante los desafíos del desarrollo sostenible hizo que el Estado cubano lo asumiera a partir de la década del 90. Una de tantas vías utilizadas fue la aprobación de un programa de maestría para la formación de capacidades en esta área del conocimiento. En este trabajo se fundamenta la importancia que tiene el Programa de Maestría en Manejo Integrado en Zonas Costeras que posee la Universidad de Cienfuegos “Carlos Rafael Rodríguez”. Este programa de maestría persigue la formación de profesionales cuyas investigaciones contribuyan a la comprensión de los fenómenos que ocurren en la zona costera y sus cuencas tributarias; a identificar problemas relacionados con el manejo integrado de las zonas costeras; y a recomendar soluciones, entre otros aspectos. Desde el punto de vista metodológico se realizó un análisis de los avances del programa académico a partir de sus fundamentos teóricos, metodológicos e investigativos. Se concluye que las zonas costeras constituyen un nuevo campo de investigaciones el cual requiere la formación de capacidades interdisciplinarias para el abordaje de los problemas que presentan estos importantes espacios complejos y frágiles.

ABSTRACT The socio-environmental problems experienced by coastal zones have conditioned the emergence of some environmental management tools and approaches to try to provide interdisciplinary answers and solutions to them. The emergence of the Integrated Coastal Zone Management approach in the 1970s and its subsequent implementation throughout the world in the face of the challenges of sustainable development led the Cuban government to adopt it in the 1990s. One of the many ways used was the approval of a master's degree program for capacity building in this area of knowledge. This work is based on the importance of the Master's Program in Integrated Coastal Zone Management at the University of Cienfuegos "Carlos Rafael Rodríguez". This master's program seeks to train professionals whose research contributes to the understanding of the phenomena that occur in the coastal zone and its tributary basins; to identify problems related to the integrated management of coastal zones; and to recommend solutions, among other aspects. From the methodological point of view, an analysis was made of the progress of the academic program based on its theoretical, methodological and research foundations. It is concluded that coastal zones constitute a new field of research which requires the formation of interdisciplinary capacities to address the problems presented by these important complex and fragile spaces.

Abstract Objective: To analyze the existing state legislation, including not only the ordinary laws, but also their infralegal regulation and the state legislation on Hospital Dentistry. Material and Methods: A survey was carried out in the databases of the Legislative Assemblies of the Brazilian States and the Federal District, as well as the Regional and Federal Councils of Dentistry in Brazil. Subsequently, a survey was carried out in the databases of the Ministry of Health, State Dental Councils and Federal Dental Council in Brazil. Results: Only 8 Brazilian states have legislation in force regarding hospital dentistry, which represents 29.63% of the federative units. Among the Brazilian regions, the Midwest presented the highest prevalence of the laws found (37.50%), followed by the North (25%) and the other regions with the same coverage (12.50%). Also, an orientation and an ordinance from the Ministry of Health, six resolutions from the Federal Council of Dentistry, and a technical note from the National Health Surveillance Agency were found. Conclusion: Several States do not have rules on the subject, making it imperative to create a federal rule that not only imposes the presence of the dentist, but also regulates the proportion of the team, workload, and availability. Objective Methods District Brazil Subsequently Results dentistry 2963 29 63 29.63 units 37.50%, 3750 37.50% , 37 50 (37.50%) 25% 25 (25% 12.50%. 1250 12.50% . 12 (12.50%) Also Conclusion subject dentist team workload availability 296 2 6 29.6 375 37.50 3 5 (37.50% (25 125 12.50 1 (12.50% 29. 37.5 (37.50 (2 12.5 (12.50 37. (37.5 ( 12. (12.5 (37. (12. (37 (12 (3 (1

Resumen: Este estudio evaluó el reconocimiento (imitación, identidad e identificación) y la denominación de estímulos emocionales negativos (enfado y tristeza) y positivos (alegría y sorpresa) y la influencia de los tipos de estímulos utilizados (social-femenino, social-masculino, familiar y emoji ) de niños y jóvenes con autismo o síndrome de Down, a través de tareas aplicadas por la familia, mediadas por recursos tecnológicos durante la pandemia de la covid-19. Participaron cinco niños y dos adultos jóvenes con autismo, y un niño y dos adultos jóvenes con síndrome de Down. Se planificaron e implementaron tareas de identidad, reconocimiento, nombramiento e imitación con estímulos faciales con función evaluativa (sin consecuencia diferencial) y enseñanza (con consecuencia diferencial, uso de ayudas y criterios de aprendizaje), buscando la emergencia del nombramiento emocional después de la enseñanza de tareas de reconocimiento. Los resultados de la línea de base identificaron que para los participantes que tenían un tiempo de respuesta más corto para el mismo género, la diferencia en el tiempo de respuesta fue un 57,28% menor. En cuanto a la valencia emocional, el 50% de los participantes mostraron diferencias en las respuestas correctas, en función de la valencia positiva y negativa, y el 66,66% tuvieron diferencias en el tiempo de respuesta, en función de la valencia emocional. Después del procedimiento de enseñanza, los participantes mostraron mayor número de aciertos en las tareas evaluadas, independientemente del tipo de estímulo o valencia emocional, lo que genera una oportunidad para la generalización del aprendizaje de reconocimiento y denominación de emociones, además de consolidar la viabilidad de estrategias de enseñanza mediadas por recursos tecnológicos y aplicadas por la familia. Resumen imitación, (imitación identificación enfado tristeza alegría sorpresa socialfemenino, socialfemenino social femenino, femenino (social-femenino socialmasculino, socialmasculino masculino, masculino social-masculino Down familia covid19. covid19 covid 19. 19 covid-19 sin diferencial aprendizaje, , aprendizaje) género 5728 57 28 57,28 menor 50 correctas negativa 6666 66 66,66 evaluadas emociones covid1 1 covid-1 572 5 2 57,2 666 6 66,6 covid- 57, 66,

Abstract: This study evaluated the recognition (imitation, identity, and identification) and naming of negative (anger and sadness) and positive (joy and surprise) emotional stimuli alongside the influence of the types of stimuli (social-female, social-male, family, and emoji) in children and young adults with autism and Down syndrome, via tasks applied by the family and mediated by technological resources, during the COVID-19 pandemic. Five children and two young adults with autism and one child and two young adults with Down syndrome participated. Identity, recognition, naming, and imitation tasks were planned and implemented using facial stimuli with evaluative (without differential consequence) and teaching (with differential consequence, tips, and learning criteria) functions, aiming at the emergence of emotional naming from the recognition teaching tasks. The baseline results showed that, for participants who had a shorter response time for the same gender, the response time difference was on average 57.28% lower. Regarding the emotional valence, 50% of the participants showed differences in the correct answers, depending on the positive and negative valence, and 66.66% showed differences in the response time depending on the emotional valence. After the teaching procedure, the participants showed a greater number of correct answers in the tasks, regardless of the stimulus type and emotional valence, creating an opportunity for generalizing learning of emotion recognition and naming, in addition to consolidating the feasibility of teaching strategies mediated by technological resources and applied by family members. Abstract imitation, (imitation identity identification anger sadness joy surprise socialfemale, socialfemale social female, female (social-female socialmale, socialmale male, male social-male emoji COVID19 COVID 19 COVID-1 pandemic participated Identity without consequence tips criteria functions that gender 5728 57 28 57.28 lower valence 50 6666 66 66.66 procedure members COVID1 1 COVID- 572 5 2 57.2 666 6 66.6 57. 66.

Resumo: Este estudo avaliou o reconhecimento (imitação, identidade e identificação) e a nomeação de estímulos emocionais de valência negativa (raiva e tristeza) e positiva (alegria e surpresa) em conjunto com a influência dos tipos de estímulos utilizados (social-feminino, social-masculino, familiar e emoji) em crianças e jovens adultos com autismo ou síndrome de Down, por meio de tarefas aplicadas pela família e mediadas por recursos tecnológicos durante a pandemia de covid-19. Participaram cinco crianças e dois jovens adultos com autismo e uma criança e dois jovens adultos com síndrome de Down. Foram implementadas tarefas de identidade, reconhecimento, nomeação e imitação, com estímulos faciais de função avaliativa (sem consequência diferencial) e de ensino (com consequência diferencial, uso de dicas e critério de aprendizagem), visando a emergência da nomeação emocional por meio do ensino das tarefas de reconhecimento. Os resultados da linha de base identificaram que, para os participantes que apresentaram menor tempo de resposta para o mesmo gênero, a diferença de tempo de resposta foi em média 57,28% menor. Em relação à valência emocional, 50% dos participantes apresentaram diferenças nos acertos, a depender da valência positiva e negativa, sendo que 66,66% apresentaram diferenças para o tempo de resposta a depender da valência emocional. Após o procedimento de ensino, os participantes mostraram maior número de acertos nas tarefas, independentemente do gênero de estímulo e valência emocional, criando ocasião para generalização da aprendizagem de reconhecimento e nomeação de emoções, além de consolidar a viabilidade de estratégias de ensino mediadas por recursos tecnológicos e aplicadas por familiares. Resumo imitação (imitação identificação raiva tristeza alegria surpresa socialfeminino, socialfeminino social feminino, feminino (social-feminino socialmasculino, socialmasculino masculino, masculino social-masculino emoji Down covid19. covid19 covid 19. 19 covid-19 sem diferencial aprendizagem, , aprendizagem) 5728 57 28 57,28 50 6666 66 66,66 emoções familiares covid1 1 covid-1 572 5 2 57,2 666 6 66,6 covid- 57, 66,

ABSTRACT Introduction: Basal cell carcinoma (BCC) of the vulva is a rare condition that accounts for less than 0.4% of BCC cases and 2% to 4% of vulvar neoplasms. BCC of the vulva is more common among white, multiparous, and postmenopausal women, especially in the seventh decade of life. The objective is to report a case of BCC of the vulva in which aspects of diagnosis and treatment were discussed. Case Report: A 63-year-old woman, G1P1A0, arrives at the office in January 2022 for treatment of a persistent lesion on her vulva. An incisional biopsy was performed which showed that it was likely nodular basal cell carcinoma with invasion of the dermis. The patient underwent tumor resection with free macroscopic margins and primary suture. The surgery had no complications preoperatively or postoperatively. The histopathology of the surgical specimen showed that it was a nodular basal cell carcinoma with an irregular, flat, white area, measuring 0.7x0.4cm, with the lateral margins 7.0 and 5.0mm apart and deep, 5.9mm; all free. Conclusion: The reported case is rare, with surgical resection of BCC of the vulva with margins being successful. Fourteen months after surgery, the patient has no evidence of local or regional recurrence. Introduction (BCC 04 0 4 0.4 2 neoplasms multiparous women life discussed Report 63yearold yearold 63 year old woman G1P1A0 GPA G P 202 dermis suture postoperatively irregular flat area 07x04cm xcm 7x0 4cm x cm 0.7x0.4cm 70 7 7. 50mm mm 5 0mm deep 5.9mm 59mm 9mm Conclusion successful recurrence 0. 6 G1P1A 20 7x

RESUMO Introdução: O carcinoma basocelular (CBC) de vulva é uma condição rara que corresponde a menos de 0,4% dos casos de CBC e de 2% a 4% das neoplasias de vulva. O CBC de vulva é mais comum entre mulheres brancas, multíparas e na pósmenopausa, especialmente na sétima década de vida. O objetivo é relatar um caso de CBC de vulva no qual discutiram-se os aspectos do diagnóstico e tratamento. Relato de Caso: Mulher de 63 anos de idade, G1P1A0, chega ao consultório em janeiro de 2022 para tratamento de lesão persistente em vulva. Realizou-se biópsia incisional que mostrou tratar-se de provável carcinoma basocelular nodular com invasão da derme. A paciente submeteu-se a uma ressecção do tumor com margens macroscópicas livres e sutura primária. A cirurgia não teve complicações no pré-operatório e no pós-operatório. O histopatológico da peça cirúrgica mostrou tratar-se de carcinoma basocelular nodular com área irregular, plana, branco, medindo 0,7x0,4cm, com as margens laterais distando 7,0 e 5,0mm e profundas, 5,9mm; todas livres. Conclusão: O caso relatado é raro, tendo sido o tratamento de ressecção cirúrgica do CBC de vulva com margens bem-sucedido. Catorze meses após a cirurgia, a paciente encontra-se sem evidências de recidiva local ou regional. Introdução (CBC 04 0 4 0,4 2 brancas pósmenopausa vida discutiramse discutiram se Caso 6 idade G1P1A0 GPA G P 202 Realizouse Realizou tratarse tratar derme submeteuse submeteu primária préoperatório pré operatório pósoperatório. pósoperatório pós operatório. pós-operatório irregular plana branco 07x04cm xcm 7x0 4cm x cm 0,7x0,4cm 70 7 7, 50mm mm 5 0mm profundas 5,9mm 59mm 9mm Conclusão raro bemsucedido. bemsucedido bem sucedido. sucedido bem-sucedido encontrase encontra regional 0, G1P1A 20 7x

Twenty-five years have passed since the initial observation of endemic zoonotic sporotrichosis in Rio de Janeiro, Brazil. Since then, this disease has spread throughout South America. Accompanying the emergence of this mycosis, some progress has been made, including the expansion of a research network in this field and higher visibility of sporotrichosis within government authorities and funding agencies. However, there are still some challenges to curbing the expansion of this disease in the coming years. These include the development of rapid and accurate diagnostic tests, new antifungal drugs, particularly for the treatment of extracutaneous manifestations of sporotrichosis, and more comprehensive care for cats with sporotrichosis. Including these actions in the sporotrichosis research agenda is required so as to change the development of this disease in the years to come. Twentyfive Twenty five Janeiro Brazil then America mycosis made agencies However tests drugs come

Abstract Introduction Chronic rhinosinusitis (CRS) is a common inflammatory disease. This high prevalence leads to high direct and indirect public health costs, which include medical visits, laboratory tests and imaging, pharmacotherapy, hospitalizations, and surgical treatment. Furthermore, CRS has a substantial impact on patient quality of life, affecting productivity and being a common cause of absence from work CRS-associated olfactory dysfunction is highly prevalent, the actual effectiveness of surgical intervention remains inconsistent. Although there are studies evaluating the postoperative course of patients with eosinophilic Chronic rhinosinusitis (eCRS) treated with high-volume budesonide irrigation, there is little objective information regarding the impact of this intervention on olfactory status and quality of life. Objective To conduct a pre- and postoperative analysis of olfaction and quality of life in patients with eCRS treated with surgical intervention followed by high-volume budesonide nasal irrigation. Methods Prospective, descriptive, uncontrolled study of patients with eCRS. All patients underwent pre- and postoperative nasal endoscopy, SNOT-22 questionnaire, and the University of Pennsylvania Smell Identification Text (UPSIT), always by the same previously trained examiner. The SNOT-22 questionnaire and the UPSIT were readministered to all patients at 3 months, 6 months, and 1 year postoperatively, and scores compared with those obtained preoperatively. Results Twenty patients were included in the study, 13 males and 7 females, between the ages of 23 and 65; 8 patients had comorbid asthma. Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063). There was no significant association between eosinophil concentrations in polypoid tissue and postoperative SNOT-22 and UPSIT results. Patients with tissue eosinophils >50 had a lower preoperative UPSIT score. As early as 3 months postoperatively, a significant improvement in quality of life was already noticeable, as represented by a decrease in SNOT-22 values, which persisted through the 1-year postoperative follow-up evaluation (p = 0.0005). Quantitative evaluation using the UPSIT test showed a significant improvement in olfaction 3 months after surgery, which remained 6 months and 1 year after surgery (p = 0.0063). Conclusion Surgery effectively controlled eCRS in patients who adhered to high-volume budesonide nasal irrigation postoperatively. There were significant improvements in quality of life and olfaction, which persisted at least up to one year postoperatively. (CRS disease costs visits imaging pharmacotherapy hospitalizations treatment Furthermore CRSassociated associated prevalent inconsistent (eCRS highvolume volume pre Prospective descriptive endoscopy SNOT22 SNOT 22 SNOT-2 UPSIT, , (UPSIT) examiner postoperatively preoperatively females 2 65 asthma p 0.0063. 00063 0.0063 . 0 0063 0.0063) results 50 >5 score noticeable values 1year followup follow 0.0005. 00005 0.0005 0005 0.0005) SNOT2 SNOT- (UPSIT 0006 0.006 006 5 > 0000 0.000 000 0.00 00 0.0 0.

Abstract Background: Loxoscelism refers to a set of clinical manifestations caused by the bite of spiders from the Loxosceles genus. The classic clinical symptoms are characterized by an intense inflammatory reaction at the bite site followed by local necrosis and can be classified as cutaneous loxoscelism. This cutaneous form presents difficult healing, and the proposed treatments are not specific or effective. This study aimed to evaluate the protective effect of mesenchymal stromal cells-derived secretome on dermonecrosis induced by Loxosceles intermedia spider venom in rabbits. Methods: Sixteen rabbits were distributed into four groups (n = 4). Except for group 1 (G1), which received only PBS, the other three groups (G2, G3, and G4) were initially challenged with 10 μg of L. intermedia venom, diluted in 100 μL of NaCl 0.9%, by intradermic injection in the interscapular region. Thirty minutes after the challenge all groups were treated with secretome, except for group 2. Group 1 (G1-control group) received intradermal injection (ID) of 60 μg of secretome in 0.15 M PBS; Group 2 (G2) received 0.9% NaCl via ID; Group 3 (G3) received 60 μg of secretome, via ID and Group 4 (G4), received 60 μg of secretome by intravenous route. Rabbits were evaluated daily and after 15 days were euthanized, necropsied and skin samples around the necrotic lesions were collected for histological analysis. Results: Rabbits of G1 did not present edema, erythema, hemorrhagic halo, or necrosis. In animals from G2, G3, and G4, edema appeared after 6h. However, minor edema was observed in the animals of G2 and G3. Hemorrhagic halo was observed in animals, six hours and three days after, on G2, G3, and G4. Macroscopically, in G4, only one animal out of four had a lesion that evolved into a dermonecrotic wound. No changes were observed in the skin of the animals of G1, by microscopic evaluation. All animals challenged with L. intermedia venom showed similar alterations, such as necrosis and heterophilic infiltration. However, animals from G4 showed fibroblast activation, early development of connective tissue, neovascularization, and tissue re-epithelialization, indicating a more prominent healing process. Conclusion: These results suggest that secretome from mesenchymal stromal cells cultured in a xeno-free and human component-free culture media can be promising to treat dermonecrosis caused after Loxosceles spiders bite envenoming. Background genus loxoscelism effective cellsderived derived Methods n 4. . 4) G , (G1) PBS (G2 G3 L 09 0 9 region G1control Gcontrol control (ID 6 015 0.1 0.9 (G3 (G4) route euthanized analysis Results erythema 6h h However Macroscopically wound evaluation alterations infiltration activation neovascularization reepithelialization, reepithelialization re epithelialization, epithelialization re-epithelialization process Conclusion xenofree xeno free componentfree component envenoming (G1 (G 01 0. (G4

Resumo Os sistemas costeiros abrangem uma variedade de ecótonos que são importantes para as espécies de peixes, fornecendo diversos micro-habitats e áreas para alimentação, proteção contra predação, reprodução e áreas para recrutamento. No entanto, a maioria desses sistemas enfrenta grandes ameaças de atividades humanas. Considerando os níveis crescentes de perturbação humana nos ecossistemas costeiros, a compreensão das associações peixe-habitat pode fornecer informações importantes sobre os padrões de ocorrência e distribuição de espécies em sistemas afetados pelo homem, que podem apoiar o desenvolvimento de medidas eficazes de conservação e gestão. Neste contexto, investigamos a relação entre os cavalos-marinhos (Hippocampus reidi) e a complexidade do habitat e diferentes espécies de fixação, para determinar a possível variação entre locais e entre estações do ano. Os dados foram obtidos nos recifes rochosos das baías de Guanabara (Praia da Urca) e Sepetiba (Ilha das Duas Irmãs), no sudeste do Brasil, por mergulho livre ao longo de transectos fixos. Os cavalos-marinhos foram contados, e o substrato usado por cada indivíduo foi registrado e identificado como espécie ou atribuído a um grupo morfofuncional. As praias diferiram quanto à composição e grupos morfofuncionais, embora compartilhando alguns grupos morfofuncionais. Os cavalos-marinhos foram mais frequentemente associados a substratos arborescentes/ramificados em ambos os locais, a foliáceos e maciços. A associação com algas foi particularmente encontrada na Urca, enquanto o coral Carijoa riisei na Ilha de Duas Irmãs. peixes microhabitats micro habitats alimentação predação recrutamento entanto humanas peixehabitat peixe homem gestão contexto cavalosmarinhos cavalos marinhos Hippocampus reidi fixação ano Praia Urca Irmãs, Irmãs , Irmãs) Brasil fixos contados morfofuncional morfofuncionais arborescentesramificados arborescentes ramificados maciços

Abstract Coastal systems encompass a range of ecotones that are important for fish species, providing diverse micro-habitats and grounds for foraging, protection from predation, reproduction and areas for recruitment. However, most of these systems face major threats from human activities. Considering the increasing levels of human disturbance in coastal ecosystems, understanding fish-habitat associations may provide important insights into patterns of species occurrence and distribution in human-impacted systems, which can support the development of effective conservation and management measures. In this context, we investigated the relationship between seahorses (Hippocampus reidi) and both habitat complexity and different holdfast species, to determine possible variation between locations and among seasons. Data were obtained from the rocky reefs of Guanabara (Urca Beach) and Sepetiba (Duas Irmãs Island) bays, in southeastern Brazil. Seahorses were counted, and the holdfast being used by each individual was recorded and identified to species or assigned to a morphofunctional group. The beaches differed in holdfast composition and morphofunctional groups, yet sharing some morphofunctional groups. Seahorses were more frequently associated with branching holdfasts at both sites, and also with foliaceous and massive. Association with algae were particularly found in Urca, while the coral Carijoa riisei in Duas Irmãs Island. microhabitats micro habitats foraging predation recruitment However activities ecosystems fishhabitat humanimpacted impacted measures context Hippocampus reidi seasons Urca Beach Island bays Brazil counted group groups sites massive

RESUMO. O envelhecimento da população mundial tem levado a um aumento da epidemiologia e da carga da Doença de Alzheimer e outras Demências. Objetivo: Descrever a Carga Global da Doença de Alzheimer de Início Precoce e outras Demências (DAIPoD) por região do mundo e nível de renda por meio de uma análise secundária do Estudo Global de Carga de Doenças (Global Burden of Disease Study – GBD), 2019. Métodos: Estudo ecológico transversal descritivo. Os dados de cinco anos por sexo e faixa etária de 40 a 64 anos foram extraídos da ferramenta de resultados do GBD. Realizou-se uma análise descritiva de prevalência, incidência, óbitos, Anos de Vida Ajustados por Incapacidade (Disability Adjusted Life Years – DALY), Anos de Vida Perdidos (Years of Life Lost – YLL) e Anos Vividos com Incapacidade (Years Lived with Disability – YLD). Resultados: Em 2019, a DAIPoD apresentou uma prevalência de 2,67 casos e uma incidência de 0,44 casos por 1.000. Foi observada uma carga significativa, resultando em 1,16 DALY por 1.000, principalmente devido aos YLL e, em menor grau, aos YLDs. As regiões mais afetadas foram o Leste Asiático e Pacífico, a América Latina e Caribe, e a América do Norte. As taxas de carga são consistentemente mais elevadas entre as mulheres; não foi observado um gradiente por nível de renda dos países. O tabagismo foi o fator de risco mais relevante, apresentando uma ampla diferença por nível de renda do país. Conclusão: A carga global do DAIPoD pode remodelar as necessidades de saúde e o impacto social das demências, e sua compreensão é relevante para informar decisões relacionadas à oferta de serviços e agendas de pesquisa. RESUMO Objetivo (DAIPoD GBD, GBD , GBD) 2019 Métodos descritivo 4 6 Realizouse Realizou se óbitos DALY, DALY) YLD. YLD . YLD) Resultados 267 2 67 2,6 044 0 44 0,4 1000 1 000 1.000 significativa 116 16 1,1 grau YLDs Pacífico Caribe Norte mulheres países país Conclusão demências pesquisa 201 26 2, 04 0, 100 00 1.00 11 1, 20 10 1.0 1.

ABSTRACT. The aging of the world population has led to an increase in the epidemiology and burden of Alzheimer's disease and other dementias. Objective: To describe the global burden of young-onset Alzheimer's disease and other dementias by world region and income through a secondary analysis of the Global Burden of Disease Study 2019. Methods: This is a descriptive cross-sectional ecological study. Data by sex and five-year age groups from 40 to 64 years were extracted from the Global Burden of Disease Study results tool. We performed a descriptive analysis of prevalence, incidence, deaths, disability-adjusted life years, years of life lost, and years lived with disability. Results: In 2019, young-onset Alzheimer's disease and other dementias presented a prevalence of 2.67 cases and an incidence of 0.44 per 1,000 inhabitants globally. It carried a significant burden, resulting in 1.16 disability-adjusted life years per 1,000 inhabitants, primarily due to years of life lost, and to a lesser extent due to years lived with disability. East Asia & the Pacific, Latin America & the Caribbean, and North America are the most affected regions. Burden rates are consistently higher among women; no gradient was observed by country income. Smoking was the most relevant risk factor, presenting a broad difference by country income level. Conclusion: The global burden of young-onset Alzheimer's disease and other dementias may reshape healthcare requirements and the societal impact of dementias, and its understanding is relevant to inform decisions related to service offerings and research agendas. ABSTRACT Alzheimers Alzheimer s Objective youngonset young onset 2019 Methods crosssectional cross sectional study fiveyear five year 4 6 tool deaths disabilityadjusted disability adjusted lost Results 267 2 67 2.6 044 0 44 0.4 1000 1 000 1,00 globally 116 16 1.1 Pacific Caribbean regions women factor level Conclusion agendas 201 26 2. 04 0. 100 00 1,0 11 1. 20 10 1,