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ABSTRACT We present the case of a 37-year-old woman who underwent bilateral penetrating keratoplasty for congenital hereditary endothelial dystrophy at the age of 10 years. Over the subsequent 27 years, the patient's vision slowly deteriorated. Our examination revealed decompensation of the right corneal graft. We addressed this with regraft surgery. We then learned that the patient had been suffering from progressive hearing loss since adolescence. Tonal audiometry revealed hearing per ceptive deafness of 25 dB, which was more prominent in the left ear. Because the patterns of progressive sensorineural hearing loss and congenital hereditary endothelial dystrophy have both been linked to the same gene, slc4a11, we tested our patient for mutations in this gene. The test was positive for a heterozygous slc4a11 gene fifth exon mutation on chromosome 20p13-p12, which causes a frameshift. A combined clinical and genetic evaluation confirmed a diagnosis of Harboyan syndrome. After the genetic diagnosis of the disease, she was evaluated for the need for a hearing aid due to her hearing loss. The patient was also informed about genetic counseling.

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Objetivo: analisar o nível de estresse percebido e sofrimento psíquico em gestores de saúde na pandemia da Covid-19. Método: estudo descritivo, transversal com abordagem quantitativa. A coleta ocorreu de abril a setembro de 2021, com 40 gestores de serviço de saúde. Utilizou-se para a coleta de dados um instrumento para caracterização sociodemográfica e ocupacional e as escalas "Perceived Stress Scale-14" e "Self Reporting Questionnaire" para avaliação do estresse percebido e sofrimento psíquico. Os dados coletados foram analisados no Statistical Package for the Social Sciences versão 22.0. O presente estudo faz parte de um projeto intitulado "Trabalhadores dos Serviços de Saúde Frente à Pandemia de Covid-19", aprovado pelo Comitê de Ética em Pesquisa sob CAAE número 35260620.9.0000.5231. Resultados: a maioria dos profissionais eram do sexo feminino (90%, N=36), casados (70%, N=28), com filhos (80%, N=32), com média de idade de 45 anos e com pós--graduação (47,5%, N=19). A média dos escores relacionados ao estresse percebido foi 31,13 pontos (DP=3,77) sendo o mínimo 24 e máximo de 42 pontos. Com relação ao sofrimento psíquico, (40%, N=16) os gestores apresentaram prováveis casos de transtornos. A prática de atividades físicas e de lazer (p<0,05) tem papel importante na diminuição do estresse percebido e do sofrimento psíquico. Conclusão: os gestores em saúde apresentaram, durante a pandemia, estresse e sofrimento psíquico, resultados esses que devem ser considerados para promoção de autocuidado aos gestores de saúde, enfatizando a necessidade da realização de atividades físicas e de lazer.

Objective: to analyze the level of perceived stress and psychological suffering in health managers during the Covid-19 pandemic. Method: descriptive, cross-sectional study with a quantitative approach. The collection took place from April to September 2021, with 40 health service managers. An instrument for socio-demographic and occupational characterization and the "Perceived Stress Scale-14" and "Self Reporting Questionnaire" scales were used for the assessment of perceived stress and psychic suffering. The collected data were analyzed using the Statistical Package for the Social Sciences version 22.0. The present study is part of a project entitled "Health Service Workers in the Face of the Covid-19 Pandemic", approved by the Research Ethics Committee under CAAE number 35260620.9.0000.5231. Results: most professionals were female (90%, N=36), married (70%, N=28), with children (80%, N=32), with a mean age of 45 years and with a postgraduate degree. -graduation (47.5%, N=19). The average score related to perceived stress was 31.13 points (SD=3.77), with a minimum of 24 and a maximum of 42 points. With regard to psychic suffering, (40%, N=16) the managers presented probable cases of disorders. The practice of physical and leisure activities (p<0.05) plays an important role in reducing perceived stress and psychological distress. Conclusion: health managers presented, during the pandemic, stress and psychic suffering, results that should be considered for promoting self-care to health managers, emphasizing the need to carry out physical and leisure activities.Keywords: Health manager; Occupational stress; Covid-19; Coronavirus infections.

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Introduction: High blood pressure (HBP) is the leading cause of death from cardiovascular disease. Despite the advances, the percentage of undiagnosed and untreated hypertensive patients is 58.4%. The evaluation of cognitive damage in HBP focuses on preventing stroke, while functional damage is ignored. This inadequate management may be multifactorial. The objective was to analyze the opinions that doctors have about the relationship between high blood pressure and cognitive damage. Methodology: Observational, descriptive, cross-sectional study developed in the period between August 2020 and August 2023. Analysis of data obtained from a self-administered, anonymous and voluntary questionnaire. Revealing information on the professional profile, knowledge of HBP, its link with cognitive impairment (CD), diagnosis and treatment. Results: 222 professionals were included, 215 (96.8%) agree with the existence of a link between HBP and other cardiovascular risk factors in CD, and 218 (98.1%) acknowledge assisting patients at risk of suffering from CD. The CD evaluation is carried out in selected cases by 132 (59.4%) participants and 59 (26.7%) always do it. Of those who perform evaluation, 103 (54%) use the Mini Mental State Examination (MMSE), 10 (5.2%) use the Montreal Cognitive Assessment (MoCA) and 9 (4.7%) use the Clock Drawing Test. Regarding the decrease in blood pressure in elderly patients and the link with risk of CD: 54 (24.3%) do not recognize risk and 65 (29.2%) recognize a moderate-high risk. In reference to the implication of the treatment of cardiovascular disease and CD: 217 (97.7%) recognized a beneficial effect. Discussion: Given the recognition of the link between HBP and CD, it would be expected that CD would be investigated in the vast majority, however only 26.7% always evaluate it. There is no consensus on the method, the MMSE being the most used, with a low application of the MoCA test and/or Clock Drawing Test, the latter being the ones that evaluate executive function, mostly altered in CD linked to HBP. Although the treatment of cardiovascular disease is recognized as beneficial with respect to CD, the control of HBP in older adults is considered risky. A diagnosis is made of a situation where a disparity is evident between what one recognizes as knowing and what one claims to do. Conclusions: The role of vascular disease in functional brain damage is recognized, considering it necessary to know the cognitive status of patients, however there is a low application of screening tests that evaluate executive function. In this context, a gap between medical knowledge and practice is shown.

Introdução: A hipertensão arterial (HA) é a principal causa de morte por doenças cardiovasculares. Apesar dos avanços, o percentual de hipertensos não diagnosticados e não tratados é de 58,4%. A avaliação do dano cognitivo na hipertensão concentra-se na prevenção do acidente vascular cerebral, enquanto o dano funcional é ignorado. Esse manejo inadequado pode ser multifatorial. É objetivo fue analisar a opinião dos médicos sobre a relação entre hipertensão arterial e danos cognitivos. Metodologia: Estudo observacional, descritivo, transversal desenvolvido no período entre agosto de 2020 e agosto de 2023. Análise de dados obtidos a partir de questionário autoaplicável, anônimo e voluntário. Revelar informações sobre o perfil profissional, conhecimento sobre a HA, sua ligação com o comprometimento cognitivo (DC), diagnóstico e tratamento. Resultados: Foram incluídos 222 profissionais, 215 (96,8%) concordam com a existência de ligação entre hipertensão e outros fatores de risco cardiovascular na DC e 218 (98,1%) reconhecem ajudar pacientes com risco de sofrer de D.C. A avaliação da DC é realizada em casos selecionados por 132 (59,4%) participantes e 59 (26,7%) a fazem sempre. Dos que realizam avaliação, 103 (54%) utilizam o Mini Exame do Estado Mental (MEEM), 10 (5,2%) utilizam a Avaliação Cognitiva de Montreal (MoCA) e 9 (4,7%) utilizam o Clock Drawing Test. Em relação à diminuição da pressão arterial em pacientes idosos e a ligação com o risco de DC: 54 (24,3%) não reconhecem risco e 65 (29,2%) reconhecem risco moderado-alto. Em referência à implicação do tratamento de doenças cardiovasculares e DC: 217 (97,7%) reconheceram o efeito benéfico. Discussão: Dado o reconhecimento da ligação entre hipertensão e DC, seria de esperar que a DC fosse investigada na grande maioria, no entanto apenas 26,7% sempre a avaliam. Não há consenso sobre o método, sendo o MEEM o mais utilizado, com baixa aplicação do teste MoCA e/ou Clock Drawing Test, sendo estes últimos os que avaliam a função executiva, majoritariamente alterada nos DC vinculados à HA. Embora o tratamento das doenças cardiovasculares seja reconhecido como benéfico em relação à DC, o controle da HA em idosos é considerado arriscado. É feito um diagnóstico de uma situação em que é evidente uma disparidade entre o que se reconhece como saber e o que se afirma fazer. Conclusões: O papel da doença vascular no dano cerebral funcional é reconhecido, considerando-se necessário conhecer o estado cognitivo dos pacientes, porém há baixa aplicação de testes de triagem que avaliam a função executiva. Nesse contexto, evidencia-se uma lacuna entre o conhecimento e a prática médica.

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Objetivo: analisar a representação social da Covid-19 para a população geral de uma cidade de pequeno porte do Estado do Rio de Janeiro. Método: estudo qualitativo, apoiado na abordagem estrutural das representações sociais. Participaram 100 usuários de serviços de saúde. Os dados foram coletados por questionário sociodemográfico de evocações livres de palavras e roteiro de entrevista semiestruturada. Os dados foram analisados com o auxílio dos softwares Excel, EVOC 2005 e análise de conteúdo temático-categorial para contextualização das evocações respectivamente. Resultados: os termos do possível núcleo central foram: morte, sofrimento, cuidados, ansiedade-angústia e vacina. Na primeira periferia: medo e prevenção. À segunda periferia: informação-desinformação; desgoverno; ter-fé e proteção. A zona de contrate: doença; isolamento-social; dificuldades; catástrofe-mundial; desemprego e pandemia. Considerações finais: marcaram essa representação os impactos psicossociais negativos resultantes da desestruturação da vida e das mortes ocasionadas pela nova doença, no entanto o grupo aderiu as medidas de cuidados de proteção.

Objective: to analyze the social representation of Covid-19 among the general population of a small-sized city in the State of Rio de Janeiro. Method: Qualitative study, based on the structural approach of social representations. One hundred healthcare service users participated. Data were collected through a sociodemographic questionnaire, free word evocation, and a semi-structured interview guide. The data were analyzed using Excel software, EVOC 2005, and thematic-categorical content analysis for contextualization of the evocations, respectively. Results: the terms of the possible central core were: death, suffering, care, anxiety-distress, and vaccine. In the first periphery: fear and prevention. In the second periphery: information-misinformation; mismanagement; having faith and protection. The contrast zone: disease; social isolation; difficulties; global catastrophe; unemployment; and pandemic. Final considerations: this representation was marked by the negative psychosocial impacts resulting from the disruption of life and the deaths caused by the new disease; however, the group adhered to protective care measures.

Objetivo: analizar la representación social del Covid-19 para la población general de una pequeña ciudad del Estado de Río de Janeiro. Método: estudio cualitativo, basado en el enfoque estructural de las representaciones sociales. Participaron 100 usuarios de servicios de salud. Los datos se recolectaron mediante un cuestionario sociodemográfico con evocación libre de palabras y una guía de entrevista semiestructurada. Los datos fueron analizados utilizando lo software Excel y EVOC 2005 y análisis de contenido temático-categórico para contextualizar las evocaciones respectivamente. Resultados: los términos del posible núcleo central eran: muerte, sufrimiento, cuidados, ansiedad-angustia y vacuna. En la primera periferia: miedo y prevención. En la segunda periferia: información-desinformación; desgobierno; tener fe y protección. La zona de contraste: enfermedad; aislamiento-social; dificultades; catástrofe-mundial; desempleo y pandemia. Consideraciones finales: esta representación se caracterizó por los impactos psicosociales negativos derivados de la desestructuración de la vida y de las muertes causada por la nueva enfermedad, sin embargo, el grupo adhirió a las medidas de protección.

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Resumen El objetivo de esta investigación fue analizar la relación entre la presencia de trastornos emocionales y el acoso escolar en los estudiantes de sexto a noveno grado de las instituciones educativas públicas de la ciudad de Floridablanca (Colombia). El diseño del estudio fue cuantitativo correlacional. Los instrumentos utilizados fueron la prueba de tamizaje cyberbullying y el Sistema de Evaluación de Niños y Adolescentes (SENA). Se evaluaron 76 menores que cumplen el rol de víctima o agresor, y los resultados obtenidos indicaron que un alto porcentaje de los involucrados en el acoso escolar como víctimas o agresores cara a cara o en línea presentan desajustes emocionales. Los datos descriptivos muestran que en Floridablanca (Colombia) aún hay fracciones de acoso escolar por debajo de la prevalencia internacional; sin embargo, existe una alta proporción de estudiantes en riesgo de asumir algún rol en el acoso escolar. Se concluyó que la Psicología es una disciplina científica que aporta herramientas para abordar los trastornos emocionales adscritos al acoso escolar. Que deben recibir tratamiento psicológico todos los involucrados en el acoso escolar en cualquiera de sus roles. Esta investigación puede considerarse como insumo para futuros trabajos que pretendan formular acciones de intervención para el acoso escolar y el trabajo de los trastornos emocionales qu e genera este problema.

Abstract The main goal for this research was to analyze the relationship between emotional disorders and bullying in schoolchildren. Participants were recruited from sixth to ninth grade in public schools from Floridablanca, Colombia. The design method was quantitative and correlational. We administered an online test called Cyberbullying to detect students involved in bullying and cyberbullying and emotional disorders were assessed using the test Sistema de Evaluación de Niños y Adolescentes (SENA). Participants were 76 schoolchildren with high scores as victims and/or aggressors. Results show a high percentage of schoolchildren involved in bullying and cyberbullying either as victims and/or aggressors that are suffering from emotional problems. Descriptive data also shows that Floridablanca still maintains a lower prevalence of bullying compared to international standards, but there's a high risk for children getting involved in these behaviors. This research can be taken as an input for future work that intends to formulate intervention actions, both for school acoso and for the work of the emotional disorders that this problem generates.

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Presenteeism is a relatively new phenomenon affecting the health of employees, and studies on this topic are scarce. It refers to being physically present in the workplace but mentally or physically unable to fully perform one's duties. For teachers in particular, this is influenced by internal and external factors that determine their relationship with work. The objective of this study was to understand how presenteeism developed among teachers from a school in the city of São Paulo, Brazil, which offers secondary education programs including basic professional and technical qualification. This was a qualitative study using Bardin's content analysis method. Twenty teachers suffering from presenteeism were randomly selected to compose the purposive sample. Data were collected from September to December 2019. Participants complaints were mainly related to school organization and their own relationship with work. Several factors lead to illness and impact teachers' health and quality of life, such as physical and emotional exhaustion, difficulties in recovering health, suffering, underperformance, difficulty taking sick leaves, and professional and financial damages. Presenteeism involves personal, financial, and sociocultural issues, as well as organizational factors that make teachers feel obligated to work even when they are sick to perform their duties.

O presenteísmo é um fenômeno relativamente novo que afeta a saúde dos trabalhadores. Estudos sobre o tema são escassos. O presenteísmo refere-se a estar fisicamente presente no local de trabalho, mas mental ou fisicamente incapaz de desempenhar plenamente suas funções. Para os professores, isso é influenciado por fatores internos e externos que determinam a sua relação com o trabalho. O objetivo deste estudo foi compreender como o presenteísmo se desenvolveu entre professores de uma escola pública de ensino médio e técnico na cidade de São Paulo. Trata-se de um estudo qualitativo que utilizou o método de análise de conteúdo de Bardin. Foram selecionados aleatoriamente 20 professores com presenteísmo para compor a amostra proposital. A coleta de dados foi realizada no período de setembro a dezembro de 2019. Questões relacionadas à organização do trabalho e à relação do indivíduo com o trabalho propriamente dito foram, entre outras, as que mais apareceram na pesquisa. Diversos fatores levam ao adoecimento e impactam a saúde e a qualidade de vida dos professores, tais como desgaste físico e emocional, dificuldades na recuperação da saúde, sofrimento, queda no rendimento, dificuldade de afastamento e prejuízos profissionais e financeiros. O presenteísmo envolve questões pessoais, financeiras e socioculturais, além de fatores organizacionais que levam o professor a trabalhar sem condições de saúde para cumprir suas funções no trabalho.

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Introduction: Increasing urban violence exposes bank workers to traumatic situations in the work environment. Objectives: This study investigated the perceptions of bank workers about their robbery and/or kidnapping experiences and the aftercare they received. Methods: This qualitative study involved in-depth interviews with 7 workers from a public banking institution in 4 states in the northeastern region of Brazil who victims of kidnappings or robberies. Results: Their experiences were classified into 2 thematic categories: the dynamics of the event and the perception of aftercare actions. Conclusions: The violent experiences caused significant and lingering suffering and trauma among the participants. They reported that the aftercare was limited and needs improvement. Caring for bank workers who have been victims of assault and kidnapping can prevent or minimize their resultant psychosocial suffering.

Introdução: O aumento da violência urbana expõe trabalhadores bancários a situações traumáticas no ambiente de trabalho. Objetivos: Neste trabalho, objetivamos conhecer as percepções de trabalhadores bancários sobre a experiência vivida em assaltos e/ou sequestros e sobre a assistência à saúde recebida após esta vivência. Métodos: Adotou-se a pesquisa qualitativa, desenvolvida com sete trabalhadores(as) bancários(as) de um banco público, em quatro estados do nordeste brasileiro, vítimas de sequestros ou assaltos. A técnica utilizada para a produção dos dados foi a de entrevistas em profundidade. Resultados: As experiências narradas organizaram-se em duas categorias temáticas: dinâmica do evento e percepção das ações de cuidado após o evento. Conclusões: Em síntese, o estudo permitiu compreender que a violência experimentada fez emergir entre os participantes sofrimentos e traumas significativos que vão além do momento do evento. Em função disso, as narrativas indicaram que a assistência recebida após o evento traumático é limitada e poderia ser aprimorada. Assim, acolher e assistir os trabalhadores bancários vítimas de assalto e sequestro pode prevenir ou minimizar sofrimentos psicossociais advindos da vivência de violência.

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Chronic neuropathic pain arises from changes in the somatosensory nervous system and can lead to disability and intense physical and emotional suffering. Recognized as a painful syndrome, its causes are diverse, ranging from stroke, trauma, and diabetes mellitus to unknown origins. It tends to be more common in women, and it is estimated that the number of people affected by this condition increases every year as the population ages. Treatments are based on pharmacological and non-pharmacological interventions; however, the therapeutic plan does not always offer satisfactory relief, and learning to live with pain is, in most cases, the only option. The treatment aims to provide relief from symptoms, and alternative measures such as physiotherapy, physical exercise, and psychological support are strongly recommended. The coronavirus disease (COVID)-19 pandemic exacerbated the pain process, impacting quality of life, generating emotional problems, and potentially contributing to the increased incidence of neuropathic pain. In this context, the narrative review aimed to explore the complex panorama of chronic neuropathic pain, not only from a physiological perspective but also encompassing the psychological perspective and actions related to the pain process.

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Pain, a prevalent and debilitating symptom in cancer patients, significantly diminishes the quality of life for both individuals and their families. Addressing this critical issue, our study presents the case of a 15-year-old diagnosed with synchronous multifocal multicentric osteosarcoma. We utilized radiofrequency ablation of bilateral splanchnic nerves, a strategy of multimodal pain and palliative care. This approach not only proved to be safe and effective but also markedly improved the patient's quality of life. Our findings shine a light of hope, emphasizing the paramount importance of innovative pain management in pediatric oncology, especially in the final stages of life. This case report highlights the unwavering dedication to excellence in relieving suffering, offering hope for patients grappling with cancer.

Pain is a common and serious problem for cancer patients, osteosarcoma is a type of bone cancer that often affects children. making life hard for them and their families. We used a therapy called radiofrequency ablation on specific nerves to manage the pain. In the case of the patient's abdominal pain, this therapy was safe, worked well, and greatly improved the patient's quality of life. Our findings show the importance of new pain management methods in helping children with cancer, helping them reduce pain, using fewer strong pain medications and helping children in this case in the final stage of life.

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BACKGROUND: Pilomatricoma is a common benign adnexal neoplasm in children. There are few epidemiological studies on this subject, with most relying solely on descriptive statistics. METHODS: A cross-sectional study conducted in two tertiary hospitals in Mexico City from January 2017 to December 2023. Clinical and electronic records of patients with histopathological diagnosis of pilomatricoma, both sexes, under 18 years old, with any type of present comorbidity were selected. Records of patients with diagnosis not confirmed by histopathology or incomplete records were not included in the study. RESULTS: Fifty-two cases with pilomatrixoma were included in the study, showing a total of 74 lesions. About 23.1% of the cases had multiple pilomatrixomas. 40.4% of the cases experienced pain; this symptom was associated with lesions > 15 mm in diameter and with multiple pilomatrixomas. Risk factors for lesions > 15 mm included age under 8 years, positive tent sign, tumor evolution longer than a year, and a non-classical clinical variety. The head and neck were the most commonly affected areas. The left upper extremity presented larger pilomatrixomas (median 18.5 mm) and occurred more frequently in adolescent patients (mean age 12.1 years) compared to other body areas. CONCLUSIONS: Pilomatrixoma in children shows clinical diversity, with specific findings based on size, number, and anatomical location.

INTRODUCCIÓN: El pilomatricoma es una neoplasia anexial benigna frecuente en la infancia. Hay muy pocos estudios epidemiológicos al respecto y la mayoría solo han utilizado estadística descriptiva. MÉTODOS: Estudio transversal realizado en dos hospitales de concentración de la Ciudad de México de enero de 2017 a diciembre de 2023. Se seleccionaron expedientes clínicos y electrónicos de pacientes con diagnóstico histopatológico de pilomatricoma, ambos sexos, menores de 18 años, con cualquier tipo de comorbilidad presente. No se incluyeron los expedientes de pacientes con diagnóstico no confirmado por histopatología o expediente incompleto. RESULTADOS: Se incluyeron 52 casos con diagnóstico de pilomatricoma que mostraron un total de 74 lesiones. El 23.1% de los pacientes tuvieron pilomatricomas múltiples. El 40.4% experimentaron dolor; este signo se asoció con lesiones de diámetro superior a 15 mm y pilomatricomas múltiples. La edad menor de 8 años, el signo de la tienda de campaña positivo, un tiempo de evolución mayor de 1 año y una variedad clínica no clásica son factores de riesgo asociados con las lesiones mayores de 15 mm. La cabeza y el cuello fueron las áreas más comúnmente afectadas por estos tumores. La extremidad superior izquierda presento pilomatricomas de mayor tamaño (mediana 18.5 mm), y ocurrieron más en pacientes adolescentes (media 12.1 años), en comparación con otras áreas del cuerpo. CONCLUSIONES: El pilomatricoma en niños muestra diversidad clínica. Presenta hallazgos y asociaciones específicas según el tamaño, el número y la ubicación anatómica.

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Background: Dynapenic obesity (DO) is the coexistence of excess adipose tissue/body weight and low muscle strength. This condition is associated with an increased risk of suffering from various chronic diseases and physical deterioration in older people. Aim: To analyze the association between DO phenotypes and physical performance in middle-aged women living in the community. Methods: This cross-sectional study was conducted on middle-aged and older women (≥50 years) residing in Guayaquil, Ecuador. Dynapenia was diagnosticated by a handgrip strength (HGS) < 16 kg; obesity was determined based on body mass index (BMI) ≥ 30 kg/m2. Participants were categorized into four groups based on their dynapenia and obesity status: non-dynapenic/non-obesity (ND/NO), obesity/non-dynapenic (O/ND), dynapenic/non-obesity (D/NO) and dynapenic/obesity (D/O). Physical performance was assessed by the Short Physical Performance Battery (SPPB). Results: A total of 171 women were assessed. The median (IQR) age of the sample was 72.0 (17.0) years. Obesity and dynapenia were 35% (n = 60) and 57.8% (n = 99) of the participants, respectively. The prevalence of ND/NO was 25.1% (n = 43), O/ND 17% (n = 29), D/NO 39.8% (n = 68) and DO 18.1% (n = 31). The mean SPPB total score was 6.5 ± 3.2. Participants of D/NO and DO groups presented significantly lower mean SPPB scores (p < 0.001) compared to those of NO/ND and O/ND groups. Conclusion: Women with DO and D/NO exhibited significantly lower SPPB scores, indicating poorer physical performance. These findings emphasize the importance of incorporating a comprehensive assessment of muscle strength and obesity in middle-aged and older women.

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Background: The one-bone forearm procedure has been considered as a potential treatment for severe forearm deformities. However, its primary limitation lies in the elevated risks of nonunion and infection. In order to enhance union rates, a technical modification was introduced, aiming not only to establish end-to-end radio-ulnar fixation but also to incorporate an additional overlay and fixation between the proximal and distal radius osteotomy stumps. This technique, initially applied in a heterogeneous patient population including individuals with neurological, tumoral, and congenital conditions, yielded promising results, achieving a consolidation rate of 100% and enabling supination corrections of up to 120°. Methods: In this study, we present a retrospective cohort of 28 patients, with an average age of 9 years, all afflicted by forearm supination contracture exceeding 90° secondary to neonatal brachial plexus injury. These patients underwent treatment with the modified technique. Results: The mean correction achieved in forearm rotation was 116°, and the average follow-up period extended to 43 months. Remarkably, all patients exhibited bone union within an average period of 6.6 weeks, without any complications. Conclusion: Our findings underscore the efficacy of this modified technique, which enables substantial rotational corrections, boasts a high union rate, and maintains a low incidence of complications. This approach is particularly valuable for young patients suffering from neonatal brachial plexus injury with severe fixed supination deformities. Case series Level of evidence: IV.

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In the context of international migration, many migrant women face an overload of care work for other people, corroborating a lack of adequate care and protection for them, which places them in vulnerable situations and at risk of suffering psychosocial harm. emotional and physical to your health. This is aggravated in the scenario of the COVID-19 pandemic, considering the structural social inequalities that have deepened to unsustainable limits for the subaltern sectors of societies, where Latin American migrant women who work in the field of domestic care of Spain and Germany. In this way, this work seeks to analyze the problem of psychosocial suffering related to care work in migrant Latin American women in Germany and Spain during the COVID-19 pandemic. For this, the integrative review was used as a qualitative synthesis procedure of previous related studies. The importance of this study lies in the fact that there are few studies on the psychosocial health of Latin American migrant women who perform domestic and care work. Some results show that, in this labor niche in Germany and Spain, the identity of women, migrants and Latin Americans, can contribute to unleash psychological and emotional suffering, due to the precarious working conditions to which many submit out of necessity and because of the field. of care to be the first "option", derived mainly from the limited perspectives of labor and social insertion in the country of destination, than from a freely and consciously chosen task.

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Objectives: Tilia viridis (Bayer) Simonk. (Malvaceae) is widely distributed in Argentina and employed for its tranquilizing properties. Other species of the genus (Tilia europaea L., Tilia cordata Mill., Tilia platyphyllos Scop.) have been traditionally used for the treatment of epilepsy. Epilepsy affects approximately 65 million people worldwide and is characterized by an imbalance between excitatory and inhibitory processes in the brain, leading to unpredictable, unprovoked, recurrent seizures. Current pharmacological interventions often present mild to moderately severe side effects. Epilepsy has been associated with oxidative and nitrative stress as well as neuroinflammation. Herbal medicine therapies may offer new treatment options with multi-target antioxidant and anticonvulsant effects for patients whose seizures remain uncontrolled, potentially providing cost-effective solutions for individuals worldwide suffering from uncontrolled epilepsy.The aim of this study was to demonstrate the anticonvulsant activity of a standardized T. viridis aqueous extract (TE). Methods: Study of the constituents of TE, TE's antioxidant and anticonvulsant activities and toxicity, and analysis of the possible relation between the potential activities and the compounds present in the extract. In order to demonstrate TE's anticonvulsant activity a zebrafish model was used. The study also assessed TE's toxicity and antioxidant activity. To standardize the extract, total polyphenols and flavonoids were quantified and specific flavonoids were identified and quantified using HPLC-MS/MS and HPLC-UV. Results: TE exhibited anticonvulsant activity at low concentrations and demonstrated antioxidant effects by scavenging free radicals, exhibiting superoxide dismutase and peroxidase-like activities, as well as inhibiting lipoperoxidation. These actions can be attributed to the presence of polyphenols, particularly flavonoids. Conclusion: TE holds promise as a complementary herbal medicine in the treatment of epilepsy and may also offer benefits for other neuropathies associated with oxidative stress, such as Parkinson's disease and Alzheimer's disease.

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BACKGROUND: Diabetic foot ulcers are challenging to heal, increase the risk of lower extremity amputation, and place a significant burden on patients, families, and healthcare systems. Prioritizing preventive interventions holds the promise of reducing patient suffering, lowering costs, and improving quality of life. This study describes a scoping review protocol that will be used to delineate the preventive interventions for diabetic foot ulcers employed in different healthcare settings. METHODS: The scoping review methodology was formulated in accordance with the PRISMA extension guidelines for scoping reviews and informed by the procedural insights provided by the JBI methodology group. Studies with participants diagnosed with type 1 and type 2 diabetes, aged 18 years or older, without an active ulcer at baseline, and studies of preventive interventions for foot ulcers in various healthcare settings will be screened. The search strategy was developed in collaboration with a research librarian using the PRESS checklist and no time or language limitations were applied. Data will be analyzed and summarized descriptively, including characteristics of studies, participants, and interventions. DISCUSSION: Understanding the strategies and gaps in diabetic foot ulcer prevention is critical. The literature can provide valuable insights for developing tailored interventions and strategies to effectively address these gaps, potentially accelerating progress toward improved outcomes in diabetic foot ulcer prevention. REVIEW REGISTRATION: Open Science Framework DOI 10.17605/OSF.IO/FRZ97 [June 19, 2023].

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BACKGROUND: Functional/dissociative seizures (FDS), also known as psychogenic non-epileptic seizures (PNES), are sudden, transient, and involuntary events that include motor, sensory, cognitive or autonomic function alterations. In this work we analyzed the psychopathological characteristics of a subgroup of women who suffer from FDS with the aim to analyze the role of psychological trauma, with special emphasis on trauma due to sexual abuse (SA). METHODS: Forty-five women diagnosed with FDS were included in the study (age range 18 to 64 years, mean = 34.7, standard deviation (SD) = 13.1). Clinical and psychopathological characteristics were reviewed. All patients have completed the clinical interviews, the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I), the Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID II) and the Global Assessment of Functioning (GAF) according to a special protocol for mental health assessment. Also, the history of sexual abuse trauma, the history of other non-sexual traumas and absence of history of trauma were reviewed. RESULTS: Eighty percent of the cases reported a history of trauma, and 40% reported a history of SA. Patients with a history of SA presented a significantly lower average age of seizure onset than patients with a history of other non-sexual traumas (p = 0.021). Significant associations were found between SA and post-traumatic stress disorder (PTSD) (p = 0.031), and SA and history of suicide attempts (p = 0.037). CONCLUSIONS: SA carries serious implications for the mental health of women suffering from FDS. Mental health professionals must consider the history of this type of trauma to provide the necessary care for this patient population.

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The development of new analgesics has been challenging. Candidate drugs often have limited clinical utility due to side effects that arise because many drug targets are involved in signaling pathways other than pain transduction. Here, we explored the potential of targeting protein-protein interactions (PPIs) that mediate pain signaling as an approach to developing drugs to treat chronic pain. We reviewed the approaches used to identify small molecules and peptide modulators of PPIs and their ability to decrease pain-like behaviors in rodent animal models. We analyzed data from rodent and human sensory nerve tissues to build associated signaling networks and assessed both validated and potential interactions and the structures of the interacting domains that could inform the design of synthetic peptides and small molecules. This resource identifies PPIs that could be explored for the development of new analgesics, particularly between scaffolding proteins and receptors for various growth factors and neurotransmitters, as well as ion channels and other enzymes. Targeting the adaptor function of CBL by blocking interactions between its proline-rich carboxyl-terminal domain and its SH3-domain-containing protein partners, such as GRB2, could disrupt endosomal signaling induced by pain-associated growth factors. This approach would leave intact its E3-ligase functions, which are mediated by other domains and are critical for other cellular functions. This potential of PPI modulators to be more selective may mitigate side effects and improve the clinical management of pain.

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Poultry production faces significant challenges, including high feed prices, diseases, and thermal stress, which impact broiler welfare and productivity. Despite advances in cooling technologies and ventilation, preslaughter operations still lead to considerable losses. This review highlights the need for the improved management of thermal environments and animal logistics. Preslaughter operations typically involve fasting broilers for 8-12 h to reduce gastrointestinal contents and contamination. Following fasting, broilers are caught, crated, and transported. Stress levels vary based on distance and conditions, with manual catching often causing stress and injuries. Catching should occur during cooler periods to minimise these issues, and transport conditions must be carefully managed. Lairage, the waiting period after transport, should be kept short (1-2 h) in climate-controlled environments to avoid stress and deterioration. Proper handling and efficient unloading are essential to prevent injuries and reduce economic losses. Stunning methods, such as electronarcosis and a controlled atmosphere, aim to minimise suffering before slaughter, though practices vary culturally and religiously. Logistics and real-time monitoring technology are crucial for enhancing animal welfare during transportation. Effective planning and the optimisation of transport processes is vital for reducing stress and losses, especially with regard to rising global temperatures and production demands.

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OBJECTIVES: To evaluate improvements in laboratory markers of anaemia (haemoglobin, haematocrit, serum iron, and ferritin) in women with subjective heavy menstrual bleeding (HMB) treated with the levonorgestrel 19.5-mg intrauterine device. MATERIALS AND METHODS: We conducted a pilot study at the Department of Obstetrics and Gynaecology, University of Campinas, Faculty of Medical Sciences, Campinas, SP, Brazil. We compared anaemia markers in 73 women aged 18-48 years suffering from HMB, one year after placement of the IUD. RESULTS: The mean age of participants was 30.0 years (range 24-38); more than half were white, and the mean body mass index (kg/m2) was 27.0. Twenty (27.4%) participants exited the study due to loss to follow-up (n = 12; 16.4%), expulsion (n = 7; 9.6%) and uterine perforation (n = 1; 1.4%). One-year post-IUD placement, amenorrhoea was reported by 10 (13.7%) women. According to intention-to-treat and per protocol analyses, the proportion of women with normal haemoglobin levels significantly improved (p = 0.014 in both analyses), as did haematocrit (p < 0.001 in both analyses) and serum iron (p = 0.003 in both analyses) compared to baseline evaluations. The proportion of women with normal ferritin levels also improved (p < 0.001) in both analyses using a cut-off of 15 ng/ml, though no significant difference was observed using a 30 ng/ml cut-off (p = 0.083 in both analyses). CONCLUSION: The levonorgestrel 19.5-mg IUD effectively improved laboratory markers of anaemia one year after placement in women with HMB.

Our results show that the levonorgestrel 19.5-mg IUD significantly improved anaemia markers in subjects with subjective HMB one year after insertion. The occurrence of expulsions emerged as a notable concern in this treatment group.

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Introdução: De grande impacto na população, queimaduras exigem análise epidemiológica e planejamento constantes para prevenção, tratamento e reabilitação dos pacientes. Este trabalho objetiva comparar, após uma década, os indicadores do Centro de Tratamento de Queimados do Hospital João XXIII, em Belo Horizonte, MG, abordados no artigo "Epidemiologia das queimaduras no estado de Minas Gerais", publicado na Revista Brasileira de Cirurgia Plástica com dados de 2010, para validar as estratégias vigentes e as futuras. Método: Revisão dos prontuários dos pacientes acometidos por queimadura, internados no referido centro em 2020. Resultados: Foram internadas 473 vítimas de queimadura no período, 87,5% causadas por acidente, sendo 34,5% por líquidos quentes, 23,7% por álcool; 61,9% provenientes do interior do estado de Minas Gerais; 63,4% do sexo masculino. A idade média foi de 30 anos, a superfície corporal queimada média foi de 18,8% e o tempo médio de internação foi de 25 dias. Foram realizados 580 desbridamentos cirúrgicos e 473 enxertos cutâneos autólogos. Faleceram 7,4% dos pacientes, correspondentes a 29,5% dos internados no CTI adulto, com superfície corporal queimada média de 49,7%, e 10,5% dos internados no CTI pediátrico. A maior causa de óbitos foi devido à sepse, em 57,1% dos casos. A mortalidade diminuiu de 16,3% para 7,4% no período estudado. Conclusão: O perfil do paciente internado por queimadura mantevese em grande parte o mesmo após 10 anos. Houve aumento do número de atendimentos a vítimas de queimadura do interior do estado e queimaduras provocadas por líquidos quentes passaram a ser mais frequentes que por álcool. ''A busca da conformidade com o tratamento baseado na literatura mundial resultou em diminuição da mortalidade."

Introduction: With a major impact on the population, burns require epidemiological analysis and constant planning for the prevention, treatment, and rehabilitation of patients. This work aims to compare, after a decade, the indicators of the Burn Treatment Center at Hospital João XXIII, in Belo Horizonte, MG, covered in the article "Epidemiology of burns in the state of Minas Gerais", published in the Revista Brasileira de Cirurgia Plástica with data from 2010, to validate current and future strategies. Method: Review of the medical records of patients suffering from burns, admitted to the aforementioned center in 2020. Results: 473 burn victims were hospitalized during the period, 87.5% were caused by an accident, 34.5% due to hot liquids, 23.7% by alcohol; 61.9% from the interior of the state of Minas Gerais; and 63.4% were male. The average age was 30 years, the average burned body surface area was 18.8% and the average length of stay was 25 days. 580 surgical debridement and 473 autologous skin grafts were performed. 7.4% of patients died, corresponding to 29.5% of those admitted to the adult ICU, with an average burned body surface area of 49.7%, and 10.5% of those admitted to the pediatric ICU. The biggest cause of death was sepsis, in 57.1% of cases. Mortality decreased from 16.3% to 7.4% in the period studied. Conclusion: The profile of patients hospitalized for burns remained largely the same after 10 years. There was an increase in the number of visits to burn victims in the interior of the state and burns caused by hot liquids became more frequent than those caused by alcohol ''The search for compliance with treatment based on world literature resulted in reduction in mortality."