Impact of urban farming on health: a systematic review.

BACKGROUND: Urban farms are spaces designated for the cultivation of plants for food security, medicinal and curative purposes. Since the turn of the century, they have become more widespread and health benefits have been claimed; however, no consensus exists regarding this information. Hence, this study aims to provide information about the health effects of urban farming. METHODS: Protocol register number CRD42023448001. We followed the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Studies addressing urban farming interventions in any population group were included without age limitation of publication from PubMed, DOAJ, CAB Abstracts and NIH. Risk of bias was assessed using the Risk of Bias In Non-randomized Studies - of Interventions tool, and data were narratively synthesized. RESULTS: The search retrieved 2578 manuscripts, reduced to seven after screening. Urban farming's impact on health has been reflected in the physical domain by increasing self-reported health levels, physical activity, perceived general health, healthy eating and decreasing drug use. Parasites' presence has also been reported. In the mental aspect, urban farming is associated with relaxation and stress reduction. From a social perspective, urban farms provide a sense of belonging, personal growth and happiness. CONCLUSIONS: The benefits of urban farming outweigh the disadvantages. Further research should be conducted to clarify the potential benefits of this practice.

Synergy of de-walled Ganoderma Lucidum spore powder (GLSP) on targeted therapy in advanced non-squamous non-small cell lung cancer with epidermal growth factor receptor (EGFR) mutant: protocol for a randomized, double-blind, placebo-controlled study.

BACKGROUND: Osimertinib is regarded as a promising third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) for advanced non-squamous non-small cell lung cancer (NSCLC) patients who developed T790M. However the adverse effects, primarily fatigue, remain an overwhelming deficiency of Osimertinib, hindering it from achieving adequate clinical efficacy for such NSCLC. Ganoderma lucidum has been used for thousands of years in China to combat fatigue, while Ganoderma Lucidum spores powder (GLSP) is the main active ingredient. The aim of this study is to investigate whether GLSP is sufficiently effective and safe in improving fatigue and synergizing with Osimertinib in non-squamous NSCLC patients with EGFR mutant. METHOD/DESIGN: A total of 140 participants will be randomly assigned to receive either de-walled GSLP or placebo for a duration of 56 days. The primary outcome measure is the fatigue score associated with EGFR-TKI adverse reactions at week 8, evaluated by the Chinese version of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire for Cancer Patients (QLQ-C30). Secondary outcomes include evaluation of treatment effectiveness, assessment of quality of life (QoL), and exploration of immune indicators and gut microbiota relationships. Following enrollment, visits are scheduled biweekly until week 12. TRIAL REGISTRATION: China Clinical Trial Registry ChiCTR2300072786. Registrated on June 25, 2023.

La objeción de conciencia en el ámbito sanitario: un equilibrio entre derechos y deberes / L’objecció de consciència en l'àmbit sanitari: un equilibri entre drets i deures / Conscientious objection in the healthcare domain: A balance between rights and responsibilities

La entrada en vigor de la Ley Orgánica 3/2021 sobre eutanasia en España (2021), ha propiciado un debate de relevancia en el ámbito de la bioética, como es el de la objeción de conciencia (OC) de los profesionales de la salud. Ahora bien, a pesar de que la literatura científica ha abordado esta cuestión, lo cierto es que la comprensión de los motivos subyacentes que impulsan a los profesionales a objetar no está del todo clara. Diversos autores han destacado que la OC halla sus fundamentos en creencias personales, ética profesional, aspectos emocionales y dinámicas del propio sistema. A su vez, se ha observado cómo hay posiciones diversas sobre la legitimidad de la OC, generando debates sobre su validez.Los objetivos de este artículo son revisar el concepto objeción de conciencia en el ámbito sanitario; analizar los factores que motivan este derecho; examinar las consecuencias de la OC en la carga asistencial de los profesionales no objetores; y explorar su posible conflicto ético con la justicia distributiva en la atención sanitaria. Por último, se reflexionará sobre la posibilidad de la OC institucional y sus posibles consecuencias en los derechos de pacientes y trabajadores.(AU)

L'entrada en vigor de la Llei Orgànica 3/2021 sobre l'eutanàsia a Espanya (2021) ha suscitat un debat rellevant en l'àmbit de la bioètica, com és el de l’objecció de consciència(OC) dels professionals de la salut. Tanmateix, malgrat que la literatura científica ha abordat aquesta qüestió, és cert que la comprensió dels motius subjacents que impulsen els professionals a objectar no està del tot clara. Diversos autors han destacatque l’OC troba els seus fonaments en creences personals, ètica professional, aspectes emocionals i dinàmiques del propi sistema. Al seu torn, s'ha observat com hi ha posicions diverses sobre la legitimitat de l’OC, generant debats sobre la seva validesa. Els objectius d'aquest article són revisar el concepte d’objecció de consciència en l'àmbit sanitari; analitzar els factors que motiven aquest dret; examinar les repercussions de l’OC en la càrrega assistencial dels professionals no objectors; i explorar el seu possible conflicte ètic amb la justícia distributiva en l'atenció sanitària. Finalment, es reflexionarà sobre la possibilitat de l’OC institucional i les seves possibles repercussions en els drets dels pacients i treballadors.(AU)

The enactment of Organic Law 3/2021 on euthanasia in Spain has sparked a significant debate in the field of bioethics, namely the issue of conscientious objection (CO) among healthcare professionals. However, despite the scientific literature addressing this matter, the understanding of the underlying reasons that drive professionals to object is not entirely clear. Several authors have highlighted that CO is rooted in personal beliefs, professional ethics, emotional aspects, and dynamics within the healthcare system. Simultaneously, there have been varying stances on the legitimacy of CO, leading to debates regarding its validity.The objectives of this article are to review the concept of conscientious objection in the healthcare context, analyze the factors motivating this right, examine the consequences of CO on the workload of non-objecting professionals, and explore its potential ethical conflict with distributive justice in healthcare. Finally, we will reflect on the possibility of institutional CO and its potential implications for the rights of patients and healthcare workers.(AU)

The repercussions of digital bullying on social media users.

Objective: This study aims to examine the repercussions of digital bullying on social media users, especially among university students in Saudi Arabia. Methods: It adopts a descriptive approach based on a social survey method with a sample of 640 male and female students from selected universities. A questionnaire was used to collect the data and to measure the repercussions of digital bullying on the victims, their families, and the society. Results: The findings reveal that most of the respondents agree that digital bullying has negative consequences for all the stakeholders involved. The results also indicate that female students are more aware of the repercussions of digital bullying than male students. Conclusion: The study recommends enhancing public awareness through organizing conferences, seminars, and workshops on the issue of digital bullying, and implementing and enforcing strict laws and penalties to punish the perpetrators and to prevent and reduce the harms of digital bullying.

Bariatric Surgery and Malpractice: an Extensive Review of Demographics, Complications, Litigation, and Proactive Mitigation Strategies.

The rising prevalence of severe obesity has led to a parallel increase in bariatric surgeries, raising a complex array of medicolegal issues. This review aims to analyze and synthesize literature on bariatric surgery malpractice, focusing on patient demographics, surgical complications, litigation costs, and the nature of malpractice cases. A systematic search was conducted across multiple databases for relevant studies published up to May 2023. Our review endeavors to provide insights into these medicolegal challenges and their implications and foster an informed dialogue on strategies for their effective management. By doing so, we hope to enhance ethical and legally sound bariatric practices, safeguarding both patient welfare and surgical practitioners from legal repercussions.

Repercussões sociais/culturais e psíquicas da linguagem escrita na aprendizagem do sujeito / Social/cultural and psychic repercussions of written language on the subject's learning

A linguagem escrita é uma ferramenta básica em nossa Cultura, pois ela permite resgatar e transmitir o patrimônio cultural através da História da Humanidade. Considera-se fundamental compreendê-la integralmente, levando em conta aspectos relacionados às quatro habilidades básicas: ler, escrever, falar e escutar, como fundamentado por Kenneth Goodman (1977) e Condemarin (1992). Aprender a ler e escrever é um "rito de passagem" que demanda experiências formais e informais, dentro e fora do contexto escolar. A produção da linguagem escrita abre espaço para a singularização, isto é, possibilita expressar e identificar-se aos valores e conceitos que contribuem para a formação individual e coletiva. Sendo considerada a "espinha dorsal da escolarização", muitas das queixas de Dificuldades de Aprendizagem podem ser relacionadas à sua fragilidade, tendo repercussões na constituição do sujeito aprendente. Este artigo tenta descrever a amplitude do que envolve a queixa escolar referente à produção de linguagem de maneira integral e integrada, apresentando enfoques teóricos que fundamentam a Psicopedagogia Dinâmica no que diz respeito ao desenvolvimento da linguagem.

Written language is a basic tool in our Culture, as it allows to rescue and transmit cultural heritage through the history of humanity. It is considered fundamental to fully understand it, considering aspects related to the four basic skills: reading, writing, speaking, and listening, as founded by Kenneth Goodman (1977) and Mabel Condemarin (1992). Learning to read and write is a "rite of passage" that requires formal and not formal experiences, both within and outside the school context. The production of written language opens space for singularization, that is, it makes it possible to express and identify oneself to the values and concepts that contribute to individual and collective formation. Being considered the "backbone of schooling", many of the complaints of Learning Difficulties can be reactivated to its fragility, having repercussions on the constitution of the learning subject. This article tries to describe the breadth of what involves the school complaint regarding the production of language in an integral and integrated way, presenting important theoretical approaches to broaden this reflection. presenting theoretical approaches that underlie Dynamic Psychopedagogy regarding language development.

Impacto clínico y forense de las prácticas de chemsex: unavisión global del fenómeno / Clinical and forensic impact of chemsex practices: an overview of the phenomenon

El consumo de drogas en el contexto de chemsex trasciende el mero uso sexualizado de sustancias yresponde a un patrón idiosincrásico de base sociocultural en el colectivo LGTBI+ que puede implicaruna serie de impactos negativos en personas con mayor vulnerabilidad. Para analizar el potencial lesivode estas prácticas en diferentes facetas de la salud, se ha realizado una revisión de las principales áreasde afectación y sus posibles repercusiones a nivel médico-sexual, toxicofílico, psicopatológico y forenseen función de la estructura de un protocolo biosanitario específico para la evaluación de la gravedadde las prácticas de chemsex. Los resultados mostraron que este uso sexualizado de drogas aumentael riesgo de padecer consecuencias no deseadas. Entre las mismas, se encuentra la transmisión de ITS,alteraciones psicopatológicas (síntomas depresivos, ansiosos, psicóticos y postraumáticos, entre otros),la muerte por suicidio o por otras causas, comisión de ilícitos penales (agresiones sexuales o delitosde tráfico de drogas, principalmente) o, ser víctima de los mismos. Sin perjuicio de lo anterior, el tipode afectación es individual y depende de las variables moduladoras de cada persona (de riesgo, deprotección y de vulnerabilidad) cuyo resultado se da a consecuencia de una dinámica multicausal que sesustenta en la trayectoria biopsicosocial de quiénes lo practican. Por tanto, desde las políticas públicasse debe promover un abordaje que vertebre una atención personalizada (preventiva y asistencial) paraafrontar la adicción o el consumo problemático. (AU)

The use of drugs within the context of chemsex extends beyond mere sexualised drug use andstems from a unique sociocultural pattern within the LGBTQ+ community, which may entail variousdetrimental effects on individuals with increased vulnerabilities. To analyse the potential harm of thesepractices across different health dimensions, a review has been conducted on the primary areas ofimpact and their potential consequences on medical-sexual, toxicophilic, psychopathological, andforensic levels, based on the framework of a specific biosanitary protocol designed to assess theseverity of chemsex practices. The results showed that this sexualised drug use increases the riskof experiencing unwanted outcomes. Among them are the transmission of STIs, psychopathologicalchanges (such as depressive, anxious, psychotic, and post-traumatic symptoms, among others), deathby suicide or other causes, committing criminal offences (mainly sexual assaults or drug traffickingcrimes), or becoming a victim of them. Nevertheless, the type of impact is individual and dependson the modulating variables of each person (risk, protective, and vulnerability factors), the outcomeof which arises from a multifaceted dynamic, rooted in the biopsychosocial trajectory of those whoengage in it. Therefore, public policies should promote an approach that provides personalised(preventative and care-based) attention to address addiction or problematic consumption. (AU)

Human and Animal Fascioliasis: Origins and Worldwide Evolving Scenario.

Fascioliasis is a plant- and waterborne zoonotic parasitic disease caused by two trematode species: (i) Fasciola hepatica in Europe, Asia, Africa, the Americas, and Oceania and (ii) F. gigantica, which is restricted to Africa and Asia. Fasciolid liver flukes infect mainly herbivores as ruminants, equids, and camelids but also omnivore mammals as humans and swine and are transmitted by freshwater Lymnaeidae snail vectors. Two phases may be distinguished in fasciolid evolution. The long predomestication period includes the F. gigantica origin in east-southern Africa around the mid-Miocene, the F. hepatica origin in the Near-Middle East of Asia around the latest Miocene to Early Pliocene, and their subsequent local spread. The short postdomestication period includes the worldwide spread by human-guided movements of animals in the last 12,000 years and the more recent transoceanic anthropogenic introductions of F. hepatica into the Americas and Oceania and of F. gigantica into several large islands of the Pacific with ships transporting livestock in the last 500 years. The routes and chronology of the spreading waves followed by both fasciolids into the five continents are redefined on the basis of recently generated knowledge of human-guided movements of domesticated hosts. No local, zonal, or regional situation showing disagreement with historical records was found, although in a few world zones the available knowledge is still insufficient. The anthropogenically accelerated evolution of fasciolids allows us to call them "peridomestic endoparasites." The multidisciplinary implications for crucial aspects of the disease should therefore lead the present baseline update to be taken into account in future research studies.

Determinação social do uso do álcool e implicações no tratamento em transplante de fígado / Social determination of alcohol use and implications in liver transplant treatment

Resumo: O presente artigo busca refletir sobre o uso de álcool no capitalismo e seus impactos no tratamento em transplante de fígado, através do prisma materialista-histórico-dialético. Foram realizadas entrevistas com sujeitos que vivenciaram esta realidade, permitindo evidenciar que, na dinâmica capitalista, o adoecimento dos sujeitos, seus enfrentamos e a própria saúde humana são caracterizados ínferos frente ao contraditório ciclo de realização mercantil.

Abstract: This article seeks to reflect through the materialist-historical-dialectical prism on the use of alcohol in capitalism and its impact on treatment in liver transplantation. Interviews were conducted with subjects who experience this reality, allowing evidence that in the capitalist dynamics, the sickness of the subjects, their confrontations and human health itself are characterized as insignificant in the face of the contradictory cycle of mercantile realization.

Organokines, Sarcopenia, and Metabolic Repercussions: The Vicious Cycle and the Interplay with Exercise.

Sarcopenia is a disease that becomes more prevalent as the population ages, since it is directly linked to the process of senility, which courses with muscle atrophy and loss of muscle strength. Over time, sarcopenia is linked to obesity, being known as sarcopenic obesity, and leads to other metabolic changes. At the molecular level, organokines act on different tissues and can improve or harm sarcopenia. It all depends on their production process, which is associated with factors such as physical exercise, the aging process, and metabolic diseases. Because of the seriousness of these repercussions, the aim of this literature review is to conduct a review on the relationship between organokines, sarcopenia, diabetes, and other metabolic repercussions, as well the role of physical exercise. To build this review, PubMed-Medline, Embase, and COCHRANE databases were searched, and only studies written in English were included. It was observed that myokines, adipokines, hepatokines, and osteokines had direct impacts on the pathophysiology of sarcopenia and its metabolic repercussions. Therefore, knowing how organokines act is very important to know their impacts on age, disease prevention, and how they can be related to the prevention of muscle loss.

Economic pressures of Covid-19 lockdowns result in increased timber extraction within a critically endangered region: A case study from the Pacific Forest of Ecuador.

Although the COVID-19 lockdowns in 2020 had some environmental benefits, the pandemic's impact on the global economy has also had conservation repercussions, especially in biodiverse nations. Ecuador, which is heavily reliant on petroleum, agricultural exports, and ecotourism, experienced a rise in poverty in response to pandemic shutdowns. In this study, we sought to quantify levels of illegal timber extraction and poaching before and after the start of COVID-19 lockdowns throughout two protected areas (Reserva Jama Coaque [JCR] and Bosque Seco Lalo Loor [BSLL]) in the endangered Pacific Forest of Ecuador. We analyzed chainsaw and gunshot acoustic data recorded from devices installed in the forest canopy from December 2019 to March 2020 and October 2020 to March 2021. Results from generalized linear mixed effects models indicated less chainsaw activity before lockdowns (ßpost.lockdown = 0.568 ± 0.266 SE, p-value = .030), although increased average rainfall also seemed to negatively affect chainsaw activity (ßavg.rainfall = -0.002 ± 0.0006 SE, p-value = .003). Gunshots were too infrequent to conduct statistical models; however, 87% of gunshots were detected during the 'lockdown' period. Observational data collected by rangers from these protected areas also noted an increase in poaching activities beginning mid to late 2020 and persisting into 2021. These results add to the steadily growing literature indicating an increase in environmental crime, particularly in biodiverse nations, catalyzed by COVID-19-related economic hardships. Identifying areas where environmental crime increased during pandemic lockdowns is vital to address both socioeconomic drivers and enforcement deficiencies to prevent further biodiversity loss and disease outbreaks and to promote ecosystem resilience. Our study also demonstrates the utility of passive acoustic monitoring to detect illegal resource extraction patterns, which can inform strategies such as game theory modeling for ranger patrol circuits and placement of real-time acoustic detection technologies to monitor and mitigate environmental crimes.

Significados, experiências e repercussões do cyberbullying: o que dizem os adolescentes do Brasil e Angola / Meanings, Experiences, and Repercussions of Cyberbullying: What Brazilian and Angolan Adolescents Say / Significados, vivencias y repercusiones del ciberacoso: lo que dicen los adolescentes de Brasil y Angola

O cyberbullying é um fenômeno presente em todo o mundo, com incalculáveis consequências para a vida dos envolvidos. Considerando que os estudos interculturais sobre o cyberbullying realizados com os países lusófo-nos se limitam a investigações que envolvem participan-tes do Brasil e Portugal, se evidencia a necessidade de ampliar o conhecimento e investigar as perspectivas de adolescentes em outros contextos. Deste modo, o presente estudo teve o objetivo de investigar os significados, experiências e repercussões do cyberbullyingem um grupo de adolescentes do Brasil e de Angola. Um total de 50 adolescentes participaram do estudo, sendo 23 brasileiros e 27 angolanos, com idades entre 11 e 17 anos (m= 13.58 anos; dp= 1.56), majoritariamente do sexo feminino (Brasil = 52.2 %; Angola = 55.6 %), do 6º ao 12° ano de escolaridade. Para a coleta de dados utilizamos entrevistas individuais semiestruturadas e a análise de conteúdo através de uma abordagem mista (categorizações dedutiva e indutiva) foi realizada para analisar os dados. Os resultados revelaram que, embora se verifiquem divergências e similaridades no que diz respeito às três perspectivas estudadas, os adolescentes de ambos os contextos atribuem significados ao cyberbu-llying que remetem a uma perspectiva comportamental e de causalidade do fenômeno. Além disso, os brasilei-ros apresentaram porcentagens mais elevadas em termos de experiências. De modo adicional, os participantes de ambos os contextos consideraram que as consequên-cias do cyberbullying são mais presentes na vida das vítimas (esfera escolar, social, psicológica-emocional e psiquiátrica). Os resultados são discutidos lançando luz sobre o caminho ainda por trilhar nesta temática atual e abrindo perspectivas para novas interrogações.

Cyberbullying is a phenomenon present across the globe, with incalculable consequences for the lives of those involved. Considering that intercultural cyberbullying studies conducted in Portuguese-speaking countries are limited to investigations involving participants from Brazil and Portugal, the need to expand this knowledge and investigate the perspectives of adolescents in other contexts is evident. Thus, the present study aimed to investigate the meanings, experiences, and repercus-sions of cyberbullying in a group of adolescents from Brazil and Angola. A total of 50 adolescents participated in the study, 23 Brazilians and 27 Angolans, aged 11 to 17 years (m= 13.58 years; sd = 1.56), mostly female (Brazil = 52.2 %; Angola = 55.6 %), from the sixth to the twelfth grade. For data collection, we used semi-structured individual interviews and content analysis through a mixed approach (deductive and inductive categorizations) was performed to analyze the data. Results revealed that, although there are divergences and similarities regarding the perspectives studied, adolescents from both contexts attribute meanings to cyberbullying that refer to behavioral and causal pers-pectives of the phenomenon. Moreover, Brazilians presented higher percentages in terms of experiences. Additionally, participants from both contexts con-sidered that the consequences of cyberbullying are more present in the lives of the victims (school, social, psychological-emotional, and psychiatric spheres). Re-sults are discussed, shedding light on the path still to be traveled regarding this current topic and opening perspectives for new questions.

El ciberacoso es un fenómeno presente en todo el mundo, con consecuencias incalculables para la vida de los implicados. Teniendo en cuenta que los estudios interculturales sobre el ciberacoso realizados con países hablantes de la lengua portuguesa se limitan a investigaciones con participantes de Brasil y Portugal, es necesario ampliar el conocimiento e investigar las perspectivas de los adolescentes en otros contextos. Por lo tanto, el presente estudio tuvo como objetivo investigar los significados, experiencias y repercusiones del ciberacoso en un grupo de adolescentes de Brasil y Angola. Participaron 50 adolescentes, 23 brasileños y 27 angoleños, con edades comprendidas entre los 11 y los 17 años (m = 13.58 años; dt = 1.56), mayoritariamente de género femenino (Brasil = 52.2 %; Angola = 55.6 %), del 6º al 12º año de escolaridad. Para la recogida de datos se utilizaron entrevistas individuales semiestructuradas y el análisis de con-tenido mediante un enfoque mixto (categorizaciones deductivas e inductivas), llevado a cabo para analizar los datos. Los resultados revelaron que, aunque existen divergencias y similitudes en relación con las tres perspectivas estudiadas, los adolescentes de ambos contextos atribuyen al ciberacoso significados que hacen referencia a una perspectiva conductual y a la causalidad del fenómeno. Además, los brasileños presentaron porcentajes más altos en cuanto a experiencias. Así mismo, los participantes de ambos contextos consideraron que las consecuencias del ciberacoso están más presentes en la vida de las víctimas (ámbito escolar, social, psicológico-emocional y psiquiátrico). Los hallazgos se discuten arrojando luz sobre el camino que queda por recorrer en este tema actual y abriendo perspectivas a nuevos interrogantes.

Toward a sustainable circular economy for cigarette butts, the most common waste worldwide on the coast.

The circular economy is based on the maximum use of resources by reducing, reusing, and recycling the elements used. Currently, the items littered most frequently in the world are cigarettes butts (CB) as these debris are freely disseminated in the marine habitat, they are generally difficult to collect and very complex to recycle. Litter CB is a great social problem that generates excessive economic costs and serious environmental problems. CB is also not biodegradable and highly toxic to marine organisms and presents a distinctive mixture of physical and chemical contamination. However, little research has been done on the management and recycling of this dangerous waste. Several proposals have been made to incorporate this waste into high-volume articles of direct production or recycling, but collection logistics are lacking since the current system is inefficient, in addition to the poor environmental behaviour of citizens. This work presents a current synthesis of the CB problem from all its possible aspects in order to have a global vision of the life cycle of the CB, indicating both the known and the gaps in the knowledge of each of them, and intends to give a general outline of the steps to follow to try to end such a worrying problem at the global level.

Afecciones, manifestaciones y repercusiones nefrológicas del COVID-19 / Nephrological conditions, manifestations, and repercussions of COVID-19

Resumen Introducción: la enfermedad del coronavirus (Covid-19) surgió en Wuhan, China, a finales del año 2019. Este es un microorganismo que por su secuenciación de genoma y análisis filogénico pertenece al grupo de betacoronavirus, en el mismo subgénero que el virus del síndrome respiratorio agudo severo (SARS). El objetivo del presente estudio es determinar las afecciones y las manifestaciones clínicas renales de los pacientes con infección por este virus. Métodos: se realizó una revisión de la literatura, donde se incluyeron estudios que evaluaran afecciones, manifestaciones y repercusiones renales en pacientes mayores de 18 años con infección por Covid-19. Las búsquedas fueron realizadas con las bases de datos de Pubmed/Medline, Science direct, Scopus, BIREME, Redalyc, Scielo y Directory of Open Access Journals (DOAJ). Resultados: en total se incluyeron 24 estudios donde se mencionan las distintas afecciones renales de estos pacientes. A nivel microscópico existen distintas alteraciones tales como pérdida del borde en cepillo, degeneración vacuolar, dilatación de la luz tubular con restos celulares y, en algunas ocasiones, necrosis franca en los túbulos proximales, desprendimiento epitelial de la membrana basal tubular y pielonefritis aguda con múltiples focos bacterianos y cilindros de células polimorfonucleares (PMN) difusos en los túbulos. A nivel del glomérulo se observó expansión mesangial nodular y la presencia de abundantes eritrocitos que obstruían las luces capilares peritubulares. Conclusiones: el SARS-CoV-2 es un virus que tiene alta afinidad por los receptores de la enzima convertidora de angiotensina II (ECA-2), los cuales se encuentran en distintos órganos del cuerpo, incluyendo los riñones. La unión del virus a este receptor puede conllevar distintas alteraciones microscópicas en las células renales, lo cual genera algunos trastornos importantes como alteraciones hidroelectrolíticas o elevación o aumento de creatinina sérica, lo que es un indicador de lesión renal aguda y que en algunos casos puede cronificarse en estos pacientes.

Abstract Introduction: Coronavirus disease (COVID - 19) emerged in Wuhan, China at the end of 2019, this is a microorganism that, due to its genome sequencing and phylogenic analysis, belongs to the group of betacoronavirus in the same subgenus as the severe acute respiratory syndrome virus (SARS). The objective of the present study is to determine the renal affections and manifestations of patients with SARS CoV-2 infection. Methods: A review of the literature was carried out, including studies evaluating renal conditions, manifestations, and repercussions in patients older than 18 years with COVID-19 infection. Results: A total of 24 studies were included where the different renal conditions of these patients were mentioned. At the microscopic level, there are different alterations such as loss of the brush border, vacuolar degeneration, dilation of the tubular lumen with cellular remains and sometimes frank necrosis in the proximal tubules, epithelial detachment of the tubular basement membrane and acute pyelonephritis with multiple bacterial foci. and diffuse polymorphonuclear cell (PMN) cylinders in the tubules. At the glomerulus level, nodular mensangial expansion and the presence of abundant erythrocytes obstructing the peritubular capillary lumens were observed. Conclusions: SARS-CoV-2 is a virus that has high affinity for Angiotensin II Converting Enzyme (ACE) receptors -2), which are found in different organs of the body, including the kidneys. The binding of the virus to this receptor will lead to different microscopic alterations in the renal cells, which will generate some important disorders such as hydro-electrolyte alterations, elevation or increase in serum creatinine, being an indicator of acute kidney injury that in some cases can become chronic in these patients.

Long-term impact of scapular notching after reverse shoulder arthroplasty.

BACKGROUND: Because it medializes the centre of rotation, one of the drawbacks of reverse shoulder arthroplasty (RSA) is the risk of impingement between the humerus and lateral border of the scapula resulting in scapular notching. The long-term impact of this notching is not well known, either on function or the risk of glenoid loosening. The aim of this longitudinal study was to analyze the drawbacks of this notching. METHODS: Between 1993 and 2006, 81 patients (91 shoulders) underwent RSA for primary glenohumeral osteoarthritis or massive cuff tear with or without osteoarthritis. This cohort was followed longitudinally with post-operative assessments done at one to two  years (T1), three to eight  years (T2), and nine+ years (T3). Before T3, 25 patients had died, nine were lost to follow-up, five  had the implants changed, and seven  had incomplete records. Thus, 45 shoulders were available for follow-up beyond nine years (mean follow-up of 12 years) and were used to determine the long-term impact of notching. Survival curves were generated using the occurrence of Sirveaux grade 3 or 4 notching and the presence of aseptic glenoid loosening as endpoints. RESULTS: The survivorship before grade 3 or 4 notching developed was 83% at five years, 60% at 10 years, and 43% at 15 years. In the end, aseptic glenoid loosening occurred in four shoulders, all of which had developed grade 4 notching. No glenoid loosening occurred in the population with grade 0, 1, 2, or 3 notching (p = 0.02). The Constant score significantly decreased between T2 and T3, although it was not different between shoulders with and without advanced notching. CONCLUSIONS: Beyond the second year post-RSA, the number of shoulders with grade 3 or 4 notching increases steadily up to the longest follow-up. Grade 4 notching always preceded the occurrence of late glenoid loosening. The functional outcomes become significantly worse after the 9th year post-RSA, although they were not correlated to the presence of high-grade scapular notching.

Violência interpessoal e suas repercussões na saúde em um hospital de pronto-socorro / Interpersonal violence and its repercussions on health at an emergency hospital / Violencia interpersonal y sus repercusiones en la salud en un hospital de emergencia

A violência é um fenômeno multicausal, complexo, heterogêneo e uma questão de saúde pública. Quando ocorre na esfera interpessoal, deve ser compreendida como um evento biopsicossocial, causando graves repercussões. No Brasil, diante do atual cenário de violência, propôs-se a implementação do Sistema de Vigilância de Violências e Acidentes, objetivando o mapeamento e prevenção do fenômeno por ato notificatório. Com metodologia descritivo-transversal e coleta retrospectiva de dados, este estudo realizou levantamento de frequência e análises de associação. Constatou-se que a violência física foi a mais notificada e a mais relacionada às internações. Os atendimentos psicológicos atingiram um baixo índice de ocorrência, contrapondo a grande quantidade de encaminhamentos de saúde mental realizados. A arma de fogo apareceu como um dos principais meios de perpetração. Esses resultados, junto à constatação de uma morosidade existente no ato de notificar, evidenciam a gravidade do tema e a relevância de estudos nessa área. (AU)

Violence is a multicausal, complex, and heterogeneous phenomenon as well as a public health question. When it occurs in the interpersonal sphere, it must be understood as a biopsychosocial event with serious repercussions. In Brazil, given the concern due to the current violence scenario, it was proposed the implementation of the Violence and Accidents Surveillance System, with the objective of mapping and preventing the phenomenon, using the notification act. We conducted a frequency survey and association analyses using a descriptive-transversal methodology and retrospective data collection. It was verified that physical violence was the most reported, and the most associated to hospitalizations. Psychological services reached a low occurrence index, despite the high number of referrals to mental health support. Firearms appeared as one of the main means of violence perpetration. These results, along with the verification of a lengthy procedure for the notification act, evidence the severity of the theme and the relevance of studies in this area. (AU)

La violencia es un fenómeno multicausal, complejo, heterogéneo y un problema para la salud pública. Cuando ocurre en el ámbito interpersonal, debe comprenderse como un evento biopsicosocial, causando graves repercusiones. En Brasil, ante la preocupación provocada por el escenario actual de violencia, se propuso la implementación del Sistema de Vigilancia de Violencias y Accidentes, con la finalidad de hacer un mapeo y prevenir el fenómeno, mediante un acto de notificación. Utilizando la metodología descriptiva transversal y la colección retrospectiva de datos, este estudio realizó una encuesta de frecuencia y análisis de asociación. Se constató que la violencia física fue la más denunciada, y la más relacionada con las internaciones hospitalarias. Los servicios de atención psicológica han alcanzado un bajo índice de ocurrencia, en contraste con el gran número de derivaciones remitidas a la red de salud mental. El arma de fuego apareció como uno de los principales medios de perpetración. Estos resultados, junto con la observación de un retraso en el acto de denuncia, evidencian la gravedad del tema y la necesidad fundamental de estudios en el área. (AU)

The psychiatric and neuropsychiatric repercussions associated with severe infections of COVID-19 and other coronaviruses.

INTRODUCTION: It is known that viral infections are epidemiologically prevalent and some of them are harmful to the central nervous system (CNS) due to the development of neuropsychiatric syndromes which affect the cognitive, affective, behavioral and perceptual domains. OBJECTIVE: To carry out a comprehensive analysis of the psychiatric and neuropsychiatric repercussions of COVID-19 based on epidemiological, pathophysiological and clinical foundations observed in previous and recent pandemic events, and also to make a proposition about effective therapeutic interventions to help tackle this serious public health problem, more specifically in its neuropsychiatric developments. METHOD: This current literature review has utilized literature reserves and scientific search engines MEDLINE, EMBASE and Web of Science. The search terms included, "SARS-CoV-2", "etiology," "psychiatric and neuropsychiatric repercussions", "severe infections" "COVID-19". Specific choices of unique papers from each of the searches were identified. The inclusion criteria were relevance and availability of full-text. Papers were excluded on the basis of relevance and non-availability of full-text. Papers were identified in the general literature reserve as pertinent to the search terms. RESULTS: The main psychiatric and neuropsychiatric repercussions analyzed were depression, anxiety, post-traumatic stress disorder, psychosis, nonspecific neurological symptoms, delirium, cerebrovascular complications, encephalopathies, neuromuscular disorders, anosmia and ageusia. CONCLUSION: The psychiatric and neuropsychiatric symptoms of acute respiratory syndromes can appear during or after the infectious stage. Among the risk factors pointed out for such effects are the female gender, health professionals, presence of avascular necrosis and distressing pain.

COVID-19 Impacts, Diagnosis and Possible Therapeutic Techniques: A Comprehensive Review.

BACKGROUND: The spread of COVID-19 has become a growing cause of mortalities over the globe since its major outbreak in December 2019. The scientific and medical communities are rallying to study different strains and probable mutations to develop more rapid and reliable molecular diagnostic tests and possible therapeutic approaches for SARS-CoV-2. INTRODUCTION: In the first section, following the introductory part, we shed light on structural and pathogenic features of SARS-CoV-2 and risk factors related to age, gender, neonatal and comorbidities. The next section summarizes the current diagnostic tests for COVID-19, such as nucleic acid and computed tomography (CT) techniques, with further emphasis on emerging diagnostic approaches for COVID-19. METHODS: Further, we also review the ongoing therapeutic practices which can block virus-host interaction, cease viral proliferation or inhibit hyperbolic host immune response with subsections on drug therapy, cell therapy, immunotherapy and herbal medicines that are being used for the possible treatment of patients. RESULTS AND CONCLUSION: Among the different promising drugs, remdesivir, by inhibiting the RNA-dependent RNA-Polymerase activity, gives much better results, including declined viral load and quick lung tissue recovery. The long-lasting repercussions of COVID-19 have also been discussed at the end. In this review, we have also critically discussed the progress in several vaccines that are under development.

Psychiatric symptomatology associated with depression, anxiety, distress, and insomnia in health professionals working in patients affected by COVID-19: A systematic review with meta-analysis.

BACKGROUND: Health professionals are key personnel to containing infectious diseases like COVID-19. In the face of long work shifts (that reach 16 h per day on average), the risk of getting infected by a high-infectious disease and the lack of enough biological protection measures, mental suffering among health professionals suddenly became evident. METHOD: We carried out an updated meta-analysis to investigate the psychiatric impacts on health professionals in the face of the physical and psychological conditions to which they are subjected due to the high demands of the COVID-19 pandemic. Papers were researched in four databases from December 2019 to April 2020. In total, eight papers were included in the study. RESULTS: Health professionals working to fight COVID-19 are being more severely affected by psychiatric disorders associated with depression, anxiety, distress and insomnia, stress, and indirect traumatization than other occupational groups. No significant differences were observed in the publication bias. CONCLUSION: There is a strong association between health professionals and COVID-19 in terms of psychiatric repercussions. Our meta-analysis showed that health professionals have a higher level of indirect traumatization, in which the level of damage exceeds psychological and emotional tolerance and indirectly results in psychological abnormalities. The incidence of obsessive-compulsive traces and somatizations was higher in situations involving front-line professionals.

The impact of hepatocyte nuclear factor-1α on liver malignancies and cell stemness with metabolic consequences.

Hepatocyte nuclear factor-1 alpha (HNF-1α) is a transcription factor expressed predominantly in the liver among other organs. Structurally, it contains POU-homeodomain that binds to DNA and form proteins that help in maintaining cellular homeostasis, controlling metabolism, and differentiating cell lineages. Scientific research over the period of three decades has reported it as an important player in various liver malignancies such as hepatocellular cancers (HCCs), hepatocellular adenoma (HA), and a more specific HNF-1α-inactivated human hepatocellular adenoma (H-HCAs). Abundant clinical and rodent data have noted the downregulation of HNF-1α in parallel with liver malignancies. It is also interesting to notice that the co-occurrence of mutated HNF-1α expression and hepatic carcinomas transpires typically along with metabolic repercussion. Moreover, scientific data implies that HNF-1α exerts its effects on cell stemness and hence can indirectly impact liver malignancies and metabolic functioning. The effects of HNF-1α on cell stemness present a future opportunity to explore a possible and potential breakthrough. Although the mechanism through which inactivated HNF-1α leads to hepatic malignancies remain largely obscure, several key signal molecules or pathways, including TNF-α, SHP-1, CDH17, SIRT, and MIA-2, have been reported to take part in the regulations of HNF-1α. It can be concluded from the present scientific data that HNF-1α has a great potential to serve as a target for liver malignancies and cell stemness.