Os estudos revelam lacunas no conhecimento sobre as barreiras ao acesso e à adesão à profilaxia pré-exposição do HIV (PrEP) em adolescentes. O artigo explora as percepções e experiências de jovens gays e bissexuais e outros homens que fazem sexo com homens (JGBHSH) na busca, uso e adesão à PrEP, considerando suas posições de acordo com marcadores sociais de diferença como raça/cor da pele, gênero, sexualidade e nível social. A interseccionalidade fornece suporte teórico e metodológico para interpretar de que maneira a interconexão desses marcadores sociais de diferença constitui barreiras e facilitadores no continuum de cuidados. O material empírico faz parte do estudo PrEP1519 e consiste em 35 entrevistas semiestruturadas com JGBHSH de duas capitais brasileiras (Salvador e São Paulo). As análises identificam conexões entre marcadores sociais de diferença, culturas sexuais e os sentidos sociais da PrEP. Aspectos estruturais subjetivos, relacionais e simbólicos permeiam o conhecimento da PrEP dentro do leque de possibilidades de prevenção. A disposição de usar e aderir à PrEP faz parte de um processo de aprendizagem, produção de sentido e negociação frente ao risco de HIV e de outras infecções sexualmente transmissíveis e as possibilidades para obter prazer. O conhecimento, acesso e uso da PrEP fazem com que muitos adolescentes estejam mais informados sobre suas vulnerabilidades, resultando em decisões com mais informação. A interconexão do continuum de cuidados em PrEP entre JGBHSH com as intersecções dos marcadores sociais de diferença pode fornecer um arcabouço conceitual para problematizar as condições e os efeitos da implementação dessa estratégia preventiva, com o potencial de trazer vantagens para os programas de prevenção do HIV.

Los estudios muestran que existen lagunas en el conocimiento sobre las barreras para acceder y adherirse a la profilaxis preexposición contra el VIH (PrEP) en el segmento adolescente. En este artículo, exploramos las percepciones y experiencias de jóvenes gays, bisexuales, y otros hombres que mantienen sexo con hombres (JGBHSH) sobre la búsqueda, uso y adherencia a la PrEP, considerando sus posiciones respecto a los marcadores sociales de las diferencias tales como: raza/color, género, sexualidad y estatus social. La interseccionalidad aporta apoyo teórico y metodológico para interpretar cómo la interrelación de estos marcadores sociales de la diferencia constituye barreras y facilitadores en el continuum del cuidado por PrEP. El material empírico analizado es parte del estudio PrEP1519 y comprende 35 entrevistas semiestructuradas con JGBHSH, procedentes de dos capitales de estados brasileños (Salvador y São Paulo). Los análisis apuntan conexiones entre marcadores sociales de la diferencia, culturas sexuales, y los significados sociales de la PrEP. Aspectos estructurales subjetivos, de relaciones y simbólicos permean la concientización de la PrEP en el rango de las posibilidades de prevención. La voluntad de utilizar y adherirse a la PrEP es parte de un proceso de aprendizaje, producción de significado, y negociación frente al riesgo de VIH y otras enfermedades de trasmisión sexual, así como la posibilidad de obtener placer. Tener conocimiento sobre el acceso y uso de la PrEP consigue que muchos adolescentes estén más informados sobre sus vulnerabilidades, logrando una toma de decisiones más informadas. Interrelacionar el continuum de la atención PrEP entre JGBHSH con las intersecciones de los marcadores sociales de diferencia tal vez pueda proveer un marco conceptual para problematizar las condiciones y efectos de implementar esta estrategia de prevención, lo que podría traer ventajas para los programas de prevención del VIH.

Studies indicate gaps in knowledge about the barriers to access and adhere to HIV pre-exposure prophylaxis (PrEP) in adolescents. In this article, we explore the perceptions and experiences of young gay, bisexual, and other men who have sex with men (YGBMSM) of the search, use and adherence to PrEP, considering their positions according to social markers of difference such as race/skin color, gender, sexuality, and social status. Intersectionality provides theoretical and methodological tools to interpret how the interlinking of these social markers of difference constitutes barriers and facilitators in the PrEP care continuum. The analyzed material is part of the PrEP1519 study and is comprised of 35 semi-structured interviews with YGBMSM from two Brazilian capitals (Salvador and São Paulo). The analyses suggest connections between social markers of difference, sexual cultures, and the social meanings of PrEP. Subjective, relational and symbolic aspects permeate the awareness of PrEP in the range of prevention tools. Willingness to use and adhere to PrEP is part of a learning process, production of meaning, and negotiation in the face of getting HIV and other sexually transmittable infections and the possibilities of pleasure. Thus, accessing and using PrEP makes several adolescents more informed about their vulnerabilities, leading to more informed decision-making. Interlinking the PrEP continuum of care among YGBMSM with the intersections of the social markers of difference may provide a conceptual framework to problematize the conditions and effects of implementing this prevention strategy, which could bring advantages to HIV prevention programs.

RESUMEN. Introducción: En el marco de esta pandemia, el personal de salud ha sufrido cambios psicológicos, debido a su relación directa con pacientes contagiados por COVID-19, convirtiéndose así en parte de un grupo vulnerable. Objetivo: Conocer los factores asociados a los trastornos de la esfera mental en el personal de salud amazónico durante la pandemia COVID-19. Material y Métodos: La población estuvo conformada por el personal de salud de dos establecimientos de I y II nivel, donde la muestra fue de 341 personas. El tipo de estudio es observacional, transversal analítico, se usó como instrumento una encuesta auto aplicada. Resultados: Se encontró mayor depresión en mujeres (RPa: 1,71; IC95%: 1,29-2,26; valor p<0,001) y menor depresión con tener mayor edad (RPa: 0,98; IC95%: 0,97-0,99; valor p=0,018). La ansiedad se asoció con tener familiares fallecidos (RPa: 1,06; IC95%: 1,01-1,12; valor p=0,029). El tener enfermedades previas (RPa: 1,72; IC95%: 1,27-2,32; valor p<0,001), tener colegas fallecidos (RPa: 1,05; IC95%: 1,05-1,06; valor p<0,001) y ser enfermera (RPa: 1,40; IC95%: 1,05-1,85; valor p=0,020) tuvo estrecha relación con el estrés post traumático (EPT). Conclusión: Se concluye que existe factores asociados a la depresión, ansiedad, estrés y EPT en el personal de salud amazónico durante la pandemia COVID-19.

ABSTRACT Introduction: In the context of this pandemic, healthcare personnel have experienced psychological changes, due to their direct contact with COVID-19 infected patients, becoming part of a vulnerable group. Objective: To identify factors associated with mental health disorders among amazonic healthcare personnel during the COVID-19 pandemic. Material and Methods: The population consisted of healthcare personnel from two level I and II establishments, with a sample size of 341 individuals. The study design was observational, cross sectional, and a self-administered survey was used as the instrument. Results: A higher prevalence of depression was found in women (adjusted prevalence ratio [aPR]: 1.71; 95% confidence interval [CI]: 1.29-2.26; p-value <0.001), and a lower prevalence of depression was associated with older age (aPR: 0.98; 95% CI: 0.97-0.99; p-value=0.018). Anxiety was associated with having deceased family members (aPR: 1.06; 95% CI: 1.01-1.12; p-value=0.029). Having previous illnesses (aPR: 1.72; 95% CI: 1.27-2.32; p-value <0.001), having deceased colleagues (aPR: 1.05; 95% CI: 1.05-1.06; p-value <0.001), and being a nurse (aPR: 1.40; 95% CI: 1.05-1.85; p-value=0.020) was closely related to post traumatic stress (PTSD). Conclusion: It is concluded that there are factors associated with depression, anxiety, stress, and PTSD among amazonic healthcare personnel during the COVID-19 pandemic.

Abstract Introduction Depression in aging may lead to loss of autonomy and worsening of comorbidities. Understanding how positive attributes contribute to healthier and happier aging has been one ofthe purposes of Positive Psychology. However, the literature still lacks studies that evaluate how depression in the elderly is related to constructs considered positive. Objective The present study aimed comparing scores of constructs of spiritual well-being, social support, selfesteem, life satisfaction, affection, optimism, and hope in the elderly with minimal, mild, moderate, and severe depression and healthy controls in order to investigate possible indirect and mediated relationships between positive constructs and depression. Methods A cross-sectional study was conducted with elderly, 62 of whom were diagnosed with different severity of Major Depression (DSM-V) (minimum, mild, moderate, and severe according to the Beck Depression Inventory — BDI) and 66 healthy controls matched by age, sex and schooling. The instruments used were adapted and validated versions of the Spirituality Self-Rating Scale, the Rosenberg Self-Esteem Scale, the Medical Outcomes Social Scale of Support, the Life Satisfaction Scale, the Positive and Negative Affect Schedule, the Revised Life Orientation Test, and the Adult Dispositional Hope Scale. After comparing the means of scores between groups, an analysis of normalized partial association networks was performed to investigate the direct and mediated relationships between depression and other evaluated constructs. Results Scores of spiritual well-being, social support, self-esteem, life satisfaction, positive affect, optimism, negative affects, and hope differed significantly between the control group and the degrees of depression (p < 0.001). The analysis of normalized partial association networks has shown that the relations of depression with the constructs of life satisfaction, self-esteem, and social support are mediated, while the constructs of dispositional hope, positive affect, spiritual well-being, and optimism are indirectly related to depression. The social class was also positively related to depression. Conclusion Depression in different degrees is associated with a reduction in the scores of instruments that evaluate positive attributes. The constructs directly associated with depression are spiritual well-being, optimism, positive affect, and dispositional hope. The others had mediated relationship. These results may contribute to the planning of future interventions for the prevention of depression among the elderly.

Studies indicate gaps in knowledge about the barriers to access and adhere to HIV pre-exposure prophylaxis (PrEP) in adolescents. In this article, we explore the perceptions and experiences of young gay, bisexual, and other men who have sex with men (YGBMSM) of the search, use and adherence to PrEP, considering their positions according to social markers of difference such as race/skin color, gender, sexuality, and social status. Intersectionality provides theoretical and methodological tools to interpret how the interlinking of these social markers of difference constitutes barriers and facilitators in the PrEP care continuum. The analyzed material is part of the PrEP1519 study and is comprised of 35 semi-structured interviews with YGBMSM from two Brazilian capitals (Salvador and São Paulo). The analyses suggest connections between social markers of difference, sexual cultures, and the social meanings of PrEP. Subjective, relational and symbolic aspects permeate the awareness of PrEP in the range of prevention tools. Willingness to use and adhere to PrEP is part of a learning process, production of meaning, and negotiation in the face of getting HIV and other sexually transmittable infections and the possibilities of pleasure. Thus, accessing and using PrEP makes several adolescents more informed about their vulnerabilities, leading to more informed decision-making. Interlinking the PrEP continuum of care among YGBMSM with the intersections of the social markers of difference may provide a conceptual framework to problematize the conditions and effects of implementing this prevention strategy, which could bring advantages to HIV prevention programs.

Los estudios muestran que existen lagunas en el conocimiento sobre las barreras para acceder y adherirse a la profilaxis preexposición contra el VIH (PrEP) en el segmento adolescente. En este artículo, exploramos las percepciones y experiencias de jóvenes gays, bisexuales, y otros hombres que mantienen sexo con hombres (JGBHSH) sobre la búsqueda, uso y adherencia a la PrEP, considerando sus posiciones respecto a los marcadores sociales de las diferencias tales como: raza/color, género, sexualidad y estatus social. La interseccionalidad aporta apoyo teórico y metodológico para interpretar cómo la interrelación de estos marcadores sociales de la diferencia constituye barreras y facilitadores en el continuum del cuidado por PrEP. El material empírico analizado es parte del estudio PrEP1519 y comprende 35 entrevistas semiestructuradas con JGBHSH, procedentes de dos capitales de estados brasileños (Salvador y São Paulo). Los análisis apuntan conexiones entre marcadores sociales de la diferencia, culturas sexuales, y los significados sociales de la PrEP. Aspectos estructurales subjetivos, de relaciones y simbólicos permean la concientización de la PrEP en el rango de las posibilidades de prevención. La voluntad de utilizar y adherirse a la PrEP es parte de un proceso de aprendizaje, producción de significado, y negociación frente al riesgo de VIH y otras enfermedades de trasmisión sexual, así como la posibilidad de obtener placer. Tener conocimiento sobre el acceso y uso de la PrEP consigue que muchos adolescentes estén más informados sobre sus vulnerabilidades, logrando una toma de decisiones más informadas. Interrelacionar el continuum de la atención PrEP entre JGBHSH con las intersecciones de los marcadores sociales de diferencia tal vez pueda proveer un marco conceptual para problematizar las condiciones y efectos de implementar esta estrategia de prevención, lo que podría traer ventajas para los programas de prevención del VIH.

Os estudos revelam lacunas no conhecimento sobre as barreiras ao acesso e à adesão à profilaxia pré-exposição do HIV (PrEP) em adolescentes. O artigo explora as percepções e experiências de jovens gays e bissexuais e outros homens que fazem sexo com homens (JGBHSH) na busca, uso e adesão à PrEP, considerando suas posições de acordo com marcadores sociais de diferença como raça/cor da pele, gênero, sexualidade e nível social. A interseccionalidade fornece suporte teórico e metodológico para interpretar de que maneira a interconexão desses marcadores sociais de diferença constitui barreiras e facilitadores no continuum de cuidados. O material empírico faz parte do estudo PrEP1519 e consiste em 35 entrevistas semiestruturadas com JGBHSH de duas capitais brasileiras (Salvador e São Paulo). As análises identificam conexões entre marcadores sociais de diferença, culturas sexuais e os sentidos sociais da PrEP. Aspectos estruturais subjetivos, relacionais e simbólicos permeiam o conhecimento da PrEP dentro do leque de possibilidades de prevenção. A disposição de usar e aderir à PrEP faz parte de um processo de aprendizagem, produção de sentido e negociação frente ao risco de HIV e de outras infecções sexualmente transmissíveis e as possibilidades para obter prazer. O conhecimento, acesso e uso da PrEP fazem com que muitos adolescentes estejam mais informados sobre suas vulnerabilidades, resultando em decisões com mais informação. A interconexão do continuum de cuidados em PrEP entre JGBHSH com as intersecções dos marcadores sociais de diferença pode fornecer um arcabouço conceitual para problematizar as condições e os efeitos da implementação dessa estratégia preventiva, com o potencial de trazer vantagens para os programas de prevenção do HIV.

Abstract The COVID-19 pandemic has placed unprecedented burdens on individuals and communities around the world. The isolation, fear, and uncertainty caused by the virus has led to increased rates of anxiety, depression, and other mental health issues. The pandemic has also had a disproportionate impact on individuals and communities with low income and socioeconomic status. Objective To shed light on the consequences of the pandemic on individuals from minorities and low-income areas, we investigate the main reasons that led patients who were referred to a social clinic of a private university in Rio de Janeiro to seek psychological treatment before (2019) and during the pandemic (2020 and 2021). Methods We conducted a quanti-qualitative study with a lexical analysis that evaluated 549 complaint forms of patients seeking treatment in these two distinct periods. Our analyses included descending hierarchical analysis (DHA) and correspondence factor analysis (CFA). Results Family dynamics and communication factors play a dominant role in the reason for seeking therapy and psychological treatment. Additionally, our study suggested an increase in anxiety and panic attacks among other mental health issues associated with griefand losses during the pandemic years. Conclusion Based on these analyses, we can begin to identify a few changes in the main demand and redirection of complaints of patients during the period of COVID-19.

Abstract Objective: Depression and anxiety were disorders evidenced during the - Coronavirus disease19 pandemic. In this study, these conditions were evaluated as a function of Spirituality/Religiosity, as well as private prayer practices and attendance at religious spaces. Spirituality and religiosity have been widely investigated as health promoters. Methods: A sample of 1,293 participants completed the Beck Depression Inventory Primary Care, the State-Trait Anxiety Inventory, the Religious Spiritual Coping Brief Scale, and a sociodemographic questionnaire. The group was separated into Spirituality/Religiosity levels, prayer practices, and attendance at religious centers. Results: An ANOVA concluded that those who pray alone daily develop lower anxiety traits (F (8,133) = 7.885, p < 0.001) compared with individuals who pray once or twice a year. Participants who self-declared to be very spiritual exhibited fewer depressive symptoms (M = 2.57, SD = 2.88) compared to non-spiritual participants (M = 4.29, SD = 4.07, p < 0.001). Conclusion: In summary, Spirituality/Religiosity can positively impact mental health.

Resumo Objetivo: A espiritualidade e a religiosidade têm sido amplamente investigadas como promotoras de saúde. Depressão e ansiedade foram transtornos evidenciados durante a pandemia da doença do coronavírus” 19. Neste estudo, essas condições foram avaliadas em função da espiritualidade e religiosidade, assim como práticas de oração privada e atendimento em espaços religiosos. Método: Uma amostra de 1.293 participantes completou o Inventário de Depressão de Beck na Atenção Primária, o Inventário de Ansiedade Traço-Estado, a Escala Breve de Enfrentamento Espiritual Religioso e um Questionário Sociodemográfico. O grupo foi dividido em níveis espiritualidade e religiosidade, práticas de oração e frequência em centros religiosos. Resultados: Uma ANOVA concluiu que aqueles que rezam sozinhos diariamente apresentam menores traços de ansiedade (F (8,133) = 7,885, p < 0,001) em comparação com aqueles que rezam uma ou duas vezes por ano. Participantes muito espirituais apresentaram menos sintomas depressivos (M = 2,57, DP = 2,88) do que os participantes não espirituais (M = 4,29, DP = 4,07, p < 0,001). Conclusão: Em resumo, espiritualidade e religiosidade podem impactar positivamente a saúde mental.

RESUMO Objetivo: descrever a condução de extração, análise e codificação de dados utilizando a Grounded Theory, na perspectiva Straussiana, em Metassínteses de literatura. Método: trata-se de um ensaio teórico-reflexivo sobre a condução da extração de dados de revisões com metassíntese. Para delineamento do processo de busca dos estudos qualitativos, este ensaio aborda, de forma sucinta, as etapas sequenciais do Preferred Reporting Items for Systematic Review and Meta-Analyses e da Joanna Briggs Institute. O processo de extração, análise e codificação foi realizado seguindo os pressupostos da Grounded Theory, com a perspectiva Straussiana. São as bases teórico-metodológicas nas primeiras etapas das diretrizes dos guias de revisão de literatura e Metassíntese, iniciando com a pergunta de pesquisa até chegar às etapas da revisão, divididas em identificação, seleção, elegibilidade e inclusão. Resultados: nos resultados são descritos o processo de extração, análise e codificação de dados na perspectiva Straussiana, com uso de análise comparativa dos dados, memorandos, diagramas e possibilidades de novos grupos amostrais a partir da leitura analítica minuciosa dos estudos inclusos. Por fim, é realizada a saturação teórica, com síntese dos achados, com exemplos de categorias e subcategorias, emersão do fenômeno central e apresentação da modelo paradigmático. Conclusão: o ensaio apresenta subsídios para a compreensão da condução de extração, análise e codificação de dados em Metassínteses baseada na perspectiva Straussiana, possibilitando, de forma sistematizada, a síntese de evidências qualitativas e contribuindo no desenvolvimento de modelos ou teorias de caráter conceitual. Objetivo Theory Straussiana Método tratase trata se teóricoreflexivo teórico reflexivo metassíntese qualitativos aborda sucinta MetaAnalyses Meta Analyses Institute teóricometodológicas metodológicas Metassíntese identificação seleção inclusão Resultados memorandos inclusos fim teórica achados subcategorias paradigmático Conclusão possibilitando sistematizada conceitual

RESUMEN Objetivo: describir la conducta de extracción, análisis y codificación de datos utilizando la Teoría Fundamentada, en la perspectiva Straussiana, en la Metasíntesis de la Literatura. Método: se trata de un ensayo teórico-reflexivo sobre la conducción de la extracción de datos a partir de revisiones de metasíntesis. Para delinear el proceso de búsqueda de estudios cualitativos, este ensayo aborda brevemente los pasos secuenciales de los Elementos de informe preferidos para la revisión sistemática y los metanálisis y el Instituto Joanna Briggs. El proceso de extracción, análisis y codificación se realizó siguiendo los supuestos de la Grounded Theory, con la perspectiva straussiana. Son las bases teórico-metodológicas en las primeras etapas de los lineamientos de las guías de revisión de literatura y Metasíntesis, partiendo de la pregunta de investigación hasta llegar a las etapas de revisión, divididas en identificación, selección, elegibilidad e inclusión. Resultados: los resultados describen el proceso de extracción, análisis y codificación de datos desde la perspectiva straussiana, utilizando análisis de datos comparativos, memorandos, diagramas y posibilidades de nuevos grupos de muestra a partir de una lectura analítica exhaustiva de los estudios incluidos. Finalmente, se realiza una saturación teórica, con una síntesis de los hallazgos, con ejemplos de categorías y subcategorías, emergencia del fenómeno central y presentación del modelo paradigmático. Conclusión: el ensayo presenta subsidios para la comprensión de la extracción, análisis y codificación de datos en Metasíntesis a partir de la perspectiva straussiana, permitiendo, de forma sistemática, la síntesis de evidencias cualitativas y contribuyendo al desarrollo de modelos o teorías de carácter conceptual. naturaleza. Objetivo Fundamentada Straussiana Literatura Método teóricoreflexivo teórico reflexivo metasíntesis cualitativos Briggs Theory straussiana teóricometodológicas metodológicas identificación selección inclusión Resultados comparativos memorandos incluidos Finalmente teórica hallazgos subcategorías paradigmático Conclusión permitiendo conceptual naturaleza

ABSTRACT Objective: to describe the conduction of data extraction, analysis and codification using the Straussian perspective of Grounded Theory, in Literature Meta-analysis. Method: this is a theoretical-reflexive study on the data extraction from reviews with meta-anaylses. To design the process of searching for qualitative studies, this study briefly addresses the sequential steps of Preferred Reporting Items for Systematic Review and Meta-Analyses and the Joanna Briggs Institute. The extraction, analysis and codification process were carried out following the assumptions of grounded theory, with the Straussian perspective. They are the theoretical-methodological bases in the first stages of the guidelines of the literature review and Meta-analyses guides, starting with the research question until reaching the review stages, divided into identification, selection, eligibility, and inclusion. Results: the results describe the process of data extraction, analysis and codification from the Straussian perspective, using comparative analysis of data, memoranda, diagrams and possibilities of new sample groups from the detailed analytical reading of the included studies. Finally, theoretical saturation is performed, with an analysis of the findings, with examples of categories and subcategories, the emergence of the central phenomenon and presentation of the paradigmatic model. Conclusion: the essay presents subsidies for the understanding of the conduction of extraction, analysis and codification of data in meta-analyses based on the Straussian perspective, enabling the systematized analysis of qualitative evidence and contributing to the development of models or theories of conceptual character Objective Theory Metaanalysis. Metaanalysis Meta analysis. Meta-analysis Method theoreticalreflexive reflexive metaanaylses. metaanaylses meta anaylses. anaylses meta-anaylses studies MetaAnalyses Analyses Institute theory theoreticalmethodological methodological Metaanalyses analyses guides identification selection eligibility inclusion Results memoranda Finally performed findings subcategories model Conclusion metaanalyses

ABSTRACT: Introduction: Neurofibroma is a benign tumor that compromises the neural sheath of nerve tissue, intimately associated with Neurofibromatosis. Due to the involvement of peripheral and/or central nerves, its clinical expression is wide as a result of compression and/or displacement of neighboring structures, making its diagnosis difficult. Objective: The aim of this article is to review the literature on Neurofibromatosis and its manifestations in the maxillofacial territory, along with the presentation of a case of mandibular Hyperchondylism associated with a neurofibroma in the temporomandibular joint region in a patient with a history of Neurofibromatosis. Methods: We present the case of a patient with laterogenesis and a history of Neurofibromatosis type I (NF1). By imaging study, a right Hyperchondylism is detected along with the presence of a radiolucent area related to the neck of the compromised condyle, whose histopathological result confirmed the diagnosis of neurofibroma. Conclusions: There is a diverse clinical picture in patients with NF1, presenting a pre-disposition to neurofibromas development and bone abnormalities, leading to the compromise of the maxillofacial territory and causing facial asymmetries. Because of this, it is essential to have knowledge and consideration of both pathologies for the right planning of patient treatment.

RESUMEN: Introducción: El neurofibroma corresponde a un tumor benigno que compromete la vaina neural del tejido nervioso, asociándose íntimamente a la neurofibromatosis. Debido al compromiso de nervios periféricos y/o centrales, su expresión clínica es muy variada producto de la compresión y/o desplazamiento de estructuras vecinas dificultando así su diagnóstico. Objetivo: El objetivo de este artículo, es el de realizar una revisión de la literatura en relación con la neurofibromatosis y sus manifestaciones en el territorio máxilofacial en conjunto con la presentación de un caso de hipercondilismo mandibular asociado a un neurofibroma en la región de la articulación temporomandibular en un paciente con antecedentes de neurofibromatosis. Métodos: Se presenta el caso de un paciente con laterognasia y antecedentes de Neurofibromatosis tipo I (NF1). Por medio de estudio imagenológico, se confirma Hipercondilismo derecho y presencia de una zona radiolúcida relacionada con el cuello del cóndilo comprometido, cuyo resultado histopatológico confirmo el diagnóstico de neurofibroma. Conclusiones: Existe una muy variada clínica en pacientes con NF1, presentando una predisposición a la formación de neurofibromas y alteraciones oseas que pudiesen comprometer el territorio máxilofacial y causar asimetrías faciales. Debido a esto, resulta imprescindible tener conocimiento y consideración de ambas patologías para una correcta planificación del tratamiento de los pacientes.

ABSTRACT Introduction: Since the coronavirus disease 2019 (COVID-19) pandemic, cardiac surgeries in patients with previous infection by COVID-19 were suspended or postponed, which led to surgeries performed in patients with an advanced stage of their disease and an increase in the waiting list. There is a heterogeneous attitude in Latin America on the optimal timing to cardiac surgery in patients with previous COVID-19 infection due to scarce data on its outcome. Two Latin American associations joined to establish common suggestions on the optimal timing of surgery in patients with previous COVID-19 infection. Methods: Data collection was performed using a pre-established form, which included year of publication, objective, type of study (prospective/retrospective, descriptive/analytical), number of patients, year of study, waiting time between infection and surgery, type of surgery, morbidity, mortality, and conclusions regarding the association between mortality and morbidity. Final recommendations were approved by the board of directors of Latin American Association of Cardiac and Endovascular Surgery (LACES) and Latin American Confederation of Anesthesia Societies (CLASA). Results: Of the initial 1,016 articles, 11 comprised the final selection. Only six of them included patients who underwent cardiac surgery. According to the analyzed literature, optimal timing for cardiac surgery needs to consider the following aspects: deferable surgery, symptomatic COVID-19 infection, completeness of COVID-19 vaccination. Conclusion: These recommendations derive from the analysis of the scarce literature published at present on outcomes after cardiac surgery in patients with previous COVID-19 infection. These are to be taken as a dynamic recommendation in which Latin American reality was taken into consideration.

Abstract: Tourism is a very important aspect that each state must consider in order to offer its tourist resources to the rest of the world, although these resources are usually natural and are not commercial, so that tourists are interested in knowing them, this includes knowledge of the culture of each country and other aspects of the region. However, tourism is not only about offering the natural wonders of each country, rather it directly influences the economic factor of a region, this product of the participation of businesses that intervene to offer their products to tourists, helping in one way or another to the economy of a specific sector, so if a good management of tourism promotion is done, the local economy will benefit successfully. Based on this idea, countries have developed programs to promote their culture and tradition to the rest of the world. Ecuador has great attractions, the province of Pastaza is not left behind, which being located in the eastern region, has great natural attractions, also encouraging the local economy through tourism.

Resumen: El turismo es un aspecto muy importante que cada estado debe considerar con el fin de ofrecer sus recursos turísticos al resto del mundo, si bien estos recursos por lo general son naturales y no son comerciales, por lo que hace que los turistas presenten interés por conocerlos, esto incluye el conocimiento de la cultura de cada país y otros aspectos de la región. Sin embargo, el turismo no solo consiste en la oferta de las maravillas naturales de cada país, más bien esto influye directamente el factor económico de una región, esto producto de la participación de negocios que intervienen para ofrecer sus productos a los turistas, ayudando de una forma y otra a la economía de un sector en específico, por lo que si se realiza una buena gestión de promoción de turismo, la economía local se va a beneficiar de manera exitosa. Basada en esta idea, los países han desarrollado programas para incentivar su cultura y tradición hacia el resto del mundo. Ecuador tiene grandes atractivos, la provincia de Pastaza no se queda atrás, la cual al estar ubicado en la región oriental, presenta grandes atractivos naturales, incentivando además la economía local a través del turismo.

Abstract The ionospheric investigations have improved our understanding of the space weather role in the upper atmosphere conditions, particularly at higher latitudes where the geospace phenomena print their signatures. The simultaneous observations using multi-instruments have improved our knowledge of the coupling processes inside the ionosphere, and their connection with the magnetosphere and neutral atmosphere processes under the space weather phenomena. The ionosphere probing at EACF started on 1986 using an analogical very low frequency (VLF) system, and after the year 2004 using digital VLF system, global navigation satellite system (GNSS), riometers and Canadian digital ionosonde (CADI). This paper presents the different radio techniques that have been used at Brazilian Antarctic Station Comandante Ferraz (EACF) to characterize the ionospheric conditions, and the highlights of the studies using multi-instrument observations performed in the last few decades.

RESUMEN El objetivo del estudio fue evaluar los efectos de la levadura Saccharomyces cerevisiae como aditivo para la preparación de ensilado de avena y cebada en dos tiempos de fermentación (21 y 42 días). Se prepararon minisilos de avena y cebada y se evaluaron cuatro niveles de levadura (0, 15, 30 y 45 g/kg FV). Los minisilos fueron abiertos a los 21 y 42 días. Se prepararon tres repeticiones de ensilado para cada combinación de ensilado x nivel de levadura x tiempo de ensilado. Los valores de composición bromatológica del ensilado de avena en términos de proteína cruda (PC), materia mineral (MM), fibra detergente neutra (FDN), fibra detergente ácida (FDA), extracto etéreo (EE) y pH aumentaron cuando se agregó la levadura con relación al control, pero disminuyó la materia seca (MS). La calidad del ensilado de cebada en términos de MS, PC, FDN, FDA y EE mejoró al agregar 30 y 45 g/kg de levadura, en comparación al control; sin embargo, disminuyó para EE y pH. Los resultados demuestran que la inoculación de S. cerevisiae en los dos tiempos de fermentación incrementa el contenido de PC, EE, MM y pH del ensilado; sin embargo; el alto nivel de pH no permite conservar la calidad del ensilado. Se concluye que el mejor valor nutricional se obtuvo con la adición de S. cerevisiae de 45 g/ kg a los 42 días de fermentación en ambos ensilados, aunque disminuye algunos parámetros de importancia.

ABSTRACT The aim of this study was to evaluate the effects of the yeast Saccharomyces cerevisiae as an additive for the preparation of oat and barley silage in two fermentation times (21 and 42 days). Oat and barley minisilos were prepared using four levels of yeast (0, 15, 30 and 45 g/kg FV). The minisilos were opened at 21 and 42 days. Three silage replicates were prepared for each combination of silage x yeast level x silage time. The bromatological composition values of the oat silage in terms of crude protein (CP), mineral matter (MM), neutral detergent fibre (NDF), acid detergent fibre (FDA), ethereal extract (EE) and pH increased when the yeast was added in relation to the control, but the dry matter (DM) decreased. The quality of the barley silage in terms of DM, CP, NDF, FDAand EE improved when adding 30 and 45 g/kg of yeast, compared to the control; however, it decreased for EE and pH. The results show that the inoculation of S. cerevisiae in the two fermentation times increases the content of CP, EE, MM and pH of the silage; nevertheless; the high pH level does not allow proper conservation of the quality of the silage. It is concluded that the best nutritional values were obtained with the addition of S. cerevisiae of 45 g/kg at 42 days of fermentation in both silages, although it decreases some important parameters.

RESUMO A educação exerce uma poderosa influência no desempenho em testes neuropsicológicos. Até o momento, o número de anos que uma pessoa frequenta a escola tem sido o método preferido para operacionalizar o nível educacional (NE). No entanto, a fluência de leitura (FL) surge como um método alternativo que pode informar a qualidade do ensino. Objetivo: comparar a influência do número de anos de estudo versus FL no desempenho cognitivo em uma amostra controle. Métodos: Administrou-se uma escala neuropsicológica juntamente com uma tarefa de FL a 56 participantes-controle com idades variáveis (17–87) e diferentes níveis de educação (3–19 anos de escolaridade formal). A escala mediu atenção, memória, linguagem, funções executivas e práxis construtiva. A tarefa de FL consistiu em um texto curto. A pontuação foi o número de palavras lidas corretamente por minuto. O r de Pearson foi usado para calcular correlações. Resultados: Os resultados mostraram que a FL tinha uma correlação mais elevada (0,53) do que anos de escola (0,38) com as pontuações da escala neuropsicológica. Conclusões: A fluência de leitura é uma tarefa prática, curta e de fácil aplicação em diferentes idiomas, que se destaca como uma ferramenta promissora para a avaliação do NE. Também é uma alternativa adequada à leitura de palavras irregulares como uma medida qualitativa de NE.

ABSTRACT Education exerts a powerful influence on the performance on neuropsychological tests. Recently, the number of years that a person attends school has been the preferred method to operationalize educational level (EL). However, reading fluency (RF) has emerged as an alternative method that can define the quality of education. Objective: To compare the influence of the number of years of education with RF on the cognitive performance in a control sample. Methods: Fifty-six control participants with varying ages (17–87 years) and levels of education (3–19 years of formal schooling) were administered a neuropsychological scale along with an RF task. This scale measured attention, memory, language, executive functions, and constructional praxis. The RF task consisted of a short text. The score was the number of words read correctly per minute. Pearson’s r was used to compute correlations. Results: Results showed that RF had a higher correlation (0.53) than the years of schooling (0.38) with the scores of the neuropsychological scale. Conclusions: Reading fluency is a short, practical task that is easy to use in different languages and is a promising tool for EL assessment. It is also an adequate alternative to the reading of irregular words as a qualitative measure of EL.

ABSTRACT Introduction: bibliometrics is a means of situating the production of a country in relation to the world, an institution in relation to their country and scientists in relation to their own communities. Objectives: Analyze the scientific production contained in the journal “Acta Médica del Centro” in the period 2007-2019, through bibliometric indicators. Methods: the application of metric techniques led to obtaining data from a quantitative point of view on the production of the magazine in all the years it was published. The following were determined as indicators: productivity by years, authors, articles produced / cited, percentage of inbreeding, occasional or transitory authors, transience index, distribution of authors according to their productivity, most cited authors, h-index, producing institutions, typology of articles and keywords. Results: 2011 was the most productive year and 2014 was the most cited. The author with the highest productivity index was Dr. Luis Alberto Santos Pérez. 346 transitory authors were found for a transitory index of 67%. 95% of the authors have published between 1 and 4 articles in the journal. 34% were original works. Conclusions: the journal kept oscillating the number of works published per year. There is no presence of editorial inbreeding. The visibility of the journal's scientific production is 32% and the authors' h-index is very low. Scientific production is mainly centered on authors from the “Arnaldo Milián Castro” Clinical-Surgical Hospital, which is why institutional inbreeding is observed.

RESUMEN Introducción: la bibliometría constituye un medio para situar la producción de un país con respecto al mundo, una institución en relación con su país y los científicos en relación con sus propias comunidades. Objetivos: analizar la producción científica contenida en la Revista “Acta Médica del Centro” en el período comprendido entre 2007 y 2019 a través de indicadores bibliométricos. Métodos: la aplicación de técnicas métricas propició que se obtuvieran datos desde el punto de vista cuantitativo sobre la producción de la revista en todos los años que se editó. Se determinaron como indicadores: productividad por años, autores, artículos producidos/citados, por ciento de endogamia, autores ocasionales o transitorios, índice de transitoriedad, distribución de los autores según su productividad, autores más citados, índice h, instituciones productoras, tipología de artículos y palabras clave. Resultados: el año más productivo fue 2011 y el más citado fue 2014. El autor de mayor índice de productividad fue el Dr. Luis Alberto Santos Pérez. Se encontraron 346 autores transitorios, para un índice de transitoriedad del 67%. El 95% de los autores han publicado entre uno y cuatro artículos en la revista. El 34% fueron trabajos originales. Conclusiones: la revista mantuvo de forma oscilante el número de trabajos publicados por año. No existe presencia de endogamia editorial. La visibilidad que tiene la producción científica de la revista es de un 32% y el índice h de los autores es muy escaso. La producción científica se centraliza principalmente en autores del Hospital “Arnaldo Milián Castro”, por lo que se observa endogamia institucional.