[Congenital Central Hypoventilation Syndrome: neonatal diagnosis and management]. / Síndrome de Hipoventilación Central Congénito: diagnóstico y manejo neonatal.

Congenital Central Hypoventilation Syndrome (CCHS) is a rare genetic condition affecting the autonomic nervous system and respiratory center due to mutations in the PHOX2B gene, and it is associated with alveolar hypoventilation during sleep and sudden death. It requires early invasive mechanical ventilation (IMV). OBJECTIVE: To report a neonatal case successfully treated with non-invasive ventilatory support (NVS), avoiding tracheostomy. CLINICAL CASE: Full-term newborn, whose mother uses nocturnal NVS due to CCHS. During the transition period, she presented desaturations associated with hypercapnia and respiratory acidosis, without pulmonary involvement. She developed severe hypoventilation during sleep, with no respiratory effort, peripheral oxygen saturation (SpO2) < 80%, plus respiratory acidosis. While awake, she had good respiratory effort and normal SpO2 without assistance. Noninvasive continuous positive airway pressure and oxygen therapy worsened her condition while sleeping. Complete NVS with nasal interface and bi-level airway positive pressure, inspiratory/expiratory pressure 14-16/4 cm H2O, normalized SpO2 during sleep, and arterial blood gases while awake. Sequencing of the PHOX2B gene confirmed the presence of a heterozygous pathogenic variant with the 20/26 genotype. At 2 months of age, she was discharged maintaining NVS with nasal interface and 0 PEEP, achieving adequate neurodevelopment. CONCLUSION: We highlight the importance of genetic diagnosis of CCHS in neonates with clinical presentation of early alveolar hypoventilation, especially if there is a family history. We are not aware of other reports of neonatal onset in which NVS prevents IMV, in this potentially lethal pathology.

Navigating the diagnostic maze: A case presentation of C1q vasculitis mimicking hypocomplementemic urticarial vasculitis in a patient with systemic lupus erythematosus.

In rare instances, patients with SLE may exhibit atypical clinical manifestations, such as Hypocomplementemic Urticarial Vasculitis, which can pose diagnostic challenges. Here, we present a case report of a 28-year-old female with a history of SLE with lupus nephritis clase IV who developed HUV-like symptoms, ultimately leading to a diagnosis of C1q Vasculitis. This case underscores the importance of considering C1q Vasculitis in SLE patients presenting with HUV-like features and highlights Rituximab as a promising therapeutic option for managing this rare condition.

A Capsaicin-Based Phytogenic Solution Improves Performance and Thermal Tolerance of Heat-Stressed Growing Pigs.

Exposure to heat stress (HS) detrimentally affects pig performance. This study explored whether a dietary phytogenic solution based on Capsicum spp. (PHY) could enhance the thermal tolerance of heat-stressed growing pigs. Forty-two individually housed pigs were randomly assigned to three treatments: thermoneutral pigs on a control diet (TN-C) and pigs subjected to HS fed the control diet either without (HS-C) or with supplemental PHY (HS-PHY). The TN-C group exhibited increased average daily gain (ADG) and feed intake (FI) compared to both HS-C (p < 0.01) and HS-PHY pigs (p < 0.05) and better feed efficiency compared to HS-C pigs only (p < 0.01). However, the HS-PHY pigs showed significantly higher FI (p < 0.01) and ADG (p < 0.05) compared to HS-C pigs. HS pigs displayed higher body temperatures (BTs) than TN pigs (p < 0.01), yet HS-PHY pigs experienced a lesser increase in BT compared to HS-C pigs (p < 0.05). Supplementation with PHY mitigated some effects of HS, increasing serum superoxide dismutase and catalase activity, reducing HSP90 expression in longissimus dorsi muscle, and elevating jejunal villus height compared to HS-C pigs (p < 0.05), reaching levels akin to TN-C pigs. Additionally, PHY supplementation resulted in lower serum urea levels than HS-C pigs (p < 0.01) and similar myosin gene expression to TN-C pigs (p > 0.1), suggesting enhanced amino acid post-absorptive utilization for lean tissue growth. In conclusion, dietary PHY supplementation partially offset the adverse effects of HS on pig performance by improving thermal tolerance.

Acute pesticide poisoning: Comparison of epidemiological characteristics between the rural and urban population

Objective: To analyze the behavior of pesticide poisoning associated with lethality in rural and urban populations in Colombia from 2007 to 2017. Methodology: Retrospective observational study that included a descriptive cross-sectional study and an ecological design that analyzed aggregate measures of morbidity, mortality, and risk attributable to the population in rural and urban areas. In the cross-sectional study, the relative risk was estimated to measure the factors associated with lethality among intoxications using Poisson regression with logarithmic function. For the time series, the trends were established with simple linear regression, and the seasonal decomposition was performed using the multiplicative model. Autocorrelations were tested using the Box-Ljung statistic. Results: Between 2007-2017; 89 490 cases were reported. The Morbidity due to poisoning showed a higher proportion in the rural population 36.03 cases per 100 000; this indicator was three times higher than in urban areas (12.33 cases per 100 000). The mortality rates in rural and urban areas were 1.00 and 0.13 cases per 100 000, respectively. The relative risk of fatality in case of intoxication was associated with the intention of suicide in the rural population Relative Risk (RR): 5.9 (95% CI: 5.0-6.9). Conclusion: A higher proportion of lethality associated with these events occurred in populations living in rural areas and reporting cases of suicidal intent. In addition, morbidity and mortality due to pesticide poisoning had the highest proportion in rural areas and a growing trend over time.

Objetivo: Analizar el comportamiento de las intoxicaciones por plaguicidas en poblaciones rurales y urbanas asociadas a la letalidad en Colombia durante 2007-2017. Metodología: Estudio observacional retrospectivo que incluyó: un estudio descriptivo transversal y un diseño ecológico que analizó medidas agregadas de morbilidad, mortalidad y riesgo atribuibles a la población en áreas rurales y urbanas. En el estudio transversal se estimó el riesgo relativo para medir los factores asociados a la letalidad entre las intoxicaciones mediante regresión de Poisson con función logarítmica. Para la serie de tiempo, las tendencias se establecieron con regresión lineal simple y la descomposición estacional se realizó mediante el modelo multiplicativo. Las autocorrelaciones se probaron mediante el estadístico Box-Ljung. Resultados: Entre 2007-2017; Se notificaron 89 490 casos. La Morbilidad por intoxicación presentó mayor proporción en la población rural 36,03 casos por 100 000; este indicador fue tres veces mayor que en las áreas urbanas (12,33 casos por 100 000). Las tasas de mortalidad en el área rural y urbana fueron de 1,00 y 0,13 casos por 100 000, respectivamente. El riesgo relativo de fatalidad en caso de intoxicación se asoció con la intención de suicidio en la población rural RR: 5,9 (IC 95%: 5,0-6,9). Conclusión: Una mayor proporción de letalidad asociada a estos eventos ocurrió en poblaciones que viven en áreas rurales y reportan casos de intención suicida. Además, la morbilidad y mortalidad por intoxicación por plaguicidas tuvo la mayor proporción en las zonas rurales y una tendencia creciente en el tiempo.

Objetivo: Analisar o comportamento das intoxicações por agrotóxicos em populações rurais e urbanas associadas à letalidade na Colômbia durante 2007-2017. Metodologia: Estudo observacional retrospectivo que incluiu: estudo transversal descritivo e delineamento ecológico que analisou medidas agregadas de morbidade, mortalidade e risco atribuíveis à população em áreas rurais e urbanas. No estudo transversal, o risco relativo foi estimado para medir os fatores associados à letalidade entre as intoxicações por meio da regressão de Poisson com função logarítmica. Para as séries temporais, as tendências foram estabelecidas com regressão linear simples e a decomposição sazonal foi realizada usando o modelo multiplicativo. As autocorrelações foram testadas usando a estatística Box-Ljung. Resultados: Entre 2007-2017; 89.490 casos foram notificados. A Morbidade por intoxicação apresentou maior proporção na população rural 36,03 casos por 100.000; este indicador foi três vezes superior ao das zonas urbanas (12,33 casos por 100 000). As taxas de mortalidade nas áreas rural e urbana foram de 1,00 e 0,13 casos por 100.000 habitantes, respectivamente. O risco relativo de fatalidade em caso de intoxicação associou-se à intenção de suicídio na população rural RR: 5,9 (IC 95%: 5,0-6,9). Conclusão: Maior proporção de letalidade associada a esses eventos ocorreu em populações residentes em áreas rurais e com relato de casos de intenção suicida. Além disso, a morbimortalidade por intoxicação por agrotóxicos teve maior proporção na zona rural e tendência crescente ao longo do tempo.

[Restless sleep disorder a new entity to considered in children]. / Trastorno de sueño inquieto: una nueva entidad clínica a considerar en niños.

Restless sleep disorder (RSD) is a condition recently described by a group of sleep experts who developed diagnostic and polysomnographic criteria after conducting a comprehensive review of the available literature where poor sleep or restless sleep is a symptom alone or that accompanies other disorders. This group defined RSD as a condition characterized by parental complaints of frequent jerking movements during sleep, position changes, and sleep disruption that cause significant impairment during the day. Diagnostic criteria include the presence of symptoms for at least 3 months, 3 times a week, and at least 5 movements per hour on polysomnography. Changes in behavior during the day, such as drowsiness, irritability, and hyperactivity that are not explained by a medical, pharmacological, or behavioral condition, should be considered. Its estimated prevalence is 7.7% of children referred for sleep problems. Children often have ferritin levels below 50 µg/l, a point in common with restless legs syndrome. Treatment consists of iron supplements, which have shown benefits in these children. To establish the diagnosis, secondary symptoms of medical origin or other sleep disorders such as restless legs syndrome or periodic limb movement disorder must be ruled out. The objective of this report is to review the current recommendations on this entity, describe the clinical, pathophysiological, and polysomnographic keys, in order to highlight the need to publicize this condition and expand studies in age groups other than those already defined and to generate treatment guidelines.

Phytochemicals and modulation of exercise-induced oxidative stress: a novel overview of antioxidants.

The practice of physical exercise induces a series of physiological changes in the body at different levels, either acutely or chronically. During exercise, the increase in oxygen consumption promotes the production of reactive oxygen species (ROS) and reactive nitrogen species (RNS), which are necessary to maintain homeostasis. ROS/RNS activate cellular signaling pathways, such as the antioxidant cytoprotective systems, inflammation, and cell proliferation, which are crucial for cell survival. However, in exhaustive-extended physical exercise, workloads can exceed the endogenous antioxidant defenses, which may be related to impairment of muscle contraction, fatigue, and a decrease in athletic performance. This review addresses the role of some antioxidants from plant-derived extracts called phytochemicals that can mediate the response to oxidative stress induced by physical exercise by activating signaling pathways, such as Nrf2/Keap1/ARE, responsible for the endogenous antioxidant response and possibly having an impact on sports performance.

Riesgo suicida y estrategias de afrontamiento al estrés en población campesina colombiana / Suicidal risk and strategies for coping with stress in Colombian rural population

Resumen Introducción: El comportamiento suicida hace referencia a las diversas conductas para dejar de vivir es un fenómeno multifactorial ampliamente estudiado en población urbana, sin embargo, la población campesina, especialmente agricultores y trabajadores agrícolas están entre los grupos de alto riesgo. Objetivo: Evaluar las relaciones entre el riesgo suicida y las estrategias de afrontamiento al estrés en una muestra de 76 campesinos entre los 18 y 79 años del municipio de El Santuario, Colombia, durante la emergencia sanitaria por Covid-19. Método: Para este estudio se utilizó un diseño descriptivo correlacional de corte transversal y se emplearon como instrumentos la Escala de Evaluación de Riesgo Suicida -ERS- y la Escala de Estilos y Estrategias de Afrontamiento (EEEAE). Resultados: Los resultados encontrados en la Escala ERS no indicaron niveles clínicos de riesgo suicida. Y respecto a la EEEAE casi siempre los participantes usaban las estrategias de Reevaluación positiva, Apoyo social, Desconexión cognitiva y Resolver el problema. Hubo correlaciones negativas entre todas las dimensiones de la escala ERS con EEEAE, menos entre las dimensiones Depresión/Desesperanza y Aislamiento/Soporte social (ERS) con la Desconexión cognitiva (EEEAE) y especialmente la estrategia de Reevaluación Positiva tuvo un peso significativo sobre riesgo suicida. Conclusiones: La Reevaluación Positiva es una estrategia de afrontamiento que puede proteger la salud mental ante situaciones de estrés asociados con el riesgo suicida de la población campesina, los agricultores y trabajadores agrícolas.

Abstract Introduction: Suicidal behavior refers to the various behaviors to stop living, it is a multifactorial phenomenon widely studied in the urban population, however, the rural population, especially farmers and agricultural workers, are among the high-risk groups. Objective: Evaluate the relationships between suicidal risk and stress coping strategies in a sample of 76 peasants between 18 and 79 years of age from the municipality of El Santuario, Colombia during the Covid-19 health emergency. Method: For this study, a cross-sectional correlational descriptive design was used. The Suicide Risk Assessment Scale -SRAS- and the Coping Styles and Strategies Scale were used as measurement instruments (CSSS). Results: The results found in the SRAS Scale did not indicate clinical levels of suicidal risk. And regarding the EEEAE, the participants almost always used the strategies of Positive Reappraisal, Social Support, Cognitive Disconnection and Problem-Solving skills. There were negative correlations between all the dimensions of the SRAS scale with CSSS, less between the dimensions Depression/Hopelessness and Isolation/social support (SRAS) with Cognitive Disconnection (CSSS) and especially the Positive Reappraisal had a significant weight on suicidal risk. Conclusions: Positive Reappraisal is a coping strategy that can protect mental health in situations of stress associated with suicidal risk of the rural population, farmers, and agricultural workers.

Gender disparities in multiple sclerosis research and leadership: A Colombian perspective.

Background: The neurological academic field is an illustrative example of persistent gender-related disparities reflected in compensation, funding, leadership, promotion, publishing, and recognition. Several studies indicate that neurology is one of the most underrepresented specialties with female physicians as first authors, but also has one of the highest gender payment gaps. Neglecting the role of women in academic leadership positions hinders the visibility and recognition of research and leadership in multiple sclerosis (MS). Increasing diversity within academia has positive effects, such as widening focus and expanding the plurality of research outputs. The gender gap and visibility of female MS clinicians and researchers remains an unexplored research topic in our country despite the rising number of female neurologists. Objective: This study aims to establish the gender distribution between researchers and clinical neurologists in multiple sclerosis in Colombia and raise awareness about gender disparities in this area. Methods: We applied a cross-sectional survey study of Colombian neurologists and neurology residents currently members of the Colombian Neurology Association. Mean and standard deviation (SD) were used for quantitative variables and frequency for qualitative variables. To evaluate the influence of gender, logarithmic regression was used. Data were analyzed in SPSS 26. Results: A total of 201 participants agreed to complete the survey, most of whom were female (n = 135, 67.2%). All the Colombian regions were represented in the survey. Of those surveyed, 31.5% (n = 64) had an interest in demyelinating diseases and MS, of which 46.8% (n = 30) were female. Of the women with MS training, only 50% (n =5) had more than three publications as the first author of a scientific article compared to men (n = 5, 83%). After adjusting the number of publications by gender, there were no significant differences between men and women (median 2.0[2, 1.21] vs. 2[2, 0.5], p = 0.904). However, only 16.6% (n = 5) of women had a visible academic, leadership, or teaching position compared with men 75.7% (n = 25). When adjusting the salary income by gender, we found a statistically significant difference between women and men (median 2.0 [5, 1.47] vs. 3 [5, 1.65], p = 0.006). Women in MS earned between USD 2,500 and 3,800 per month; while men earned between USD 3,800 to 5,070. Conclusion: Despite a higher number of female neurologists trained in MS in Colombia, our data suggest considerable differences and gender gaps with regard to diverse opportunities at the academic, salary promotion, leadership, teaching, and recognition levels between male and female MS neurologists.

Determining the pre-grazing sward height of Kikuyu grass (Cenchrus clandestinus - Hochst. ex Chiov.) for optimizing nutrient intake rate of dairy heifers.

Understanding the grazing process and animal response to sward structures (e.g., sward height) is key to setting targets for efficient grazing management. We hypothesized that the short-term intake rate (STIR) of dry matter (DM) and digestible organic matter (OM) by dairy heifers is maximized with Kikuyu grass (Cenchrus clandestinus-Hochst. ex Chiov.) of intermediate sward heights. The treatments consisted of five pre-grazing sward heights (10, 15, 20, 25, and 30 cm) randomly assigned to two of ten paddocks. The experimental design included two measurements of each paddock at different periods and times of day. Three Holstein heifers (440 ± 42 kg body weight) were used to determine the STIR, which was estimated using the double-weighing technique with correction for insensible weight losses. The bite mass (BM), bite rate (BR), sward structural characteristics, and nutritional value of herbage samples were assessed. The data were analyzed using mixed models with a factorial arrangement of five sward heights, two times of day, and two evaluation periods. The sward height of Kikuyu grass that maximized both STIRs was approximately 20 cm. The STIR of the DM was 30% and 15% lower than the maximum in the shortest and tallest swards tested, respectively. In swards shorter than 20 cm, the STIR was lower because the BM decreased with sward height, whereas in those greater than 20 cm, the lower BM and STIR of DM was explained by a decrease in bulk density and bite volume. The top stratum was composed mainly of highly digestible leaf blades with similar nutrient content across sward heights; therefore the STIR of digestible OM was also maximized at 20 cm. Hence, the optimal pre-grazing sward height of Kikuyu grass should be managed at 20 cm under rotational stocking systems to maximize nutrient intake rate of dairy heifers.

Emotional Impact of Graphic Health Warnings on Tobacco Packaging: Analysis of Their Content.

The use of graphic health warnings (GHWs) on tobacco packaging is one of the most widely used public health strategies worldwide, but there is little evidence of the emotional impact of its content and craving they generate. The objective of the present study was to evaluate the emotional and craving responses to GHW content. The study included 300 men and women of different ages (adolescents, young adults, and adults), both smokers and non-smokers. We evaluated the participants' emotional and craving responses to 16 GHWs with different content (i.e., cancer, cardiovascular disease, abortion, and childhood illness). We analyzed the effects of sex, smoking status, and age. GHWs exhibited the capacity to elicit aversive emotional states, with low levels of arousal and high levels of dominance and did not produce craving. GHWs that showed images of cancer and abortion had the greatest emotional impact. Non-smoking adolescent females experienced the greatest emotional impact of GHWs. The results suggest that GHWs effectively reduce the attractiveness of cigarette packages and discourage consumption, and increasing the size of GHWs may favor avoidance of the package. GHWs that depicted explicit threats had a greater emotional impact, especially in women.

Two-Step Strategy for Optimizing the Preoperative Classification of Adnexal Masses in a University Hospital, Using International Ovarian Tumor Analysis Models: Simple Rules and Assessment of Different NEoplasias in the adneXa Model.

OBJECTIVES: To evaluate the performance of a two-step strategy compared with the International Ovarian Tumor Analysis (IOTA) - Assessment of Different NEoplasias in the adneXa (ADNEX) model for preoperative classification of adnexal masses. METHODS: An ambispective diagnostic accuracy study based on ultrasound data collected at one university hospital between 2012 and 2018. Two ultrasonographers classified the adnexal masses using IOTA Simple Rules (first step). Not classifiable masses were evaluated using the IOTA ADNEX model (second step). Also, all masses were classified using the IOTA ADNEX model. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), positive likelihood ratio (LR+) and negative likelihood ratio (LR-), and receiver operating characteristic (ROC) curve were estimated. A P value of <.05 was used to determine statistical significance. RESULTS: The study included 548 patients and 606 masses. Patients' median age was 41 years with an interquartile range between 32 and 51 years. In the first step, 89 (14%) masses were not classifiable. In the second step, 55 (61.8%) masses were classified as malignant. Furthermore, for the totality of 606 masses, the IOTA ADNEX model estimated the probability that 126 (20.8%) masses were malignant. The two-step strategy had a sensitivity, specificity, PPV, NPV, LR+, LR-, and ROC curve of 86.8%, 91.01%, 51.9%, 98.4%, 9.7, 0.1, and 0.889, respectively; compared to IOTA ADNEX model that had values of 91.8%, 87.16%, 44.4%, 99%, 7.1, 0.09, and 0.895, respectively. CONCLUSION: The two-step strategy shows a similar diagnostic performance when compared to the IOTA ADNEX model. The IOTA ADNEX model involves only one step and can be more practical, and thus would be recommended to use.

[Development of a comprehensive public policy for adolescent pregnancy prevention in UruguayDesenvolvimento de uma política pública abrangente de prevenção da gravidez na adolescência no Uruguai]. / Desarrollo de una política pública integral de prevención del embarazo en adolescentes en Uruguay.

This article presents the main characteristics and achievements of Uruguay's National and Intersectoral Strategy for Prevention of Adolescent Pregnancy, implemented from 2016 to 2020. This strategy was implemented in a context in which unintentional adolescent pregnancy continues to be a major social problem for Uruguay and the Region, necessitating comprehensive, sustained, and evidence-based public policies. In Uruguay, adolescent fertility rates have remained high for over a decade. In addition to intersectoral action by government and civil society, the strategy received scientific assistance from the academic community, and technical and financial cooperation from regional and international organizations. Its actions and measures were adopted based on a socio-ecological vision, with cultural sensitivity, a gender-transformative approach, and a human rights perspective. Major barriers include social norms that value maternity as the main life project for women living in poverty, gender stereotypes (pregnancy as the exclusive responsibility of adolescent girls, without involving adolescent boys), the stigma of abortion, a lack of sexual and reproductive health services, and resistance to raising the visibility of pregnancy in girls under 15 years of age who are victims of structural and family violence. It is necessary to ensure the continuity of public policies--adjusted to a gender and human-rights approach--that take into account new scenarios such as the one imposed by the COVID-19 pandemic.

Este artigo apresenta os principais aspectos e os resultados da Estratégia Nacional e Intersetorial para Prevenção da Gravidez na Adolescência, implementada no Uruguai entre 2016 e 2020. A gravidez não intencional na adolescência persiste como uma questão social importante no Uruguai e na Região, exigindo políticas públicas com base em evidências científicas que sejam abrangentes e permanentes. A fecundidade na adolescência no Uruguai tem se mantido elevada há mais de uma década. Além da ação intersetorial do governo e da sociedade civil, a estratégia aprovada recebeu orientação científica de entidades acadêmicas, e cooperação técnica e financeira de organismos regionais e internacionais. As ações e as medidas da estratégia foram elaboradas a partir de uma visão socioecológica, com sensibilidade cultural e enfoque transformador de gênero e uma perspectiva de direitos humanos. Entre as barreiras mais importantes enfrentadas estão as normas sociais que valorizam a maternidade como principal projeto de vida para a mulher que vive em situação de pobreza, os estereótipos de gênero (a gravidez é vista como responsabilidade exclusiva da adolescente, sem envolver o parceiro adolescente), o estigma do aborto, a oferta insuficiente de serviços de saúde sexual e reprodutiva, e a resistência a dar visibilidade à gravidez de menores de 15 anos que são vítimas de violência estrutural e intrafamiliar. É necessário garantir a continuidade das políticas públicas que incorporem uma perspectiva de gênero e direitos humanos, e que sejam adaptadas aos novos cenários da pandemia de COVID-19.

Desarrollo de una política pública integral de prevención del embarazo en adolescentes en Uruguay

[RESUMEN]. Se presentan las principales características y logros de la Estrategia Nacional e Intersectorial para la Prevención del Embarazo en Adolescentes, implementada en Uruguay entre 2016 y 2020. Este proceso se desarrolló en un contexto en el que el embarazo no intencional en adolescentes continúa siendo un problema social relevante para Uruguay y la Región, por lo que se requieren políticas públicas integrales, sostenidas y basadas en evidencias científicas. En Uruguay, la fecundidad adolescente se ha mantenido en niveles elevados por más de una década. Además de la acción intersectorial del Gobierno y la sociedad civil, la estrategia aprobada contó con asesoramiento científico desde el ámbito académico y la cooperación técnica y financiera de organismos regionales e internacionales. Las acciones y medidas adoptadas se basan en una visión socio-ecológica, con sensibilidad cultural, enfoque transformador de género y perspectiva de derechos humanos. Entre las barreras más importantes están las normas sociales que valoran la maternidad como el principal proyecto de vida para las mujeres que viven en contextos de pobreza, los estereotipos de género —el embarazo como una responsabilidad exclusiva de las adolescentes, sin involucrar a los adolescentes varones—, el estigma del aborto, la insuficiente oferta de servicios de salud sexual y reproductiva, y la resistencia a visibilizar el embarazo en niñas menores de 15 años víctimas de la violencia estructural e intrafamiliar. Es necesario asegurar la continuidad de las políticas públicas, ajustadas a un enfoque de género y de derechos humanos, y que se tomen en cuenta los nuevos escenarios, como el que impone la pandemia por COVID-19.

[ABSTRACT]. This article presents the main characteristics and achievements of Uruguay’s National and Intersectoral Strategy for Prevention of Adolescent Pregnancy, implemented from 2016 to 2020. This strategy was implemented in a context in which unintentional adolescent pregnancy continues to be a major social problem for Uruguay and the Region, necessitating comprehensive, sustained, and evidence-based public policies. In Uruguay, adolescent fertility rates have remained high for over a decade. In addition to intersectoral action by government and civil society, the strategy received scientific assistance from the academic community, and technical and financial cooperation from regional and international organizations. Its actions and measures were adopted based on a socio-ecological vision, with cultural sensitivity, a gender-transformative approach, and a human rights perspective. Major barriers include social norms that value maternity as the main life project for women living in poverty, gender stereotypes (pregnancy as the exclusive responsibility of adolescent girls, without involving adolescent boys), the stigma of abortion, a lack of sexual and reproductive health services, and resistance to raising the visibility of pregnancy in girls under 15 years of age who are victims of structural and family violence. It is necessary to ensure the continuity of public policies––adjusted to a gender and human-rights approach––that take into account new scenarios such as the one imposed by the COVID-19 pandemic.

[RESUMO]. Este artigo apresenta os principais aspectos e os resultados da Estratégia Nacional e Intersetorial para Prevenção da Gravidez na Adolescência, implementada no Uruguai entre 2016 e 2020. A gravidez não intencional na adolescência persiste como uma questão social importante no Uruguai e na Região, exigindo políticas públicas com base em evidências científicas que sejam abrangentes e permanentes. A fecundidade na adolescência no Uruguai tem se mantido elevada há mais de uma década. Além da ação intersetorial do governo e da sociedade civil, a estratégia aprovada recebeu orientação científica de entidades acadêmicas, e cooperação técnica e financeira de organismos regionais e internacionais. As ações e as medidas da estratégia foram elaboradas a partir de uma visão socioecológica, com sensibilidade cultural e enfoque transformador de gênero e uma perspectiva de direitos humanos. Entre as barreiras mais importantes enfrentadas estão as normas sociais que valorizam a maternidade como principal projeto de vida para a mulher que vive em situação de pobreza, os estereótipos de gênero (a gravidez é vista como responsabilidade exclusiva da adolescente, sem envolver o parceiro adolescente), o estigma do aborto, a oferta insuficiente de serviços de saúde sexual e reprodutiva, e a resistência a dar visibilidade à gravidez de menores de 15 anos que são vítimas de violência estrutural e intrafamiliar. É necessário garantir a continuidade das políticas públicas que incorporem uma perspectiva de gênero e direitos humanos, e que sejam adaptadas aos novos cenários da pandemia de COVID-19.

Tuning the Covering on Gold Surfaces by Grafting Amino-Aryl Films Functionalized with Fe(II) Phthalocyanine: Performance on the Electrocatalysis of Oxygen Reduction.

Current selective modification methods, coupled with functionalization through organic or inorganic molecules, are crucial for designing and constructing custom-made molecular materials that act as electroactive interfaces. A versatile method for derivatizing surfaces is through an aryl diazonium salt reduction reaction (DSRR). A prominent feature of this strategy is that it can be carried out on various materials. Using the DSRR, we modified gold surface electrodes with 4-aminebenzene from 4-nitrobenzenediazonium tetrafluoroborate (NBTF), regulating the deposited mass of the aryl film to achieve covering control on the electrode surface. We got different degrees of covering: monolayer, intermediate, and multilayer. Afterwards, the ArNO2 end groups were electrochemically reduced to ArNH2 and functionalized with Fe(II)-Phthalocyanine to study the catalytic performance for the oxygen reduction reaction (ORR). The thickness of the electrode covering determines its response in front of ORR. Interestingly, the experimental results showed that an intermediate covering film presents a better electrocatalytic response for ORR, driving the reaction by a four-electron pathway.

[Adolescents faced with the decision to terminate a pregnancy in a context of legal abortion]. / Las adolescentes frente a la decisión de interrumpir un embarazo en un contexto de aborto legal.

The article presents the results of a study on the experiences of adolescents that decided to terminate a pregnancy in the context of legal abortion services in Montevideo, Uruguay, from 2016 to 2018. The main objective was to examine the decision-making process and access to legal abortion from the perspective of the adolescent girls themselves. This involved analyzing circumstances, motives, and persons that influenced the decision and the ways this was handled in the health services. A cross-sectional, exploratory, and descriptive study was designed, based on a qualitative methodology. The main technique used for collecting the information was a semi-structured interview with 14 adolescents 17 to 19 years of age who had voluntarily terminated a pregnancy in public healthcare services. The motives for the abortion reveal the weight of socially accepted reasons, incorporated as their own. The interviews showed that the adolescent's mother plays an important role as the reference for the decision. The adolescents reported that they had made the decision to have the abortion before going to the health service. The results highlight the positive role of a legal framework that enables voluntary abortion services. The results help understand the experiences of adolescents facing a difficult life decision, the family's role, particularly that of the adolescent's mother, the legal framework's place in the decision, the weight of stigma and moral sanctions, and expectations towards care in health services.

El artículo presenta resultados de una investigación sobre las experiencias de las adolescentes que decidieron interrumpir su embarazo en el marco de los servicios legales de aborto en Montevideo (Uruguay), realizada entre los años 2016 y 2018. Su objetivo principal fue examinar el proceso de toma de decisión y el acceso al aborto legal, desde la perspectiva de las propias adolescentes. Ello implicó analizar circunstancias, motivaciones y personajes que influenciaron en la toma de la decisión y cómo ésta se tramitó en el servicio de salud. Se diseñó un estudio transversal de tipo exploratorio y descriptivo, basado en metodología cualitativa. La técnica principal que se utilizó para la recolección de la información fue la entrevista semidirigida, se entrevistó a 14 adolescentes entre 17 y 19 años de edad que interrumpieron voluntariamente un embarazo en los servicios públicos de salud. Los motivos para abortar dan cuenta del peso que tienen las razones socialmente aceptadas, incorporadas como motivos propios. Se observó que la madre juega un papel importante como referente en la decisión. Las adolescentes manifestaron tomar la decisión de abortar antes de haber concurrido al servicio de salud. Se destaca el papel positivo de la existencia de un marco legal que habilita servicios de aborto voluntario. Los resultados contribuyen a comprender los procesos que viven las adolescentes frente a una decisión vital difícil, el rol de la familia, en particular de la figura materna, el lugar que tiene el marco legal en la toma de la decisión, el peso del estigma y la sanción moral, y las expectativas respecto de la atención en servicios de salud.

O artigo apresenta os resultados de uma pesquisa, desenvolvida entre 2016 e 2018, sobre as experiências de adolescentes que decidiram interromper a sua gravidez nas unidades de saúde para aborto legal em Montevidéu (Uruguai). Tinha como objetivo principal analisar o processo de tomada de decisão e o acesso ao aborto legal, do ponto de vista das próprias adolescentes. Isso envolvia avaliar as circunstancias, motivações e personagens que influenciaram a tomada de decisão e a forma como se deu no sistema de saúde. Foi construído um estudo transversal do tipo exploratório e descritivo baseado numa metodologia qualitativa. A técnica principal utilizada para a coleta de informação era a entrevista semiestruturada; foram entrevistadas 14 adolescentes entre 17 e 19 anos de idade, que tinham interrompido voluntariamente uma gravidez no sistema público de saúde. Os motivos para abortar refletem o peso das razões socialmente aceitas, incorporadas como motivos próprios. Observou-se que a mãe desempenha um papel relevante, como referente na decisão. As adolescentes afirmaram ter tomado a decisão de abortar antes de se dirigir à unidade de saúde. Destaca-se o papel positivo da existência de um marco legal que habilita serviços de aborto voluntário. Os resultados contribuem para o entendimento dos processos vivenciados pelas adolescentes diante de uma decisão vital difícil, o papel da família, em especial da figura materna, o lugar ocupado pelo marco legal na tomada da decisão, o peso do estigma e da sanção moral, além das expectativas sobre o atendimento nas unidades de saúde.

Las adolescentes frente a la decisión de interrumpir un embarazo en un contexto de aborto legal / Adolescents faced with the decision to terminate a pregnancy in a context of legal abortion / As adolescentes frente à decisão de interromper uma gravidez em um contexto de aborto legal

El artículo presenta resultados de una investigación sobre las experiencias de las adolescentes que decidieron interrumpir su embarazo en el marco de los servicios legales de aborto en Montevideo (Uruguay), realizada entre los años 2016 y 2018. Su objetivo principal fue examinar el proceso de toma de decisión y el acceso al aborto legal, desde la perspectiva de las propias adolescentes. Ello implicó analizar circunstancias, motivaciones y personajes que influenciaron en la toma de la decisión y cómo ésta se tramitó en el servicio de salud. Se diseñó un estudio transversal de tipo exploratorio y descriptivo, basado en metodología cualitativa. La técnica principal que se utilizó para la recolección de la información fue la entrevista semidirigida, se entrevistó a 14 adolescentes entre 17 y 19 años de edad que interrumpieron voluntariamente un embarazo en los servicios públicos de salud. Los motivos para abortar dan cuenta del peso que tienen las razones socialmente aceptadas, incorporadas como motivos propios. Se observó que la madre juega un papel importante como referente en la decisión. Las adolescentes manifestaron tomar la decisión de abortar antes de haber concurrido al servicio de salud. Se destaca el papel positivo de la existencia de un marco legal que habilita servicios de aborto voluntario. Los resultados contribuyen a comprender los procesos que viven las adolescentes frente a una decisión vital difícil, el rol de la familia, en particular de la figura materna, el lugar que tiene el marco legal en la toma de la decisión, el peso del estigma y la sanción moral, y las expectativas respecto de la atención en servicios de salud.

The article presents the results of a study on the experiences of adolescents that decided to terminate a pregnancy in the context of legal abortion services in Montevideo, Uruguay, from 2016 to 2018. The main objective was to examine the decision-making process and access to legal abortion from the perspective of the adolescent girls themselves. This involved analyzing circumstances, motives, and persons that influenced the decision and the ways this was handled in the health services. A cross-sectional, exploratory, and descriptive study was designed, based on a qualitative methodology. The main technique used for collecting the information was a semi-structured interview with 14 adolescents 17 to 19 years of age who had voluntarily terminated a pregnancy in public healthcare services. The motives for the abortion reveal the weight of socially accepted reasons, incorporated as their own. The interviews showed that the adolescent's mother plays an important role as the reference for the decision. The adolescents reported that they had made the decision to have the abortion before going to the health service. The results highlight the positive role of a legal framework that enables voluntary abortion services. The results help understand the experiences of adolescents facing a difficult life decision, the family's role, particularly that of the adolescent's mother, the legal framework's place in the decision, the weight of stigma and moral sanctions, and expectations towards care in health services.

O artigo apresenta os resultados de uma pesquisa, desenvolvida entre 2016 e 2018, sobre as experiências de adolescentes que decidiram interromper a sua gravidez nas unidades de saúde para aborto legal em Montevidéu (Uruguai). Tinha como objetivo principal analisar o processo de tomada de decisão e o acesso ao aborto legal, do ponto de vista das próprias adolescentes. Isso envolvia avaliar as circunstancias, motivações e personagens que influenciaram a tomada de decisão e a forma como se deu no sistema de saúde. Foi construído um estudo transversal do tipo exploratório e descritivo baseado numa metodologia qualitativa. A técnica principal utilizada para a coleta de informação era a entrevista semiestruturada; foram entrevistadas 14 adolescentes entre 17 e 19 anos de idade, que tinham interrompido voluntariamente uma gravidez no sistema público de saúde. Os motivos para abortar refletem o peso das razões socialmente aceitas, incorporadas como motivos próprios. Observou-se que a mãe desempenha um papel relevante, como referente na decisão. As adolescentes afirmaram ter tomado a decisão de abortar antes de se dirigir à unidade de saúde. Destaca-se o papel positivo da existência de um marco legal que habilita serviços de aborto voluntário. Os resultados contribuem para o entendimento dos processos vivenciados pelas adolescentes diante de uma decisão vital difícil, o papel da família, em especial da figura materna, o lugar ocupado pelo marco legal na tomada da decisão, o peso do estigma e da sanção moral, além das expectativas sobre o atendimento nas unidades de saúde.