Topical and Intralesional Therapies for Hidradenitis Suppurativa: A Systematic Literature Review. / [Artículo traducido] Tratamientos tópicos e intralesionales en hidradenitis supurativa. Una revisión sistemática de la literatura.

BACKGROUND AND OBJECTIVE: Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their use is limited. The aim of our review is to evaluate the efficacy and safety profile of topical and IL treatments in patients with HS. MATERIALS AND METHODS: We designed a systematic review of the current medical literature available following the PICO(T) method. And including all types of studies (Study type [T]) of individuals with HS of any sex, age, and ethnicity (Population [P]) who received any topical or IL treatment for HS (Intervention [I]) compared to placebo, other treatments, or no treatment at all (Comparator [C]), and reported efficacy and/or safety outcomes (Outcomes [O]). Two outcomes were defined: quality of life and the no. of patients with, at least, one adverse event. The search was conducted in the Cochrane Library, MEDLINE, and Embase databases; study selection was performed based on pre-defined criteria. The risk of bias was determined in each study. RESULTS: We obtained a total of 11,363 references, 31 of which met the inclusion criteria. These studies included 1143 patients with HS, 62% of whom were women. A total of 10, 8, 6, 2, and 5 studies, respectively, evaluated the use of photodynamic therapy (PDT), glucocorticoids, resorcinol, topical antibiotics, and other interventions. Most articles were case series (n=25), with only five randomized clinical trials (RCTs) and one cohort study. RCTs showed improvement in disease activity with topical clindamycin and botulinum toxin (BTX) vs placebo, and PDT with methylene blue (MB) niosomal vs free MB; however, intralesional triamcinolone acetonide was not superior to placebo. The risk of bias was low in three RCTs and high in two RCTs. CONCLUSION: The quality of evidence supporting the use of topical, or IL treatments is low. However, it supports the use of topical clindamycin, PDT, and BTX. Well-designed RCTs with standardized outcomes and homogeneous populations of patients and lesions are needed to support decision-making in the routine clinical practice.

Antecedentes de Andragogía en el proceso de gestión de personas mayores por profesionales de enfermería

Introducción: La gestión del cuidado de enfermería en personas mayores es todo un desafío en la actualidad para la profesión y más aún desde un enfoque andragógico. Objetivo: Exponer la fundamentación de los antecedentes de la andragogía en el proceso de gestión del cuidado de personas mayores por profesionales de enfermería. Métodos: Se realizó una revisión con el método de análisis bibliográfico a través de una búsqueda realizada entre los años 2010 al 2022, donde se consultaron bases de datos especializadas y se seleccionaron 33 publicaciones científicas sobre el tema. Resultados: El cuidado de personas mayores requiere una mirada transdisciplinaria y profesionales comprometidos con su cuidado. El profesional de enfermería responsable de la gestión debe considerar valores, actitudes y conocimientos de la disciplina que brindan una visión distinta y específica de la gestión de los cuidados. El avance científico ha permitido el incremento de la expectativa de vida de las personas, produciéndose un aumento significativo de personas mayores en el mundo manteniendo un adecuado cuidado como eslabón importante. La andragogía se encarga de la educación entre, para y por adultos y la asume como su objeto de estudio y realización, vista o concebida esta, como autoeducación, por lo cual, cobra importancia en los cuidados, pues interpreta el hecho educativo como un hecho andragógico, donde la educación y los cuidados se realizan como autoeducación. Conclusiones: Resulta importante la ejecución de investigaciones que beneficien el desarrollo del profesional de enfermería, para ayudar a disminuir las brechas que constan en la formación investigativa de estos profesionales y en las estructuras organizativas en las que estos se incorporan, dado en el proceso de gestión del cuidado de personas mayores desde un enfoque andragógico como mecanismo esencial.

Introduction: The management of nursing care in older people is a challenge for the profession today and even more so from an andragogical approach. Objective: To present the foundation of the background of andragogy in the process of managing the care of elderly people by nursing professionals. Methods: A review was carried out using the bibliographic analysis method through a search carried out between the years 2010 to 2022, where specialized databases were consulted and 33 scientific publications on the topic were selected. Results: Caring for the elderly requires a transdisciplinary approach and professionals committed to their care. The nursing professional responsible for the management must consider values, attitudes and knowledge of the discipline that provide a different and specific vision of care management. Scientific advances have allowed an increase in people's life expectancy, producing a significant increase in the number of older people in the world, maintaining adequate care as an important link. Andragogy is responsible for education among, for and by adults and assumes it as its object of study and realization, seen or conceived, as self-education, which is why andragogy gains importance in care, since it interprets the educational fact as an andragogical fact, where education and care are carried out as self-education. Conclusions: It is important to carry out research that benefits the development of nursing professionals, to help reduce the gaps that exist in the research training of these professionals and in the organizational structures in which they are incorporated, given in the care management process of older people from an andragogical approach as an essential mechanism.

A contribuição de terapeutas ocupacionais no domínio da gestão de risco e desastres: um protocolo de revisão de escopo / Contribution of occupational therapists to the field of risk and disaster management: a scoping review protocol

Resumo Introdução Desastres trazem consequências humanas, socioeconômicas e ambientais e agravam situações de vulnerabilidade. Tanto países centrais, altamente industrializados, como países com dificuldades econômicas estão sujeitos a esses eventos. No Brasil, a pandemia de COVID-19 e o rompimento de barragens evidenciam dificuldades em se antecipar e responder esses tipos de eventos. Ações da terapia ocupacional no campo das emergências e desastres são escassas na literatura, notadamente na esfera da prevenção. Objetivo Explorar as evidências da contribuição de terapeutas ocupacionais no domínio da gestão de risco e desastres a partir das características, prioridades e principais áreas de interesse da produção intelectual em terapia ocupacional. Método Uma pesquisa abrangente será conduzida nos periódicos Disasters, Hazards & Crisis in Public Policy, International Journal of Mass Emergencies and Disasters, and Risk, International Journal of Risk Reduction e Journal of Contingencies and Crisis Management, assim como nas bases de dados Occupational Therapy Literature Search Service (OTDBASE), PubMed e Web of Science. Critérios de inclusão Ações e experiências no âmbito da terapia ocupacional, notadamente aquelas de terapeutas ocupacionais na gestão de riscos e desastres, encontradas em estudos revisados por pares, que adotem métodos quantitativos, qualitativos e mistos, nos idiomas espanhol, inglês e português, sem restrição temporal. A abordagem preconizada pelo Joanna Briggs Institute (JBI) para seleção de estudos, avaliação crítica, extração e síntese de dados será utilizada.

Abstract Introduction Disasters bring human, socioeconomic, and environmental consequences and exacerbate situations of vulnerability. Both highly industrialized core countries and those facing economic difficulties are subject to these events. In Brazil, the COVID-19 pandemic and the collapse of dams highlight difficulties in anticipating and responding to these types of events. Actions of occupational therapy in the field of emergencies and disasters are scarce in the literature, notably in the sphere of prevention. Objective To explore the evidence of the contribution of occupational therapists in the field of risk management and disasters based on the characteristics, priorities, and main areas of interest of intellectual production in occupational therapy. Method A comprehensive search will be conducted in the journals Disasters, Hazards & Crisis in Public Policy, International Journal of Mass Emergencies and Disasters, and Risk, International Journal of Risk Reduction, and Journal of Contingencies and Crisis Management, as well as in the databases Occupational Therapy Literature Search Service (OTDBASE), PubMed, and Web of Science. Inclusion Criteria Actions and experiences in the field of occupational therapy, notably those of occupational therapists in risk and disaster management, found in peer-reviewed studies adopting quantitative, qualitative, and mixed methods, in Spanish, English, and Portuguese, without temporal restriction. The approach advocated by the Joanna Briggs Institute (JBI) for study selection, critical appraisal, and data collection and synthesis will be used.

Habilidades Sociales y personas con discapacidad: panorama de las investigaciones brasileñas / Habilidades sociais e pessoas com deficiência: panorama das pesquisas brasileiras / Social skills and people with disabilities: overview of brazilian research

Pesquisas sobre o campo das habilidades sociais vêm crescendo nas últimas décadas e, em paralelo, estudos que buscam sistematizar o que vem sendo produzido. Este estudo teve como objetivo caracterizar, por meio de uma revisão da literatura, estudos empíricos realizados por autores brasileiros publicados em periódicos que investigam diretamente as habilidades sociais de pessoas com deficiência. Foi realizada uma busca nas bases de dados SciELO, PEPSIC, LILACS, Index Psi, BDENF e Periódicos CAPES com os descritores habilidades sociais e competência social, sem restrição quanto ao período de publicação. Foram caracterizados 43 artigos quanto a aspectos bibliográficos e metodológicos. Os resultados indicam alto volume de pesquisas com delineamento descritivo, maior frequência de participantes com deficiência intelectual, predomínio de inventários como forma de avaliação e escassez de pesquisas instrumentais sobre validação ou desenvolvimento de medidas. Essa revisão poderá contribuir com informações para auxiliar novas pesquisas sobre habilidades sociais junto a pessoas com deficiência.

Investigaciones sobre el campo de las habilidades sociales siguen creciendo en las últimas décadas y, en paralelo, estudios que buscan sistematizar lo que vienen siendo producido. En este estudio se tuvo como objetivo caracterizar, por intermedio de una revisión de la literatura, estudios empíricos realizados por autores brasileños publicados en periódicos que investigan directamente las habilidades sociales de personas con discapacidad. Se realizó una búsqueda en las bases de datos SciELO, PEPSIC, LILACS, Index Psi, BDENF y Periódicos CAPES con los descriptores habilidades y competencia sociales, sin restricción al período de publicación. Se caracterizaron 43 artículos cuanto al aspectos bibliográficos y metodológicos. Los resultados indican alto volumen de investigaciones con delineamento descriptivo, mayor frecuencia de participantes con discapacidad intelectual, predominio de inventarios como forma de evaluación y escasez de investigaciones instrumentales sobre validación o desarrollo de medidas. Esta revisión podrá contribuir con informaciones para ayudar nuevas investigaciones sobre habilidades sociales junto a personas con discapacidad.

ABSTRACT Research about the social skills field has been growing in recent decades and, in parallel, studies that seek to systematize what has been produced. This study aimed to characterize, through a literature review, empirical studies carried out by Brazilian authors published in journals that directly investigate the social skills of people with disabilities. A search was carried out in the SciELO, PEPSIC, LILACS, Index Psi, BDENF and Periodicals CAPES databases with the descriptors social skills and social competence, without restriction regarding the period of publication. It was found 43 articles were characterized in terms of bibliographic and methodological aspects. The results indicate a high volume of research with a descriptive design, a higher frequency of participants with intellectual disabilities, a predominance of inventories as a means of evaluation and a scarcity of instrumental research on validation or development of measures. This review may contribute with information to support further research on social skills with people with disabilities.

Plantas medicinais da caatinga: uma revisão integrativa dos saberes etnobotânicos no semiárido nordestino / Medicinal plants from the caatinga: an integrative review of ethnobotanical knowledge in the northeastern semi- arid region / Plantas medicinales de la caatinga: una revisión integradora del conocimiento etnobotánico en la región semiárida nororiental

A vegetação da Caatinga é rica em uma diversidade de espécies vegetais utilizadas para satisfazer as necessidades humana. Muitas dessas espécies são utilizadas para fins terapêuticos por populações. As formas de uso dessas espécies podem ser registradas e resgatadas através de estudos etnobotânicos, os quais contribuem no levantamento das potencialidades dos recursos vegetais, bem como em planos de recuperação e conservação da vegetação. Assim, com base em uma revisão integrativa, o presente trabalho buscou copilar informações sobre como os trabalhos de etnobotânica das plantas medicinais estão sendo desenvolvidos, assim como a respeito das principais espécies e famílias botânicas de potencial medicinal descritas, em levantamentos realizados em áreas caatinga localizadas na região semiárida do Nordeste. Para isso, foram selecionados artigos publicados entre os anos de 2010 e 2022, que abordassem a temática relacionada. Foram considerados trabalhos publicados no formato de artigos originais, disponíveis de forma online, gratuito e completo, em língua portuguesa e inglesa. Esses artigos foram consultados em diferentes bases de dados. A análise integrativa evidenciou as características das publicações, como a concentração de estudos direcionados aos estados da Bahia, Paraíba e Pernambuco, bem como demonstrou uma rica diversidade de plantas medicinais que são utilizadas pela população no semiárido nordestino, destacando-se, principalmente, os saberes tradicionais sobre as suas formas de uso e propriedades terapêuticas.

The Caatinga vegetation is rich in a diversity of plant species used to satisfy human needs. Many of these species are used for therapeutic purposes by populations. The forms of use of these species can be registered and rescued through ethnobotanical studies, which contribute to the survey of the potential of plant resources, as well as plans for the recovery and conservation of vegetation. Thus, based on an integrative review, the present work sought to compile information on how ethnobotany works on medicinal plants are being developed, as well as on the main species and botanical families with medicinal potential described, in surveys carried out in caatinga areas located in the semi-arid region of the Northeast. For this, articles published between the years 2010 and 2022 that addressed the related theme were selected. Works published in the format of original articles, available online, free and complete, in Portuguese and English, were considered. These articles were consulted in different databases. The integrative analysis showed the characteristics of the publications, such as the concentration of studies directed to the states of Bahia, Paraíba and Pernambuco, as well as demonstrating a rich diversity of medicinal plants that are used by the population in the northeastern semi-arid region, highlighting, mainly, the knowledge traditional practices about their forms of use and therapeutic properties.

La vegetación de la Caatinga es rica en una diversidad de especies vegetales utilizadas para satisfacer las necesidades humanas. Muchas de estas especies son utilizadas con fines terapéuticos por las poblaciones. Las formas de uso de estas especies pueden ser registradas y rescatadas a través de estudios etnobotánicos, que contribuyen al levantamiento del potencial de los recursos vegetales, así como a los planes de recuperación y conservación de la vegetación. Así, a partir de una revisión integradora, el presente trabajo buscó recopilar información sobre cómo se están desarrollando los trabajos etnobotánicos sobre plantas medicinales, así como sobre las principales especies y familias botánicas con potencial medicinal descritas, en relevamientos realizados en áreas de caatinga ubicadas en la región semiárida del Nordeste. Para ello, se seleccionaron artículos publicados entre los años 2010 y 2022 que abordaran la temática relacionada. Se consideraron trabajos publicados en formato de artículos originales, disponibles en línea, gratuitos y completos, en portugués e inglés. Estos artículos fueron consultados en diferentes bases de datos. El análisis integrador mostró las características de las publicaciones, como la concentración de estudios dirigidos a los estados de Bahía, Paraíba y Pernambuco, además de demostrar una rica diversidad de plantas medicinales que son utilizadas por la población de la región semiárida del nordeste, destacándose, principalmente, los conocimientos tradicionales sobre sus formas de uso y propiedades terapéuticas.

Albológica sine die: De vivencias que habitan memorias donde subsiste la figura y la obra de Francisco Herrera-Rodríguez (1957-2023) / Albológica sine die: De experiências que habitam memórias onde vivem a figura e a obra de Francisco Herrera-Rodríguez (1957-2023) / Albológica sine die: Of experiences that inhabit memories where the figure and work of Francisco Herrera-Rodríguez (1957-2023) subsists

The objective of this article is to vividly evoke the shared experiences with Professor and researcher Francisco Herrera-Rodríguez and to explicitly outline the most significant aspects of his contribution to the history of medicine and nursing, based on both historical research and narrative, highlighting his strong commitment and dedication to literary sources. The methodology employed has focused on autobiography, recalling shared moments in academic, artistic, literary, and leisure contexts; that is, the creation of autobiographical life stories focused on the times when various interactions occurred between Francisco Herrera-Rodríguez and the author. The results demonstrate the importance of Francisco Herrera-Rodríguez's contributions to the history of medicine and nursing. Likewise, the great humanistic quality of the mentioned researcher is evident. Conclusions: Francisco Herrera-Rodríguez, through the cultivation of his favorite passions—historical research, literature, drawing, painting, and art in general—emerged as a profound humanist who positively influenced the education of historians in the fields of medicine and nursing.(AU)

El objetivo de este artículo consiste en evocar de forma nítida las vivencias compartidas con el profesor e investigador Francisco Herrera-Rodríguez y explicitar los aspectos más significativos de su aportación a la historia de la medicina y la enfermería basadas tanto en la investigación histórica como en la narrativa resaltando su gran compromiso y dedicación con las fuentes literarias. La metodología empleada se ha centrado en la autobiografía rememorando momentos compartidos en contextos académicos, artísticos, literarios y de puro ocio; es decir en la elaboración de relatos de vida autobiográficos enfocados a los tiempos en los que se han producido interacciones de diversa índole entre Francisco Herrera-Rodríguez y el autor. Los resultados muestran la importancia de las aportaciones de Francisco Herrera-Rodríguez a la historia de la medicina y la historia de la enfermería. Asimismo, queda demostrada la gran calidad humanística del mencionado investigador. Conclusiones: Francisco Herrera-Rodríguez, mediante el cultivo de sus predilectas pasiones: la investigación histórica, la literatura, el dibujo, la pintura y el arte en general; se erigió en un humanista de gran calado que incidió positivamente en la formación de historiadores de la medicina y la enfermería.(AU)

O objetivo deste artigo é evocar de forma nítida as experiências compartilhadas com o professor e pesquisador Francisco Herrera-Rodríguez e explicitar os aspectos mais significativos de sua contribuição para a história da medicina e enfermagem, com base tanto na pesquisa histórica quanto na narrativa, destacando seu grande comprometimento e dedicação às fontes literárias. A metodologia utilizada concentrou-se na autobiografia, recordando momentos compartilhados em contextos acadêmicos, artísticos, literários e de lazer; ou seja, na elaboração de relatos de vida autobiográficos focados nos momentos em que ocorreram interações de diversas naturezas entre Francisco Herrera-Rodríguez e o autor. Os resultados mostram a importância das contribuições de Francisco Herrera-Rodríguez para a história da medicina e enfermagem. Da mesma forma, a grande qualidade humanística do referido pesquisador fica evidente. Conclusões: Francisco Herrera-Rodríguez, por meio do cultivo de suas paixões preferidas - pesquisa histórica, literatura, desenho, pintura e arte em geral - tornou-se um humanista de grande envergadura que teve um impacto positivo na formação de historiadores da medicina e enfermagem.(AU)

¿qué investigamos cuando estudiamos la violencia en redes sociales en colombia? una revisión sistemática de la literatura

Con el incremento en el acceso y uso de las redes sociales en Colombia, es de esperar que prácticas y discursos violentos se trasladen a estos espacios digitales. Sin duda, hoy en día las redes sociales son parte de los ecosistemas de información y comunicación de los colombianos en los que las culturas de violencia y paz se expanden y transforman. En este contexto, es esencial explorar las formas en las que investigamos la violencia en redes sociales, ya que entender este fenómeno permite responder mejor a las necesidades y experiencias de las comunidades del país. Este artículo busca explorar cómo se ha estudiado la violencia en las redes sociales en Colombia mediante una revisión sistemática de la literatura. Resultados muestran un complejo trayecto de investigación en el país que comprende variados objetivos, como entender las diferentes formas en las que la violencia es ejercida a través de redes sociales o sobre cómo nos permite conocer más contextos de violencia. Igualmente, los resultados muestran que las investigaciones están principalmente enfocadas en dos plataformas: Facebook y Twitter. Finalmente, se encontró que los artículos están principalmente orientados a investigar tres tipos de violencias: violencia de género, violencia relacionada con conflicto armado y violencia escolar. Los hallazgos de esta revisión sistemática de la literatura permiten, por un lado, valorar previos estudios que han demostrado el complejo panorama de la violencia mediática en el país y, por otro lado, descubrir posibles vacíos en la literatura que podrían ser respondidos por investigadoras e investigadores en el futuro.

With the increase in the access and use of social media platforms in Colombia, it is expected that violent practices and discourses transfer to these digital spaces. Certainly, today's social media are part of the information and communication ecosystems of Colombians, where cultures of violence expand and transform. In this context, it is essential to explore the ways in which we examine and research social media violence, since understanding this phenomenon allows us to strengthen a culture of peace that better responds to the needs and experiences of the country's communities. Thus, this article seeks to explore how social media violence has been studied in Colombia, through a systematic literature review. Results show a complex trajectory of research in the country that includes various objectives, such as understanding the different ways in which violence is exercised through social media, or how it allows us to learn more about contexts of violence. Likewise, the results show that research is mainly focused on two platforms: Facebook and Twitter. Finally, the articles were found to be mainly focused on three types of violence: gender-based violence, violence related to armed conflict, and school violence. Overall, findings of this systematic literature review allow, on the one hand, to assess previous studies that have demonstrated the complex landscape of social media violence in the country, and, on the other hand, to discover possible gaps in the literature that could be addressed by researchers in the future.

Historia de la hipertensión arterial: revisión narrativa

Introducción: La medición de la presión arterial es uno de los procedimientos más realizados en la práctica clínica. La presente revisión narrativa pretende sintetizar los aspectos relevantes que rodearon la definición de la hipertensión arterial, el recorrido histórico del tratamiento de esta y el aporte de los estudios a la disminución de la mortalidad por enfermedad cardiovascular en el tiempo. Metodología: Revisión narrativa de la historia de la hipertensión arterial, desde el reconocimiento de la presión arterial alta como un factor asociado al riesgo cardiovascular y la evolución histórica del tratamiento hasta los hallazgos significativos del estudio SPRINT, publicado en 2015. Resultados: Hasta hace aproximadamente 50 años la hipertensión arterial era conocida como una patología esencial, es decir, esta condición no siempre fue considerada como una enfermedad. El descubrimiento de la presión sanguínea ha sido atribuido a Stephen Hales, poeta, orador y sacerdote nacido en Inglaterra. La primera medición de la presión sanguínea e incidentalmente de la presión del pulso la realizó en 1733 en animales. Se describe el origen de la presión arterial, la hipertensión arterial, el camino recorrido para el reconocimiento de esta condición como enfermedad y posteriormente su tratamiento, hasta llegar al estudio SPRINT en 2015, el cual fue contundente en demostrar el beneficio de reducir la cifra de presión arterial sistólica objetivo en una población no diabética. Conclusión: Los resultados de esta revisión narrativa exponen cómo el reconocimiento de la presión arterial alta como un factor de riesgo cardiovascular permitió el avance en la investigación científica para determinar el tratamiento y las cifras de presión arterial que favorecen la reducción de la mortalidad y morbilidad por esta causa.

Background: Blood pressure measurement is one of the most performed procedures in clinical practice. This narrative review aims to expose the relevant aspects surrounding the definition of arterial hypertension, the historical path of its treatment, and the contribution of studies to the decrease in mortality due to cardiovascular disease over time. Methodology: Narrative review of the history of arterial hypertension from recognizing high blood pressure as a factor associated with cardiovascular risk to the historical evolution of treatment up to the SPRINT study published in 2015. Results: Until about 50 years ago, arterial hypertension was known as an essential pathology; this condition was not always considered a disease. The discovery of blood pressure has been attributed to Stephen Hales, a poet, orator and priest born in England. The first measurement of blood pressure and incidentally pulse pressure was made in 1733 in animals. The origin of blood pressure, arterial hypertension, and the path travelled for recognizing this condition as a disease and later its treatment until reaching the SPRINT study in 2015, which demonstrated the benefit of reducing the target systolic blood pressure figure in a non-diabetic population. Conclusion: This narrative review demonstrates that the recognition of high blood pressure as a cardiovascular risk factor allowed progress in scientific research to determine the treatment and blood pressure figures that favor the reduction of mortality and morbidity from this cause.

Coinvestigación con NNA: una revisión sistemática de literatura según las directrices Prisma

(analítico) Se realiza una revisión que examina la participación de niños, niñas y adolescentes como coinvestigadores. El estudio se apoya en la declaración para revisión sistemática de literatura Prisma y analiza las producciones científicas entre 2019 y 2022. Los artículos revisados revelan tendencias en los roles y las denominaciones que se asignan a los niños, niñas y adolescentes en la investigación, así como metodologías participativas que los reconocen como sujetos de derechos y expertos de su entorno, capaces de participar en la co-construcción de conocimiento con los adultos investigadores. También se identifican desafíos metodológicos, éticos y políticos que enfatizan la necesidad de una reflexión crítica sobre el propósito y las implicaciones de la participación infantil, las dinámicas de poder involucradas y el reconocimiento de las capacidades y perspectivas de los niños, niñas y adolescentes.

(analytical) This article conducts a systematic literature review of children and adolescents' participation as co-researchers. The study uses the PRISMA statement and analyzes scientific publications between 2019 and 2022. The reviewed articles reveal different trends regarding the roles and names assigned to children and adolescents as co-researchers. The authors also encountered a number of participatory methodologies that recognize this population as subjects of rights and experts in relation to their own settings who are capable of actively participating in the co-construction of knowledge with adult researchers. Methodological, ethical, and political challenges that occur with this research modality are identified in the reviewed articles. This highlights the need for critical reflection about the purpose and implications of child and adolescent participation in research, the power dynamics involved, and the importance of recognizing this population's diverse capacities and perspectives as part of this process.

(analítico) É realizada uma revisão sistemática da literatura da categoria co-investigação utilizada em metodologias participativas com crianças e adolescentes, seus papéis e as etapas dos processos investigativos em que intervêm. O estudo é baseado na declaração Prisma, e analisa as produções científicas no período de 2019 a 2022. Os artigos revisados revelam tendências nos papéis atribuídos a crianças e adolescentes nas pesquisas, bem como metodologias participativas que os reconhecem como sujeitos de direitos e especialistas em seu contexto, capazes de participar da co-construção do conhecimento com os adultos pesquisadores. Também são identificados desafios metodológicos, éticos e políticos, que enfatizam a necessidade de reflexão crítica sobre o propósito e as implicações da participação infantil, as dinâmicas de poder envolvidas e o reconhecimento das capacidades e perspectivas das crianças.

Repercussões da Pandemia de COVID-19 no Tratamento de Pacientes com Anorexia/Bulimia: Revisão de Escopo / Repercussions of the COVID-19 Pandemic on the Treatment of Patients with Anorexia and Bulimia: Scoping Review

A emergência sanitária deflagrada pela pandemia de COVID-19 exigiu que os serviços de saúde especializados na assistência aos Transtornos Alimentares se adaptassem às novas circunstâncias impostas pela necessidade de distanciamento social. Considerando essa perspectiva, delineou-se uma revisão de escopo com objetivo de analisar as estratégias de cuidado adotadas por profissionais da saúde para garantirem a continuidade do atendimento interdisciplinar aos pacientes em tempos de COVID-19. Foram consultadas as bases Web of Science, Scopus, PubMed/MEDLINE, CINAHL, PsycINFO, Embase, LILACS e SciELO entre 2020 e 2022. Identificaram-se 387 registros nas bases de dados, dos quais 11 preencheram os critérios de elegibilidade e foram selecionados. Os resultados foram organizados em três categorias temáticas: (1) a "não escolha" da escolha do formato online: prós e contras; (2) foco na comunicação e acolhimento: ressignificando o uso do dispositivo online; (3) intervenções online: adaptações, inovações e recursos alternativos. As principais estratégias utilizadas durante a transição do tratamento para o ambiente online foram: teleatendimento e psicoterapia online. Apesar de terem sido bem avaliadas, foram percebidas barreiras para superar as limitações do cuidado online, como a desconfiança dos pacientes e seus potenciais efeitos na qualidade do vínculo terapêutico.

The health emergency triggered by the COVID-19 pandemic demanded that health services specialized in treating Eating Disorders adapt to the new circumstances imposed by social distancing. Considering this perspective, a scoping review was designed with the objective of analyzing the care strategies adopted by health professionals to maintain continuity of interdisciplinary care to patients in times of COVID-19. The Web of Science, Scopus, PubMed/MEDLINE, CINAHL, PsycINFO, Embase, LILACS, and SciELO databases were queried. A total of 387 records were identified in the databases, of which 11 met the eligibility criteria and were selected. The results were organized into three thematic categories: (1) the "non-choice" of choosing the online format: pros and cons; (2) focus on communication and welcoming: resignifying the use of the online device; (3) online interventions: adaptations, innovations and alternative resources. The main strategies used during the transition of the treatment to the online environment were: telehealth and online psychotherapy. Although well evaluated, barriers to overcome the limitations of online care were perceived, such as patients' distrust and its potential effects on the quality of the therapeutic bond.

Topical and Intralesional Therapies for Hidradenitis Suppurativa: A Systematic Literature Review.

BACKGROUND AND OBJECTIVE: Topical and intralesional (IL) treatments may be considered the first-line therapy in patients with hidradenitis suppurativa (HS); however, the evidence supporting their use is limited. The aim of our review is to evaluate the efficacy and safety profile of topical and IL treatments in patients with HS. MATERIALS AND METHODS: We designed a systematic review of the current medical literature available following the PICO(T) method. And including all types of studies (Study type [T]) of individuals with HS of any sex, age, and ethnicity (Population [P]) who received any topical or IL treatment for HS (Intervention [I]) compared to placebo, other treatments, or no treatment at all (Comparator [C]), and reported efficacy and/or safety outcomes (Outcomes [O]). Two outcomes were defined: quality of life and the no. of patients with, at least, one adverse event. The search was conducted in the Cochrane Library, MEDLINE, and EMBASE databases; study selection was performed based on pre-defined criteria. The risk of bias was determined in each study. RESULTS: We obtained a total of 11,363 references, 31 of which met the inclusion criteria. These studies included 1143 patients with HS, 62% of whom were women. A total of 10, 8, 6, 2, and 5 studies, respectively, evaluated the use of photodynamic therapy (PDT), glucocorticoids, resorcinol, topical antibiotics, and other interventions. Most articles were case series (n=25), with only five randomized clinical trials (RCTs) and one cohort study. RCTs showed improvement in disease activity with topical clindamycin and botulinum toxin (BTX) vs placebo, and PDT with methylene blue (MB) niosomal vs free MB; however, intralesional triamcinolone acetonide was not superior to placebo. The risk of bias was low in three RCTs and high in two RCTs. CONCLUSION: The quality of evidence supporting the use of topical, or IL treatments is low. However, it supports the use of topical clindamycin, PDT, and BTX. Well-designed RCTs with standardized outcomes and homogeneous populations of patients and lesions are needed to support decision-making in the routine clinical practice.

Estratégias de cuidado a pessoas que tentaram suicídio segundo a literatura / Care strategies for individuals who have attempted suicide according to literature / Estrategias de atención a personas que intentan suicidio según la literatura

O suicídio representa um problema de saúde pública e o cuidado desenvolvido com pessoas que tentam suicídio pode ser determinante para evitar a ocor-rência de novas tentativas. Este trabalho teve como objetivo identificar as estra-tégias de cuidado às pessoas que tentam suicídio e mais especificamente seus alcances e limites. Foi realizada uma revisão da literatura a partir de buscas nas bases Google Scholar, Scielo e Pepsic com a palavra-chave "tentativa de suicídio". Foram selecionados e lidos na íntegra oito artigos publicados entre 2006 e 2017. Destaca-se a importância do acolhimento, ações com a família, trabalho em equipe multiprofissional e encaminhamento para outros serviços da rede. Observam-se dificuldades do trabalho em rede, ausência de diálogo entre as equipes, dificuldades no cuidado de pessoas que tentam suicídio, falta de capacitação e problemas de infraestrutura. Ressalta-se a necessidade da educação permanente em saúde e o oferecimento de suporte psicossocial para os profissionais. (AU)

Suicide represents a public health issue, and the care provided to individuals who attempt suicide can play a crucial role in preventing further attempts. This study aimed to identify the care strategies for individuals who attempt suicide, specifically examining their effectiveness and limitations. A litera-ture review was conducted using searches in the Google Scholar, Scielo, and Pepsic databases with the keyword "suicide attempt." Eight articles published between 2006 and 2017 were selected for in-depth review. The importance of providing support, involving families, fostering multidisciplinary teamwork, and referring individuals to other network services is emphasized. Challenges in establishing effective networks, fostering communication among teams, addressing the complexities of caring for suicide attempt survivors, addressing training gaps, and overcoming infrastructure issues are observed. The need for ongoing health education and the provision of psychosocial support for healthcare professionals is underscored. (AU)

El suicidio es un problema de salud pública y la atención a las personas que intentan suicidarse puede ser determinante para prevenir nuevos intentos. Este trabajo tuvo como objetivo identificar las estrategias de atención a las personas que intentan suicidarse, su alcance y límites. Se realizó una revisión de la literatura a partir de búsquedas en las bases de datos Google Scholar, Scielo y Pepsic con la palabra clave "intento de suicidio". Se seleccionaron ocho artículos publicados entre 2006 y 2017. Se destaca la importancia de la acogida, las acciones con la familia, el trabajo en equipo multiprofesional y la derivación a otros servicios de la red. Existen dificultades en el trabajo en red, ausencia de diálogo entre equipos, dificultades en la atención, falta de formación y problemas de infraestructura. Se enfatiza la necesidad de educación permanente para la salud y la provisión de apoyo psicosocial a los profesionales. (AU)

Violência doméstica e seu impacto emocional sobre o adolescente: um estudo de revisão / Domestic violence and its emotional impact on adolescents: a review study / La violencia doméstica y su impacto emocional en los adolescentes: un estudio de revisión

Considerando a violência doméstica contra crianças e adolescentes como um problema social e de saúde pública que atinge milhares de famílias de todas as partes do mundo, o objetivo desta revisão de literatura é compreender o impacto emocional da violência doméstica na vida de adolescentes. Foram sele-cionados artigos científicos delimitados pelos descritores "domestic violence", "adolescent" e "emotional impact", nos idiomas português, inglês e espanhol, nas bases de dados Scielo, PsycINFO (APA) e Pubmed. Incluímos artigos empíricos avaliados por pares publicados nos últimos dez anos (2010- 2020). A partir da análise crítica dos 14 estudos selecionados identificamos que o impacto emocional da violência doméstica é resultado de uma complexa inte-ração entre fatores culturais, sociais, familiares e emocionais. De modo geral, o jovem vitimado apresenta sintomas depressivos, ansiedade e autoestima diminuída, a qual se revela por crenças negativas sobre si e sobre o mundo. Compreendemos a sintomatologia dos jovens como uma estratégia de sobre-vivência psíquica em ambientes familiares invasivos e negligentes quanto às suas necessidades físicas e emocionais. Concluímos pela necessidade de inter-venções preventivas e interventivas que objetivem tanto o bem estar de crianças e adolescentes quanto a oferta de um cuidado parental suficientemente bom. (AU)

Considering domestic violence against children and adolescents as a social and public health problem affecting thousands of families all over the world, the objective of this literature review is to understand the emotional impact of domestic violence on the lives of adolescents. Scientific articles delimited by the descriptors "domestic violence", "adolescent" and "emotional impact" were selected, in Portuguese, English and Spanish, in the Scielo, PsycINFO (APA) and Pubmed databases. We include peer- reviewed empirical articles published in the last ten years (2010-2020). Based on a critical analysis of 14 selected studies, we identified that the emotional impact of domestic violence is the result of a complex interaction between cultural, social, family and emotional factors. In general, the victimized youth presents depressive symptoms, anxiety and reduced self-esteem, which is revealed in negative beliefs about themselves and about the world. We understand the symptoms of young people as a psychic survival strategy in invasive family environments that neglect their physical and emotional needs. We conclude that there is a need for preventive and interventive actions aiming both at the well-being of children and adolescents and at offering a sufficiently good parental care.(AU)

Considerando la violencia intrafamiliar contra la niñez y adolescencia como un problema social y de salud pública afectando a miles de familias del mundo, el objetivo de esta revisión de literatura es comprender su impacto emocional en la vida de los adolescentes. Se seleccionaron artículos científicos delimitados por los descriptores "violencia doméstica", "adolescente" y "impacto emocional", en portugués, inglés y español, en las bases de datos Scielo, PsycINFO (APA) y Pubmed. Incluimos artículos empíricos revisados por pares publicados en los últimos diez años (2010-2020). A partir de un análisis crítico de 14 estudios seleccionados, identificamos que el impacto emocional de la violencia doméstica es el resultado de una interacción compleja entre factores culturales, sociales, familiares y emocionales. En general, el joven victimizado presenta síntomas depresivos, ansiedad y disminución de la autoestima, lo que se manifiesta en creencias negativas sobre sí mismos y el mundo. Entendemos los síntomas de los jóvenes como una estrategia de supervivencia psíquica en entornos familiares invasivos que descuidan sus necesidades físicas y emocionales. Concluimos que existe necesidad de intervenciones preventivas y intervencio-nistas apuntando tanto al bienestar de los niños y adolescentes como a ofrecer un cuidado parental suficientemente bueno. (AU)

Postoperative management and nursing care after implantation of a total artificial heart: Scoping review.

INTRODUCTION: End-stage heart failure (HF) is a condition whose only successful long-term treatment, with a survival of more than 10 years, is heart transplantation. However, limited organ availability and the progressive increase in the number of patients with advanced HF have served as an impetus for the development of implantable mechanical assistive devices. AIM: To provide an overview of postoperative management and nursing care after the implementation of a Total Artificial Heart (TAH). METHODS: A scoping review was carried out by consulting the PUBMED, CINAHL, and COCHRANE databases. From all the documents located, information was extracted on the date of publication, country of publication, type of study, and results of interest to answer the research question. In addition, the degree of recommendation was identified. RESULTS: Twenty-three documents were included in the scoping review. Results were classified in relation to: 1) description of the CAT SynCardia®; 2) nursing care in the immediate postoperative period (management of the device and management of hematological, infectious, nephrological, nutritional complications, related to immobilization, sleep-rest disturbances, psychological disorders, and patient and family education); and 3) follow-up at home. CONCLUSIONS: The complexity of implantation of the TAH, the multiple related complications that can arise during this process, both in the immediate post-operative and late, require a standardised and multidisciplinary management. The absence of standardised protocols raises the need for future studies to measure the effectiveness of care in patients with TAH. A multidisciplinary approach is crucial. Nurses must acquire autonomy and involvement in decision-making and develop competencies to address the patient's and family's physiological and psychosocial needs.

Revisión sistemática y coste efectividad del tratamiento con abobotulinumtoxinA Para la espasticidad post-ictus en comparación con fisioterapia / Systematic review and cost-effectiveness analysis of the treatment of post-stroke spasticity with abobotulinumtoxinA compared to physiotherapy

Objective Post-stroke spasticity (PSS) is a common complication in stroke survivors, causing severe burden to patients living with it. The aim of this review was to conduct a cost-effectiveness analysis (CEA) of the treatment of post-stroke spasticity, in adults, with abobotulinumtoxinA compared to the best supportive care, based on results from a systematic literature review. Given that abobotulinumtoxinA (aboBoNT-A) is always accompanied by the best supportive care treatment, the CEA compared aboBoNT-A plus the best supportive care with the best supportive care alone. Methods A systematic literature review in EMBASE (including Medline and PubMed), Scopus, and other sources (Google Scholar) was conducted. Articles of all types, providing information on the costs and/or effectiveness measures for the current treatments of PSS in adults were included. The synthesis of information from the review provided the parameters for the design of a cost-effectiveness analysis of the mentioned treatment of interest. The societal perspective was compared to a perspective where only direct costs were observed. Results In total, 532 abstracts were screened. Full information was revised from 40 papers and 13 of these were selected as core papers for full data extraction. Data from the core publications formed the basis for the development of a cost-effectiveness model. In all the included papers physiotherapy was the best supportive care treatment (SoC)... (AU)

Antecedentes La espasticidad post-ictus es una enfermedad común que afecta a los adultos y causa una carga grave a los pacientes que la padecen. El objetivo de la revisión fue realizar un análisis coste-efectividad (ACE) del tratamiento de la espasticidad post-ictus, en adultos, con abobotulinumtoxinA (aboBoNT-A) en comparación con el tratamiento convencional, basado en los resultados de una revisión sistemática de la literatura. Dado que este tratamiento se proporciona siempre al mismo tiempo que el tratamiento convencional, el ACE se realizó del tratamiento aboBoNT-A con el tratamiento convencional, en comparación con recibir únicamente el tratamiento convencional. Métodos Se realizó una revisión sistemática de la literatura en EMBASE (incluyendo Medline y Pubmed), Scopus y otras fuentes (Google Scholar). Se incluyeron artículos de todo tipo que proporcionaran información sobre los costes y/o las medidas de efectividad de los tratamientos actuales del PSS en adultos. La síntesis de la información de la revisión proporcionó los parámetros para el diseño de un análisis coste-efectividad del mencionado tratamiento de interés. Se comparó la perspectiva social con una perspectiva donde solo se observaron los costes directos del tratamiento. Resultados Se revisaron un total de 532 resúmenes. Se revisó la información completa de 40 artículos y se seleccionaron 13 artículos para la extracción completa de datos. La información de estos documentos se sintetizó y utilizó para desarrollar un modelo de coste-efectividad. En todos los artículos incluidos se identificó el tratamiento con fisioterapia como el tratamiento convencional principal... (AU)

des troço / dis section

Com poemas escritos entre janeiro de 2020 e junho de 2023, "des troço" apresenta, de maneira poética, o modo como seu autor elaborou um olhar estético para elementos singulares que transversalizaram nossos corpos individuais e coletivos em um período intenso e difícil da vida no Brasil e no mundo. A obra conta com 45 poemas, divididos em cinco partes/capítulos, tem prefácio de Alexis Milonopoulos e capa com pintura de Júlia Nascimento Gomes.

Don Quijote de la Mancha y la descripción del sueño bifásico en la literatura española / Don Quixote de la Mancha and the description of biphasic sleep in Spanish literature

Introducción: El sueño bifásico o segmentado es el hábito de dormir un primer y un segundo sueño separados por una vigilia. El historiador Ekirch describe que así se dormía en los tiempos preindustriales antes de la potente iluminación artificial. Se basó en textos en diferentes idiomas, desde la Antigüedad hasta el siglo xx, pero llama la atención la ausencia de fuentes en español. Objetivo: Se revisó la literatura española en busca de referencias al sueño bifásico usando como palabras clave ‘primer sueño’ y ‘a los primeros gallos’. Desarrollo: En la segunda parte de Don Quijote de la Mancha (capítulo 68), Cervantes describe el sueño bifásico con notable acierto, correlacionando los biotipos de Quijote y Sancho con sus temperamentos y hábitos de sueño y alimentarios. Curiosamente, Ekirch cita el capítulo, pero no el sueño bifásico. En esta revisión reproduzco 11 textos en español (siglos xiii a xix), mayormente obras clásicas, que lo refieren, disponiendo sus fases en coincidencia con las horas en que se dividía la noche en la era preindustrial: 20:00-21:00 a 00:00, primer sueño; 00:00 a 03:00, vigilia; 03:00 a 06:00, segundo sueño. La Celestina aporta datos significativos. Estudios recientes probaron que este hábito es fisiológico y se adapta al estilo de vida que lo requiere. Conclusiones: Se identifican y citan por primera vez referencias al sueño bifásico en la literatura española, confirmando la hipótesis de Ekirch. El Quijote lo describe con mayor amplitud y agudeza.(AU)

Introduction: Biphasic or segmented sleep is the habit of sleeping a first and a second sleep separated by a watching. The historian A Ekirch found that this was how people slept in pre-industrial times before the powerful artificial lighting. He is based on texts in different languages, from Antiquity to the 20th century, but the absence of sources in Spanish is striking. Aim: Review the Spanish literature searching references of the biphasic sleep using the keywords ‘first sleep’ and ‘at the first cockcrow’. Development: In the Second Part of Don Quixote de la Mancha (Chapter 68), Cervantes describes biphasic sleep with remarkable success, correlating the biotypes of Quixote and Sancho with their temperaments and sleeping and eating habits. Strangely, Ekirch cites the chapter, but not biphasic sleep. In this review I reproduce eleven texts in Spanish (13th to 19th centuries), mostly classical works, which refer to it by arranging its phases in a way that coincides with the hours in which the night was divided in the pre-industrial era: 20:00-21:00 to 00:00, first sleep, 00:00 to 03:00, wakefulness; 03:00 to 06:00, second sleep. La Celestina provides significant data too. Recent studies proved that this habit is physiological, and it adapts to the lifestyle that requires it. Conclusions: References to biphasic sleep in Spanish literature are identified and cited for the first time, confirming Ekirch’s hypothesis. In Don Quixote, Cervantes describes it with great breadth and sharpness.

¿Cuántos Tipos de Revisiones de la Literatura Existen? Enumeración, Descripción y Clasificación. Revisión Cualitativa / How Many Types of Literature Reviews are There? Listings, Description and Classification

La expansión y consolidación de la práctica clínica basada en la evidencia ha llevado entre otras, a la necesidad de realizar una variedad cada vez mayor de tipos de revisión de la literatura científica; lo que permite avanzar en el conocimiento y comprender la amplitud de la investigación sobre un tema de interés, teniendo en cuenta que una de las propiedades del conocimiento es su carácter acumulativo. Sin embargo, la diversidad de la terminología utilizada genera confusión de términos y conceptos. El objetivo de este manuscrito fue proporcionar un listado de los tipos de revisiones de la literatura más frecuentemente utilizados con sus características y algunos ejemplos de ellas. Revisión cualitativa. Se examinaron de forma dirigida las bases de datos PubMed, WoS y Scopus, en búsqueda de términos asociados a tipos de revisiones y síntesis de la literatura científica. Se encontraron 21 tipos de revisión; y 29 variantes y sinonimias asociadas; las que ilustran los procesos de cada una de ellas. Se da una descripción general de las características de cada cual, junto con las fortalezas y debilidades percibidas. No obstante, se verificó que sólo algunos tipos de revisión poseen metodologías propias y explícitas. Este enfoque, proporciona un punto de referencia para quienes realizan o interpretan revisiones en el ámbito sanitario, y sugiere dos tipos de propuestas de clasificación.

SUMMARY: The expansion and consolidation of evidence-based clinical practice has led, among other things, to the need to carry out an increasing variety of types of literature reviews, which allows advancing in knowledge and understanding the breadth of research on a topic of interest. However, the diversity of the terminology used generates confusion of terms and concepts. The aim of this manuscript was to provide a list of the most frequently used review types with their characteristics and some examples. Qualitative review. PubMed, WoS and Scopus databases were examined in a directed way, searching for terms associated with types of reviews and syntheses of the scientific literature. Twenty-one types of review, and 29 variants and associated synonymies were found; those that illustrate the processes of each of them. An overview of the characteristics of each is given, along with perceived strengths and weaknesses. However, it was verified that only some types of review have their own explicit methodologies. This approach, provides a point of reference for those who perform or interpret reviews in the health field and suggests two classification proposals.

Los hermanos cuervo. Violencias cotidianas amalgamadas en la ilusión de estabilidad de la lenga y de la identidad del sujeto / The Cuervo Brothers: Everyday Violence Amalgamated in the Illusion of Stability of the Language and the Identity of the Subject

La novela Los hermanos Cuervo, del colombiano Andrés Felipe Solano, subraya, a través de la parodia, la ilusión de estabilidad de la lengua y del sujeto en la que se amalgama una violencia simbólica, naturalizada en la familia, el colegio y la ciudad. Esta subjetividad resuena en un territorio rígidamente dividido en estratos socioeconómicos, amalgamados simbólica e imaginariamente en narrativas culturales clasistas y profundamente excluyentes, organizadas en torno a la pareja de opuestos: todo o nada

The novel Los hermanos Cuervo, by the Colombian Andrés Felipe Solano, underlines, through parody, the illusion of stability of the language and of the subject in which a symbolic violence is amalgamated, naturalized in the family, school and the city. This subjectivity resonates in a territory rigidly divided into socioeconomic strata, symbolically and imaginarily amalgamated in classist and deeply exclusive cultural narratives, organized around the pair of opposites: all or nothing

Systematic review and cost-effectiveness analysis of the treatment of post-stroke spasticity with abobotulinumtoxinA compared to physiotherapy. / [Artículo traducido] Revisión sistemática y coste-efectividad del tratamiento con abobotulinumtoxinA para la espasticidad postictus en comparación con la fisioterapia.

OBJECTIVE: Post-stroke spasticity is a common complication in stroke survivors, causing severe burden to patients living with it. The aim of this review was to conduct a cost-effectiveness analysis (CEA) of the treatment of post-stroke spasticity, in adults, with abobotulinumtoxinA compared to the best supportive care, based on results from a systematic literature review. Given that abobotulinumtoxinA (aboBoNT-A) is always accompanied by the best supportive care treatment, the CEA compared aboBoNT-A plus the best supportive care with the best supportive care alone. METHODS: A systematic literature review in EMBASE (including Medline and PubMed), Scopus, and other sources (Google Scholar) was conducted. Articles of all types, providing information on the costs and/or effectiveness measures for the current treatments of post-stroke spasticity in adults were included. The synthesis of information from the review provided the parameters for the design of a CEA of the mentioned treatment of interest. The societal perspective was compared to a perspective where only direct costs were observed. RESULTS: In total, 532 abstracts were screened. Full information was revised from 40 papers and 13 of these were selected as core papers for full data extraction. Data from the core publications formed the basis for the development of a cost-effectiveness model. In all the included papers physiotherapy was the best supportive care treatment. The cost-effectiveness analysis showed that even in the most conservative scenario, assuming the worst case scenario, the probability of a cost per quality-adjusted life-year (QALY) gained below €40,000, for aboBoNT-A together with physiotherapy is above 0.8, and with certainty below €50,000/QALY when either a direct costs, or a societal perspective was taken. On average, the probabilistic model obtains a negative mean incremental cost-effectiveness ratio of around -15,000 €/QALY. CONCLUSION: The cost-effectiveness analyses show that aboBoNT-A together with physiotherapy would be a cost-effective treatment compared with physiotherapy alone, independently of the perspective considered.