[Epidemiological profile of traumatic brain injury at the Dr. Rafael A. Calderón Guardia Hospital, Neurosurgery Department, during the period from 2007 to 2012]. / Perfil epidemiológico del traumatismo craneoencefálico en el Servicio de Neurocirugía del Hospital Dr. Rafael A. Calderón Guardia durante el período 2007 a 2012.

OBJECTIVE: To determine the epidemiological profile of the patients who suffered traumatic brain injury (TBI) and were treated at the Dr. Rafael A. Calderón Guardia Hospital (HCG) Neurosurgery department, during the period from 2007 to 2012. MATERIAL AND METHODS: An observational, descriptive, retrospective and cross section study was performed on all the patients with TBI and who were admitted to the emergency room of the HCG during the period 2007 to 2012. There were a total of 721 cases, of which 566 records were obtained of patients who had the variables established in this study, excluding those with incomplete or inconsistent information. RESULTS: The present study established the epidemiological profile of the TBI in the population seen during the period 2007 to 2012 at the HCG. It was determined that the male sex made up the majority of the cases were male, with mean age of 46 years. The mortality rate was 12.69% (n=69). Car accidents were the most frequent cause of TBI (n=259 persons) in the age group of 25 to 44 years, followed by falls (n=174). It was observed that the majority were farmers, followed by students, and then construction workers. No chronic illnesses were recorded in 71.6% of the medical charts. No alcohol or other drugs were reported in 74.9% of the cases, while there was evidence of the presence of alcohol recorded in 22.8%. The clinical and laboratory parameters that had statistical significance (P<.05) were GCS equal to less than 8 (P=.035), presence of mydriasis (P=.00), deviation of the LM (P=.006), cranial fracture (P=.04), lack of endotracheal intubation on admission (P=.007), prolonged PT (P=.04), prolonged PTT (P=.025), and MAP<60 (P=.002). The most frequent surgical procedure in the study population was craniotomy with hematoma drainage alone or associated with some other procedure (esquillectomy or monitoring of PIC) (n=298). CONCLUSIONS: There is great difficulty in determining the epidemiology of TBI worldwide, due to the lack of standardisation of the international studies. From the present study, it can be concluded that the population that mainly suffers from this type of lesion are adults under 45 years old, with car accidents being the main cause of these lesions (45.8%) in combination with alcohol consumption. Also, the consequences of such are aggravated when the victims present with chronic diseases such as, systemic arterial hypertension and mellitus diabetes. As regards the post-traumatic indicators directly related to a poor outcome, it was determined that a GCS score equal to or less than 8, a mean blood pressure less than 60, the prolongation of the coagulation times, the presence of mydriasis, and skull fractures, have a direct association with the negative or fatal outcome for the victim.

Where Does I Stand? Reflections on Home and Identity Ensnared in a Cultural Narrative.

In this paper the author explores a cultural narrative that she suggests rests on the concepts of the Feminine and Masculine as such, employing both as though they contain an agreed set of universal givens. These givens are extrapolated from an androcentric perspective on female and male bodies, in particular their biological functions regarding reproduction. The metaphors of the baby-in-womb, mother's preoccupation with child and heteronormative sexual relations are the primary cyphers for the narrative. She suggests that remaining unconscious of this narrative, such that it is taken as a universal given, can hamper a person's relation to themselves, the world and others. The author names two concepts, Home and Identity: Home being an hospitable and accommodating space with Identity denoting the one who inhabits the space. In the narrative these two are unhelpfully categorized as belonging to the Feminine and the Masculine respectively. For ease of understanding the author uses a capital letter to designate an abstract idea, and lower case when referring to the concrete or particular. Clinical examples are given throughout the paper to illustrate how acknowledgement and awareness of this narrative might free the analyst or therapist to think more broadly around issues pertaining to space and identity.

Dans cet article, l'auteur explore un récit culturel qui, selon elle, repose sur les concepts du Féminin et du Masculin en tant que tels, utilisant ces deux termes comme s'ils contenaient un ensemble convenu de données universelles. Ces données sont dérivées à partir d'une perspective androcentrique des corps féminins et masculins, en particulier leurs fonctions biologiques en matière de reproduction. Les métaphores du bébé dans le ventre de la mère, de la préoccupation de la mère pour les enfants et des relations sexuelles hétéro-normatives sont les principaux codes du récit. Elle suggère que si l'on reste inconscient de ce récit, et que l'on continue à le considérer comme une donnée universelle, cela peut entraver la relation d'une personne à elle-même, au monde et aux autres. L'auteur nomme deux concepts, « Home ¼ et Identité: « Home ¼ étant un espace hospitalier et accueillant, et « Identité ¼ désignant celui qui habite l'espace. Dans le récit, ces deux termes sont catégorisés comme appartenant respectivement au Féminin et au Masculin, ce qui pose problème. Pour faciliter la compréhension, l'auteur utilise une majuscule pour désigner une idée abstraite, et des minuscules lorsqu'elle se réfère au concret ou au particulier. Des exemples cliniques sont donnés tout au long de l'article pour illustrer que prendre la mesure de ce récit et développer la prise de conscience pourraient libérer l'analyste ou le thérapeute et lui permettre de réfléchir de manière plus large aux questions relatives à l'espace et à l'identité.

En este artículo la autora explora una narrativa cultural que, según sugiere, se basa en los conceptos de lo Femenino y lo Masculino como tales, empleando ambos como si contuvieran un conjunto consensuado de datos universales. Estas premisas se extrapolan desde una perspectiva androcéntrica de los cuerpos femenino y masculino, en particular de sus funciones biológicas en relación con la reproducción. Las metáforas del bebé en el vientre materno, la preocupación de la madre por el niño y las relaciones sexuales heteronormativas son las principales claves de la narrativa. Sugiere que permanecer inconsciente de esta narrativa, de modo que se tome como un hecho universal, puede obstaculizar la relación de una persona consigo misma, con el mundo y con los demás. La autora nombra dos conceptos, Hogar e Identidad: El hogar es un espacio hospitalario y acogedor, mientras que la identidad designa a la persona que lo habita. En la narrativa, estos dos conceptos se clasifican de manera infructuosa como pertenecientes a lo Femenino y lo Masculino, respectivamente. Para facilitar la comprensión, la autora utiliza la mayúscula para designar una idea abstracta, y la minúscula cuando se refiere a lo concreto o particular. A lo largo del artículo se ofrecen ejemplos clínicos para ilustrar cómo el reconocimiento y la toma de conciencia de esta narrativa pueden liberar al analista o al terapeuta para pensar de forma más amplia en torno a cuestiones relacionadas con el espacio y la identidad.

Inner-outer couple: anima and animus revisited. New perspectives for a clinical approach in transition.

The conflicts of the outer couple (crises, separations, divorces) with a high incidence in the rates of depression, reveal the archetypal dysfunction of the relationship between the inner-couple (in-shadow) and the outer-couple (in-crisis). To understand this in depth, a new animated and integrated model of the masculine (animus) and the feminine (anima) is explored. It is a transformational model, in which Jung's contributions are integrated and understood as knowledge in transition. Masculine and feminine cosmogonic principles are personified in the human psyche as anima-animus archetypes-complexes. Their relationship, mediated by the binding eros (cosmogonic-eros), configures the inner-couple-complex. Masculine and feminine are differentiations of the Self energy, present in both men and women. In the conscious dimension, they structure the ego-anima-animus identity; in the dimension of the personal unconscious, the anima-animus complexes; and at the archetypal level, the deep identity of the primordial feminine/masculine. In this initial restructured model, the anima-animus relationship and the description of the dual quaternity as the dynamics of the inner-outer couple interrelation are especially significant. The breadth and comprehensive richness of the new model is illustrated in the clinical/dream material of a patient under analysis, presenting the dynamics: inner couple in shadow - outer couple in crisis.

Les conflits du couple extérieur (crises, séparations, divorces) avec une forte incidence du taux de dépression révèlent le dysfonctionnement archétypal de la relation entre le couple intérieur (dans l'ombre) et le couple extérieur (dans la crise). Pour une compréhension profonde de ceci nous étudions un modèle nouveau, animé et intégré, du masculin (animus) et du féminin (anima). Il s'agit d'un modèle de transformation dans lequel les apports de Jung sont intégrés et compris en tant que savoir en transition. Les principes cosmogoniques de masculin et féminin sont personifiés dans la psyché humaine comme archétypes-complexes anima-animus. Leur relation, médiée par Eros qui relie (cosmogonique-eros) configure les complexes couples intérieur-extérieur. Masculin et féminin sont des différentiations de l'énergie du Soi, présent à la fois chez les hommes et les femmes. Ils structurent, dans la dimension consciente, l'identité du moi-anima-animus dans la dimension de l'inconscient personnel, les complexes anima-animus, et au niveau archétypal, l'identité profonde du féminin/masculin primordial. Dans ce modèle initial restructuré, la relation anima-animus est particulièrement significative, ainsi que la description de la quaternité duale en tant que/comme dynamique de l'interrelation couple intérieur-extérieur. L'amplitude et la richesse inclusive du nouveau modèle est illustrée dans le matériel clinique et les rêves d'un patient en analyse et qui présente la dynamique: couple intérieur dans son ombre - couple extérieur en crise.

Los conflictos de la pareja exterior (crisis, separaciones, divorcios,) con alta incidencia en las tasas de depresión, ponen de manifiesto la disfunción arquetípica de la relación pareja-interior (en-sombra) y pareja exterior (en-crisis). Para comprender esto, en profundidad, se explora un nuevo modelo, animado e integrado, de lo masculino (animus) y lo femenino (ánima). Un modelo transformado, donde los aportes de Jung son integrados y comprendidos como conocimientos en transición. Se considera que los principios cosmogónicos masculino y femenino se personifican en la psique humana como arquetipos-complejos ánima-animus. Su relacionamiento, mediado por el eros vinculante (eros-kosmogónico), configura el complejo-pareja-interior. Masculino y femenino son diferenciaciones de la energía sélfica, presentes en hombres y mujeres. Ellas estructuran, en la dimensión consciente, la identidad ego-ánima-animus, en la dimensión de lo inconsciente personal los complejos ánima-animus, y a nivel arquetípico, la identidad profunda de lo femenino/masculino primordial. En el modelo inicial re-estructurado, es especialmente significativo la relación ánima-animus, y la descripción del doble cuaterno como la dinámica de interrelación pareja interior-exterior. La amplitud y riqueza comprensiva del nuevo modelo es ilustrado en el material clínico/onírico de un paciente en análisis que presenta la dinámica pareja interior en sombra- pareja exterior en crisis.

Os conflitos do casal externo (crise, separações, divórcios) com alta incidência nas taxas de depressão revelam a disfunção arquetípica da relação entre o casal interno (na sombra) e o casal externo (em crise). Para entender isso em profundidade, um novo modelo, animado e integrado, do masculino (animus) e do feminino (anima) é explorado. É um modelo transformacional, no qual as contribuições de Jung são integradas e entendidas como conhecimento em transição. Princípios cosmogônicos masculinos e femininos são personificados na psique humana como arquétipos-complexos anima-animus. Sua relação, mediada pelo eros de ligação (cosmogônico-eros), configura o complexo de casal interno. Masculino e feminino são diferenciações da energia do Si Mesmo, presentes em homens e mulheres. Eles estruturam, na dimensão consciente, a identidade ego-anima-animus; na dimensão do inconsciente pessoal, os complexos anima-animus; e no nível arquetípico, a identidade profunda do feminino/masculino primordial. No modelo reestruturado inicial, a relação anima-animus é especialmente significativa, e a descrição da quaternidade dual como a dinâmica da inter-relação interior-exterior do casal. A amplitude e a riqueza abrangente do novo modelo são ilustradas no material clínico/sonho de um paciente em análise, apresentando a dinâmica: casal interno na sombra - casal externo em crise.

Avaliação da saúde esquelética em homens brasileiros com doença celíaca ao diagnóstico: qual a importância? / Skeletal health assessment in brazilian men with celiac disease at diagnosis: how important is it?

ABSTRACT Background: Low bone mass density (BMD) is an extraintestinal finding in celiac disease (CD). This may result in bone fractures leading to loss in quality of life. Objective: To assess BMD in male CD patients at diagnosis according to the patient's age. Methods: Descriptive retrospective carried out during the period between 2013 and 2023 in a single office that studied dual-energy X-ray absorptiometry (DXA) results in 28 male patients with a recent diagnosis of CD, divided into three groups: group 1 (age up to 18 years); group 2 (from 19 to 49 years of age) and group 3 (over 50 years of age). Were studied demographic and anthropometric parameters, time delay between symptoms onset and CD diagnosis and fracture occurrence. Results: Celiac patients studied had median age 36.0 years (IQR=16.5-50.7). Among them, 39.3% had osteopenia and 14.3% had osteoporosis. Only 36% of the sample had normal DXA values (group 1 with 37.5%; group 2 with 46% and group 3 with 14.2%). No pathological fracture was observed in this sample. CD diagnosis delay observed had median 1.0 year (IQR=1.0-4.7). When the number of individuals with normal and abnormal DXA results were compared, there was no difference in body mass index, time of diagnosis delay or Marsh classification (P=0.18). Conclusion: Male patients at the time of CD diagnosis showed a high prevalence of low BMD, which was particularly evident in individuals over 50 years of age.

RESUMO Contexto: A baixa densidade de massa óssea (DMO) é um achado extraintestinal na doença celíaca (DC). Isso pode resultar em fraturas ósseas levando à perda de qualidade de vida. Objetivo: Avaliar a DMO em pacientes masculinos com DC no momento do diagnóstico de acordo com a idade do paciente. Métodos: Estudo retrospectivo descritivo realizado no período entre 2013 e 2023 em um único consultório que estudou resultados de "dual-energy X-ray absorptiometry" (DEXA) em 28 pacientes do sexo masculino com diagnóstico recente de DC, divididos em três grupos: grupo 1 (idade até 18 anos); grupo 2 (de 19 a 49 anos) e grupo 3 (acima de 50 anos). Foram estudados parâmetros demográficos e antropométricos, tempo decorrido entre o início dos sintomas e o diagnóstico da DC e ocorrência de fraturas. Resultados: Os pacientes celíacos estudados tinham mediana de idade de 36,0 anos (IIQ=16,5-50,7). Dentre eles, 39,3% apresentavam osteopenia e 14,3% apresentavam osteoporose. Apenas 36% da amostra apresentou valores normais de DEXA (grupo 1 com 37,5%; grupo 2 com 46% e grupo 3 com 14,2%). Nenhuma fratura patológica foi observada nesta amostra. O atraso no diagnóstico da DC observado teve mediana de 1,0 ano (IQR=1,0-4,7). Quando comparado o número de indivíduos com resultados de DEXA normais e alterados, não houve diferença no índice de massa corporal, tempo de atraso no diagnóstico ou classificação de Marsh (P=0,18). Conclusão: Pacientes do sexo masculino no momento do diagnóstico da DC apresentaram alta prevalência de baixa DMO, o que foi particularmente evidente em indivíduos com mais de 50 anos de idade.

Bocio endotorácico / Endothoracic Goiter

Introducción: Un bocio se considera intratorácico cuando más de un 50 por ciento de la glándula tiroides está en el mediastino, o sea, por debajo del nivel del estrecho torácico superior. Se trata de una enfermedad poco frecuente que padece aproximadamente el 3 por ciento de los pobladores del mundo. La incidencia del bocio nodular ha disminuido debido a la ingestión en algunos países de sal yodada y alimentos ricos en yodo. Esta enfermedad alcanza alrededor del 10 por ciento de las masas mediastínicas. Objetivo: Presentar el caso de un paciente masculino, operado de bocio endotorácico en la provincia de Cienfuegos. Presentación de caso: Se presenta un paciente masculino, de 48 años de edad, que acude a consulta y refiere aumento de volumen del cuello en la región anterior, que se acompaña de decaimiento y en ocasiones disfagia tanto a los alimentos líquidos como a los sólidos. Además, refiere ligera disnea que tolera adecuadamente cuando realiza las actividades de la vida diaria. Por tratarse de una enfermedad poco frecuente, se considera de interés científico publicar el caso para conocimiento de los profesionales dedicados al estudio y tratamiento de las afecciones tiroideas. Conclusiones: El bocio endotorácico es una entidad poco frecuente y en todos los casos requiere de intervención quirúrgica(AU)

Introduction: A goiter is considered intrathoracic when more than 50 percent of the thyroid gland is in the mediastinum; in other words, below the level of the superior thoracic outlet. It is a rare disease that affects approximately 3 percent of the world's population. The incidence of nodular goiter has decreased due to the ingestion of iodized salt and iodine-rich foods in some countries. This disease accounts for about 10 percent of mediastinal masses. Objective: To present the case of a male patient operated on for endothoracic goiter in the province of Cienfuegos. Case presentation: The case is presented of a 48-year-old male patient who comes for consultation referring a volume increase in the anterior neck region, accompanied by decay and sometimes dysphagia to both liquid and solid food. In addition, he reports slight dyspnea that he tolerates adequately when performing daily living activities. Since this is a rare disease, it is considered of scientific interest to publish the case for the knowledge of professionals dedicated to studying and treating thyroid disorders. Conclusions: Endothoracic goiter is a rare entity and, in all cases, requires surgical intervention(AU)

Adesão ao preservativo masculino: realidade comportamental e conhecimento de universitários / Adherence to the male condom: behavioral reality and knowledge of university students

Homens e mulheres saberem a função do preservativo na prevenção de Infecções Sexualmente Transmissíveis e gravidez, várias situações dificultam o seu uso, entre elas, a ideia de que o preservativo interfere no prazer. OBJETIVO: Descrever o conhecimento e comportamentos de universitários sobre a adesão ao preservativo masculino. METODO-LOGIA: Estudo exploratório descritivo, quantitativo, com 136 estudantes de uma Universidade Pública. RESULTADOS: A média de idade foi de 20 anos, maior parte são heterossexuais (76,5%); a maioria teve a primeira relação sexual aos 17 anos, sendo que 33,5% não usaram camisinha, 85% utilizam camisinha para evitar gravidez, 92,5% para prevenção de Infecções Sexualmente Transmissíveis, 48,5% deixaram de ter relação sexual com penetração por não ter preservativo; 84% não utilizaram por não conseguir colocar e 54% tinham camisinha e não utilizou. CONCLUSÃO: Evidenciou a necessidade de repensar a educação sexual para instrumentalizar quanto a percepção, comportamento e adesão ao preservativo.(AU)

Men and women recognize condoms' role in preventing both Sexually Transmitted Infec-tions and pregnancy. However, various obstacles, such as concerns about reduced pleasure, impede their use. OBJECTIVE: To describe the knowledge and behaviors of university students regarding adherence to male condoms. METHODOLOGY: This was a descriptive, quantitative exploratory study involving 136 students from a public university. RESULTS: The average age was 20 years, with most identifying as heterosexual (76.5%). A significant portion (33.5%) did not use condoms. Furthermore, 85% used con-doms for pregnancy prevention, 92.5% for Sexually Transmitted Infections prevention, while 48.5% ceased sexual activity due to a lack of condoms. Additionally, 84% faced challenges with putting on condoms, and 54% possessed unused condoms. CONCLU-SION: These findings highlight the necessity to reevaluate sex education, providing indi-viduals with the tools to comprehend, modify their behavior, and enhance adherence to condom usage.(AU)

Hombres y mujeres conocen el papel del condón en la prevención de las Infecciones de Transmisión Sexual y el embarazo, varias situaciones dificultan su uso, entre ellas la idea de que el condón interfiere con el placer. OBJETIVO: Describir los conocimientos y comportamientos de estudiantes universitarios respecto de la adherencia al condón masculino. METODOLOGÍA: Estudio descriptivo, cuantitativo, exploratorio con 136 estudiantes de una Universidad Pública. RESULTADOS: La edad promedio fue de 20 años, la mayoría son heterosexuales (76,5%); la mayoría tuvo su primera relación sexual a los 17 años, el 33.5% no utilizó condón, el 85% utilizó condón para evitar el embarazo, el 92.5% para prevenir Infecciones de Transmisión Sexual, el 48.5% dejó de tener relaciones sexuales con penetración debido a no tener condón; El 84% no lo usó porque no pudo colocarlo y el 54% tenía condón pero no lo usó. CONCLUSIÓN: Se destacó la necesidad de repensar la educación sexual para brindar herramientas sobre percepción, comportamiento y adherencia al uso del condón.(AU)

Perder o apetite. A recusa do outro como busca de si mesmo. Exemplos saharianos, japoneses e franceses / La pérdida del apetito y el rechazo del otro como búsqueda de si mismo. Ejemplos saharianos, japoneses y franceses / Losing one's appetite. Rejection of the other as a quest for oneself. Examples from the Sahara, Japan and France / Perdre l'appétit. Le refus de l'autre comme quête de soi. Exemples sahariens, japonais et français

Esta reflexão antropológica baseia-se em pesquisas realizadas com jovens de 13 a 25 anos de idade, que permanecem isolados no seu quarto. Sua imobilidade, que não se justifica por nenhuma deficiência física ou psicológica, questiona o lugar do corpo no momento da passagem para a vida adulta. Estes jovens expressam uma ausência de apetite do outro, que vai de mãos dadas com a abstinência sexual forçada pelo seu isolamento. A hipótese é que eles experimentam uma relação com seu corpo, sua identidade sexual -e sua sexualidade -assim como com a alimentação, comparável às adolescentes que sofrem de anorexia nervosa, mas ao contrário. Estes comportamentos questionam as relações de gênero e a distribuição de papéis dentro da família. Com base em entrevistas e observações, tanto em casa como nos centros de cuidados, este artigo mostra que estes corpos adolescentes, tornados invisíveis por confinamento ou magreza extrema, são paradoxalmente uma expressão ostensiva de despossessão de si. Um novo apetite é possível quando surge o desejo de diferenciação e permite-se novos encontros

Esta reflexión antropológica se basa en una investigación realizada con jóvenes, de 13 a 25 añosde edad, que están enclaustrados en su habitación. Su inmovilidad, que no se justifica por ningúna discapacidad física o psicológica, cuestiona el lugar del cuerpo en el momento del paso a la edad adulta. Estos jóvenes manifiestan una ausencia de apetito por los demás que va unida a la abstinencia sexual a la que les obliga su aislamiento. La hipótesis es que experimentan una relación con su cuerpo, su identidad sexual -y su sexualidad-así como con la comida, comparable a la de las adolescentes que sufren anorexia nerviosa, pero a la inversa. Estos comportamientos cuestionan las relaciones de género y el reparto de roles en la familia. Basándose en entrevistas y observaciones, tanto en el hogar como en los centros de atención, este artículo muestra que estos cuerpos adolescentes, invisibilizados por el confinamiento o la extrema delgadez, son paradójicamente una ostentosa expresión del desposeimieto de si. Un nuevo apetito es posible cuando surge el deseo de diferenciación y se permite nuevos encuentros

This anthropological reflection is based on research carried out with young boys, aged 13 to 25, who are cloistered in their room. Their immobility, which cannot be explained by any kind of physical or psychological disability, raises questions about the body's place at the time they are passing into adulthood. These young people express an absence of appetite for others that goes hand in hand with the sexual abstinence that their withdrawal forces them to have. The hypothesis is that they experience a relationship with their body, their sexual identity -and their sexuality -as well as with food, comparable to young girls suffering from anorexia nervosa but in reverse. These behaviours question gender relations and the distribution of roles within the family. Based on interviews and observations, both at home and in care facilities, this article shows that these adolescent bodies, made invisible by confinement or extreme thinness, are paradoxically an ostentatious expression of self-dispossession. A new appetite is possible when the desire for differentiation emerges and allows new encounters

Cette réflexion anthropologique s'appuie sur une recherche menée auprès de jeunes garçons, de 13 à 25 ans, cloîtrés dans leur chambre. Leur immobilité, que ne justifie aucun handicap physique ou psychique, interroge la place du corps au moment du passage à l'âge adulte. Ces jeunes expriment une absence d'appétit de l'autre qui va de pair avec l'abstinence sexuelle que leur retrait oblige. L'hypothèse émiseest qu'ils vivent un rapport au corps, à leur identité sexuelle -et à leur sexualité-ainsi qu'à l'alimentation, comparable aux jeunes filles souffrant d'anorexie mentale mais de manière inversée. Ces conduites interrogent les rapports de genre et la distribution des rôles au sein de la famille. À partir d'entretiens et d'observations, à domicile et dans des structures de soin, cet article montre que ces corps adolescents invisibilisés par l'enfermement ou l'extrême maigreur sont paradoxalement une expression ostentatoire d'une dépossession de soi. Un appétit nouveau est possible lorsque le désir de différenciation émerge et permet de nouvelles rencontres

Treatment of stress urinary incontinence after prostatectomy with the adjustable transobturator male system (ATOMS®) with preattached scrotal port. / Tratamiento de la incontinencia urinaria de esfuerzo tras prostatectomía con el sistema masculino transobturador ajustable (ATOMS®) con puerto escrotal premontado.

INTRODUCTION: Stress urinary incontinence (SUI) is a significant sequela of prostate cancer surgery. In this article, we present the surgical technique and safety and efficacy of the adjustable transobturator male system (ATOMS®) with preattached scrotal port. MATERIAL AND METHOD: An open prospective study was conducted at a university hospital with the main objective of changing the baseline condition after adjustment in the daily pad count and their wet weight (pad test). The secondary objectives were the quality-of-life assessment (International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF] and Incontinence Impact Questionnaire-7 [IIQ-7], baseline and after the adjustment), patient-perceived results (Patient Global Index [PGI] and Global Response Assessment [GRA] at 1 year) and assessment of complications according to Clavien-Dindo. The numerical values are expressed in median ± IQR. RESULTS: We analysed 60 consecutive patients with a follow-up of 21±22 months. The baseline pad-test was 465±450mL, and the pad-count was 5+3 pads/day. The baseline SUI was mild (11.6% of patients), moderate (25%) and severe (63.3%). The operative time was 60±25min, the hospital stay was 1±0 days, and the visual analogue scale of pain on day 1 after surgery was 0±1. The total filling was 16.5±7mL, and the number of refillings was 1±2. The pad-test and pad-count after the adjustment were 0±20mL and 0±1, respectively (both p<.0001 compared with baseline). SUI disappeared (81.7%) or remained mild (11.7%), moderate (5%) or severe (1.6%). We observed a reduction in the ICIQ-SF (p<.0001) and IIQ-7 scores (p=.0003). Both continence (p=.002) and satisfaction (p=.03) were lower in the irradiated patients. Complications occurred in 11 cases (18.6%), 8 (13.5%) of which were grade I and 3 (5.1%) of which were grade 3. The treatment satisfaction rate was 91.7%, and the patient-perceived overall improvement at 1 year was highly pronounced (PGI-I score, 1±1; GRA, 6±1). CONCLUSIONS: SUI treatment of men using third-generation ATOMS® is safe and effective in the short-term, even in patients with severe SUI. The rate of dry patients after the adjustment exceeded 80%, and the satisfaction rates exceeded 90%. The patients assessed this treatment highly positively.

Is the adjustable transobturator system ATOMS® useful for the treatment of male urinary incontinence in low to medium volume urological centers? / ¿Es útil el sistema transobturatriz ajustable ATOMS® para el tratamiento de la incontinencia urinaria masculina en centros urológicos de bajo y medio volumen?

INTRODUCTION: Urinary incontinence (UI) is a complication of radical prostatectomy (RP) and transurethral resection of the prostate (TURP). The gold-standard treatment is the artificial urinary sphincter, however, new treatments have been investigated. OBJECTIVE: To examine the outcome of an adjustable transobturator male system (ATOMS®) in men with UI after prostatic surgery in a low to medium volume continence center. MATERIALS AND METHODS: Twenty-five men with UI were implanted with ATOMS® system between 2012 and 2014. The most common indication was UI after RP (92%), followed by UI after TURP (8%). Eleven patients (44%) had received adjuvant external beam radiotherapy (RT). Patients were considered to be 'dry' if they stopped wearing pads or needed just one protective pad per day; and improved if the daily number of pads used decreased by at least half. The Incontinence Quality of Life questionnaire (ICIQ-SF) was used, adding a verbal question about the satisfaction of the patient considering the outcome. RESULTS: After a mean follow-up of 21.56 months, 64% were dry and 8% revealed a significant improvement. The success of the procedure was negatively correlated with the severity of the previous UI and with previous treatment with RT. Concerning patients satisfaction, 84% of the patients would repeat the procedure. CONCLUSION: ATOMS® offers good rates of cure and improvement of UI after prostatic surgery with a reasonable rate of minor complications. The results of this study, performed in a low to medium volume continence center, are comparable to the results achieved in high volume continence centers.

Caracterización del dengue con bradicardia en adolescentes

Introducción: El dengue es una enfermedad infecto contagiosa de variada intensidad, oriunda de climas tropicales como los que predominan en la región de las Américas. Es trasmitida por el mosquito Aedes aegypti y afecta a la población pediátrica. Su espectro clínico incluye alteraciones de la conducción cardíaca y de bradicardia. Objetivo: Caracterizar el dengue con bradicardia en adolescente. Métodos: Se realizó un estudio observacional descriptivo, longitudinal y retrospectivo en el Hospital Pediátrico Provincial Universitario Dr. Eduardo Agramonte Piña de la provincia Camagüey en el periodo comprendido desde enero a diciembre de 2021. El universo quedó conformado por 28 pacientes con diagnóstico de dengue que presentaron bradicardia. Los datos se recogieron en un formulario y se procesaron en una base de datos creada con SPSS versión 22. Resultados: Los resultados mostraron predominio de los pacientes del sexo masculino, del municipio Camagüey, entre los síntomas iniciales más frecuentes fue el dengue sin signos de alarma, el inicio de la bradicardia es durante la hospitalización, la bradicardia sinusal se presenta en todos los pacientes, en la mayoría de los casos la duración es en la etapa de recuperación. Conclusiones: Entre los síntomas encontrados predominaron los pacientes que no presentaron signos de alarma de dengue, la aparición de estos signos se asoció con bradicardia sinusal en la etapa de recuperación.

Introduction: Dengue is a contagious infectious disease of varying intensity that originates from tropical climates such as those that predominate in the region of the Americas. It is transmitted by the Aedes aegypti mosquito and affect the pediatric population. Its clinical spectrum includes alterations in cardiac conduction and bradycardia. Objective: To characterize dengue with bradycardia in adolescents. Methods: A descriptive, longitudinal and retrospective observational study was carried out at the Dr. Eduardo Agramonte Piña University Provincial Pediatric Hospital in Camagüey province in the period from January to December 2021.The universe was made up of 28 patients diagnosed with dengue who presented bradycardia. The data was collected in a from and processed in a database created with SPSS version 22. Results: The results grouped in the form of tables, showed a predominance of male patients, from the municipality of Camagüey, among the most frequent initial symptoms is dengue without warning signs, the onset of bradycardia is during hospitalization, it occurs in all patients, in most cases the duration is in the recovery stage. Conclusions: Among the symptoms found, patients who did not present dengue alarm signs was associated with sinus bradycardia during recovery.

Evidências sobre o prêmio salarial masculino do casamento e da coabitação no Brasil / Evidence on the male marriage wage premium and cohabitation premium in Brazil / Evidencias sobre el premio salarial masculino del matrimonio y de la cohabitación en Brasil

Resumo O objetivo principal é analisar a associação entre o casamento e a coabitação e o rendimento do trabalho masculino no Brasil. O artigo discute o fenômeno do "prêmio salarial masculino do casamento" - geralmente, homens casados apresentam rendimentos mais elevados do que os solteiros no mercado de trabalho. Tendo em vista que no Brasil a união informal é uma modalidade conjugal bastante comum, o prêmio para a coabitação também é investigado nessa situação. A associação entre o estado conjugal e o trabalho remunerado dos homens brasileiros é analisada por meio de regressões lineares, quantílicas e decomposições de Oaxaca-Blinder para os diferenciais de rendimentos entre os homens solteiros, casados e coabitantes. O Censo Demográfico de 2010 é a fonte de dados utilizada. Os resultados confirmam a existência de prêmios do casamento e da coabitação para os homens brasileiros. Os prêmios observados tendem a ser menores para a coabitação do que para o casamento. As decomposições dos diferenciais de rendimentos mostram que os prêmios devem-se à estrutura salarial e não a efeitos de composição.

Abstract The article aims to explore the correlation between marriage, cohabitation, and male labor income. It delves into the concept of the "male marriage wage premium" - a phenomenon where married men earn higher wages compared to single men in the labor market. Since consensual unions are prevalent in Brazil, the study also examines the cohabitation premium. The research employs linear regressions, quantile regression, and Blinder-Oaxaca decompositions of earnings differentials between single, married, and cohabiting men to analyze the association between marital status and paid work among Brazilian men. The data utilized were from the 2010 Demographic Census. The results of the study validate the existence of marriage and cohabitation premia for Brazilian men. However, the observed premium tend to be lower for cohabitation than for marriage. The decompositions reveal that these differentials are due to wage structure and not composition effects.

Resumen El objetivo principal es analizar la asociación entre el matrimonio y la cohabitación y las diferencias salariales masculinas en Brasil. El artículo analiza el fenómeno del premio salarial del matrimonio masculino: en general, los hombres casados tienen ingresos más altos que los hombres solteros en el mercado laboral, aunque ya que en Brasil la cohabitación es una modalidad marital muy común, también se investiga el premio de la cohabitación. La asociación entre el estado civil y el trabajo remunerado entre los hombres brasileños se analiza utilizando regresiones lineales, regresión cuantil y descomposiciones Oaxaca-Blinder para los diferenciales salariales entre hombres solteros, casados y en cohabitación. La fuente de datos fue el censo demográfico de 2010. Los resultados confirman la existencia de premios para el matrimonio y la cohabitación, que tienden a ser menores para la cohabitación que para el matrimonio. La descomposición de los diferenciales de ingresos mostró que los premios se deben a la estructura salarial y no a efectos de composición.

Depresión en la tercera edad / Depression in elderly

RESUMEN Introducción: La depresión constituye un problema de la Salud Pública a nivel mundial. Los adultos mayores se encuentran dentro de los grupos de edades vulnerables. Objetivo: Determinar la frecuencia de depresión en adultos mayores de las casas de abuelos del municipio Holguín. Métodos: Desde el enfoque cuantitativo se realizó un estudio descriptivo entre agosto de 2019 y marzo de 2020. El universo estuvo constituido por 84 adultos mayores de las casas de abuelos del municipio Holguín. Se seleccionaron 66 adultos mediante el cálculo de la fórmula en el paquete estadístico EPIDAT 3.1. Se consideraron variables sociodemográficas, los antecedentes psicopatológicos personales, la funcionabilidad, el funcionamiento cognitivo y la depresión. Se utilizaron la entrevista semiestructurada, el mini-examen del estado mental, la escala de depresión geriátrica de Yesavage, el índice de Katz, la escala de Lawton y la revisión documental. Los resultados se procesaron en el Epidat 3.1 y MedCalc. Resultados: Un porcentaje menor de sujetos presentó depresión. Obtuvieron mayores por cientos los del sexo masculino, del rango de edad de 71-80 años, blancos, con nivel de escolaridad primario, viudos, con hijos, que vivían solos, con enfermedades crónicas, antecedentes personales de trastorno mental y sin deterioro cognitivo. Conclusiones: La frecuencia de depresión en los adultos mayores de las casas de abuelos del municipio Holguín fue baja. Predominó la depresión en sujetos de sexo masculino, blancos, del rango de edad de 71-80 años, con nivel de escolaridad primario, viudos, que viven solos, con hijos, enfermedades crónicas, con antecedentes personales de trastorno mental y sin deterioro cognitivo.

ABSTRACT Introduction: Depression is a Public Health problem worldwide. Older adults are within vulnerable age groups. Objective: To determine the frequency of depression in older adults in grandparents' homes in the Holguín municipality. Methods: A descriptive and cross-sectional study was carried out from a quantitative approach from August 2019 to March 2020. The universe was made up of 84 older adults from the grandparents' houses of the Holguín municipality. The sample was selected probabilistically and it was made up of 66 older adults. Sociodemographic variables, personal psychopathological history, functionality, cognitive functioning and depression were considered. The semi-structured interview, the mini-mental state examination, the Yesavage geriatric depression scale, the Katz index, the Lawton scale and the documentary review were used. The results were processed in Epidat 3.1 and MedCalc. Results: A smaller percentage of subjects presented depression. Males, in the age range of 71-80 years, whites, with a primary education level, widowers, with children, who lived alone, with chronic diseases, with a personal history of mental disorder and without cognitive impairment had the highest percent. Conclusions: The frequency of depression in the elderly in the grandparents' houses of the Holguín municipality was low. Depression predominated in male subjects, white, age range 71-80 years, with primary education level, widowers, living alone, with children, with chronic diseases, with a personal history of mental disorder and without cognitive impairment.

Effects of aging and the body mass index on male sex hormones: a cross-sectional study in 701 Brazilian men / Efeitos do envelhecimento e do índice de massa corporal sobre os hormônios sexuais masculinos: um estudo transversal em 701 homens brasileiros

Background: Some studies indicated that body mass index (BMI) is inversely proportional to serum testosterone concentrations in men. Purposes: This study aimed to analyze the effects of aging and obesity on total testosterone (TT), free testosterone (FT), bioavailable testosterone (BT), luteinizing hormone (LH), and sex hormone-binding globulin (SHBG) levels. Methods: A cross-sectional study was performed to assess the clinical and laboratory profiles of 701 patients treated at a private urology clinic in Ponta Grossa, Brazil, from January 2016 to December 2018. Results: Patients' age ranged from 16 to 88 years (mean, 56.9 ± 13.62 years). Age did not significantly influence serum TT concentrations, except compared to patients aged >70 years. However, changes were observed in FT and BT (p < 0.05). The mean SHBG increased with age (p < 0.05). A tendency toward LH elevation was observed in older patients, but it was not statistically significant. An inverse proportional relationship between TT, FT, and BT and the testosterone deficiency rate (TT < 300 ng/dL) was observed within BMI groups (p < 0.05). The testosterone deficiency rate was 21.5% in individuals with normal BMI, 29% in overweight individuals, and 37% in obese individuals. Conclusions: Aging affected the testosterone concentrations in men and became increasingly evident using FT and BT instead of TT. SHBG increased with age. Obesity was associated with a decrease in TT, FT, and BT but also increased the rate of hypogonadism. (AU)

Fundamentos: Alguns estudos indicam que o índice de massa corporal (IMC) é inversamente proporcional à con-centração de testosterona sérica em homens. Objetivos: O objetivo deste estudo é analisar o efeito do envelhe-cimento e da obesidade na testosterona biodisponível total e livre, bem como nos níveis de hormônio luteinizante e globulina ligadora de hormônio sexual. Métodos: Foi realizado um estudo transversal abordando o perfil clínico e laboratorial de 701 pacientes atendidos em uma clínica privada de urologia em Ponta Grossa, Brasil, de janei-ro de 2016 a dezembro de 2018. Resultados: A idade dos pacientes variou de 16 a 88 anos (média de 56,9 ± 13,62 anos). A idade não influenciou significativamente as concentrações séricas de testosterona total, exceto quando comparada a pacientes com mais de 70 anos. No entanto, foi observada diferença na testosterona livre e biodisponível (p <0,05). A média de globulina de ligação aos hormônios sexuais aumentou com a idade (p <0,05). Embora uma tendência à elevação da luteinização tenha sido observada em pacientes mais idosos, ela não foi significativa. Relação inversa entre testosterona total, livre e biodisponível e taxa de deficiência de testosterona (testosterona total <300 ng / dL) foi observada dentro dos grupos de índice de massa corporal (p <0,05). A taxa de deficiência de testosterona em indivíduos com índice de massa corporal normal foi de 21,5%, indivíduos com sobre-peso foi de 29% e em indivíduos com obesidade foi de 37%. Conclusões: O envelhecimento afetou a concentração de testosterona em homens, mais evidente ao avaliar testosterona livre e biodisponível em vez de testosterona total. A globulina de ligação aos hormônios sexuais aumentou com a idade. A obesidade foi associada à redução da testosterona total, livre e biodisponível e ao aumento da taxa de hipogonadismo. (AU)

Forma aguda de histoplasmose em paciente imunocompetente: relato de caso / Acute form of histoplasmosis in immunocompetent patient: case report

A histoplasmose é uma doença granulomatosa infecciosa sistêmica cuja transmissão é aerógena e a contaminação se dá pelo contato com fezes de aves e morcegos, depende da exposição e da imunidade do paciente. Trata-se de uma doença com difícil diagnóstico, dada a semelhança dos sintomas com os de outras doenças granulomatosas infecciosas, principalmente em pacientes imunocompetentes, visto que a regressão é geralmente espontânea. Um homem de 34 anos, branco, natural e procedente de Atibaia, previamente hígido, iniciou quadro de dor e edema no tornozelo esquerdo, e evoluiu com dispneia progressiva, com piora ao decúbito, acompanhada de sudorese noturna, tosse seca e febre baixa. Foi realizado o exame de tomografia computadorizada (TC) de tórax sem contraste, que evidenciou espessamento difuso das paredes brônquicas, de aspecto inflamatório, micronódulos esparsos bilateralmente. Paciente apresentou PCR elevado, COVID, sorologias, BAAR e hemoculturas negativas, punção articular e ecocardiograma sem alterações. Optado por COXCIP 4, sulfametoxazol-trimetoprim e anfotericina B de forma empírica. Pesquisa de fungos em escarro positivo; leveduras e lavado brônquico sugestivos de histoplasmose. Evoluiu com insuficiência respiratória necessitando de intubação orotraqueal, posteriormente, traqueostomia e apesar do tratamento antifúngico, evoluiu com óbito após 21 dias. A histoplasmose é uma doença grave, com diversas formas clínicas e prognóstico normalmente autolimitado, mas que pode ser fatal, mesmo em pacientes previamente imunocompetentes.

Histoplasmosis is a systemic infectious granulomatous disease whose transmission is airborne, and contamination occurs through contact with bird and bat feces, depending on the exposure and immunity of the patient. It is a disease with difficult diagnosis, given the similarity of symptoms with those of other infectious granulomatous diseases, especially in immunocompetent patients since regression is usually spontaneous. A 34-year-old Caucasian man from Atibaia, previously healthy, developed pain and swelling in his left ankle, progressing to progressive dyspnea, worsening in recumbency, accompanied by night sweats, dry cough and low-grade fever. A non-contrast-enhanced computed tomography (CT) scan of the chest was performed, which showed diffuse thickening of the bronchial walls, with an inflammatory appearance, and bilaterally sparse micronodules. Patient had high C-reactive protein, COVID, serology, BAAR and negative blood cultures, joint puncture, and echocardiogram without changes. Empirically opted for COXCIP 4, trimethoprim-sulfamethoxazole and amphotericin B. Search for fungi in positive sputum, yeasts, and bronchial lavage suggestive of histoplasmosis. He envolved with respiratory failure requiring orotracheal intubation, later tracheostomy and despite antifungal treatment, he died after 21 days. Histoplasmosis is a serious disease, with several clinical forms and a prognosis that is usually self-limiting, but it can be fatal, even in previously immunocompetent patients

Transgenderism and transformation: an attempt at a Jungian understanding.

While transgenderism as a cultural phenomenon seems to be based on a collective taste for the sensational, its emergence represents a collective shift towards a new or more differentiated way of experiencing and expressing sex and gender, a movement of world soul. This paper attempts to explore that emergence from a Jungian perspective. The paper utilizes clinical examples which illustrate how dissociated aspects of the personality are seeking assimilation and expression in order to move the personality towards greater wholeness. In that sense, it attempts to understand the teleology of transgenderism on an individual and collective level. The paper is intended as a starting-off point for discussion and explores gender as fantasy, anima/animus dynamics, the psyche/soma relationship, the role of hormones/biochemistry in our experience of ourselves and what transgender people carry and suffer for our culture.

A devastação no masculino e a violência contra o feminino nas mulheres / Devastation in the masculine and violence against feminine in women / Dévastation chez le masculin et violence faite au féminin chez les femmes / Devastación en lo masculino y la violencia contra lo femenino en las mujeres

O presente artigo tem como objetivo trazer algumas contribuições da psicanálise para o esclarecimento da questão da violência contra a mulher, um fenômeno que se repete na história das sociedades. Buscando pensar sobre as bases estruturais dessa violência, recorremos à teoria lacaniana dos gozos fálico e gozo Outro, feminino, propondo uma diferenciação entre o que se supõe como gozo Outro e o que se estabelece como gozo do Outro. Seguindo o caminho aberto por Lacan, lançamos a hipótese de que o gozo do Outro pode estar relacionado com a vivência no sujeito posicionado do lado do masculino, de um gozo intrusivo e devastador atribuído a um Outro vivido como absoluto, mobilizando reações misóginas e mesmo feminicidas. Tal distinção foi operativa no sentido de nos possibilitar pensar no que aqui designamos como "devastação no masculino" e sua possível relação com o que no artigo discernimos como "violência contra o feminino na mulher".

This article aims to provide some contributions from psychoanalysis to clarify the issue of violence against women, a phenomenon that has occurred repeatedly in the history of societies. To analyze the structural bases of that kind of violence, we resort to the Lacanian theory of phallic jouissance and Other jouissance, feminine, proposing a differentiation between what is supposed to be Other jouissance and what is established as jouissance of the Other. Following the path proposed by Lacan, we suggest the hypothesis that jouissance of the Other may be related to the experience by the subject positioned on the masculine side, of an intrusive and devastating jouissance attributed to an Other, lived as absolute, mobilizing misogynous and even feminicide reactions. This distinction was operative in the sense that it allowed us to think about what we call here "devastation in the masculine" and its possible relationship with what we discern as "violence against the feminine in women" in this article.

Cet article vise à apporter quelques contributions de la psychanalyse pour adresser la question de la violence contre les femmes, phénomène qui se répète dans l'histoire des sociétés. Cherchant à réfléchir sur les fondements structurels de cette violence, nous recourons à la théorie lacanienne des jouissances phalliques et de la jouissance Autre, féminine, proposant une différenciation entre ce qui est supposé être la jouissance Autre et ce qui s'établit comme jouissance de l'Autre. En suivant la voie ouverte par Lacan, nous avançons l'hypothèse que la jouissance de l'Autre pourrait être liée à l'expérience du sujet positionné du côté masculin, d'une jouissance intrusive et dévastatrice attribuée à un Autre vécu comme absolu, mobilisant des réactions misogynes et même féminicides. Cette distinction était opérative dans le sens qu'elle nous permettait de penser ce que nous désignons ici comme la « dévastation chez le masculin ¼ et sa relation possible avec ce que nous discernons dans l'article comme « violence contre le féminin chez la femme ¼.

Este artículo tiene como objetivo presentar algunos aportes del psicoanálisis para aclarar el tema de la violencia contra la mujer, un fenómeno que se repite en la historia de las sociedades. Buscando reflexionar sobre las bases estructurales de esta violencia, recurrimos a la teoría lacaniana del goce fálico y del goce Otro, femenino, proponiendo una diferenciación entre lo que se supone que es el goce Otro y lo que se establece como goce del Otro. Siguiendo el camino abierto por Lacan, lanzamos la hipótesis de que el goce del Otro puede estar relacionado con la experiencia del sujeto ubicado al lado de lo masculino, de un goce intrusivo y devastador atribuido a un Otro vivido como absoluto, movilizando reacciones misóginas e incluso feminicidas. Esta distinción fue pertinente para permitirnos pensar en lo que designamos aquí como "devastación en lo masculino" y su posible relación con lo que en el artículo discernimos como "violencia contra lo femenino en la mujer".

Anatomo-histological evaluation of male reproductive system of the juvenile Caiman crocodilus yacare / Evaluación anátomo-histológica del sistema reproductor del Caiman crocodilus yacare macho juvenil

SUMMARY: The Caiman crocodilus yacare was once close to extinction. Studies about the male reproductive tract may aid in their reproduction and conservation. In this work, after sedation and euthanasia, seven young male C. yacare were submitted to necropsy, and macroscopic evaluation of the reproductive system, while the three others were admitted for histological study. The histological sections were stained with Hematoxylin & Eosin and Masson's Trichrome. After opening the pleuroperitoneal cavity it was possible to identify that the testicles were disposed in pairs and attached to its dorsal surface. The epididymis showed elongated and convoluted shapes and were located at the cranial margin of the testicles, following its medial portion, which was the same portion that the "vas deferens" stems from until the opening of the cloaca. The crocodile phallus presented a tubular shape, with conical appearance, displaying little resistance while maintaining its flexibility, compatible with a fibrocartilaginous tissue. On light microscopic analysis it was possible to observe that the testis was delimited by the tunica albuginea. The seminiferous tubules were contorted, and the interstitial space was filled with interstitial tissue and Leydig cells. The epididymal ductus were covered with non-ciliated pseudostratified epithelium with cells varying between cuboidal and prismatic shapes. The ductus deferens were characterized by a narrow girth shrouded with non- ciliated pseudostratified prismatic epithelium. The phallus of the crocodile was covered with a non-keratinized squamous epithelium surrounded by connective tissue. The findings support anatomic and histologic knowledge Alligatoridae reproductive system, enabling further research in the C. yacare reproduction and conservation.

RESUMEN: El Caiman crocodilus yacare ha estado en peligro de extinción. Los estudios sobre el aparato reproductor del macho pueden ser de ayuda en su reproducción y conservación. En este trabajo, fueron sometidos a necropsia y evaluación macroscópica del aparato reproductor, siete machos jóvenes de C. yacare, mientras que otros tres fueron utilizados para su estudio histológico. Las secciones histológicas se tiñeron con hematoxilina y eosina y tricrómico de Masson. Después de examinar la cavidad pleuroperitoneal se pudo identificar que los testículos estaban dispuestos en pares y adheridos a su superficie dorsal. El epidídimo presentaba formas alargadas y contorneadas y se ubicaba en el margen craneal de los testículos, siguiendo su porción medial, que era la misma porción de donde parten los conductos deferentes hasta la apertura de la cloaca. El pene del cocodrilo presentaba forma tubular, de apariencia cónica, mostrando poca resistencia manteniendo su flexibilidad, compatible con un tejido fibrocartilaginoso. En el análisis microscópico óptico se pudo observar que el testículo estaba delimitado por la túnica albugínea. Los túbulos seminíferos estaban contorsionados y el espacio intersticial estaba lleno de tejido intersticial y células intersticiales (células de Leydig). El epidídimo estaba cubierto con epitelio pseudoestratificado no ciliado con células que variaban entre formas cuboideas y prismáticas. Los conductos deferentes se caracterizaron por una circunferencia estrecha envuelta en un epitelio prismático pseudoestratificado no ciliado. El pene del cocodrilo estaba cubierto con un epitelio escamoso no queratinizado rodeado de tejido conectivo. Los hallazgos corroboran el conocimiento de la anatomía del sistema reproductivo de Alligatoridae, lo que permite una mayor investigación sobre la reproducción y conservación de C. yacare.

Revisão integrativa sobre o perfil da vítima de abuso sexual infantil masculina e as consequências desse abuso / Integrative review on the profile of the male child sexual abuse victim and the consequences of that abuse

O objetivo geral deste trabalho é descrever o perfil da vítima de abuso sexual infantil (ASI) mascu-lina e as consequências desse abuso. Trata-se de uma revisão bibliográfica integrativa dos últimos 10 anos, utilizando as bases de dados Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs), Medical Literature Analysis and Retrieval System on-line (Medline) e Scientific Eletronic Library Online (Scielo). A equação de busca utilizada foi "masculino" e "abuso sexual". Os critérios de inclusão foram artigos relacionados diretamente ao tema, excluindo-se artigos re-petidos e/ou publicados antes de 2010. Ao final, foram selecionados 24 artigos. O estereótipo de força e virilidade relacionado ao gênero masculino representa um obstáculo na revelação do abuso. Foi notório que os meninos abusados sofreram inúmeras consequências emocionais e comporta-mentais. O perfil do menino abusado sexualmente não difere significativamente do das meninas. Já com relação à comparação das consequências do ASI, a literatura apontou que meninos sofrem mais com comportamentos externalizadores. São necessários mais estudos focando a problemática do ASI masculino a fim de quebrar estigmas sociais, conscientizar o meio acadêmico e a sociedade, aprimorar a prevenção e o tratamento de consequências emocionais e comportamentais e melhorar o combate e a identificação dessa violência.

Male child sexual abuse (CSA) is poorly addressed by the academic community, which helps the victim to remain confidential and prevents the reception and treatment of possible psychic disor-ders. Confidentiality on this topic also raises doubts about CSA statistics against boys, as it makes reporting difficult. The general objective of this study is to describe the consequences of male CSA. This is an integrative bibliographic review of the last 10 years, conducted using the databases Lat-in American and Caribbean Literature on Health and Science (Lilacs), Online Medical Literature Analysis and Retrieval System (Medline), and Scientific Electronic Library Online (Scielo). The search used the equation "masculine and sexual abuse". The criterion included articles directly related to the topic, excluding repeated articles or the ones published before 2010. We selected 24 articles. The stereotype of strength and virility related to the male gender represents an obstacle in revealing the abuse. It was notorious that the abused boys suffered numerous emotional and behav-ioral consequences. The profile of the sexually abused boy does not differ from the girls' history. Regarding the comparison of the consequences of CSA, literature has pointed out that boys suffer more with externalizing behavior. More studies focusing on the issue of male CSA are needed to break social stigmas, raise awareness among the academic environment and society, improve the prevention and treatment of emotional and behavioral consequences, and improve the fight and identification of this violence.

Epigenética, sexo masculino y enfermedades neonatales

RESUMEN Introducción: Estudios recientes han demostrado diferencias entre el sexo femenino y el masculino y su influencia en aspectos básicos de la biología, los cuales podrían influir a su vez, en la etiología y fisiopatología de enfermedades en la etapa neonatal. Es conocido que los cambios en la regulación epigenética por factores que afectan la exposición del cortisol fetal muestra efectos específicos según el tipo de sexo. Objetivo: Determinar la posible relación entre los cambios epigenéticos, el sexo masculino y las enfermedades neonatales. Métodos: Se realizó una búsqueda bibliográfica en Pubmed, Scielo, LILACS y en la plataforma Clínica Key entre los años 2017-2020, en idioma inglés y español. Se utilizaron diferentes palabras clave como diferencias sexuales, sexo masculino, epigenética y enfermedades neonatales. Análisis e integración de la información: En esta revisión se abordan aspectos como la epigenética en el desarrollo humano y su relación con el sexo, el papel de la placenta y su relación con el sexo fetal, las complicaciones perinatales y su relación con el sexo masculino. Además, se abordan las afecciones respiratorias, las afecciones neurológicas y otras de la etapa neonatal vinculadas con el sexo y la posible relación con los mecanismos epigenéticos. Conclusiones: El sexo masculino es un factor predisponente en la prevalencia de determinadas enfermedades neonatales. La epigenética puede estar involucrada en la aparición de muchas enfermedades neonatales moduladas por el sexo por mecanismos aun no bien esclarecidos. Investigaciones futuras pudieran arrojar mayor conocimiento sobre la etiopatogenia de estas enfermedades y su forma de abordarlas.

ABSTRACT Introduction: Recent studies have confirmed differences among the female and male sex and their influence in basic aspects of biology, which can also impact in the etiology and physiopathology of diseases in the neonatal stage. It is known that changes in the epigenetic regulation due to factors that affect the exposition to fetal cortisol show specific effects according to the type of sex. Objective: Determine the possible relation among the epigenetic changes, male sex and the neonatal diseases. Methods: It was carried out a bibliographic search in Pubmed, Scielo, LILACS and in the platform called Clínica Key, in the period 2017-2020, in English and Spanish languages. The following key words were used: sexual differences, male sex, epignetic and neonatal diseases. Analysis and Integration of the information: This review deals with aspects as epigenetic in human development and its relation with sex, the role of placenta and its relation with fetal sex, perinatal complications and their relation with male sex. In addition, the review also mentions respiratory conditions, neurologic conditions and others of the neonatal stage related with sex and the possible relation with epigenetic mechanisms. Conclusions: Male sex is a predisposing factor in the prevalence of certain neonatal diseases. Epigenetic can be involved in the onset of many neonatal diseases modulated by the sex due to mechanisms that are not clear yet. Future researches might show more knowledge on the etiopathogenesis of these disease and the way to approach them.

Comparative study of anthropometric measurement and body composition between elite handball and volleyball players from the Serbian national league / Estudio comparativo de medición antropométrica y composición corporal entre jugadores de balonmano y voleibol de élite de la liga nacional Serbia

SUMMARY: The purpose of this study was to describe the anthropometric characteristics and body composition of elite handball and volleyball players from the Serbian national league as well as to make comparisons between them. Sixty males were enrolled, divided into three groups: 15 handball players, 14 volleyball players, and 31 healthy sedentary subjects. All subjects were assessed for the anthropometric measures required for the calculation of body composition variables, using the standardized procedures recommended by established literature. Data were analysed using SPSS, and the descriptive statistics were expressed as a mean (SD) for each variable, while the ANOVA and LSD Post Hoc tests were carried out to detect the effects of each type of sport. The results showed there was no significant difference for body weight and body mass index, nor were there any differences for the bone contents of bodies among the groups, while significant differences were found for body height, as well as for muscle and fat content of body among the groups. These findings may give coaches from the region better working knowledge and enable them to follow recent selection process methods and to be more careful during talent identification.

RESUMEN: El objetivo de este estudio fue describir las características antropométricas y la composición corporal de los jugadores de balonmano y voleibol de élite de la liga nacional serbia, y realizar comparaciones entre ellos. Se evaluaron sesenta hombres divididos en tres grupos: 15 jugadores de balonmano, 14 jugadores de voleibol y 31 sujetos sedentarios sanos. Se evaluaron las medidas antropométricas de todos los sujetos requeridas para el cálculo de las variables de composición corporal, utilizando los procedimientos estandarizados recomendados por la literatura establecida. Los datos se analizaron mediante SPSS y las estadísticas descriptivas se expresaron como media (DE) para cada variable, mientras que se realizaron las pruebas ANOVA y LSD Post Hoc para determinar los efectos de cada tipo de deporte. Los resultados mostraron que no hubo diferencias significativas para el peso corporal y el índice de masa corporal, ni hubo diferencias para el contenido óseo de los cuerpos entre los grupos, mientras que se encontraron diferencias significativas de altura corporal, así como para el contenido de músculo y grasa corporal. Estos hallazgos pueden proveer un mejor conocimiento de trabajo a los entrenadores de la región y permitirles seguir los métodos recientes del proceso de selección y estar más atentos durante la identificación de talentos.