FIGIJ and NASPAG Advocacy Statement-Eliminating the Persistent Misconception of the "Virgin Hymen".

This advocacy statement endeavors to clarify the concept of the hymen as a symbol of "virginity." The anatomic variants of this structure precludes any correlation to prior sexual activity and the value of physical assessment of this structure is thus questioned. Moreover, physical examination of the hymen is painful, traumatic, and humiliating and is a form of gender-based violence.

[Strengthening leadership for educational management in the Americas: an action research strategyFortalecimento da liderança para a gestão educacional na Região das Américas: uma estratégia de pesquisa-ação].

The training of human resources for health (HRH) is a recurring concern. The Virtual Campus for Public Health (VCPH) - the educational platform of the Pan American Health Organization (PAHO) - seeks to improve access to public health education, emphasizing leadership training for teams that plan, implement, and evaluate policies and educational initiatives.The objective of this work is to present the results of a consultation with experts on the virtual course "Leadership for Educational Management in Health Organizations", as part of a PAHO/VCPH strategy to strengthen leadership capacities for educational management in the Americas.

[Digital artery pseudoaneurysm. Case report and systematic review of the literature].

Introduction: aneurysms are focal and permanent dilations of an artery; in pseudoaneurysms, the normal layers of the blood vessel are replaced by fibrous tissue. Due to their low incidence, as well as the diagnostic and therapeutic challenge they represent; our objective is to present the clinical case of a pseudoaneurysm of a digital artery of the hand and to carry out a systematic review of this pathology.

Material And Methods: literature search in Medline, using the terms "digital artery" and "aneurysm.

Late consolidation of the scaphoid. Case report and literature review.

Scaphoid fractures are a common wrist injury accounting for 2-7% of all adult fractures. Nonunion is described in 5-12% of cases leading to osteoarthritis. Several classifications have been developed focused on this pathology and its complication.

Latin America and the Caribbean Code Against Cancer 1st edition: Building capacity on cancer prevention to primary healthcare professionals.

Introduction: Every year 1.5 million new cancer cases are diagnosed in Latin America and the Caribbean (LAC). Of these, about 40 % could be prevented.

[Not Available].

La colitis fulminante por Clostridium difficile se caracteriza por el desarrollo de una inflamación aguda severa del colon, asociada a toxicidad sistémica, y es la forma más grave de colitis aguda con una mortalidad de hasta el 80%. Presentamos el caso de un varón de 45 años que acude al servicio de urgencias por dolor abdominal agudo, diarrea y fiebre. La tomografía computarizada mostró engrosamiento parietal difuso circunferencial del colon, incluido el recto, asociado con estriación de los tejidos circundantes y formaciones ganglionares.

[Fulminant colitis due to Clostridium Difficile in a patient with a history of liver transplantation: a severe life-threatening complication].

Clostridium difficile´s fulminant colitis is characterized by the development of severe acute inflammation of the colon, associated with systemic toxicity. Fulminant colitis is the most serious form of acute colitis with a mortality of up to 80%. We present the case of a 45-year-old man who presented to the emergency department with acute abdominal pain, diarrhea and fever.

Valgus Deformity and Posterolateral Instability after Elbow Dislocation in a Pediatric Patient- Case Report.

Introduction: ?Introduction: The aim of this paper is to report a rare case of a child who suffered a simple elbow dislocation (SED) that developed a post-traumatic valgus deformity and a subsequent posterolateral elbow instability.

Case Report: We report a case of a female patient who suffered a posterolateral SED of her elbow at the age of 12. She was treated with closed reduction and over the years, she developed an asymptomatic valgus deformity.

[Pillars and lines of action for integrated and people- and community-centered health systemsPilares e linhas de ação para sistemas integrados de saúde centrados nas pessoas e nas comunidades].

This paper presents the position of the Latin American working group of the International Foundation for Integrated Care (IFIC). The working group brings together various Latin American actors and organizations in support of actions that facilitate the transformation of health systems in the region towards integrated systems that focus on people not as isolated individuals but as subjects of law in the complex social and environmental contexts where they live and interact. The working group proposes nine pillars of integrated care to be used as a conceptual framework for policy development and changes in practices: 1) shared vision and values; 2) population health; 3) people and communities as partners; 4) resilient communities; 5) capacities of human resources for health; 6) governance and leadership; 7) digital solutions; 8) aligned payment systems; and 9) public transparency.

[Notes on telework, psychiatric care and changes in communication during pandemic].

COVID-19 has accelerated the transformations of teleworking, generating conditions of great opportunities and terrible threats. The digital divide deepens inequities and exploitation, where the most unprotected countries and the most vulnerable populations are closer to the abyss Digital changes have formatted new modes of care, which are constantly changing and present new challenges to find their scope and limits.

Incidence of COVID-19 after pulmonary function tests: a retrospective cohort study.

Introduction: It has been proposed that exposure to pulmonary function tests (PFT) could be associated with a higher risk of viral transmission. The risk of the Coronavirus Disease 2019 (COVID-19) transmission after performing PFT is unknown. We aimed to assess the incidence  of COVID-19 after a PFT at an academic teaching facility in Buenos Aires, Argentina.

Fatal enhanced respiratory syncytial virus disease in toddlers.

In 1967, two toddlers immunized with a formalin-inactivated vaccine against respiratory syncytial virus (FIRSV) in the United States died from enhanced RSV disease (ERD), a severe form of illness resulting from aberrant priming of the antiviral immune response during vaccination. Up to 80% of immunized children subsequently exposed to wild-type virus were hospitalized. These events hampered RSV vaccine development for decades.

[Acute lumbalgia frequency and treatment at a private hospital emergency plant].

Introduction: Acute back pain (LA) is a considerable problem in any care setting. The Emergency Department (ED) intended to provide immediate, timely and effective care. Our objective was to estimate the prevalence and describe the usual care process.

Relationship between the posterior septal artery and the upper edge of the choana.

Background: The pedicled nasoseptal flap has been a key element in advancing the endoscopic transnasal approach (ETA) for the treatment of skull base lesions from the anterior cranial fossa to the occipitocervical junction. To preserve vascular supply, an anatomical knowledge of the location of the posterior septal artery (PSA) is essential. The objective of this work is to establish the relationship between PSA and the superior edge of the choana to define a safety margin during the opening of the sphenoidal rostrum preserving PSA.

ART in HIV-Positive Persons With Low Pretreatment Viremia: Results From the START Trial.

Background: The benefit of immediate antiretroviral therapy (ART) at CD4 >500 cells/μL was established in the Strategic Timing of Antiretroviral Treatment (START) study. The benefits and risks of immediate ART in participants with low pretreatment viremia, including virologic suppressors, were further assessed.

Setting: Randomized prospective international study.

[Post-op paraspinal atrophy: Does the approach matter?].

Objective: To compare the level of post-op muscle atrophy related to the different approaches used in segmental lumbar fusion for degenerative disease (midline vs. Wiltse vs. MIS TLIF).

[IgG4 related disease presenting as panhypopituitarism and perimacular scotoma].

IgG4-related disease (IgG4-RD) is a recently described systemic entity of unknown origin. It predominantly affects older men and has distinctive histopathologic features as storiform fibrosis, obliterative phlebitis, dense lymphoplasmacytic infiltrate with immunostaining for IgG4, and it may be associated with elevated serum levels of IgG4. Although any organ can be affected, pituitary gland is rarely involved.

Central nervous system manganese induced lesions and clinical consequences in patients with hereditary hemorrhagic telangiectasia.

Background: Around 47-74% of patients with hereditary hemorrhagic telangiectasia (HHT) have hepatic vascular malformations (HVMs); magnetic resonance images (MRI) of the central nervous system (CNS) might show in T1 sequences a hyper-intensity signal in different areas, mainly in the basal ganglia (BG) as consequence of manganese (Mn) deposits as observed in cirrhotic patients. These patients might suffer from different neuropsychiatric disorders (hepatic encephalopathy). In HHT patients, even in the presence of hepatic shunts, hepatocellular function is usually preserved.

[Excessive osteoporosis screening in women under 65 years: a cross-sectional study].

Overuse of osteoporosis screening in women at low risk of fracture may lead to overdiagnosis, inappropriate treatment and medicalization. The objective of this work was to estimate the proportion of women aged 45 to 64 enrolled in a private health insurance plan in Buenos Aires undergoing hip dual-energy x-ray absorptiometry (DXA) in 2011 without meeting osteoporosis screening criteria. In this cross-sectional study, 4310 women of this age range that had undergone a hip DXA were identified.

[Comparison of the Biochemical Recurrence risk between Radical Prostatectomy and Brachytherapy in the treatment of low- and intermediate-risk prostate cancer].

Objectives: To evaluate the results of patients treated with Radical Prostatectomy (RP) and Brachytherapy for low- and intermediate-risk localized prostate cancer and to determine the Biochemical Recurrence (BCR) risk according to the treatment performed.

Methods: The study included 129 patients treated with iodine-125 seeds Brachytherapy, 98 patients treated with Laparoscopic RP (LRP), and 61 patients treated with Robotic RP (RRP) at our institution between December 1999 and January 2010, who had a low-risk disease according to D'Amico criteria (PSA <10 ng/mL, Gleason < or = 6, cT1c-T2a), or an intermediate-risk disease (PSA = or >10 and < 20 ng/mL, Gleason = 7, cT2b), but with a tumor burden of up to 30%. Follow-up was conducted with PSA at 1, 3, and 6 months, and then every six months.