International Seven Journal of Multidisciplinary
The International Seven Multidisciplinary Journal (ISMJ) ISSN- 2764-9547 is a journal dedicated to the publication of articles and studies related to all areas of knowledge, with bilingual publications in English, Spanish and Portuguese.
SCHOOL ORAL HEALTH PROMOTION STRATEGIES AND PREVENTION OF CHILDHOOD ORAL DISEASES
Oral health in childhood is a cornerstone of quality of life; however, the high prevalence of conditions such as dental caries, periodontal diseases, and traumatic injuries requires comprehensive and multisectoral preventive strategies. This study consists of a narrative literature review which, based on evidence from PubMed over the last five years, sought to systematize oral health promotion strategies in the school environment and the mitigation of childhood oral health problems. The results highlight schools and families as central pillars for effective programs. Successful interventions go beyond the passive transmission of information by adopting behavioral approaches, such as Motivational Interviewing and Health Coaching, to promote autonomy and the consolidation of lasting healthy habits. Effectiveness is supported by systematic regional programs and by the use of tools such as the “Passport for Healthy Teeth,” which demonstrated protection of permanent dentition into adulthood. The study emphasizes the importance of integrating oral health into prenatal care, involving non-dental health professionals in parental education, and using technologies such as teledentistry for the rapid management of emergencies, including dental trauma. It is concluded that the sustainability of children’s oral health requires continuous investment in public policies and integrated care models that address the entire life cycle.
Copyright (c) 2026 https://creativecommons.org/licenses/by-nc/4.0
SURGICAL APPROACHES AND MULTIDISCIPLINARY MANAGEMENT IN THE TREATMENT OF OBSTRUCTIVE SLEEP APNEA
This study consists of a narrative literature review aimed at analyzing contemporary scientific evidence regarding surgical approaches and multidisciplinary management in the treatment of Obstructive Sleep Apnea (OSA). OSA is a prevalent chronic respiratory disorder associated with severe cardiovascular morbidities, with continuous positive airway pressure (CPAP) therapy being the gold-standard management for moderate to severe cases, despite its low long-term adherence. Data collection was carried out in the PubMed database using the descriptors “Sleep Apnea, Obstructive” and “Orthognathic Surgery” in articles published within the last five years. The results highlight maxillomandibular advancement (MMA), performed with the assistance of virtual surgical planning (VSP) and CAD/CAM technology, as the key procedure for upper airway expansion and significant reduction of the Apnea-Hypopnea Index (AHI). Although accuracy analyses indicate a small discrepancy between the planned and achieved sagittal movements, the evaluation of patient-reported outcome measures (PROMs) confirms a substantial and stable long-term improvement in subjective quality of life and reduction of daytime sleepiness. Multidisciplinary management is essential, in which the orthodontist plays a central role in screening and referral for definitive diagnosis through polysomnography, with the need for monitoring patients undergoing mandibular setback surgeries due to the risk of inducing OSA.
HORMONAL PROTOCOLS AND REPRODUCTIVE EFFICIENCY IN FIXED-TIME ARTIFICIAL INSEMINATION (FTAI) IN ANIMALS
Fixed-Time Artificial Insemination (FTAI) represents one of the main biotechnologies applied to bovine reproduction, contributing to genetic improvement, increased productive efficiency, and optimization of reproductive herd management. The present study aimed to review the main hormonal protocols used in FTAI and the factors influencing reproductive efficiency in cattle. This is a narrative literature review developed from scientific articles published over the last fifteen years and indexed in the PubMed database. The results demonstrate that hormonal protocols based on GnRH, estradiol, progesterone, and equine chorionic gonadotropin (eCG) promote ovulation synchronization and improve pregnancy rates, especially when associated with proper animal management. Furthermore, factors such as body condition score, heat stress, nutritional status, herd health, and technical training of professionals directly influence reproductive outcomes. Recent studies also highlight the potential use of molecular biomarkers as auxiliary tools for early pregnancy assessment. It is concluded that the association between efficient hormonal protocols, appropriate sanitary and nutritional management, and biotechnological advances is essential to maximize reproductive performance in FTAI.
THERAPEUTIC PROTOCOLS AND MANAGEMENT OF NEUROLOGICAL MANIFESTATIONS IN THE TREATMENT OF HEPATIC ENCEPHALOPATHY
Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome mediated by dysfunction of the gut-liver-brain axis, in which hyperammonemia and intestinal dysbiosis promote neuroinflammation and astrocytic edema. This study conducted a narrative literature review (PubMed, last five years) aiming to analyze therapeutic protocols and the management of neurological manifestations of the condition. The findings confirm lactulose as the cornerstone therapy, while rifaximin — especially in combination therapy — demonstrates superiority in maintaining remission and reducing hospitalizations. Emerging microbiome modulation strategies, such as probiotics and fecal microbiota transplantation, appear promising for restoring intestinal integrity. In neurological management, adjuvant therapies such as L-ornithine L-aspartate (LOLA) and albumin infusion stand out. In pediatrics, monitoring must be rigorous due to the risk of rapid progression to cerebral edema. It is concluded that HE management requires a multidisciplinary and individualized approach focused on reducing nitrogen load and modulating the intestinal environment to optimize prognosis and patients’ quality of life.
EMERGENCY SURGICAL APPROACH AND THERAPEUTIC MANAGEMENT IN THE TREATMENT OF SIGMOID VOLVULUS
Sigmoid volvulus (SV) is an abnormal twisting of the sigmoid colon and represents the third most common cause of large bowel obstruction, carrying a potential risk of ischemia, necrosis, and intestinal perforation, being more prevalent in elderly male patients. Anatomical factors such as an elongated colon (dolichosigmoid) and a narrow mesenteric base are central to its pathophysiology. The present study is a narrative literature review that analyzed the surgical and therapeutic approaches to SV. Early diagnosis is supported by plain radiography (the “coffee bean” sign), but Computed Tomography (CT) is crucial to confirm obstruction, differentiate subtypes (mesenteroaxial and organoaxial), and identify vascular compromise. Endoscopic decompression is the initial treatment of choice in the absence of peritonitis or gangrene; however, the high recurrence rate requires surgical sigmoid resection as definitive treatment. In emergency cases complicated by necrosis or perforation, immediate resection, often through the Hartmann procedure, is mandatory. Advances in minimally invasive techniques, such as single-port laparoscopy, have shown promise for frail patients and are associated with lower morbidity. Careful definition of the therapeutic approach, based on risk stratification, is fundamental for effective management.
MULTIMODAL APPROACH AND THERAPEUTIC ADVANCES IN THE TREATMENT OF OSTEOSARCOMA
Osteosarcoma is the most prevalent primary malignant bone neoplasm, occurring predominantly in children and adolescents. It is characterized by the production of immature osteoid matrix and by an extremely unstable and heterogeneous genomic profile. Although standard chemotherapy (MAP) has increased the five-year survival rate to 60–70% in localized disease, the prognosis for metastatic or recurrent disease remains stagnant at approximately 20%. The complexity of treatment lies in the genetic instability and the intricate interaction with the bone microenvironment, which acts as a vital support for tumor growth and dissemination, promoting therapeutic resistance. This study is a narrative literature review that sought to synthesize contemporary scientific evidence regarding the multimodal approach and therapeutic advances in combating osteosarcoma. The findings reveal that overcoming chemoresistance requires the integration of innovative strategies, such as nanotechnology for active and targeted drug delivery, using specific ligands (e.g., bisphosphonates or folate), which maximize drug concentration at the tumor site and mitigate systemic toxicity. In immunotherapy, the focus is on manipulation of the cGAS-STING axis and repolarization of tumor-associated macrophages (TAMs) to the M1 phenotype, as observed with mifamurtide, aiming to reverse microenvironmental immunosuppression. Other approaches include multiple kinase inhibitors (MKIs), such as sorafenib and regorafenib, and unconventional administration routes, such as inhaled chemotherapy for pulmonary metastases. In conclusion, the effective integration of these innovative strategies (nanotechnology, immunomodulation, and targeted therapies) represents the future of osteosarcoma oncology, offering renewed hope for prolonging progression-free survival and overall survival in patients.
Rafael Lucas Batista Cavalcante de Moura
NUTRITIONAL INTERVENTIONS AND CLINICAL MANAGEMENT IN THE TREATMENT OF CARDIAC CACHEXIA
Cardiac cachexia is a severe and multifactorial complication of heart failure (HF), characterized by malnutrition, severe loss of skeletal muscle mass, catabolic metabolic imbalance, and systemic inflammation, being an independent predictor of morbidity and mortality. This pathological state worsens the progression of HF, leading to reduced functional capacity and increased hospitalizations. This narrative review examines current nutritional interventions and clinical management strategies for this condition, focusing on evidence from the last ten years available in PubMed. Studies highlight Growth Differentiation Factor 15 (GDF15) as a critical biomarker and a promising therapeutic target, whose antagonism may prevent cachexia and delay worsening of cardiac function. Management strategies should be multidisciplinary, focusing on adequate protein supplementation (1.0 to 1.2 g/kg/day), the use of leucine metabolites such as beta-hydroxy-beta-methylbutyrate (HMB), and correction of Vitamin D deficiency to modulate inflammation. Aerobic and resistance exercise constitutes the most robust intervention to attenuate muscle catabolism and reduce myostatin levels and should be integrated with optimized guideline-directed pharmacological therapy. It is concluded that successful management of cardiac cachexia depends on the early and combined application of hyperproteic nutritional support, physical rehabilitation, and optimized pharmacological management.
CLINICAL MANAGEMENT AND EMERGENCY INTERVENTIONS IN THE TREATMENT OF EGG BINDING IN BIRDS
Egg binding is classified as a potentially fatal avian reproductive emergency of multifactorial etiology, characterized by the physiological inability to expel the egg and frequently associated with dystocia and nutritional deficiencies such as hypocalcemia. Management of the condition requires immediate diagnosis, based on clinical evaluation and imaging exams, as well as a staged and integrated therapeutic intervention, resulting in an overall success rate of 72.7% in psittacines. Initial medical management, focused on patient stabilization and calcium supplementation, is essential but demonstrates low efficacy when used alone (33.1%). Mechanical assistance (86.1%) and ovocentesis (85.7%) are the most effective interventions for most non-obstructive cases, with ovocentesis offering lower anesthetic risk. Surgical management (60.6% success rate) is reserved only for critical patients and obstructive dystocia cases. A positive prognosis is associated with factors such as higher body weight and the absence of stuporous states upon admission. Effective control requires correction of chronic nutritional deficiencies and long-term strategies, such as deslorelin implants, to suppress the reproductive cycle and prevent recurrence.
SURGICAL TECHNIQUES AND POSTOPERATIVE CARE OF ORCHIECTOMY IN DOGS
This article reviews the main surgical techniques and clinical care guidelines necessary for the successful performance of orchiectomy in dogs. Elective orchiectomy is a common procedure, essential for population control, mitigation of undesirable behaviors, and prevention of andrological diseases such as benign prostatic hyperplasia (BPH). However, the timing of neutering requires individualized evaluation, since early castration may be associated with an increased risk of orthopedic disorders and neoplastic conditions in predisposed breeds. In the surgical context, the conventional technique coexists with laparoscopic castration, which stands out as a minimally invasive method resulting in less tissue trauma and reduced postoperative pain and stress. For procedural success, adequate analgesic management (with NSAIDs and opioids) and maintenance of thermoregulation during the perioperative period are essential to mitigate complications and ensure the patient’s welfare and rapid recovery.
THERAPEUTIC APPROACH AND CLINICAL MANAGEMENT IN THE TREATMENT OF FELINE HYPERTHYROIDISM
Feline hyperthyroidism is the most common endocrinopathy in elderly cats, resulting from the excessive production of thyroid hormones mainly due to adenomatous hyperplasia or functional adenomas of the thyroid gland. The disease causes significant multisystemic alterations, including cardiovascular, metabolic, and renal repercussions, and is frequently associated with the coexistence of Chronic Kidney Disease (CKD). The objective of this narrative literature review was to examine the main therapeutic approaches and clinical management strategies for the treatment of feline hyperthyroidism. Data collection was carried out in PubMed using descriptors related to the disease and its treatment in felines. The therapeutic modalities highlighted include radioactive iodine, antithyroid drug therapy with thioureylene compounds, surgical thyroidectomy, and iodine-restricted diets, each with specific indications and limitations. Continuous clinical follow-up is essential due to the risk of renal decompensation, iatrogenic hypothyroidism, and systemic arterial hypertension after treatment. It is concluded that therapeutic success requires an individualized approach and periodic monitoring of renal and thyroid functions to ensure quality of life and survival in feline patients.
PUBLIC HEALTH STRATEGIES AND PHARMACOLOGICAL MANAGEMENT IN THE TREATMENT OF CHILDHOOD TUBERCULOSIS
Childhood tuberculosis (TB) represents a significant global public health challenge, characterized by high morbidity and diagnostic difficulty due to the paucibacillary nature of the disease in children and the challenges associated with sample collection. The present study consisted of a narrative literature review aimed at synthesizing contemporary scientific evidence regarding public health strategies and pharmacological management in the treatment of childhood TB. The findings indicate advances in diagnosis through the use of molecular methods, such as the detection of circulating DNA of Mycobacterium tuberculosis (CRISPR-TB), offering minimally invasive alternatives for paucibacillary cases. In pharmacological management, the SHINE clinical trial validated the shortened four-month treatment regimen for non-severe cases, facilitating treatment adherence. However, therapeutic success depends on the integration of social protection strategies (cash transfer programs and patient navigation), which have proven effective in reducing catastrophic costs and improving adherence. It is concluded that care should be comprehensive and humanized, combining improved clinical interventions with social and multidisciplinary support for families in order to mitigate the socioeconomic impact of the disease and ensure continuity of treatment and child development.
PLAYING, LIVING TOGETHER AND RESPECTING: PLAYFULPEDAGOGICAL STRATEGIES IN CHILDREN'S SEXUAL EDUCATION AS AN INSTRUMENT FOR SOCIALIZATION AND PROTECTION OF RIGHTS
Sex education in early childhood has become a highly relevant topic in contemporary educational contexts, especially in light of challenges related to child protection and the development of individuals aware of their rights. This article aims to analyze the role of playful pedagogical strategies in the development of early childhood sex education, considering their contribution to socialization, autonomy building, and violence prevention. The study adopts a qualitative, bibliographic approach, grounded in theoretical frameworks from the sociology of childhood, education, and public policies for child protection. It is based on the assumption that sex education, when properly adapted to children's developmental stages, goes beyond biological aspects and encompasses emotional, social, and cultural dimensions, fostering respect for one's own body and for others. In this context, play emerges as an essential pedagogical tool, enabling meaningful and accessible learning processes for children. Furthermore, the articulation between sex education and the defense of children's rights proves to be crucial in addressing child sexual abuse, particularly in cases where violence occurs within the family environment. The study also engages with concepts from the sociology of childhood, which recognizes children as active social agents, and with Pierre Bourdieu’s notion of habitus, explaining how social dispositions shape behaviors and perceptions from early life. The findings indicate that the integration of playful methodologies into sex education enhances emotional development, strengthens social bonds, and promotes a culture of protection. It is concluded that early childhood sex education, when guided by sensitive and well-structured pedagogical approaches, is an indispensable tool for the comprehensive development of children and for the promotion of a more just and conscious society.
Copyright (c) 2026 Kathia Susana Almeida https://creativecommons.org/licenses/by-nc/4.0
THERAPEUTIC APPROACH AND CLINICAL MANAGEMENT OF TAKOTSUBO CARDIOMYOPATHY: BROKEN HEART SYNDROME
Takotsubo Cardiomyopathy (TTC), also known as “Broken Heart Syndrome,” is a form of acute and transient heart failure, often triggered by intense emotional or physical stressors. This study aimed to review current scientific evidence on the clinical management and therapeutic strategies for this condition. It is a narrative literature review based on recent scientific articles discussing the pathophysiology mediated by a “catecholamine storm,” diagnostic criteria, and therapeutic escalation. The results indicate that, although TTC has historically been considered benign, it carries risks of mortality and acute complications comparable to Acute Coronary Syndrome (ACS). Management should be individualized, focusing on hemodynamic stabilization, respiratory support, and, in severe cases, the use of mechanical circulatory support, avoiding inotropic agents in patients with left ventricular outflow tract obstruction (LVOTO). It is concluded that prompt differential diagnosis and long-term follow-up with renin–angiotensin–aldosterone system inhibitors are essential to reduce morbidity and prevent recurrence.
PSYCHOMETRIC VALIDATION OF A DIAGNOSTIC TRIGONOMETRY TEST APPLIED TO UNIVERSITY STUDENTS
The present study aimed to analyze the psychometric properties of a diagnostic trigonometry test designed for university students. The study design was quantitative, non-experimental, cross-sectional, and instrumental. A total of 50 higher education students participated, selected through non-probabilistic purposive sampling. The instrument consisted of 10 dichotomous items (1 = correct, 0 = incorrect) assessing trigonometric functions, identities, and triangle solving. The difficulty index (p), corrected point-biserial correlation (rₚᵦ), and Cronbach’s alpha coefficient (α) were calculated. The results indicated acceptable reliability (α = 0.748). Item analysis showed that most items had moderate difficulty and adequate discrimination; however, Item 8 showed virtually no discrimination (rₚᵦ = 0.001), while Items 3 and 7 presented low discrimination. It is concluded that the instrument has satisfactory psychometric properties as a diagnostic tool, although it requires revision of three specific items to improve its technical quality. The findings provide useful empirical evidence for decision-making in introductory university-level trigonometry instruction.
STRENGTHENING ANALYTICAL COMPETENCIES: HETEROGENEOUS PHOTOCATALYSIS IN EMERGING CONTAMINANTS
The development of analytical competencies constitutes a fundamental axis in the scientific training of future chemistry teachers. This study analyzes their strengthening through a formative experience based on the photocatalytic removal of acetaminophen in synthetic wastewater using TiO₂ as a catalyst. The research was conducted with undergraduate Chemistry students at the Universidad Pedagógica Nacional (Colombia), through an experiential learning approach articulated with Kolb’s model and the analytical competencies framework of Torres-Salcedo. Methodologically, it was structured in three phases: initial diagnosis, experimental implementation, and subsequent evaluation. The results showed progress at a medium-high level in the interpretation of experimental data, establishment of relationships between variables, formulation of hypotheses, and scientific argumentation based on evidence. A significant improvement was observed in the ability to analyze quantitative results and in the understanding of complex physicochemical processes. The experience allowed the integration of knowledge from environmental chemistry, chemical kinetics, and instrumental analysis in an applied context. However, limitations were identified in the deepening of critical analysis in some students and in the autonomous formulation of explanatory models. It is concluded that this type of experimental strategy favors the development of analytical competencies; however, future efforts should strengthen metacognitive reflection processes and the transfer of knowledge to new problem contexts.
SURGICAL TECHNIQUES AND POSTOPERATIVE MANAGEMENT IN THE TREATMENT OF ABOMASAL DISPLACEMENT IN COWS
Abomasal displacement (AD) in dairy cows is a common condition in ruminant clinical practice, occurring due to multifactorial etiologies such as hypomotility, tympany, acidosis, diets rich in concentrates and poor in effective fiber, abrupt dietary changes, and especially conditions associated with the postpartum period. Thus, abomasal displacement leads to economic impacts and production losses. The condition is characterized by the migration of the abomasum from its normal anatomical position to the left side (LDA), which is more common, or to the right side (RDA), and may progress to volvulus, a surgical emergency. Treatment consists of anatomical repositioning of the organ and permanent fixation through techniques such as abomasopexy or omentopexy to prevent recurrence. The choice of technique should be based on the severity of the clinical condition and the animal's status. Postoperative management is as critical to success as the surgical technique itself. During this period, clinical and biochemical monitoring is required, with emphasis on biomarkers of intestinal injury, such as I-FABP and TFF3, restoration of metabolic balance, provision of an adequate diet rich in fiber with proper adaptation to support ruminal motility recovery, adequate hydration for electrolyte correction, and, when necessary, the use of antibiotics and anti-inflammatory drugs.
PUBLIC HEALTH CONTROL MEASURES AND CASE MANAGEMENT IN THE TREATMENT OF RABIES IN DOGS
Canine rabies remains a lethal threat to global public health, being responsible for approximately 60,000 deaths annually, with infected dogs acting as the main reservoir of the virus. With no reliable treatment after the onset of symptoms, primary prevention through mass immunization is the central public health strategy. This study, characterized as a narrative literature review, analyzed the most recent scientific evidence related to canine rabies control measures. The persistence of the disease is sustained by low vaccination coverage in canine populations (observed in 73.14% of aggressor dogs in one study). Eradication requires sustained annual vaccination coverage of at least 70% of the population. Oral Vaccination (ORV) emerges as an indispensable and cost-effective tool to complement parenteral vaccination, reaching free-roaming dogs and contributing to critical levels of herd immunity. While pharmacovigilance surveillance reinforces the global safety of immunobiologicals, prevention remains the central axis. It is concluded that effective rabies control depends on interrupting transmission in the canine reservoir through mass vaccination, aligned with the One Health concept.
THERAPEUTIC APPROACH AND CLINICAL MANAGEMENT PROTOCOLS IN THE TREATMENT OF CANINE EHRLICHIOSIS
Canine monocytic ehrlichiosis (CME), caused by the bacterium Ehrlichia canis and transmitted by the tick Rhipicephalus sanguineus, is an important globally distributed zoonosis that can progress from acute presentations to severe chronic states characterized by progressive pancytopenia and bone marrow suppression. The therapeutic management of CME requires an integrated approach, focused both on the eradication of the etiological agent and on support for systemic damage, such as renal injury and vasculitis of the central nervous system. This study is a narrative literature review aimed at synthesizing recent scientific evidence on treatment protocols for CME. The literature reaffirms doxycycline as the standard protocol and drug of choice, demonstrating high efficacy in resolving complex clinical signs, including multifocal neurological lesions. In addition to antibiotic therapy, clinical management includes the promising use of adjuvant therapies, such as N-acetylcysteine (NAC), which acts as an antioxidant agent to enhance bone marrow activity and assist in the recovery of pancytopenia. Rigorous monitoring of target organs, using biomarkers such as SDMA and UP/C, is crucial for the early detection of alterations and prevention of progression to chronic kidney disease. It is concluded that successful treatment of canine ehrlichiosis depends on an integrated approach, based on the combination of doxycycline, preventive clinical monitoring, and targeted supportive interventions.
PSYCHOTHERAPEUTIC AND PHARMACOLOGICAL INTERVENTIONS IN THE TREATMENT OF BORDERLINE PERSONALITY DISORDER
Borderline Personality Disorder (BPD) is a debilitating psychiatric condition characterized by a persistent pattern of instability in interpersonal relationships, self-image, and affects, as well as marked impulsivity, imposing a significant burden on healthcare systems due to high rates of self-harming behaviors and suicide attempts. The clinical management of BPD establishes psychotherapy as the gold standard of treatment, while pharmacological interventions remain strictly adjunctive tools, often used to manage the high rate of associated comorbidities. This study is a narrative literature review, developed through data collection from the PubMed and Cochrane Library databases, with the objective of compiling and analyzing current scientific evidence on therapeutic interventions for BPD. The findings indicate that structured psychotherapies, such as Dialectical Behavior Therapy (DBT) and Mentalization-Based Treatment (MBT), are established as first-line interventions, demonstrating robust results in reducing emotional dysregulation and impulsive behaviors. In contrast, the evidence for the efficacy of pharmacotherapy alone on the core symptoms of BPD is limited and of low certainty, with no medication specifically approved for the disorder. The use of medications, such as anticonvulsants and second-generation antipsychotics, is predominantly off-label, focused on mitigating specific target symptoms (such as anger and affective instability) or managing comorbidities. A favorable prognosis depends on the integration of evidence-based approaches, prioritizing functional recovery and overcoming institutional and social stigma.
CARE PROTOCOLS AND PHARMACOLOGICAL MANAGEMENT IN THE TREATMENT OF CONGENITAL SYPHILIS
Congenital Syphilis (CS) is a fully preventable condition resulting from the vertical transmission of Treponema pallidum from an infected and inadequately treated pregnant woman to the fetus, leading to severe gestational outcomes such as fetal/neonatal death and serious clinical manifestations in the newborn. In light of the alarming reemergence of CS, disease control depends on the effectiveness of care protocols and immediate pharmacological management. The present study is a narrative literature review aimed at synthesizing scientific evidence on the management of CS, using the descriptors "Syphilis, Congenital" and "Therapeutics" in the PubMed database. The main strategy for eradication is universal screening of pregnant women during prenatal care (treponemal tests and VDRL). The standard pharmacological management for pregnant women is Benzathine Penicillin G, and it is crucial that maternal treatment be completed at least 30 days before delivery to be considered adequate for the fetus. The persistence of the disease is linked to multifactorial failures, including gaps in prenatal care, health inequities, stigma, and low adherence of sexual partners to treatment. Neonatal treatment is performed with Crystalline Penicillin G or Procaine Penicillin. It is concluded that treatment success goes beyond the pharmacological act, requiring a comprehensive care protocol within a healthcare network, with strengthening of public policies and health education in order to interrupt the cycle of vertical transmission.
Nelice Cristina Gomes dos Santos Fortunato
ADVANCES IN TARGETED THERAPIES FOR THE TREATMENT OF LIGHT CHAIN AMYLOIDOSIS
Light chain amyloidosis (AL) is a complex disorder resulting from the deposition of misfolded proteins in vital organs, requiring rapid interventions to prevent irreversible damage, especially in the cardiac and renal systems. This study aims to analyze recent scientific evidence on advances in targeted therapies for the disease, using a narrative literature review based on PubMed data from the past five years. The results indicate that the introduction of the monoclonal antibody daratumumab into the standard regimen (Dara-CyBorD) has revolutionized first-line treatment, increasing complete hematologic response rates to over 50%. For cases of relapse or refractory disease, promising options have emerged, such as elranatamab and venetoclax, the latter specifically targeting patients with the t(11;14) translocation. In addition, new research directions focus on therapies that remove existing amyloid deposits, aiming at direct recovery of affected organs. It is concluded that the management of AL amyloidosis is moving toward increasingly personalized precision medicine, where early diagnosis and the achievement of deep hematologic responses are key to transforming the prognosis into a chronic and controllable condition.
ANTIVIRAL THERAPY AND MANAGEMENT OF COMPLICATIONS IN THE TREATMENT OF HERPETIC ENCEPHALITIS
The management of Herpes Simplex Encephalitis (HSE) requires advancing beyond the mere eradication of viral load. Although intravenous acyclovir remains the unquestionable cornerstone of treatment, its effectiveness is intrinsically limited by the timing of administration—ideally within the first 24 to 48 hours—and by its inability to prevent biological damage independent of viral replication. The persistence of sequelae in up to 70% of survivors highlights that virological control does not guarantee neurological preservation. The pathogenesis involves sustained activation of the TNF/NF-κB inflammatory pathway and the identification of ferroptosis (iron-dependent cell death driven by lipid peroxidation) as a key event, suggesting new adjuvant therapeutic targets such as ferroptosis inhibitors. Long-term complications, such as post-herpetic autoimmune encephalitis, occur in approximately 25% to 27% of patients and require rapid intervention with aggressive immunotherapy. The discovery that around 10% of sporadic pediatric HSE cases originate from inborn errors of immunity (defects in the TLR3 pathway and type I interferon signaling) underscores the need for genomic surveillance to support precision medicine strategies. In summary, the future of HSE treatment lies in the implementation of multimodal protocols that integrate genetic and immunological diagnostics with early virological control, combining antivirals with neuroprotective and immunomodulatory agents.
Chrystianne Ferreira da Silva Braz Cunha
EMERGENCY APPROACH AND BILIARY DECOMPRESSION IN THE TREATMENT OF ACUTE CHOLANGITIS
Cholangitis, although often presenting a chronic course, poses critical challenges in scenarios of acute exacerbation and severe biliary obstruction. This narrative literature review aimed to consolidate contemporary scientific evidence on emergency management and biliary decompression strategies, with the goal of preserving hepatic function and reducing morbidity and mortality. The methodology consisted of data retrieval from the PubMed database (MeSH terms: "Cholangitis" and "Therapeutics"), focusing on high methodological rigor studies published within the last five years. The findings demonstrate that therapeutic effectiveness is intrinsically linked to the accuracy of differential diagnosis among the various etiologies. In Primary Biliary Cholangitis (PBC), the use of ursodeoxycholic acid (UDCA) remains the gold standard for slowing disease progression. On the other hand, IgG4-Related Cholangitis (IgG4-SC) requires diagnostic caution due to its ability to mimic neoplasms, showing a dramatic response to corticosteroid therapy and avoiding unnecessary surgical interventions. In Primary Sclerosing Cholangitis (PSC), given the absence of curative pharmacological therapies, mechanical decompression via endoscopic approach (ERCP) plays a central role in managing dominant strictures and preventing recurrent infectious episodes. Ultimately, hemodynamic stabilization and prompt biliary decompression constitute the absolute priorities in the treatment of acute cholangitis to prevent biliary sepsis. It is concluded that patient prognosis depends directly on a multidisciplinary approach that integrates early recognition of complications, intensive clinical support, and the individualization of maintenance strategies according to the immunopathological profile of each condition.
RATE OF TORQUE DEVELOPMENT OF TRUNK MUSCLES IN WOMEN WITH DIFFERENT TRAINING BACKGROUNDS
Objectives: To compare the DTR of the trunk extensors and flexors of healthy individuals who practice training modalities with different movement patterns during trunk exercises such as Pilates, CrossFit and traditional resistance training. Methods: Thirty-two volunteers aged 23.72 ± 3.4 years participated in the study and were allocated to one of four groups based on their training experience: Pilates, CrossFit. Participants included in the trained groups must have a history of practicing their respective modalities. Participants included in the CON group should not have exercised regularly in the last six months. Normality, homogeneity and sphericity tests were used. rate of torque development (RTD) and Isometric peak torque (IPT) values were compared between groups using one-way ANOVA followed by Bonferroni post-hoc tests. A significance level of p < 0.05 was adopted. Results: No significant differences were found in age and body mass. Women with experience in CrossFit training have significantly greater IPT and RTD of trunk during isometric extension and flexion. Trunk flexion IPT was also significantly higher for participants who practiced CrossFit. RTD for trunk extension and flexion was not different between participants with experience in Pilates, traditional resistance training and those without experience with physical training. Furthermore, the CF group presented significantly higher RTD values in all time intervals analyzed. Conclusion: The results obtained confirm that women who practice CrossFit training benefit from a greater capacity for rapid force production with the trunk flexors and extensors. Regular CrossFit practice results in superior RTD when compared to traditional resistance training, Pilates and a sedentary lifestyle in women. Maximum trunk strength is also greater for women who practice CrossFit.
MUSIC THERAPY AS AN IMPORTANT TOOL FOR THE TREATMENT OF PATIENTS WITH ALZHEIMER’S DISEASE
Introduction: Alzheimer’s disease (AD) is a progressive neurodegenerative disorder that affects memory and cognition, being one of the main causes of cognitive decline in older adults, and is associated with executive dysfunction and functional loss. Music therapy emerges as a non-pharmacological treatment alternative to reduce some symptoms experienced by patients with AD, including anxiety, agitation, and depression. Objective: To identify the role of music therapy as a complementary tool in the treatment of Alzheimer’s disease. Methodology: The study was structured based on the SANRA methodology (Scale for the Assessment of Narrative Review Articles). Articles were obtained from the databases Regional Portal of the Virtual Health Library, LILACS, PubMed, and SciELO, and selected according to the proposed inclusion and exclusion criteria. Results: Seven articles were selected, including randomized clinical trials, experimental studies, and observational studies, all of which demonstrated benefits of music therapy on Alzheimer’s disease symptoms. Discussion: Music therapy has shown promise as a complementary approach in the treatment of AD, demonstrating positive effects on cognition, behavior, and communication in patients. However, its effectiveness varies according to professional training, study context, and type of intervention, suggesting the need for further research with larger samples and standardized methodologies. Conclusion: Music therapy is a therapeutic approach for AD that offers cognitive, emotional, and social benefits to patients. It improves quality of life and alleviates symptoms such as agitation, anxiety, and depression by creating emotional connections and stimulating memories and cognitive functions in a safe and personalized manner. Thus, music therapy has shown promising results, suggesting that music can activate memories, improve communication, and delay the progression of cognitive deficits.
Maria Vitória Carneiro Pollini Carrara Rodrigues
Odontogenic myxoma (OM) is a rare benign neoplasm of ectomesenchymal origin (or mesenchymal origin associated with the dental apparatus), locally aggressive and invasive. It preferentially affects the bones of the maxilla and mandible in young adults, with a slight predominance in females. OM initially presents as a slow-growing and asymptomatic lesion, but it may exhibit an infiltrative behavior that results in bone destruction, cortical expansion, and facial deformity. Despite its benign histological nature, the lesion has significant destructive potential and a high recurrence rate when treated conservatively. The definitive diagnosis is challenging due to the absence of pathognomonic signs and the similarity of its clinical and radiographic features to other osteolytic or odontogenic benign and malignant lesions, requiring careful integration of histopathological data. Recent studies indicate that factors such as radiographic pattern, tumor extent, histological characteristics, and biological behavior are directly related to prognosis and recurrence risk; therefore, early identification and integrated analysis of clinical, imaging, and histopathological data are essential for appropriate therapeutic planning. This article, therefore, presents an updated narrative review on the diagnosis of odontogenic myxoma, with emphasis on clinical presentations, radiographic findings, main differential diagnoses, the role of immunohistochemistry, and diagnostic implications in defining surgical extent and recurrence risk, aiming to review the main diagnostic criteria, indicators of tumor aggressiveness, advanced imaging methods, and relevant histological aspects for treatment definition and clinical follow-up.
CHALLENGES IN THE MANAGEMENT OF TEETH WITH EXTENSIVE STRUCTURAL LOSS AFTER ENDODONTIC TREATMENT
Endodontically treated teeth present increased susceptibility to fracture, mainly due to the loss of dental structure and associated biomechanical changes. The restorative management of these teeth, especially when there is extensive structural compromise, represents a significant clinical challenge and requires an evidence-based approach. The present study aimed to analyze, through a narrative literature review, the main restorative strategies and biomechanical factors involved in the rehabilitation of teeth with severe structural loss after endodontic treatment. The databases PubMed, Scopus, and Web of Science were consulted, including studies published between 2021 and 2025, such as clinical trials, systematic reviews, and laboratory studies. The findings indicate that the amount of remaining dental structure is the primary determinant of restorative success. The presence of a ferrule is associated with greater fracture resistance, while intraradicular posts play a fundamental role in core retention without providing significant structural reinforcement. Fiber glass posts exhibit more favorable biomechanical behavior, with better stress distribution and a lower incidence of irreparable fractures. Additionally, endocrowns have shown to be a conservative and effective alternative, with performance comparable to conventional restorations in selected cases. It is concluded that the success of restorative treatment depends on individualized planning, maximum preservation of dental structure, and appropriate selection of technique and materials, favoring minimally invasive approaches and greater clinical longevity.
PROTOCOLS FOR THE DIAGNOSIS OF FACIAL FRACTURES
Maxillofacial trauma is a very common injury, accounting for approximately 30% of emergency department admissions, which requires rapid and interdisciplinary diagnostic protocols without compromising accuracy. Ghanaati (2022) discusses how a systematic approach in the initial examination can prevent wasted time with unnecessary diagnostic tools, optimizing the flow of care. It is fundamental that the protocol prioritizes the patient's systemic stabilization before any maneuver aimed at facial injuries, as pointed out by Rittri (2024), who also emphasizes the need for a detailed examination of facial nerve function and parotid gland integrity in cases of deep lacerations or amputations. According to Boljevic (2023), in the clinical examination, signs such as dental malocclusion, paresthesia (mainly in the infraorbital nerve), facial asymmetry, and limitation of mouth opening (trismus) are considered pathognomonic indicators that should guide the initial clinical suspicion. High-resolution computed tomography (CT) is undoubtedly the gold standard in the field of imaging for a definitive diagnosis. When dealing with complicated cases of atrophic mandibles, Cienfuegos (2023) highlights that it is crucial to perform CT scans with 1 mm slices for a thorough study of cancellous bone density and mandibular height, which allows the application of the Luhr Classification (Classes I to III) as a guide to the need for bone grafts and the choice of fixation system. Regarding sports injuries, Shreya (2022) points out that, although mandibular fractures are recorded, soft tissue injuries and dental trauma, such as avulsions and enamel fractures, occur more frequently, requiring specific protocols for tooth preservation. Finally, according to the evidence cited by Boljevic (2023), diagnostic and therapeutic intervention should ideally be performed within the first two to three days after the trauma in order to avoid complications such as infections and malunions, ensuring a rapid functional return for the patient.
Copyright (c) 2026 Victor Oliveira de Andrade, Murilo de Lorenzo, Elisa Bertrand Melo Veras, João Decezaro Boeira, Walbert Gomes Alves, Marina Paraluppi, Ana Cláudia do Nascimento Menezes https://creativecommons.org/licenses/by-nc/4.0
DIAGNOSTIC CRITERIA FOR SYSTEMIC ARTERIAL HYPERTENSION (SAH)
High cardiovascular risk is one of the main determinants of morbidity and mortality in different populations. Systemic arterial hypertension (SAH), a chronic condition with high prevalence in Brazil, has well-established diagnosis and treatment, and the correct identification of its diagnostic criteria is essential for proper risk stratification and clinical management. This study consists of a narrative literature review aimed at synthesizing evidence on SAH, with emphasis on diagnostic methods and their different clinical presentations. The methodology was based on a search of scientific databases, followed by a critical analysis of the literature. The results highlight the relevance of ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM) as fundamental tools for the diagnosis and follow-up of SAH. In addition, resistant hypertension is identified as a complex and often underdiagnosed condition, whose detection can be improved through the proper application of these methods.
Ambulatory Blood Pressure Monitoring (ABPM)
DIAGNOSIS AND SCREENING OF COLORECTAL CANCER IN THE ELDERLY
Colorectal cancer (CRC) is the third most common malignancy and the second leading cause of cancer-related death worldwide, with older adults representing the main risk group and the primary focus of early diagnosis and screening strategies. Traditional screening, based on colonoscopy and fecal tests, faces challenges related to adherence and invasiveness, driving the search for precision medicine approaches. Recent advances highlight the integration of biomarkers (proteomic and metabolic, such as oleic acid and allocoholic acid) and polygenic risk scores for individualized stratification and optimization of the ideal screening age. Artificial intelligence (AI) has also emerged as a powerful tool, using computed tomography classifiers to stratify recurrence risk in stage II CRC. Furthermore, molecular testing for KRAS and BRAF mutations is mandatory in advanced disease to guide more effective and less toxic targeted therapies. Circulating tumor DNA (ctDNA) stands out as a crucial non-invasive biomarker for detecting minimal residual disease and predicting recurrence, enabling individualized management. It is concluded that the future of CRC screening and diagnosis in the elderly lies in the convergence of liquid biomarkers, genomics, and AI, aiming at detection in curable stages and high-precision treatment.