Introduction: Falls from standing height in the elderly represent one of the main causes of visits to emergency services, contributing significantly to the overcrowding of emergency care units in the Brazilian Unified Health System (SUS). Objective: To analyze, through an integrative literature review, the relationship between falls from standing height in elderly individuals and overcrowding in emergency services within the Brazilian Unified Health System (SUS), highlighting clinical, structural, and organizational repercussions, as well as implications for public health policies. Methods: An integrative review was conducted in the SciELO, PubMed, LILACS, and Virtual Health Library (VHL) databases between April and June 2025. Articles published between 2018 and 2024, in Portuguese or English, addressing falls in the elderly and the burden on emergency services were included. Selection was based on thematic relevance, methodological quality, and applicability to the Brazilian context. Results: The selected studies showed that approximately 30% of older adults suffer at least one fall per year, with a significant portion requiring immediate attention in emergency services, increasing the flow and length of stay in emergency care units.1,2 Failures in fall prevention and longitudinal follow-up by Primary Health Care, a shortage of geriatric beds, insufficient trained multidisciplinary teams , and critical limitations in the long-term care network3,4 were identified, which favors prolonged hospitalizations and unnecessary readmissions. Conclusion: Falls from standing height in the elderly significantly worsen overcrowding in emergency services and highlight the urgent need to reorganize the Health Care Network, strengthening Primary Health Care, implementing risk stratification protocols, and improving the quality of care. emergencies and expansion of rehabilitation and long-term care services for the elderly population.5
The clinical presentation of brucellosis is highly polymorphic including neurological, cardiac, ocular, cutaneous, digestive, and renal manifestations, some of which are considered unusual or atypical. Isolated psychiatric manifestations are uncommon in human brucellosis and often associated with the specific neurological involvement of this infection (neurobrucellosis). The inaugural psychiatric presentations of this disease are exceptional and represent a real diagnostic challenge for clinicians. We report an original observation of depression as an isolated manifestation revealing acute brucellosis without neurobrucellosis in a 38-year-old woman with favorable outcome under adapted antibiotherapy. As rare as it is, this clinical presentation of brucellosis deserves to be known by healthcare professional and brucellosis must be considered in the differential diagnosis of psychiatric symptoms in endemic countries for this infection.
This study investigates the therapeutic potential of a natural, cannabinoid-based protocol using Cannabis sativa flower infusion in MCT coconut oil and a shea butter topical cream in adults diagnosed with anxiety and/or depression. Twenty patients (10 males and 10 females; ages 25–60; body weights 52–96 kg) participated. The personalized treatment consisted of an oral dose of full-spectrum extract (5% THC, 2.5% CBD, plus minor cannabinoids), at 1 drop per 10 kg body weight, administered twice daily. A topical MCT-shea butter cream with 2.5% CBD was applied nightly to hormone-sensitive and neuroreceptive regions (umbilicus, nasal mucosa, genital area). After 90 days, most patients reported moderate to significant improvements in mood, anxiety reduction, sleep, and daily functioning. No serious adverse effects occurred. These preliminary findings support the safety and potential efficacy of full-spectrum cannabinoids delivered through a personalized, integrative protocol.
Studying this case studies the intersections of the syndrome, creativity and the reflection of Asperger by observing the works of a ten -year -old child for one years in a year. The study is avoiding the approach based on a shortage for a force -based force, emphasizing how children with Asperger have amplified cognitive, visionary and creative thinking skills in their work. By an analysis by the qualitative theme of children's drawings, the thinking processes are systematized, accurate, repetition and the concern of future technologies and themes have been found. The drawing presents the support of mechanical and organized characteristics and few representing social interactions, showing the dominance of the visual space and very analytical orientation. The results show how children with asparagus can use art to explain themselves, even in the case of abstract emotions or typical social representatives. This project emphasizes the need to stay out of the vision of autistic spectral disorders (TSA) on communication in communication and instead of promoting the values of education and diverse neurological therapy. He also called on artistic learning and intervention models to focus on STEM to adapt to the separate forces of high-level autistic individuals.
Prayer (or athlete’s) nodules are hyperplastic, flesh-colored dermal masses that arise after repetitive trauma to an area, commonly occurring with prayer rituals or sports-related activities such as boxing. These nodules can appear worrisome and may prompt testing for malignancy if a detailed history is not gathered. We present a case of a prayer’s nodule to demonstrate the importance of thorough social history-taking and adjusting treatment plans to align with the patient's best interest while also addressing their concerns.
A 45-year-old female with recurrent urinary tract infections since adolescence presented with nephrolithiasis, managed by open anatrophic nephrolithotomy in 1997 and percutaneous nephrolithotomy (PCNL) in 2009. In 2018, an MRI incidentally revealed a forgotten catheter transfixing the liver and right kidney, which remained untreated until she experienced worsening of flank pain, hematuria, and pyelonephritis. Upon admission in January 2025, a new CT prompted surgical interventions, including flexible RIRS, PCNL, and laparoscopy for foreign body and calculi removal, with double-J stent placement. This case highlights the importance of proper material counting, imaging control and adequate follow-up to prevent complications.
Introduction: Epstein-Barr virus (EBV) infects more than 95% of the world's population and is associated with infectious mononucleosis as well as a number of cancers in various geographical locations.It can usually cause tonsillitis, fever and adenomegaly, however it can present in severe forms with hematological alterations, with alterations in the bone marrow or with systemic alterations involving several apparatuses and systems. Clinical case:We present the case of a 2-year-old female patient who developed a febrile respiratory condition and torpidly progressed to respiratory distress, tonsil hypertrophy obstruction, adenomegaly, hepatosplenomegaly, carditis, hematological alterations with leukemoid reaction.Discussion/conclusion: Monoucleosis whose classic presentation is characterized by the presence of fever, pharyngitis and generalized lymphadenopathy, it is produced by the Epstein Barr virus, it has been called the kissing disease affecting adolescents and adults however it can occur in children being a picture beyond tonsillitis, we observe serious cases such as the one we will describe, we must carefully observe all the data that are presented and be able to integrate the diagnosis early.
Urethral stricture is a prevalent condition that often has a major physical and psychological impact on patients. Current treatment includes minimally invasive techniques for mild cases and reconstructive surgery for more severe conditions. However, the objective assessment of surgical outcomes lacks a specific questionnaire validated in Portuguese, although this tool has been available since 2011.
Vocal fold polyps are benign lesions typically found unilaterally and are the second most common laryngeal lesion, following vocal nodules. No significant differences in age or gender distribution have been observed for these lesions. These polyps can be categorized based on morphology as either sessile or pedunculated, and histologically as gelatinous or translucent, fibrous or organized, and angiomatous or hemorrhagic. The etiology of vocal polyps is primarily phono traumatic. Nonetheless, additional irritative factors such as gastroesophageal reflux, smoking, inhalation of noxious chemicals, or strenuous respiratory activities can also contribute to their development.
At the beginning of life, millions of spermatozoa enter the adventure of reaching the goal, many remain in the fight, others arrive but only one is chosen, accepted, and manages to enter and when both pronuclei merge, they begin a new life.
Hepatoblastoma (Hb) is a rare Pediatrics cancer. The incidence is low and diagnosis very difficult, especially in low income countries where the diagnostic tools may not be readily available and accessible. Here we reported a 30 months (3years and 6months) old male child that was referred with symptoms of 3 month history of recurrent cough, fever, abdominal mass with distention. Child was treated for 8 weeks with anti-tuberculosis therapy with no clinical improvement, hence referred for an expert care. Child was assessed on presentation in our center and immediate work-up investigation results were in keeping with childhood Hb. Immediate definitive medical treatment was commenced to which child responded promptly with resolution of the symptoms and steady decrease in Alfa Fetoprotein level (AFP). Child was discharged and currently on follow-up visit.
The face is a vital structure with uttermost importance aesthetically and functionally. Complex facial scar is a surgical challenge due to scarred and fibrotic surrounding tissue with unpredictable healing. We describe a case of a 50-year-old male with multiple times operated scars over his face. In this technique, we used dermis fat grafting attached to tensor fascia lata designed as a wristwatch. The tensor facia lata was designed as a dial of a watch which was attached on both sides by dermis fat graft like a wristband. Both tissues were used in a single stage to manage an intractable complex facial scar with ectropion. There were no significant complications post-operatively.
Ulnar longitudinal deficiency (ULD) is an infrequent congenital anomaly found in approximately 1 in 100,000 live births. In an incidental discovery, a 57-year-old healthy man, referred to our Orthopedic Center due to a right medial malleolus fracture, was diagnosed with ULD. A comprehensive physical examination revealed notable abnormalities in the patient's right upper extremity, marked by significant shortening, pronation, and internal rotation. Radiological examinations exposed a complex skeletal deformity, including radiohumeral synostosis, the complete absence of the ulna and carpal bones, along a shortened and bowed radius. Remarkably, only the thumb and the first metacarpal bone were present in the hand, accompanied by a distinctive ulnar deviation of the wrist by Cole and Manske’s classification (type D) and Goldfarb’s classification (type V), the patient's condition was identified through a thorough clinical assessment. This detailed characterization advances our understanding of the specific anatomical features and classifications associated with ULD, offering valuable insights for clinical management and potential interventions in similar cases.
The core pathology of Alzheimer’s disease (AD), amyloid plaques and neurofibrillary tangles, has been the target of attention for over 100 years. But how they came into being has always been anonymous. Recently, early diagnosis of AD, especially mild cognitive impairment (MCI), and even subjective cognitive decline (SCD) has become increasingly emphasized to slow down the progression of the disease. Recently, another fresh disease or pathological phenomenon has attracted attention, aging-related tau astrogliopathy (ARTAG), which has been found to be not only related to tauopathy, such as progressive supranuclear palsy (PSP), corticobasal degeneration (CBD) or frontotemporal lobar degeneration (FTLD), but about 50% of AD and geriatric brains have such pathologies.
