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Men who have sex with men are at increased risk of acquiring sexually transmitted infections. Although behavioral and contextual interventions have improved, infections are still spreading. A new focus is needed regarding the influence of sexual compulsivity and gender self-identification. The objective was to explore the relationship between SC and gender stereotype self-identification in MSM in Spain. A cross-sectional study based on an anonymous online survey of a sample of 881 MSM in Spain was performed. A validated Sexual Compulsivity Scale was applied as well as the Bem Sex Role Inventory to identify gender stereotype self-identification. A total of 87.5% of participants identified as gay, while 106 (12%) were sexually compulsive. The Bem Sex Role Inventory showed excellent reliability (0.92 Cronbach’s alpha). Gender stereotype classification showed the undifferentiated category as predominant (n = 325; 36.9%). The androgynous category had higher scores on the Sexual Compulsivity Scale, while the feminine category had lower scores (p < 0.007). Those identifying as androgynous scored higher overall on the Sexual Compulsivity Scale (15; p < 0.001; [12–20]) and subscales (“Interference of sexual behavior” (5; p < 0.001; [4–7]) and “Failure to control sexual impulses” (9; p = 0.014; [7–12])). Education level, cohabitation, sexual role, and unprotected sexual practices are related to sexual compulsivity according to different gender stereotypes. Sexual compulsivity is related to gender stereotype self-identification in men who have sex with men. Specific sociodemographic, behavior, and sexual profiles exist for those at greater risk of sexually transmitted infection dissemination. The undifferentiated category is at greater risk of engaging in unprotected practices. New avenues of prevention that include these findings could shift heteronormative standards to better understand current trends in the sexual health of men who have sex with men.

The aims of this study were to analyze proton pump inhibitor (PPI) users in Germany, defining and classifying them in terms of treatment appropriateness, and to analyze the PPI prescription practices of healthcare providers. The updated DGVS (Deutsche Gesellschaft für Gastroenterologie, Verdauungs-und Stoffwechselkrankheiten) gastroesophageal reflux disease (GERD) treatment guideline (published March 2023) for mild heartburn symptoms recommends carrying out a probatory treatment of mild symptoms via other medication such as antacids, alginates, and H2 blockers before escalating to PPI treatments, if the patient profile allows. This retrospective cross-sectional study was based on data from the IQVIA™ Disease Analyzer database (DA) and included adult patients (18 years or older) in 1006 general and 39 gastroenterological practices in Germany who received at least 1 PPI prescription or alginate between September 2019 and September 2021 (hereinafter referred to as the index period). Analyses included indications associated with PPI prescription, co-diagnoses, co-therapies of PPI patients, duration of PPI therapy, dosages of PPI prescriptions, and proportions of practices prescribing PPIs and alginates. A total of 472 146 patients taking PPIs and 9101 patients taking alginates were available for analysis. Very few patients (4.5%) of the total cohort were treated in complete adherence to treatment guidelines. Conditions such as gastritis and duodenitis (47.2%) and reflux diseases (38.4%) were more frequently associated with PPI prescriptions. The average PPI treatment period lasted 141 days, and 36.6% of patients were treated for >6 months. High doses were prescribed relatively often (ie, 42.8% of esomeprazole prescriptions were 40 mg, 59.1% of lansoprazole prescriptions 30 mg, 28.6% of omeprazole prescriptions 40 mg). With each practice prescribing PPIs to at least 10% of their patients; 72% of general practitioners (GPs) and 8% of GENTS (Gastroenterologists) prescribed alginates. This study highlights that discrepancies exist between clinical guidelines and real-life prescribing practices of PPIs in Germany. Particular attention should be given to the incidence of patients being prescribed high-dose or long-duration PPI with mild indications. These findings are particularly apt considering the publication (March 2023) of new guidelines on the “management of gastroesophageal reflux disease and eosinophilic esophagitis,” by the DGVS.

Las instrucciones del primer Provincial del Paraguay Diego de Torres Bollo para las dos primeras reducciones del Paraguay, en 1609 y 1610, son un instrumento normativo interno de la Compañía de Jesús para orientar el desarrollo de la misión dirigido a los jesuitas enviados a la misma. Estas instrucciones tienen un enorme valor histórico por lo que muestran sobre el papel que las reducciones querían jugar en este contexto inicial colonial del Paraguay como una experiencia que representa de manera paradigmática la tradición jesuita en su praxis histórica.

Traducción del texto del P. Diego de Torres Bollo

Jesuit Francisco Suárez as eminent theologian, philosopher and jurist of his time plays an important role as a precedent in the construction of the categories of modern thought. One of these categories, not contemporary of Francisco Suárez, are human rights. Many authors anticipate some of its fundamental elements already in the thinking around the Law developed by Francisco Suárez in his main treatises on legal and political philosophy such as De Legibus and Defensio fidei. In this article we will try to connect the virtuality of the suarist approach in the field of human rights, exploring in his work these antecedents and the direction in which they are directed, as well as the possibilities of dialogue that opens around the construction of the conception of human rights in the current context.

Specifically we understand that the capability approach of Amartya Sen, is his greatest contribution to thinking about human rights. In this paper, in addition to placing its origin and significance for them, we will put in relation the capability approach with some contributions of liberation thought on Latin American as Ellacuría, highlighting its importance in connection with an intercultural vision human rights. We will discuss other relevant versions of the capability approach, specifically that of Martha Nussbaum. Finally, the most relevant reviews are located and the author's response to them.

Se realizó un estudio descriptivo transversal con el objetivo de caracterizar a los pacientes que recibieron un esquema de quimioterapia neoadyuvante con metotrexato, vinblastina, adriamicina y cisplatino en los tumores irresecables de vejiga. La muestra incluyó a 47 pacientes atendidos en el Hospital Universitario «Dr. Celestino Hernández Robau», de septiembre de 2010 a diciembre de 2014, con diagnóstico anatomopatológico de carcinoma de vejiga irresecable en estadio clínico T3b-T4a-b y N0 M0. El 72,3 % de los pacientes respondieron de forma favorable a esta terapia. Los pacientes que peor respondieron fueron los que tenían diagnóstico de carcinoma epidermoide (4,3 %); la mejor respuesta objetiva antitumoral ocurrió en el estadio clínico T3 b (44,6 %). La mayoría de los pacientes respondieron favorablemente a la quimioterapia neoadyuvante de primera línea en el tratamiento del carcinoma vesical irresecable. Los factores pronósticos relacionados con la respuesta al tratamiento fueron la histología y el tamaño tumoral.

El melanoma lentiginoso acral (MLA) es la variante anatomoclínica del melanoma cutáneo que con mayor frecuencia afecta a personas de la raza negra; su patogenia no está asociada a la exposición solar, como las restantes variantes, y afecta con mayor frecuencia la palma yla planta de los pies. Esta localización anatómica condiciona que el diagnóstico de la enfermedad se realice tardíamente y por consiguiente que el paciente acuda a la primera consulta especializada en un estadio avanzado. Esto constituye un factor pronóstico negativo que repercute en la supervivencia de los pacientes. El caso clínico que presentamos es un paciente al que se le diagnosticó un melanoma lentiginoso acral en estadio IIIC que evolucionó en pocos meses hacia la metástasis sistémica y la muerte.

It is presented the clinical case of a patient with a diagnosis of primary lymphoma of bone-a clinicopathologic rare disease that accounts for less than 1% of all lymphomas and 3 to 4% of primary bone tumors and it is defined as that in which a bone lesion is documented only-no evidence of lymph node involvement or general symptoms suggesting a systemic commitment six months after the diagnosis of the primary lesion; although there have been reports of multifocal bone injury medical literature includes only small case series. It is presented a patient of 21 years with a tumor located in the distal third of the left tibia, with histological diagnosis of non-Hodgkin lymphoma diffuse of large cell he received treatment as polichemitherapy-in-remission induction therapy and in consolidation.

Los tumores malignos de la vaina nerviosa periférica o schwanomas son tumores de alto grado de malignidad, que se originan de las células de Schwann de los nervios periféricos. Se localizan con mayor frecuencia en las extremidades y afectan sobre todo al sexo masculino en la edad media de la vida.Estos tumores se encuentran asociados a neurofibromatosis en un 50 % de los casos, lo cual facilita su diagnóstico diferencial. La neurofibromatosis (NFM) tipo 1, o enfermedad de Von Recklinghausen, comprende el 85 al 90 % de todos los casos de neurofibromatosis; el restante 10 al 15 % corresponde a las variedades no clásicas de la enfermedad, dentro de las que se encuentran: · NFM III (Mixta): Caracterizada por tumores del sistema nervioso central y periférico, manchas de color café con leche y neurofibromas en las partes blandas. · NFM IV (Variante): Presencia de manchas de color café con leche y neurofibromas difusos, sin deformidades. · NFM V (Segmentaria): Aparecen los neurofibromas en un segmento del cuerpo, de forma unilateral. Es una variedad no hereditaria. · NFM VI (Macular): Predomina en esta variante el componente macular del síndrome. · NFM VII (Tardía): Se inicia después de los 20 años de edad. · NFM VIII (Inespecífica): Es una neurofibromatosis definida, pero no característica de ninguna otra variedad.

Fournier gangrene is a potentially fatal necrotizing fasciitis that occurs as a result of a polybacterial infectious process that affects especially the perineum, genitals and perianal tissue. The case of a 46-year-old patient is reported. She was given a course of chemotherapy due to suffering from a nodular cutaneous scalp melanocarcinoma with cervical lymph node and pulmonary metastasis. One week after being administered the scheme she was diagnosed with Fournier gangrene in the soft parts of the perineum, the vulva and perianal tissue, starting about an ulcerative mucositis of the rectal mucosa associated with neutropenia due to cytostatics.

Recensión de la obra de: PORRAS NADALES, A. (2014) La acción de gobierno: gobernabilidad, gobernanza, gobermedia. Madrid, Trotta, 148 pp.

La manipulación de los motores diésel de la empresa Volkswagen en los Estados Unidos para pasar los controles preventivos medioambientales ha sido la ocasión de un inmenso –y todavía no cerrado en sus consecuencias– fraude, que está teniendo repercusión mundial en diversos aspectos: técnicos, políticos, jurídicos –derivados de la confianza en el consumo o de las responsabilidades y daños a terceros– y, sobre todo, éticos. El debate sobre la Responsabilidad social empresarial debe ajustarse a nuevas situaciones y retos, profundizando tanto en sus previsiones como en sus fundamentos.

This paper presents some of the aspects related to the multidisciplinary research process initiated in III LIDI for the development of a learning environment focused on the WEB (WebLIDI). It attempts to gather, in a work group, the technology working logic and the basic notions about teaching and learning. This project not only aims at developing a distance course design methodology, but also at the possibility of applying it through the WebLIDI environment - based on the principles connected to the pedagogical and technological variables involved in teaching and learning instances. Some of the decisions taken throughout this process are here presented in detail, ranging from general information of a course to content structuring and evaluation possibilities. Also, the current state of the development - expected to be used experimentally as from the second semester of 2003- is specified.

El trabajo compara las nociones de "historicidad" e "irreversibilidad" en la concepción del tiempo de Prigogine y de San Agustín, estableciendo semejanzas y diferencias. Analiza primero la idea agustiniana de la temporalidad siguiendo el Libro Undécimo de las Confesiones, y las interpretaciones de dicha idea efectuadas por Paul Ricoeur y por Jean Guitton. A continuación, analiza la redefinición del tiempo llevada a cabo por Ilya Prigogine, diferenciándola fundamentalmente de la concepción estática o geométrica de la dinámica newtoniana. Muestra que esta reconceptualización lo diferencia de la física clásica y lo acerca a la idea agustiniana del tiempo, en tanto y en cuanto, en ambos autores, las nociones de "irreversibilidad", "historicidad", "novedad", "acontecimiento" y "creatividad", son cruciales para entender la temporalidad. Finalmente, pone de manifiesto las diferencias entre los dos autores: mientras que San Agustín se refiere fundamentalmente a un tiempo humano o existencial, en el que está presente un claro sentido de la trascendencia, Prigogine alude al tiempo de la dinámica y la termodinámica de los procesos irreversibles alejados del equilibrio, en un sentido ciertamente inmanente y físico.The essay compares the notions of "historicity" and "irreversibility" in the Prigoginean and Agustinian conceptions, establishing likenesses and differences. It analyzes the Agustinian idea of the temporality following the Book Eleventh of the Confessions, and the interpretations of Paul Ricoeur and Jean Guitton. It analyzes, next, the redefinition of the "time" formulated by Ilya Prigogine, differentiating it, fundamentally, from the static or geometric conception of the Newton's dynamic. It shows that this re-conceptualization differentiates it from the classic Physics and brings it nearer to the Agustinian idea of the time, as that, in both authors, the "irreversibility", "historicity", "novelty", "event" and "creativity" notions are crucial to understand the temporality. Finally, it is shown here the differences between both authors: while St. Agustin fundamentally refers to a human or existential time, in which a clearing sense of the transcendency is present, Prigogine refers to the time of the dynamics and the thermodynamics, of the irreversible processes receded from the equilibrium, and certainly in a physical immanent sense.

Reseña de la obra de: HORTAL, A., ETXEBERRIA, X. (Eds.) (2011) Profesionales y vida pública. Bilbao, Desclée de Brouwer – UNIJES (Colección Ética de las profesiones), 328 pp.