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Hormone blockers are defined as substances that suppress the release of sex hormones, thus inhibiting the development of secondary sexual characteristics in teenagers. There is currently an increase in young people seeking healthcare services due to a mismatch between their birth-assigned gender and their perceived or self-identified gender. In early childhood, individuals are not usually affected by their physical appearance. Dysphoria may arise during the initial stages of adolescence and if the self-perceived gender does not align with the external appearance. This may have a negative impact on adolescents’ mental health. Could the use of hormone blockers have a positive effect on mental health? The primary objective of this review is to assess whether the use of hormone blockers can have positive effects on the mental health of transgender youth. The review also seeks to evaluate the usage of hormone blockers and the diagnosis of gender dysphoria. A literature search of scientific evidence was conducted across various databases—PUBMED, CUIDEN, ELSEVIER, COCHRANE, DIMENSIONS, SCIELO, PSYCINFO, and CINAHL—alongside a review of the latest publications in high-impact scientific journals and the gray literature. The following terms were used: , , , , , , and . A time period was specified, covering the last ten years (2014–2024). The initial search identified a total of 290 references, which were subsequently narrowed down to 5 studies, with 1 additional study retrieved through other methods. The literature findings are clear. They show that the use of hormone blockers in transgender adolescents can be beneficial, as a reduction in mental health issues was observed during and after their use. Mental healthcare in transgender teenagers is of crucial importance to their physical, psychological, social, and academic spheres. It is also very important for their families. Nurses must be aware of this knowledge to improve the care provided to these individuals and their families during the difficult time surrounding decisions about the use of hormone blockers.

A simultaneous arterial and venous approach has been widely described for the endovascular treatment of dural arteriovenous fistula (DAVFs) and recently for arteriovenous malformation (AVMs). Conventional venous approaches are performed by direct internal jugular puncture or by femoral access. Although complication rates are low, there are potential life-threatening complications that should be avoided. The advantages of radial artery access have been widely proven, nevertheless the use of upper limb veins in neurointervention are rarely reported. We present five cases of the simultaneous arteriovenous approach through the radial artery and superficial veins of the forearm for the treatment of intracranial neurovascular diseases.

Introduction Tranexamic acid (TXA) is becoming widely used in orthopedic surgery to reduce blood loss and transfusion requirements, but consensus is lacking regarding the optimal route and dose of administration. The aim of this study was to compare the efficacy and safety of topical and intravenous routes of TXA with routine hemostasis in patients undergoing primary total knee arthroplasty (TKA). Materials and methods We performed a randomized, multicenter, parallel, open-label clinical trial in adult patients undergoing primary TKA. Patients were divided into three groups of 50 patients each: Group 1 received 1 g topical TXA, Group 2 received 2 g intravenous TXA, and Group 3 (control group) had routine hemostasis. The primary outcome was total blood loss. Secondary outcomes were hidden blood loss, blood collected in drains, transfusion rate, number of blood units transfused, adverse events, and mortality. Results One hundred and fifty patients were included. Total blood loss was 1021.57 (481.09) mL in Group 1, 817.54 (324.82) mL in Group 2 and 1415.72 (595.11) mL in Group 3 (control group). Differences in total blood loss between the TXA groups and the control group were clinically and statistically significant ( p  < 0.001). In an exploratory analysis differences between the two TXA groups were not statistically significant ( p  = 0.073) Seventeen patients were transfused. Transfusion requirements were significantly higher in Group 3 ( p  = 0.005). No significant differences were found between groups regarding adverse events. Conclusion We found that 1 g of topical TXA and 2 g of intravenous TXA were both safe strategies and more effective than routine hemostasis to reduce blood loss and transfusion requirements after primary TKA. Level of evidence I.

Purpose The intracranial aneurysm (IA) rupture is associated with a subarachnoid hemorrhage. One third of patients die, and one third remain depend for daily activities. Genetic factors are crucial in the formation and clinical evolution of IAs. Multiple loci have been associated with AIs, much of them implicating multiple pathways related to vascular endothelial maintenance and extracellular matrix integrity. Thus, the aim of our study was to characterize whether polymorphisms in genes implicated in the vascular endothelial maintenance could modify the risk of developing IAs. Subjects and methods We have studied 176 patients with IA recruited in the Service of Neurosurgery at the University Hospital of Valladolid (Spain) and a control group if 150 sex-matched healthy subjects. Clinical variables were collected from each patient. We have analyzed VEGFA rs833061, VEGFR2 rs2071559, endothelin rs5370, endoglin rs3739817, and eNOS rs1799983 polymorphisms. Results Our results showed that allele T of the eNOS rs1799983 polymorphism is correlated with decreased risk of developing the disease; thus, allele G of the eNOS rs1799983 polymorphism increased the risk of developing IA. Conclusion The association of eNOS rs1799983 polymorphism with the risk to suffer IA reinforces the hypothesis that genetic variants in eNOS gene could be crucial in the pathogenesis of IA.

Kaposi’s sarcoma (KS) is an angioproliferative neoplasia associated with human herpesvirus 8 (HHV-8) infection. HHV-8 generates KS by means of the secretion of vascular endothelial growth factor (VEGF) andup-regulation of VEGF receptor, KDR, in endothelial cells. We report a case of KS in a 72-year-old male with a renal transplant who had received immunosuppressant drugs including sirolimus, mycophenolate mofetil, tacrolimus and steroids. KS developed 11 months after transplantation, in relation to deep venous thrombosis and withdrawal of sirolimus due to toxicity. Multiple purple papules and nodules were observed exclusively in the limb affected by thrombosis. Diagnosis of KS was confirmed by biopsy. Progressive withdrawal of prednisone was accompanied by full remission of the tumour. The thrombosis and withdrawal of sirolimus may have acted as cofactors in the development of KS, favouring the activation of the VEGF/KDR autocrine loop. Our experience contributes to further evidence that sirolimus may protect against KS.

The following project presents an autonomous system of classification of objects by colors which it is applied to the caps of plastic bottles, emulating an automated work cell, which serves to students to know the operation of industrial processes, from construction, programming and even maintenance point of view. The entire project consists of the design of a conveyor system which has a sensor to identify colors, and actuators which allow the caps are correctly classified in the containers according to its color. The work cell was built in a modular way in such a way that in the future it can be adapted to other work cells and simulate flexible manufacturing cells, since it can be reprogrammed not only to identify by colors but also by sizes. Besides, the pieces were built using the 3D printer and the laser cutter in order to use the tools of the laboratories of our institution in the construction of elements for future laboratory equipment which will strengthen the electromechanical program.

Considering that the coefficient of friction between materials is one of the important characteristics in the design, either by wear or by requiring friction for power transmission, and this value is usually achieved in tables and these values come out of experimentation or results with tests using devices. Furthermore, these devices are not often found in the laboratories of the universities. For this reason, it was decided to adopt one of the methods of calculation, in this case the inclined plane. This consists of finding the angle of inclination in which one material begins to slide on another, since calculating the tangent of this angle determines the coefficient of friction. To this end, a device was built, consisting of a platform that by means of a mechanism is tilted little by little, until the object under study begins to move. In addition, to exclude human error, the device has sensors and an adequate control, in such a way that the process is completely automatic. Finally, the device is based on open technology, such as Arduino, managing to build a device to obtain the coefficient of friction at low cost. Its development and the results obtained are shown in this paper.

Purely extradural lumbar spinal arteriovenous malformations (AVMs) are rare lesions that have diverse presentations and imaging features. The treatment of a symptomatic high flow paraspinal AVM with multiple feeders remains a challenge. We report the first use of an Ascent balloon (dual lumen balloon catheter) to deliver Onyx with excellent penetration to a paraspinal AVM.

IntroductionWe assessed the efficacy of fibrin sealant (FS) and tranexamic acid (TXA) administered topically in patients with a hip fracture treated with prosthetic replacement.Materials and methodsParallel, multicentre, open label, randomised, clinical trial. We compared three interventions to reduce blood loss: (1) 10 ml of FS, (2) 1 g of topical TXA, both administered at the end of the surgery, and (3) usual haemostasis (control group). The main outcome was blood loss collected in drains. Other secondary variables were total blood loss, hidden blood loss, transfusion rate, average hospital stay, complications, adverse events, and mortality.ResultsA total of 158 patients were included, 56 in the FS group, 52 in the TXA group, and 50 in the control group. The total amount of blood collected in drains was lower in the TXA group (148.6 ml, SD 122.7 in TXA; 168.2 ml, SD 137.4 in FS; and 201.5 ml, SD 166.5 in control group) without achieving statistical significance (p = 0.178). The transfusion rate was lower in the TXA group (32.7%), compared with FS group (42.9%) and control group (44.0%), without statistical significance (p = 0.341). There were no complications or adverse effects related to the evaluated interventions.ConclusionsThe use of TXA and FS administered topically prior to surgical closure in patients with a sub-capital femoral fracture undergoing arthroplasty did not significantly reduce either postoperative blood loss or transfusion rate, compared with a group that only received usual haemostasis.

Purely extradural lumbar spinal arteriovenous malformations (AVMs) are rare lesions that have diverse presentations and imaging features. The treatment of a symptomatic high flow paraspinal AVM with multiple feeders remains a challenge. We report the first use of an Ascent balloon (dual lumen balloon catheter) to deliver Onyx with excellent penetration to a paraspinal AVM.