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OBJECTIVE: Polycystic ovary syndrome (PCOS) is an endocrine disorder that affects one in every 15 women worldwide. This disorder is mainly characterized by increased levels of male hormones (androgens), acne, and hirsutism, and can lead to long-term insulin resistance, miscarriage, or even infertility in women. PCOS is a disorder that can be treated with natural and allopathic remedies that work against the PCOS mechanism. The present study reviews previous studies on the treatment of PCOS using natural drugs. METHODS: The data in this study were collected from articles published in reputable databases including ScienceDirect, PubMed, Google Scholar, and SID in the field of medicinal plants from 1990 to 2021. RESULTS: A review of the literature showed that plants such as aloe vera and chamomile improve fertility by increasing the number of ovarian follicles. Besides, Vitex agnus-castus and octane reduce hirsutism by reducing testosterone and androgen levels. It was also shown that liquorice, ginseng, cinnamon, and de chiro Inositol improve the adverse effects of diabetes caused by PCOS by lowering lipid and blood glucose levels. Moreover, Stachys lavandulifolia and fennel are effective in changing endometrial tissue parameters in PCOS by reducing estrogen and hyperplasia. CONCLUSIONS: Various studies have shown that herbal medicines can improve PCOS symptoms in women with minimal side effects but a longer treatment cycle.

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Complementary and alternative medicine or therapies (CAM) are frequently used by skin cancers patients. Patient's self-administration of CAM in melanoma can reach up to 40%-50%. CAMs such as botanical agents, phytochemicals, herbal formulas ("black salve") and cannabinoids, among others, have been described in skin cancer patients. The objective of this review article was to acknowledge the different CAM for skin cancers through the current evidence, focusing on biologically active CAM rather than mind-body approaches. We searched MEDLINE database for articles published through July 2022, regardless of study design. Of all CAMs, phytochemicals have the best in vitro evidence-supporting efficacy against skin cancer including melanoma; however, to date, none have proved efficacy on human patients. Of the phytochemicals, Curcumin is the most widely studied. Several findings support Curcumin efficacy in vitro through various molecular pathways, although most studies are in the preliminary phase. In addition, the use of alternative therapies is not exempt of risks physicians should be aware of their adverse effects, interactions with standard treatments, and possible complications arising from CAM usage. There is emerging evidence for CAM use in skin cancer, but no human clinical trials support the effectiveness of any CAM in the treatment of skin cancer to date. Nevertheless, patients worldwide frequently use CAM, and physicians should educate themselves on currently available CAMs.

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El Trastorno del Espectro Autista (TEA) es una condición que afecta el neurodesarrollo caracterizada por presentar alteraciones en la comunicación, conducta y en las interacciones sociales, y que afecta el funcionamiento del individuo a lo largo de su vida. Los tratamientos recomendados por la evidencia científica incluyen un enfoque interdisciplinario que combina intervenciones educativas, terapias psicológicas/conductuales, terapia del habla y el lenguaje, terapia ocupacional/física y tratamientos médicos. Para muchas familias, barreras económicas y geográficas limitan el acceso a los tratamientos específicos. Este y otros motivos llevan a incorporar tratamientos alternativos y/o complementarios. El Centro Nacional de Medicina Complementaria y Alternativa (NIH-EEUU) define los Tratamientos Alternativos Complementarios (TAC) como "un grupo de diversos sistemas médicos y de cuidados de la salud; prácticas y productos que generalmente no son considerados parte de la medicina convencional". La prevalencia del uso de TAC en personas con TEA está entre las más altas respecto a otras patologías y a otros trastornos del desarrollo, con porcentajes entre 52% y 95%. Su uso debe ser preguntado en las consultas de seguimiento, y debe discutirse sobre riesgos, beneficios y costos. La cantidad y el tipo de intervención que reciben niños, niñas, adolescentes (NNyA) y adultos con TEA varían enormemente en todo el mundo e incluso dentro de un mismo país y región. El pronóstico del TEA es mejorado cuando el diagnóstico es oportuno y temprano y el abordaje educativo terapéutico es iniciado y orientado a aspectos funcionales y centrados en la familia. (AU)

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by alterations in communication, behavior, and social interactions that affect the individual's functioning throughout life. Evidence-based treatments include an interdisciplinary approach that combines educational interventions, psychological/behavioral therapies, speech and language therapy, occupational/physical therapy, and medical treatments. For many families, economic and geographic barriers limit access to specific treatments. This and other reasons have led to the incorporation of alternative and/or complementary treatments. The National Center for Complementary and Integrative Health (NCCIH - USA) defines complementary alternative medicine (CAM) as "a group of diverse medical and health care systems, practices and products that are not generally considered part of conventional medicine". The prevalence of the use of CAM in people with ASD is among the highest compared to other diseases and developmental disorders, with percentages ranging from 52% to 95%. Their use should be considered in follow-up visits, and risks, benefits, and costs should be discussed. The amount and type of intervention received by children, adolescents, and adults with ASD varies greatly around the world and even within the same country and region. The prognosis of ASD is improved with timely diagnosis and early, family-centered and functionally oriented educational and therapeutic approaches

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Introducción: Los problemas de salud crónicos son considerados enfermedades multidimensionales, por lo que demandan del personal de enfermería una atención integral y holística. Una opción para brindar un cuidado holístico y autónomo son las terapéuticas alternativas y complementarias. Objetivo: Sistematizar las terapias alternativas como solución al cuidado de problemas crónicos de salud. Métodos: Revisión sistemática de documentos publicados desde 2005 hasta 2020 en español e inglés, con una clara metodología y referencial teórico seleccionado durante el 2020. La pregunta se elaboró a través de la estrategia PICO. Se utilizaron las palabras claves identificadas en DeCS y operadores booleanos: "atención de enfermería" AND "terapias complementarias" AND "enfermedades crónicas" y en inglés, las identificadas por MeHS: "Complementary therapies" AND "Nursing care" AND "Chronic disease". La búsqueda fue realizada en las bases de datos: Pubmed, Clinical Key, SciELO, Dialnet, Index, Google Scholar. Se utilizó el diagrama de flujo (PRISMA) para contribuir a la formulación de la estrategia de búsqueda. Mediante los métodos de análisis documental, síntesis y sistematización se dio la posibilidad de organizar e interpretar los conocimientos presentes en las bibliografías encontradas. Conclusiones: Las terapias alternativas como una solución a los problemas de salud, es una herramienta que puede ser usada por el personal de enfermería, para aumentar la gama de cuidados que se les brindan a las personas con problemas de salud crónicos(AU)

Introduction: Chronic health problems are considered multidimensional diseases; therefore, they demand, from the nursing staff, a comprehensive and holistic care. One option to provide holistic and autonomous care is alternative and complementary therapies. Objective: To systematize alternative therapies as a solution for the care of chronic health problems. Methods: A systematic review of documents published from 2005 to 2020 in Spanish and English was developed, with a clear methodology and theoretical references selected during 2020. The question was elaborated through the PICO strategy. In Spanish, the following keywords, identified in the DeCS, as well as Boolean operators were used: "atención de enfermería" AND "terapias complementarias" AND "enfermedades crónicas". In English, the corresponding keywords found in the MeHS were taken into account: "Complementary therapies" AND "Nursing care" AND "Chronic disease". The search was carried out in the Pubmed, Clinical Key, SciELO, Dialnet, Index and Google Scholar databases. The PRISMA flow diagram (Preferred Reporting Items for Systematic Review and Meta-Analyses) was used to contribute to the formulation of the search strategy. The methods of documental analysis, synthesis and systematization permitted to organize and interpret the knowledge present in the theoretical references found. Conclusions: Alternative therapies, as a solution to health problems, are a tool that can be used by the nursing staff, in order to increase the range of care provided to people with chronic health problems(AU)

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INTRODUCTION: Use of complementary and alternative medicine (CAM) therapies had been described in patients with disabling, chronic and painful conditions; these characteristics define the majority of vascular surgery (VS) entities. A lack of disclosure about CAM use from patients has been universally cited and may impact effective patient-doctor communication. Our primary objective was to describe CAM use, modalities, perceived benefits, safety, and associated factors among adult patients attending a VS outpatient clinic; we additionally explored patient's attitudes about CAM disclosure with their primary vascular surgeon. METHODS: This cross-sectional study invited 223 consecutive outpatients to an interview where the ICAM-Q (International Complementary and Alternative Medicine Questionnaire) and the PDRQ-9 (Patient-Doctor Relationship Questionnaire-9 items) were applied. In addition, sociodemographics, vascular disease and treatment-related information, comorbidity, and disease severity characteristics were obtained. Appropriated statistics was used; multiple logistic regression analysis identified factors associated to CAM use. All statistical tests were two-sided, and a p value ≤ 0.05 was considered significant. IRB approval was obtained. RESULTS: Patients recruited were primary females (69%) and had a median age of 65 years (54-75). Most frequent vascular diagnoses were chronic venous insufficiency (36.2%) and peripheral artery disease (26%). There were 104 (46.6%) patients who referred CAM use, primarily self-helped practices (96%), and use of herbal, vitamins, or homeopathic medicines (23.7%). Overall, the majority of the patients perceived CAM modalities helpful and 94.6% denied any adverse event. Female sex (OR: 1.768, 95% CI: 0.997-3.135, p = 0.051) and hospitalization during the previous year (OR: 3.173, 95% CI: 1.492-6.748, p = 0.003) were associated to CAM use. The majority of the patients (77%) agreed about CAM disclosure with their primary vascular surgeon; meanwhile, among CAM users, up to 54.9% did not disclose it, and their main reasons were "Doctor didn't ask" (32%) and "I consider it unnecessary" (16%). The patient-doctor relationship was rated by the patients with high scores. CONCLUSIONS: CAM use is frequent and perceived as safe and beneficial among VS outpatients; nonetheless, patients do not disclose CAM use with their primary vascular surgeons, and a wide range of reasons are given by the patients that prevent effective and open communication.

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Com referencial teórico do ano de 2020, foram condensadas as evidências sobre o uso de plasma convalescente no tratamento da Covid-19, abordando um estudo de uma série de casos de cinco pacientes com diagnóstico de COVID-19 e síndrome do desconforto respiratório; um estudo piloto, 10 pacientes com diagnostico de COVID-19 confirmado por RT-PCR; um estudo (preprint) envolvendo 5.000 pacientes; um ensaio clínico aberto, multicêntrico incluindo 103 pacientes com quadro grave de COVID-19; uma atualização de Revisão da Cochrane, que incluiu 20 estudos, 5443 participantes (5211 receberam tratamento com plasma). Resumem as Diretrizes de Food and Drug Administration (FDA), dos Estados Unidos para utilização da terapia. No Brasil, pontua as recomendações da ANVISA, as considerações do Ministério da Saúde e os esclarecimentos do Ofício Circular nº 40/2020. Os estudos analisados pontuam resultados positivos quanto à eficácia e segurança e apontam necessidade de maiores evidências

With the theoretical framework of the year 2020, the evidence on the use of convalescent plasma in the treatment of Covid-19 was condensed, addressing a study of a case series of five patients diagnosed with COVID-19 and respiratory distress syndrome; a pilot study, 10 patients with a diagnosis of COVID-19 confirmed by RT-PCR; a study (preprint) involving 5,000 patients; an open, multicenter clinical trial including 103 patients with severe COVID-19; a Cochrane Review update, which included 20 studies, 5443 participants (5211 received plasma treatment). They summarize the US Food and Drug Administration (FDA) Guidelines for using the therapy. In Brazil, the recommendations of ANVISA, the considerations of the Ministry of Health and the clarifications of Circular Letter nº 40/2020 are punctuated. The analyzed studies show positive results regarding efficacy and safety and point to the need for more evidence

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RESUMO Introdução: A Epistemologia do Sul valoriza a pluralidade e o diálogo entre os diversos saberes. Na saúde, valoriza as diversas práticas do cuidar, abrindo espaço para a inserção das Práticas Integrativas e Complementares. Objetivo: Refletir sobre a dimensão das Práticas Integrativas e Complementares para o cuidado de enfermagem sob perspectiva da Epistemologia do Sul. Métodos: Trata-se de um ensaio reflexivo acerca das Práticas Integrativas e Complementares, embasado no referencial teórico da Epistemologia do Sul. Estruturou-se quatro categorias reflexivas: Desvelando a Epistemologia do Sul; O caminhar histórico das Práticas Integrativas e Complementares; A Epistemologia do Sul e o transitar entre o saber popular e o saber científico no uso das plantas medicinais; e O entrelaço das Práticas Integrativas e Complementares com a enfermagem, frente à Epistemologia do Sul. Conclusão: As Práticas Integrativas e Complementares, sob o olhar da Epistemologia do Sul, é mais uma ferramenta utilizada no processo de trabalho do enfermeiro capaz de ampliar a assistência em saúde, com valorização de conhecimentos e das práticas de cuidado adotadas pelos usuários dos serviços(AU)

RESUMEN Introducción: La epistemología del Sur valora la pluralidad y el diálogo entre los diversos saberes. En la salud, valoriza las diversas prácticas del cuidar, abriendo espacio para la inserción de las Prácticas Integrativas y Complementarias. Objetivo: Reflexionar sobre la dimensión de las Prácticas Integrativas y Complementarias para el cuidado de enfermería bajo perspectiva de la epistemología del Sur. Métodos: Se trata de un ensayo reflexivo acerca de las Prácticas Integrativas y Complementarias, basadas en el referencial teórico de la epistemología del Sur. Se estructuraron cuatro categorías reflexivas: Desvelando la epistemología del Sur; El caminar histórico de las Prácticas Integrativas y Complementarias; La epistemología del Sur y el transitar entre el saber popular y el saber científico en el uso de las plantas medicinales; y el entrelazamiento de las Prácticas Integrativas y Complementarias con la enfermería, frente a la epistemología del Sur. Conclusiones: Las Prácticas Integrativas y Complementarias, bajo la mirada de la epistemología del Sur, son una herramienta utilizada en el proceso de trabajo del enfermero capaz de ampliar la asistencia en salud, con valorización de conocimientos y las prácticas de cuidado adoptadas por los usuarios de los servicios(AU)

ABSTRACT Introduction: The epistemology of the south values plurality and dialogue between the different instances of knowledge. In health, it values the various care practices, opening space for the inclusion of integrative and complementary practices. Objective: To reflect on the dimension of integrative and complementary practices for nursing care from the perspective of the epistemology of the south. Methods: This is a reflective essay about integrative and complementary practices, based on the theoretical reference of the epistemology of the south. Four reflexive categories were structured: unveiling the epistemology of the south, the historical evolution of integrative and complementary practices; the epistemology of the south and the transit between popular knowledge and scientific knowledge in the use of medicinal plants, and the intertwining of integrative and complementary practices with nursing compared to the epistemology of the south. Conclusions: The integrative and complementary practices, under the view of the epistemology of the south, are a tool used in the nurse's work process as being capable of extending health care, with the valorization of knowledge and care practices adopted by the users of services(AU)

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OBJECTIVES: Primary dysmenorrhea is a painful uterine contraction caused by endometrial laceration. Drug therapies and complementary medicine have been used to treat dysmenorrhea. The aim of this study was to investigate and offer an updated perspective on the treatments for dysmenorrhea. METHODS: The present study was conducted in accordance with the PRISMA checklist for systematic reviews and meta-analyses. The required information was collected based on searches for the following keywords: treatment, primary dysmenorrhea, medicinal plants, chemical drugs, and herbs. Searches were performed on databases Pubmed, Web of Sciences, Scopus, Iran medex, and SID by March 2018 to find literature in the English and Persian languages on this subject without a time limit. RESULTS: This review included 17 papers, 10 of which on complementary medicine, three on drug therapies, and four on acupuncture and acupressure. The largest and smallest samples had 303 and 24 patients, respectively. Length of treatment ranged from one to six months and the measures most commonly used in the studies were the visual analogue scale and clinical efficacy. Reported complications included gastrointestinal events, nausea, vomiting, diarrhea, abdominal pain, and liver and kidney disorders. CONCLUSION: Medicinal plants, drugs, and acupressure seem to suppress pain by reducing the level of prostaglandins, mediating nitric oxide, increasing beta-endorphin levels, blocking the calcium channel, and enhancing circulatory flow through the uterine pathway. Further trials are required to confirm the benefits of the procedures described and ensure the absence of complications.

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INTRODUCTION: Primary dysmenorrhea (PD) is another term for idiopathic menstrual cramps. Treatments include the use of oral non-steroidal anti-inflammatory drugs (NSAIDs). These drugs have several side effects. The objective of this study was to perform a systematic review on the transdermal administration of drugs and the use of alternative therapies for the treatment of PD. AREAS COVERED: The article bases were Web of Science, PubMed and Sciencedirect and the patent bases were INPI, EPO and WIPO with publications on Primary Dysmenorrhea and associations with Transdermal Administration; Complementary Therapies and Medicinal Plants. 21 articles and 12 patents were analyzed. The results demonstrate the need for alternative therapies for the treatment of PD, with greater effectiveness and lower side effects, mainly in an attempt to reduce the intensity and duration of pain as well as reducing the continuous use of medications. EXPERT OPINION: The study of technological prospection highlighted the relevant importance in seeking new methods for the relief of the symptoms provoked by this condition. The perspectives coexist in the discovery of new natural and biotechnological pharmacological applications, mainly in the development of new devices capable of facilitating and optimizing this form of administration in an attempt to reduce side effects.

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