The article presents an analysis of literature data and the results of our own clinical and Doppler examination of 116 young patients with migraine. (18-45 years old), a clinical and neurological examination was performed, an assessment of the intensity of the degree of decrease in the patient's functional activity, a study of the state of cerebral arteries and cerebrovascular reactivity using ultrasound Doppler. Cerebral hemodynamics during a migraine attack is characterized by a pattern vasospasm in migraine without aura and a pattern of impaired perfusion in migraine with aura in the middle cerebral arteries, as well as increased perfusion in the cerebral arteries. For patients with migraine without aura, the characteristic Doppler The pattern is hyperresponsiveness to hypercapnic stress, and for patients with migraine with aura, hyperresponsiveness to hyperventilatory stress, reflecting a hyperconstrictive vascular response.The use of Topiramate for the preventive treatment of migraine in both clinical groups significantly reduces the frequency, duration and intensity of migraine attacks and . Under the influence of the drug, a decrease in the frequency, duration and intensity of attacks was observed. The vascular effect of the drug was manifested in a decrease in the initially increased blood flow velocity in the SMA. The drug contributed to the normalization of cerebrovascular hyperreactivity , mainly to the CO2 test in patients with migraine with aura and to the photoreactivity test in patients with migraine without aura.

Originality: The Ethics in Health Institute, in partnership with Fundação Getulio Vargas - FGVethics and FGVsaúde, which received the Stars of Education Award in 2025 for best private university in Brazil; launched the questionnaire for the research "Indicators of the Perception of Corruption in the Health Sector," applied to 987 representatives from different segments of the health chain.

The research, released in May 2026, indicated that 66.8% of respondents classify corruption in health as high and 21.5% as moderate. The negative perception reaches 92.5% of public institutions and 88.4% of private institutions. In addition, 63.6% of participants reported having experienced or witnessed concrete situations of corruption, such as favoritism in contracting and undue influence in prescription. The results also show that 66.8% of respondents classify corruption in health as high, while another 21.5% consider it moderate. In practice, almost nine out of ten participants perceive corruption as a relevant problem in the sector.

There is a large gap in literature on the topic of public health consortia for two reasons:

(i) The articles do not address, in a multidisciplinary way, the problems that arise in the formation and maintenance of public consortia, whose theoretical framework is Collaborative Governance, such as the management of differences in resources and power among members, difficulties in knowledge sharing, and articulation.disorder (leadership) (ii) both issues, collaborative governance (knowledge) and consortia ( intelligence) are new in the academic literature.

Furthermore, it is not clear what the main purposes of a Consortium are, such as sharing resources or obtaining better prices, or both. It is a common knowledge the strong corruption in Brazil due to being a culture turned to distraction such as Carnival. In this case, the consortiums have great difficulty in providing effective services to the citizens because they function as intermediaries between the government and the hospitals without social control or social participation.

Objetive: The objective of this work is to provide a new way to build a Public Consortium, through Communities of Practice (Knowledge Management) to better share knowledge and decisions. Unlike social networks, communities of practice rely on experts in thematic groups (ex. Auctions) as mediators of the discussion/debate with the focus always on patient-citizens.

Material and Methods: A questionnaire regarding consortia (collaborative governance) was completed by the executive secretaries of two consortia in Rio de Janeiro (https://forms.gle/N9CNGRiZrBari7yP9).

Results: This work is not interested in resolving political's issues, such as the sponsorship of the State governor in relation to certain prefectures and these with certain hospitals. It is interested in improving the flow of resources (human, financial, intangible) within the Consortium without altering corruption issues (only in the last four years 383 Brazilian mayors lost their positions due to corruption.) Therefore, the greater result is the proposed a Collaborative Governance model for Consortia in Brazil, based on Communities of Practice, a tool of Knowledge Management.

 Conclusions: This model is especially useful for Rio de Janeiro, which is going through true chaos in its health system as a result of the various arrests of governors (5) and mayors (1) and municipal secretaries (1) during and after the two major sporting events (2014 and 2016), a situation that has not yet been resolved.

The indiscriminate use of plant-derived piscicides in artisanal fisheries has raised concerns regarding their potential adverse effects on non-target aquatic organisms. This study evaluated the effects of sublethal concentrations of aqueous crude bark extract of Albizia gummifera on water-quality parameters and oxidative stress biomarkers in Clarias gariepinus juveniles. A total of 80 acclimatised juveniles (mean weight 20.66 ± 1.64 g; mean length 13.96 ± 0.38 cm) were randomly assigned to four treatment groups exposed to 0.00 (control), 0.10, 0.20 and 0.30 g L⁻¹ of the extract under a static-renewal bioassay. Water-quality parameters, including temperature, pH, electrical conductivity, total dissolved solids, salinity, alkalinity, general hardness and dissolved carbon dioxide, were monitored throughout the exposure period. Oxidative stress biomarkers comprising superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), reduced glutathione (GSH) and malondialdehyde (MDA) were analysed in the liver, gills, testes and ovaries. Data were analysed using one-way analysis of variance (ANOVA) at a significance level of P < 0.05. Among the measured water-quality variables, only alkalinity differed significantly (P < 0.05) among treatments, whereas temperature, pH, salinity, electrical conductivity, total dissolved solids, general hardness and dissolved carbon dioxide remained statistically comparable with the control. Exposure to A. gummifera crude bark extract elicited tissue-specific antioxidant responses. In the liver, GPx and CAT activities increased with increasing extract concentration, while MDA generally declined, suggesting activation of antioxidant defense mechanisms. Gill tissues exhibited variable antioxidant responses, reflecting their direct exposure to dissolved phytochemicals. Marked increases in SOD and CAT activities were observed in the testes at higher exposure concentrations, indicating enhanced oxidative stress responses. In the ovaries, elevated MDA concentrations and reduced CAT activity at the highest concentration suggested increased lipid peroxidation and oxidative challenge. Overall, antioxidant biomarkers responded more sensitively to the extract than conventional water-quality parameters. The study demonstrates that sublethal exposure to aqueous crude bark extract of Albizia gummifera disrupts redox homeostasis and induces tissue-specific oxidative stress in Clarias gariepinus juveniles despite causing minimal changes in general water chemistry. These findings highlight the potential ecological risks associated with the indiscriminate use of A. gummifera as a traditional piscicide and support the use of oxidative stress biomarkers as sensitive indicators for monitoring sublethal toxicity in freshwater ecosystems.

The body of living beings (in particular that of man, to whom this note is dedicated) has its own “normality” (health), developed over the centuries by medical speculation. Alongside the standard, considered “normal”, anomalies, i.e. exceptions (diseases), appear in individual subjects.

Beyond the history of medicine, there is a phenomenon in which pathological cases seem to disappear without therapeutic reason (spontaneous remission). The speculative clinical argument is mostly entrusted to meta-studies, that is, observations born from the comparison of similar results in other pathological branches, without there being a common unifying framework. Due to their frequency and importance, spontaneous remissions require a separate medical branch that goes beyond the individual pathology.

In last decades, information technology (IT) and artificial intelligence (AI) have provided medical science with a revolutionary contribution in dealing with the patient, where diagnosis and therapy are built on the physiology of the individual subject. Their combination with statistics and graph theory has given rise to network medicine.

A convergence of these speculative approaches promises significant medical and scientific progress.

In addition, brief notes on the epistemology of medical and pharmacological science.

Background: Continuous didactic instruction in health professions curricula presents cognitive challenges that lead to attentional decay and increased cognitive load. To counteract classroom fatigue, active micro-interventions have gained attention in nursing education. This study evaluated the effectiveness of a structured, four-phase ice-breaking intervention on improving learning concentration among first-year undergraduate nursing students.

Methods: A single-arm, quasi-experimental pre-test/post-test study was conducted among 53 first-year B.Sc. Nursing students taking the Nursing Foundations course at a college of nursing in Puducherry, India. The intervention was delivered across 12 50-minute lecture sessions over four weeks. Each session incorporated two 5-minute validated ice-breaking activities embedded at the mid-session and terminal points. Student concentration was measured at baseline and after a one-week washout period using the validated Mizan-Meta Concentration Scale (score range: 4–20). Pre- and post-intervention scores were compared using a paired Student's t-test.

Results: At baseline, the mean concentration score was 13.40 ± 1.94, with 73.6% (n = 39) of participants categorized as having adequate concentration and 26.4% (n = 14) as moderate. Following the four-week intervention, 100% (n = 53) of students achieved adequate concentration levels, with the mean score increasing to 17.94 ± 1.25. The absolute mean improvement of 4.54 points was statistically significant (t (52) = -16.05, p < 0.001).

Conclusion: Embedding brief, structured ice-breaking activities within traditional lecture blocks significantly improved self-reported learning concentration among undergraduate nursing students. This low-resource pedagogical approach serves as an effective cognitive reset to mitigate attentional decay in dense healthcare curricula.

Inaddition,briefnotesontheepistemologyofmedicalandpharmacologicalscience.