Objective: To determine the prevalence of menopausal symptoms and factors related to severity in mid-aged women.Methods: Cross-sectional study in which 216 urban-living women from Asunción-Paraguay (40-60 years) were surveyed with the 10 item Cervantes Scale (CS-10) and a general questionnaire (personal and partner data).Results: Median (interquartile range [IQR]) age of the sample was 48 [9] years, 48.1% were postmenopausal, 8.8% used menopausal hormone therapy, 39.4% psychotropic drugs, 43.5% had hypertension, 6.5% diabetes, 51.9% abdominal obesity, and 89.3% had a partner (n = 193). A history of sexual abuse was present in 2.8%. Median total CS-10 score was 8.5 [9.75]. Overall, 93.3% (180/193) of women having a partner were sexually active, with a median coital frequency of 8 times per month. According to the CS-10, the three most prevalent menopausal symptoms were: aching in muscles and/or joints (70.8%), anxiety and nervousness (70.8%) and hot flashes/night sweats (54.2%). Factors associated with higher CS-10 scores were: female age and educational level, marital status, menopausal status, and marital sexual aspects. Partner educational level was inversely correlated (rho Spearman coefficient) with CS-10 total scores. However, multiple linear regression analysis found that higher total CS-10 scores (more severe menopausal symptoms) negatively correlated to coital frequency and positively correlated with peri- and postmenopausal status, parity, sedentary lifestyle and a history of sexual abuse.Conclusion: Menopausal symptoms in this mid-aged urban female Paraguayan sample were related to hormonal, sexual and other female aspects.

COVID-19, a contagious disease caused by the novel coronavirus SARS-CoV-2, emerged in 2019 and quickly became a pandemic, infecting more than 700 million people worldwide. The disease incidence, morbidity and mortality rates have started to decline since the development of effective vaccines against the virus and the widespread immunization of the population. SARS-CoV-2 vaccines are associated with minor local or systemic adverse reactions, while serious adverse effects are rare. Thyroid-related disorders have been reported after vaccination for COVID-19, and Graves’ disease (GD) is the second most common amongst them. Thyroid eye disease (TED), an extrathyroidal manifestation of GD, is rarely observed post-COVID-19 vaccination. All TED cases followed mRNA-based vaccinations, but two new onset mild TED cases post-viral vector vaccine (ChAdox1nCoV-19) have also been reported. We report the case of a 63-year-old woman who presented with new onset hyperthyroidism and moderate-to-severe and active TED 10 days after she received the first dose of a viral vector vaccine against SARS-CoV-2. This is the first case of moderate-to-severe TED after such a vaccine. Our patient was initially treated with intravenous glucocorticoids, and subsequently with intravenous rituximab, due to no response. The disease was rendered inactive after rituximab, but constant diplopia persisted, and the patient was referred for rehabilitative surgery.

A thorough understanding of microorganisms is considered essential in order for students to understand their importance in biological systems and increasing use in industry and technology. However, research shows that the majority of students conceptualize them solely as dangerous and harmful. It has been argued that education should emphasize the importance that microorganisms have in human lives; a conceptual change to the representation of microorganisms that integrates their diversity and beneficial contributions seems an essential goal for science education. Considering the fact that science textbooks determine largely what is learned about science in the classroom, we explored Greek science textbooks in regard to the representation of microorganisms. Eight textbooks currently in use were investigated. Paragraphs mentioning microbes or microorganisms (187) were coded by both authors in mutually exclusive categories with satisfactory inter-rater agreement. Analysis of results shows that (a) in most cases microorganisms are mentioned in relation to health, and (b) the instances where microorganisms are presented in negative ways (i.e. as pathogens for humans and other organisms) are more than the instances where microorganisms are presented in positive ways (i.e. as part of the human microbiome or having a role in beneficial applications and procedures). Relevant literature and possible implications are discussed.

It has been argued that, as evidence-based medicine emerged in the 1990s, healthcare practitioners are required to partake in more intricate and elaborate cognitive processes. As a result, knowing the characteristics and constraints of scientific knowledge — i.e., an advanced understanding of the Nature of Scientific Knowledge (NOSK) — has become progressively imperative. In this paper, we discuss snapshots of the research on SARS-CoV-2 that may be used in order to illustrate aspects of NOSK to medical students and how they may be introduced within teaching interventions.