Introduction. The autolytic attempt is caused by a psychological-emotional destabilization of the person, who deliberately generates violence on himself and commits the act through various means without resulting in death, but with serious injuries and has a high possibility of becoming a suicide. Objective. To analyze the risk factors and causes associated with self-inflicted attempts, as well as suicidal behaviors, through a systematic literature review. Methodology. For this study, a bibliographic review was developed in databases such as: SciELO, Regional Portal of the Virtual Health Library, Scopus, PubMed, ProQuest, Dialnet and Redalyc, using Google Scholar and search engines in the selection of articles. Results. The authors agree that self-harming behaviors are influenced by personal, interpersonal, socioeconomic, cultural, and psychiatric factors, present at all stages of life, but more common in adolescence and adulthood. Risk factors include age, marital status, family dysfunction, substance abuse, and socioeconomic problems, among others. Biological, psychiatric, and emotional causes, such as personality disorders and depression, stand out for their high lethality. Therefore, it is essential that nursing professionals are trained to recognize and address these risk factors, focusing on prevention and timely intervention. Conclusion. The identification of multifactorial risk factors for self-injurious behavior underscores the complexity and severity of the problem, especially in vulnerable populations. The training and preventive approach of Nursing professionals are essential for early detection and effective intervention, thus contributing to the reduction of suicide attempts and their tragic consequences. General area of study: Health. Specific area of study: Nursing. Type of study: Original article.

Introduction. Attempted suicide represents the third cause of death among people aged 15 to 29 and most suicides occur in low- and middle-income countries. In the face of suicidal behaviors and behaviors, health professionals must work to promote protective factors that provide security for the sustenance of life and focus on minimizing predisposing circumstances, which may at some time precipitate lethal behaviors. Objective. Characterize protective factors and nursing interventions in primary prevention, monitoring and control of suicidal behaviors or a potential act of suicide. Methodology. The study was developed as a descriptive bibliographic review, including scientific publications available in databases such as Scopus, PubMed, SciELO, ProQuest, the Regional Portal of the Virtual Health Library, Dialnet and Redalyc. The search strategy integrated the use of Google Scholar and the search engines of each database. Results. Protective factors such as social support, positive family dynamics, emotional regulation and self-esteem are essential to prevent suicidal behaviors. Nursing interventions should focus on enhancing these factors through preventive actions from primary care, addressing education, early identification of risks and creation of support networks. In addition, it is necessary to establish standardized protocols, strengthen continuous training and promote a humanized approach. The therapeutic relationship, based on empathy and trust, is key to identifying risks, promoting healthy behaviors, and reintegrating patients into their community environments. Conclusion. Protective factors are essential in suicide prevention, while the nursing role focuses on implementing preventive strategies, strengthening therapeutic bonds based on empathy and trust, and managing risks effectively. General area of study: Health. Specific area of study: Nursing. Type of study: Original article.

Introduction: Reconstruction of traumatized limbs involves complex challenges in injuries affecting vascular, bone and soft tissue structures. Free flaps are preferred in severe cases due to their ability to ensure functional and stable coverage through vascularized transplantation. The choice of flap is based on the location, size of the defect and availability of tissue, with options such as fasciocutaneous and helix flaps standing out. In exposed fractures type IIIB and IIIC according to Gustilo Anderson, the use of flaps is crucial to manage vascular compromise and reduce infections, optimizing the function and aesthetics of the limb. Objective: To evaluate the risks and benefits of flap reconstruction in the treatment of traumatic injuries of the lower limbs, through a comparative analysis that considers the severity of the injury and the intrinsic factors of each patient, in order to determine the viability of this technique. Materials and methods: This is a literature review on reconstructive strategies with flaps in traumatic injuries of the lower limbs, based on recent studies (2019-2024) with a high level of evidence. Six articles were analyzed after an exhaustive search in scientific databases using rigorous eligibility and clinical relevance criteria. Results: Locoregional flaps are an effective and versatile option for the reconstruction of traumatized lower limbs, especially in settings with limited resources or patients with comorbidities. Techniques such as the DIEP, Propeller and hemitriceps surae flaps provide reliable coverage, reduce complications and offer good aesthetic and functional results, being a valuable alternative to microsurgical flaps. Conclusions: The use of flaps for lower limb reconstruction is an effective, reliable, and adaptable technique that improves the functional and aesthetic quality of life of patients. The appropriate selection of the technique depends on the characteristics of the defect, the patient's comorbidities, and the experience of the medical team. Although serious complications are not frequent, they should be carefully considered to minimize the risk of reconstruction failure. General area of ​​study: Medicine. Specific area of ​​study: Traumatology. Type of study: Literature review.

Introduction. In recent years, forensic genetics has become key evidence in multiple criminal and civil proceedings. With the ability to confirm or eliminate a suspect, as well as to determine family relationships, for the criminal and civil process, a new and valuable means of solving crimes. It is an essential technique that is added to those that have been used until now. In the criminal field, it allows analyzing criminal strategies and identifying those responsible, improving judicial and police management of different legal matters. Objective. Analyze the importance of genetic profiles in people deprived of liberty by taking oral swab samples to apply in criminal and judicial investigations and identification of corpses. Methodology. The research was characterized by being a bibliographic review with a descriptive approach, documentary and non-experimental design, cross-sectional cohort with a retrospective approach. To carry out this review, digital articles were accessed through various databases such as Medline, Scopus. 30 scientific articles were reviewed and 15 articles were selected through the inclusion and exclusion criteria. Results. The studies analyzed demonstrate the proven practical usefulness of the highly effective study of the genetic profile in people deprived of liberty in penitentiary centers. Conclusion. The inclusion of identifying genetic data of people involved in a criminal act, search for missing persons and prison riots is very useful and important. General study area: Criminalistics and Forensic Sciences. Specific area of study: Forensic genetics. Type of study: Literature review articles

Introduction. The prevalence of the phenomenon of the appearance of pink teeth, demonstrating as a potentially relevant thanatological finding in the forensic process, characterized by presenting a reddish color change due to the blood staining of its pulp that is given by hemoglobin, existing in the blood cells that begin to disarticulate and develop deoxyhemoglobin, appearing in the body with a red to purple color, specifically in the teeth after death. Objective. To know the prevalence of the post-mortem pink tooth phenomenon in forensic odontology due to unnatural deaths. Methodology. Descriptive bibliographic research, scientific articles related to the topic from the last 5 years. Results and discussion. Information has been selected in relation to the pink tooth phenomenon, demonstrating the histological changes that the dental pulp undergoes post-mortem, identifying the main associated factors and the technique that allows the study of this phenomenon to be identified, considering it an essential element in the forensic context. Conclusion. A direct relationship between the postmortem pink tooth and the cause of death is not established, since scientifically it cannot be attributed to this phenomenon. General area of ​​study: Dentistry. Specific area of ​​study: Forensic odontology. Type of study: Literature review.

Introduction. Humanized childbirth in Ecuador focuses on respecting the cultural practices of diverse communities, guaranteeing the right of women to decide how to experience their childbirth process, integrating their customs and beliefs onto public health system. Objective. To describe the practice of intercultural humanized birth in the health system in Ecuador in recent years. Methodology. Descriptive qualitative systematic research based on a detailed review using the PRISMA method, of studies obtained from the following databases: Pub Med, Scopus, Google Academic, Scielo, among others, including studies published in Spanish and Portuguese conducted Ecuador. Results. The results are organized into two main axes (1) Access to cultural practices, which focus on analyzing the most frequent cultural practices used in the health system, (2) Effects and experiences on maternal and neonatal health, which focused on the security that the mother has when choosing how to carry out her birthing process. Conclusion. The findings underline the importance of strengthening the decision to give birth in free position while respecting their beliefs and customs. General Area of Study: Medicine. Specific area of study: Gineco-Obstetricia. Type of study: Bibliography Review.

Introduction. Ophidian accidents are a health problem that affects 5.4 million people a year. They are more frequent in the Latin American region, especially in tropical and subtropical areas with elevated levels of biodiversity, such as Ecuador, which has around 240 ophidian species, 15% of which are poisonous. Objective. To evaluate the efficacy of antiphonic sera available in Ecuador for the treatment of snakebites, considering the diversity of venomous snake species in the country. Methodology. A literature review was carried out, based on the analysis of selected studies using inclusion and exclusion criteria, published since 2019, in scientific sources such as: PubMed, Google Scholar, Medigraphic, Medline, Elsevier, Scopus, Scielo, Dialnet, among others, and official pages of the World Health Organization, Pan American Health Organization and Ministry of Public Health of Ecuador. Results. A total of 7090 cases were reported in Ecuador between 2019 and 2023, with prevalence in the provinces of Manabí, Morona Santiago, and Orellana. The most frequent accidents are caused by snakes of the family viperadae, such as: bothrops atrox or equis del oriente, bothrops asper (equis) and bothrops b. atrox (pitalala). For the treatment of bites, the polyspecific antiophidic sera SAO-B and SAO-C imported from Costa Rica, Mexico and Brazil are used. Conclusion. The efficacy of antiophidic sera in Ecuador is approximately 70%, their range is reduced because they are not developed with local snake toxins, which require the administration of high doses. Side effects are associated with anaphylactic conditions and serum sickness. In addition, no evidence was found pointing to the antivenom as a cause of severe complications. General area of study: Medicine. Specific area of study: Tropical medicine. Type of study: Bibliographic review.

Introducción . La mastitis es una enfermedad importante en la lechería que afecta la productividad y el bienestar de las vacas. Se manifiesta en formas clínicas, subclínicas y crónicas, de ellas, la subclínica es la más común y difícil de detectar. En Ecuador, el 50% de la producción de leche se vende sin control de calidad, lo que supone un alto riesgo de residuos de antibióticos y altos recuentos de células somáticas. Además, Staphylococcus aureus , un patógeno resistente, es un factor clave en la mastitis subclínica y puede desarrollar resistencia a la meticilina debido al mal uso de antibióticos. Objetivo. El objetivo de esta revisión es describir los factores de riesgo durante el ordeño asociados a la mastitis bovina subclínica causada por Staphylococcus aureus resistente a la meticilina (SAMR). Metodología. Se realizó una búsqueda crítica para recopilar documentación sobre los factores de riesgo durante el ordeño relacionados con la mastitis bovina subclínica causada por MRSA. Se utilizaron un total de 45 artículos en inglés, español y portugués publicados entre 2019 y 2024. Resultados y Discusión. El principal factor de riesgo es la falta de higiene durante todo el proceso de ordeño. Esto, combinado con otros factores como manos sucias del ordeñador, método de ordeño, mal uso de toallas de secado y antisépticos, diferencias en la conformación de ubre y pezón, número de lactancias, período de transición y estrés, aumenta la incidencia y prevalencia de mastitis relacionadas con MRSA. Conclusión . El principal factor de riesgo es la falta de higiene en los pasos de ordeño, que, al combinarse con otros factores, facilita la entrada del patógeno causante de mastitis subclínica. Área de Estudio General. Medicina Veterinaria. Área de Estudio Específica. Ciencias Veterinarias. Tipo de Estudio. Artículo de Revisión.