Objective: To evaluate the response to treatment of acute trigeminal neuralgia (TN) exacerbations in the emergency department (ED).Background: TN is characterized by recurrent and intense pain paroxysms. Some patients experience severe acute exacerbations requiring ED presentation. The optimal management of these episodes is not well established. Methods:We present a case series of TN exacerbations in adults who presented to the ED of a tertiary center from January 2008 to December 2020. We analyzed demographic and clinical data, including pharmacological management in the ED. The primary outcome was pain relief, classified into "no relief," "partial relief," and "satisfactory relief" based on the qualitative description in the ED's records. Results:Ultimately 197 crisis episodes corresponding to 140 patients were included.Most were women (61%, 121/197) with a median age of 63 years (interquartile range: 52-73). Acute TN exacerbations were treated with opioids in 78% (108/139) of crisis episodes, nonsteroidal anti-inflammatory drugs in 42% (58/139), corticosteroids in 21% (29/139), intravenous phenytoin in 18% (25/139), and intravenous lidocaine in 6% (8/139). Of the 108 cases treated with opioids, 78 (72%) required additional drugs for pain management. Intravenous phenytoin allowed satisfactory pain relief in 64% of cases. Conclusion:In our sample, opioids were the most used therapeutic approach in acute TN exacerbations despite their low efficacy and subsequent need for further drug treatment in most cases. Most crisis episodes managed with intravenous phenytoin reached total pain relief. Prospective studies are needed to guide the treatment of acute exacerbations of TN.

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Mental health and substance abuse challenges are widespread among incarcerated populations, often coupled with complicated histories of abuse, trauma, and other psychological problems. Traditional treatments have largely consisted of psychological or pharmaceutical interventions. However, the implementation, effectiveness, and financial burden of traditional interventions have led to exploration into alternative approaches. The purpose of this study was to evaluate the effectiveness of a six-week yoga intervention on body dissociation, emotion regulation, and signs of substance relapse among incarcerated females. Participants were assigned to an intervention group, therapeutic community, or general population control group. This study conceptualized body awareness and emotional regulation as mechanisms of change and hypothesized that improvements in these constructs would ultimately lead to improved signs of substance use relapse scores as compared with the wait-listed control and comparison groups. An analysis of covariance revealed significant differences in warnings of relapse (p < .01), emotion regulation (p < .01), and body dissociation (p < .05). Paired samples t tests revealed significant change from pre- to posttest for the intervention group across all outcome variables. Findings suggest that yoga may be an effective integrative treatment for mental health and substance use challenges among incarcerated females.

In recent years, economic scandals and fraudulent practices in financial institutions have captured national attention, prompting the demand for ethical conduct, transparency, and responsibility. Compliance, as a form of corporate governance, has gained significance in the Brazilian context, particularly within the financial sector. This research aims to examine how historical banking practices serve as a foundation for the establishment and advancement of compliance mechanisms in optimizing financial activities. Using an inductive methodology supported by bibliographic and documentary research, this study analyzes historical cases to determine if banking activities have deviated and adopted fraudulent systems. The research begins by examining the concept of the contract of deposit of fungible goods in ancient Rome, focusing on the concrete case of the Bank of Calisto I. It then explores medieval banking practices in commercial Italian cities, particularly Florence and the Medici Bank, as well as Catalonia, with emphasis on Barcelona. The study further investigates the financial systems of the modern era, analyzing banks in Amsterdam, Stockholm, and the Bank of England, specifically their handling of deposits and reserve contingencies. Finally, the research explores the link between past banking practices and the contemporary financial system, evaluating current prevention mechanisms, internal and external oversight of banks, and the historical contributions of financial activities to the evolution of existing control mechanisms. This research provides valuable insights into the historical foundations that have shaped compliance practices in Brazil. By understanding the historical context, it offers valuable knowledge for enhancing and sophisticating financial activities within the compliance framework, contributing to improved transparency, risk mitigation, and ethical behavior in the financial sector.

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