Manejo Terapêutico do Paciente com Gangrena de Fournier: Revisão de Literatura

This Fournier syndrome, known as Fournier Gangrene, is a serious polymicrobialinfection that mainly affects the perineum and genital region. The research, anintegrative review between 2020 and 2024, resulted in the analysis of 41 articles, ofwhich 6 were selected. The incidence is higher in men, with an increase after the age of50. The results point to several sources of technology, highlighting skin, urological andgastrointestinal. The pathophysiology involves endarteritis obliterans, ischemia andthrombosis, leading to necrosis. The progression of the disease is divided into fourphases, with the third phase characterized by general signs and severe infectioussyndrome, which can lead to septic shock. Treatment includes broad-spectrumantibiotics, surgical debridement and, in severe cases, superficial scrotal debridement.Hyperbaric oxygen therapy is considered an adjuvant, periodic at the request ofmicroorganisms and stimulating healing. It concludes by highlighting the urgency ofearly diagnosis and multidisciplinary treatment, given the rapid progression of necrosisand high rates of morbidity and mortality associated with Fournier syndrome. Theresearch contributes to clinical understanding and highlights the importance ofimproving knowledge for a correct diagnosis and improving treatment conditions.A síndrome de Fournier, conhecida como Gangrena de Fournier, é uma infecçãopolimicrobiana grave que afeta principalmente a região do períneo e genital. Apesquisa, uma revisão integrativa entre 2020 e 2024, resultou na análise de 41 artigos,dos quais foram selecionados 6. A incidência é maior em homens, com aumento apósos 50 anos. Os resultados apontam diversas fontes de infecção, destacando pele,urológicas e gastrointestinais. A fisiopatologia envolve endarterite obliterante,isquemia e trombose, levando à necrose. A progressão da doença é dividida em quatrofases, com a terceira fase caracterizada por sinais gerais e síndrome infecciosa grave,podendo levar ao choque séptico. O tratamento abrange antibióticos de amploespectro, desbridamentos cirúrgicos e, em casos graves, reconstrução escrotal. Aoxigenioterapia hiperbárica é considerada adjuvante, reduzindo a proliferação demicro-organismos e estimulando a cicatrização. Conclui-se ressaltando a urgência dodiagnóstico precoce e tratamento multidisciplinar, dado o rápido avanço da necrose ealtas taxas de morbimortalidade associadas à síndrome de Fournier. A pesquisacontribui para a compreensão clínica e destaca a importância de aprimorar oconhecimento para um diagnóstico correto e melhorar as condições de tratamento

Manejo Terapêutico do Paciente Queimado: Revisão de Literatura

Burns are traumatic wounds resulting from thermal, chemical, electrical or radioactive agents that compromise vital skin functions. In Brazil, they constitute one of the main external causes of death, alongside transport accidents and homicides. An integrative review was carried out, using the Google Scholar database with the following descriptors “Burn”, “Pain Management”, “Therapeutic Indication”. In which 8 articles were selected from 1,710, published in English and Portuguese from 2019 to 2024. The main author conducted the analysis, with disagreements resolved between the authors. WHO estimates indicate 300,000 annual deaths from burns globally. In Brazil, one million people suffer burns annually, with young adults being the most vulnerable, mainly in domestic or work environments. The classification of burns, extent of the affected area and treatment are fundamental for the best therapeutic management, given that pain is a prevalent complaint that is difficult to control in these patients. Protocols vary, and wound care, hydration, and pain management are challenges. Different therapies, including agents such as silver sulfadiazine and essential fatty acids, show promising results. Surgical treatment aims to remove compromised tissues, contributing to effective healing. The study reinforces the importance of medical knowledge in the management of burns and its relevance to public health.As queimaduras são feridas traumáticas resultantes de agentes térmicos, químicos, elétricos ou radioativos que comprometem funções vitais tanto da pele, como dos demais órgãos internos. No Brasil, constituem uma das principais causas externas de morte, disputando com acidentes de transporte e homicídios. Realizou-se uma revisão integrativa, utilizando a base de dados Google Acadêmico com os seguintes descritores “Queimadura”, “Manejo da Dor”, “Indicação Terapêutica”. Nos quais foram selecionados 8 artigos entre 1.710, publicados em inglês e português de 2019 a 2024. O autor principal conduziu a análise, com discordâncias resolvidas entre os autores. Estimativas da OMS indicam 300 mil mortes anuais por queimaduras globalmente. No Brasil, um milhão de pessoas anualmente sofrem queimaduras, sendo adultos jovens mais vulneráveis, principalmente em ambientes domésticos ou laborais. A classificação das queimaduras, extensão da área afetada e o tratamento são fundamentais para o melhor manejo terapêutico, haja vista que a dor é uma queixa prevalente e de difícil controle nesses pacientes. Protocolos variam, e o cuidado da ferida, hidratação e manejo da dor são desafios. Diferentes terapias, incluindo agentes como sulfadiazina de prata e ácidos graxos essenciais, apresentam resultados promissores. O tratamento cirúrgico visa a remoção de tecidos comprometidos, contribuindo para a cicatrização eficaz. O estudo reforça a importância do conhecimento médico na abordagem de queimaduras e sua relevância para a saúde pública

The Effect of Diet on the Cardiac Circadian Clock in Mice: A Systematic Review

Circadian rhythms play important roles in regulating physiological and behavioral processes. These are adjusted by environmental cues, such as diet, which acts by synchronizing or attenuating the circadian rhythms of peripheral clocks, such as the liver, intestine, pancreas, white and brown adipose tissue, lungs, kidneys, as well as the heart. Some studies point to the influence of diet composition, feeding timing, and dietary restriction on metabolic homeostasis and circadian rhythms at various levels. Therefore, this systematic review aimed to discuss studies addressing the effect of diet on the heart clock in animal models and, additionally, the chronodisruption of the clock and its relation to the development of cardiovascular disorders in the last 15 years. A search was conducted in the PubMed, Scopus, and Embase databases. The PRISMA guide was used to construct the article. Nineteen studies met all inclusion and exclusion criteria. In summary, these studies have linked the circadian clock to cardiovascular health and suggested that maintaining a robust circadian system may reduce the risks of cardiometabolic and cardiovascular diseases. The effect of time-of-day-dependent eating on the modulation of circadian rhythms of the cardiac clock and energy homeostasis is notable, among its deleterious effects predominantly in the sleep (light) phase and/or at the end of the active phase