Dinâmica de parâmetros limnológicos e uso e cobertura da terra nas bacias hidrográficas das represas Dr. João Penido e São Pedro, Juiz de Fora (MG)

Esta pesquisa teve por objetivo correlacionar os parâmetros limnológicos dos principais tributários das represas Dr. João Penido e São Pedro no município de Juiz de Fora com o uso da terra nas bacias hidrográficas destes mananciais. As amostras foram coletadas mensalmente no período de 2012 até 2013, escolhendo-se seções na nascente, foz e captação, contemplando quatro pontos na bacia da Represa de São Pedro e seis pontos na bacia da Represa Dr. João Penido. Através de uma Sonda Multiparamétrica, foram verificados em campo, os parâmetros: OD, pH, temperatura, condutividade, STD e salinidade. Em cada ponto amostral, foram coletados três litros de água para análise dos parâmetros: DBO5,20, OD, cloreto, turbidez, sólidos totais, pH, fósforo total, nitrogênio total, nitrato, nitrito, amônia e uma amostra de 100ml para análise de coliformes termotolerantes e/ou E-coli. Tais parâmetros foram analisados no LADINAA, Ecologia e outros laboratórios, seguindo as metodologias do Standard Methods for Examination of Water and Waste water (APHA, 2012). As cartas de uso e cobertura da terra foram elaboradas utilizando as Ortofotos Digitais da Prefeitura de Juiz de Fora e adotando a classificada supervisionada MAXVER no software ArcGIS 10.2. Estes dados foram tratados utilizando correlação monótona, relacionando as porcentagens de cada classe de uso da terra até cada seção de monitoramento com os parâmetros citados. Foi utilizado o coeficiente de correlação “” de Spearman com os seguintes resultados: a classe Mata Atlântica aumentou o OD e diminuiu Nitrato, Fósforo e ST; o Eucalipto reduziu o OD e aumentou o Nitrato; a Pastagem Degradada (possivelmente abandonada) reduziu Nitrato e Fósforo; a Pastagem aumentou Coliformes, Fósforo e ST e; finalmente, a Classe Urbanização aumentou Coliformes, Turbidez e Condutividade. Vale ressaltar o fato de as classes de uso da terra não serem independentes: o aumento da porcentagem de “Eucalipto” provoca espacialmente uma diminuição das demais classes. Estes resultados, ainda que parciais, apontam para a necessidade de estudos que orientem o poder público sobre os usos menos impactantes em bacias de mananciais

TECNOLOGÍAS EDUCATIVAS DE SALUD PARA PRÁCTICAS DE INVESTIGACIÓN DE MUERTE EN EL DISTRITO FEDERAL

Este estudo teve por objetivo descrever a utilização das tecnologias educacionais como estratégia para a Educação Permanente das Comissões de Revisão de Óbito. Trata-se de um estudo de intervenção educativa realizado em 2020 pela equipe da Gerência de Informação e Análise da Situação em Saúde (GIASS) da Secretaria de Estado de Saúde do Distrito Federal, realizado em 2020 e que envolveu três etapas: identificação dos problemas, uso das Tecnologias Educacionais e avaliação do processo. A análise dos dados foi realizada por meio de frequência relativa e absoluta e apresentadas em forma de tabelas e gráficos. Há aprovação do Comitê de Ética em Pesquisa para esse estudo. Em 2019, houve baixo percentual dos registros (16%) dos óbitos no FormSUS, indicando que as Comissões ainda não estavam estruturadas para execução da investigação da causa básica de óbito. Desse modo, as tecnologias educacionais foram úteis para aprimorar o processo de trabalho das Comissões. A partir dessa experiência foi possível ter uma devolutiva das informações em tempo oportuno, com maior adesão ao FormSUS em 2020 (36%), pelas Comissões. A intervenção possibilitou melhoria no registro dos dados disponibilizados pelas comissões por meio do FormSUS e consequentemente viabilizou a qualificação do Sistema de Informação sobre Mortalidade de forma rápida e eficaz.This study aimed to describe the use of educational technologies as a strategy for the permanent education of death review commissions. This is an educational intervention study carried out in 2020 by the Federal District Department of Health investigative team and which involved three stages: identification of problems, use of educational technologies, and process evaluation. Data analysis was performed using relative and absolute frequencies and presented in the form of tables and graphs. Approval was granted by the Research Ethics Committee for this study. In 2019, there was a low percentage of records (16%) of deaths on FormSUS, indicating that death review commissions were not yet structured to properly carry out investigations concerning the basic cause of death. Educational technologies were useful for improving the work process of death review commissions. Based on this experience, it was possible to guarantee the information was returned in a timely manner and with greater adhesion to FormSUS in 2020 (36%), on the part of death review commissions. The intervention made it possible to improve the registration of data made available by the commissions through the FormSUS and, consequently, enabled to qualify the Mortality Information System quickly and effectively.Este estudio tuvo como objetivo describir el uso de tecnologías educativas como estrategia para la educación permanente de las comisiones de revisión de la muerte. Se trata de un estudio de intervención educativa realizado en 2020 por el equipo investigador del Departamento de Salud del Distrito Federal y que involucró tres etapas: identificación de problemas, uso de tecnologías educativas y evaluación de procesos. El análisis de los datos se realizó utilizando frecuencias relativas y absolutas y se presentó en forma de tablas y gráficos. La aprobación fue otorgada por el Comité de Ética en Investigación para este estudio. En 2019, hubo un bajo porcentaje de registros (16%) de muertes en FormSUS, lo que indica que las comisiones de revisión de muertes aún no estaban estructuradas para llevar a cabo adecuadamente las investigaciones sobre la causa básica de muerte. Las tecnologías educativas fueron útiles para mejorar el proceso de trabajo de las comisiones de revisión de defunciones. Con base en esta experiencia, fue posible garantizar que la información fuera devuelta en tiempo y forma y con mayor adhesión a FormSUS en 2020 (36%), por parte de las comisiones de revisión de defunciones. La intervención permitió mejorar el registro de los datos puestos a disposición por las comisiones a través del FormSUS y, en consecuencia, permitió calificar el Sistema de Información de Mortalidad de manera rápida y efectiva

Association of the clinical profile and overall survival of pediatric patients with acute lymphoblastic leukemia

IntroductionThe clarification of etiopathology, the improvement of chemotherapy regimens and their risk stratifications, and the improvement in treatment support have increased the survival of children and adolescents affected by Acute Lymphoblastic Leukemia (ALL) past few years. This study aimed to estimate overall survival (OS) and event-free survival (EFS) in an onco-hematology treatment center in Brazil, reports the main clinical-laboratory characteristics of patients at diagnosis, verify the frequency of treatment-related adverse effects and the main causes of death.Material and methodsRetrospective analysis involving patients diagnosed with ALL, treated with the protocol of the Brazilian Group for Treatment of Leukemias in Childhood (GBTLI), between 2010 and 2020 was carried out; the outcomes (relapse, deaths, development of new neoplasms) were analyzed SPSS® software was used for the statistical analyses, and the p-value was considered significant when less than 0.05 for all analyses.Results109 patients were included in the study; the median age was 5 years, with a slight predominance of males. Sixty-six patients were classified as high-risk (HR) group and 43 patients were classified as low-risk (LR) group. After 5 years of diagnosis, the OS was 71.5%, and the EFS was 65%. No statistical difference was found between the HR and LR groups for OS and EFS, while leukocyte counts were statistically associated with the outcome of death (p = 0.028). Among the patients, 28 (25.6%) died due to infection accounting 46.4% of death causes. Among the 34 patients with unfavorable outcomes (death and/or relapse), 32 had no research for the minimal residual disease at the end of remission induction, and 25 were not investigated for the presence of chromosomal abnormalities. The most reported complications and treatment-related adverse effects were increased liver transaminases (85.9%), airway infection (79.4%), oral mucositis (67.2%), febrile neutropenia (64.4%), and diarrhea (36.4%).ConclusionsThe rates of OS and EFS obtained in this cohort are similar to those obtained in the few previous similar studies in Brazil and lower than those carried out in developed countries. The unavailability of prognostic tests may have hindered risk stratification and influenced the results obtained

A influência da suplementação de coenzima Q10 sobre o esquema de tratamento medicamentoso de Hipertensão Arterial Sistêmica

Objetivo: Avaliar, através de revisão de literatura, qual o efeito do uso de CoQ10 sobre a dose dos medicamentos hipotensores, quando usados em conjunto. Método: Trata-se de um estudo de revisão da literatura. A busca de artigos foi realizada na base de dados Medline entre os meses de janeiro a março de 2023. Foram utilizados na pesquisa os descritores “hypertension” e “coenzyme Q10”. Resultados: Foram encontrados 17 estudos, mas atenderam aos critérios da pesquisa apenas 2 estudos; em uma publicação os autores descreveram o resultado da administração de CoQ10 a pacientes hipertensos e em outra compilou várias intervenções feitas com o uso de CoQ10 em diferentes cardiopatias. Conclusão: Os estudos que avaliaram a influência da CoQ10 na dose de anti-hipertensivos quando associada ao tratamento padrão mostraram necessidade de menor dose ou de menos medicamentos para controle pressórico

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time,1,2 and attempts to address it require a clear un derstanding of how ecological communities respond to environmental change across time and space.3,4 While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes,5–7 vast areas of the tropics remain understudied.8–11 In the American tropics, Amazonia stands out as the world’s most diverse rainforest and the primary source of Neotropical biodiversity,12 but it remains among the least known forests in America and is often underrepre sented in biodiversity databases.13–15 To worsen this situation, human-induced modifications16,17 may elim inate pieces of the Amazon’s biodiversity puzzle before we can use them to understand how ecological com munities are responding. To increase generalization and applicability of biodiversity knowledge,18,19 it is thus crucial to reduce biases in ecological research, particularly in regions projected to face the most pronounced environmental changes. We integrate ecological community metadata of 7,694 sampling sites for multiple or ganism groups in a machine learning model framework to map the research probability across the Brazilian Amazonia, while identifying the region’s vulnerability to environmental change. 15%–18% of the most ne glected areas in ecological research are expected to experience severe climate or land use changes by 2050. This means that unless we take immediate action, we will not be able to establish their current status, much less monitor how it is changing and what is being lostinfo:eu-repo/semantics/publishedVersio

A evolução clínica do paciente portador de abscesso pulmonar: Clinical evolution of patients with lung abscess

Atualmente, com a era da antibioticoterapia e demais meios terapêuticos, o abscesso pulmonar decaiu em termos de morbimortalidade, mas ainda permanece como um desafio em termos diagnósticos e manejo clínico. O abscesso pulmonar corresponde a uma cavidade com pus no pulmão, envolvido por tecido inflamado e geralmente oriunda de uma infecção. O artigo objetivou descrever de modo narrativo a evolução clínica do portador de abscesso pulmonar, ressaltando os principais dados para a compreensão deste fenômeno. Um abscesso pulmonar é causado principalmente por bactérias existentes na boca ou garganta, a qual são aspiradas até os pulmões. A sintomatologia é inespecífica, abordando fadiga, inapetência, sudorese noturna, febre, perda ponderal e tosse com expectoração. O quadro clínico geralmente necessita do complemento de exames de imagem, principalmente a radiografia torácica para diagnóstic

I Diretrizes do Grupo de Estudos em Cardiogeriatria da Sociedade Brasileira de Cardiologia

O idoso apresenta características próprias na manifestação das doenças, na resposta à terapêutica e no efeito colateral dos medicamentos. Constitui um grupo de maior risco para o aparecimento das doenças degenerativas, em geral, e cardiovasculares, em particular, além de apresentar maior número de comorbidades

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49\ub74% (95% uncertainty interval [UI] 46\ub74–52\ub70). The TFR decreased from 4\ub77 livebirths (4\ub75–4\ub79) to 2\ub74 livebirths (2\ub72–2\ub75), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83\ub78 million people per year since 1985. The global population increased by 197\ub72% (193\ub73–200\ub78) since 1950, from 2\ub76 billion (2\ub75–2\ub76) to 7\ub76 billion (7\ub74–7\ub79) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2\ub70%; this rate then remained nearly constant until 1970 and then decreased to 1\ub71% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2\ub75% in 1963 to 0\ub77% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2\ub77%. The global average age increased from 26\ub76 years in 1950 to 32\ub71 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59\ub79% to 65\ub73%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1\ub70 livebirths (95% UI 0\ub79–1\ub72) in Cyprus to a high of 7\ub71 livebirths (6\ub78–7\ub74) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0\ub708 livebirths (0\ub707–0\ub709) in South Korea to 2\ub74 livebirths (2\ub72–2\ub76) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0\ub73 livebirths (0\ub73–0\ub74) in Puerto Rico to a high of 3\ub71 livebirths (3\ub70–3\ub72) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2\ub70% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation