Manejo anestésico em gestante com dissecção aguda de aorta tipo Stanford A: Anesthetic management in pregnant women with Stanford A type acute aorta dissection

A dissecção aguda de aorta é um evento raro durante a gestação, apresentando-se de forma potencialmente catastrófica, necessitando de adequado manejo anestésico. O presente caso trata de uma mulher de 30 anos, 35 semanas e 6 dias de gestação, com história de doença hipertensiva específica da gravidez (DHEG) e quadro de precordialgia de forte intensidade. Foi diagnosticada com dissecção de aorta tipo A de Stanford, sendo realizada cesárea de emergência e posterior correção cirúrgica da dissecção da aorta com anestesia geral, sem intercorrências. O manejo anestésico disponível na literatura ainda é escasso, sendo de fundamental importância o controle pressórico e hemodinâmico. Há relatos de desfechos vantajosos sobre diferentes anestesias, não existindo consenso. É importante que os anestesiologistas conheçam as possíveis dificuldades a serem encontradas para melhor manejo dos pacientes

ENDOMETRIOSIS OF THE CECUM AND APPENDIX: REVIEW OF LITERATURE.

Endometriosis is a benign, chronic, inflammatory and estrogen dependent pathology in which there is the implantation of functional extrauterine endometrial tissue. Pelvic and abdominal endometriosis are the most frequent presentations and, in these forms, ectopic endometrial implantation affects the lesser pelvis, uterosacral ligaments, ovaries, uterine tubes, urinary and gastrointestinal tracts. Some symptoms such as altered bowel habits, pelvic pain, infertility and bleeding during bowel movements are present. In this work the focus is on the manifestations of endometriosis in the appendix and cecum. The use of imaging tests, such as transrectal and transvaginal ultrasonography, magnetic resonance imaging and colonoscopy are important tools used, however, the gold standard is videolaparoscopy with biopsy to confirm the anatomopathological findings. The surgical strategy is related to the degree of impairment and must take into account the eradication of the disease together with the preservation of fertility. Therefore, the importance of evaluating and treating all areas that endometriosis affects is clear, with a multidisciplinary approach by general surgeons and gynecologists, in order to investigate, diagnose and correctly address the disease in an organized and correct way. &nbsp

Analysis of the acute neuroinflammatory response and endogenous markers in the amygdala of animals submitted to status epilepticus by intrahippocampal pilocarpine application

Introduction: Experimental evidence and clinical evidence indicate that the inflammatory process is a crucial mechanism in the pathophysiology of epileptic seizures and temporal lobe epilepsy. The amygdala when involved in an atypical processing is associated with multiple moods such as depression and anxiety disorder and psychiatric disorders such as schizophrenia. Objective: This study investigated the acute inflammatory process and modulation of the endogenous proteins’ galectins and AnxA1 in the amygdala of animals submitted to an experimental model of temporal lobe epilepsy. Methods: The experimental procedures were approved by the Ethics Committee on the Use of Animals at UNIFESP (CEUA nº2958050814). The experiments performed in this study used data and materials that were obtained from the project “Neuroprotective and anti-inflammatory role of the mimetic peptide ac2-26 of the annexin a1 protein in intrahippocampal pilocarpine-induced status epilepticus” conducted by the advisor. The experimental model used male Wistar rats that were divided into 3 experimental groups (NAIVE; SHAM, Status Epilepticus or SE - n = 5 animals/group). Once acclimated, the animals in the SHAM and SE groups underwent stereotaxic surgery for implantation of the intracerebral cannula in the right hippocampus. The SHAM animals received sterile saline in all procedures and the NAIVE group only manipulated. The animals were monitored throughout the period and after 24 hours of experiment all animals were euthanized by overdose of thiopental to remove the brain and performed histological and immunohistochemical analysis. Results and Conclusion: Initial results demonstrate that SE and the acute inflammatory process cause damage to the amygdala, and there is also modulation of inflammatory markers in this structure. However, further studies are needed to better understand the mechanism of action in neuroinflammation in status epilepticus

Rural extension and communication in the rural environment / Extensão rural e comunicação no ambiente rural

Rural extension is one of the branches of Agrarian Sciences that is concerned with providing formal education services of a continuous nature for the rural and fishing environment, assisting and promoting processes of management, production, processing and commercialization of activities, as well as agricultural and non-agricultural services, including agroextractive, forestry and artisanal activities. Rural extension is also understood as "a process of out-of-school education, or, not formal, whose objective is to contribute to the elevation of the quality of life of rural families and, consequently, to the well-being of society as a whole". The technical assistance provided to family farmers is of relevant importance in the process of communication and dissemination of new technologies generated by research (and possibly by farmers themselves or by official rural extension services) that are essential to rural development in its broadest sense, that is, in the development of agricultural, forestry, extractivism and fishing activities. The importance of technical assistance and rural extension in bringing technology closer to society is undeniable. However, in addition to similar ones, these two strands contain differences in important points, which leave them far apart from each other. In the rural extension it is necessary to have a link between the research and the productive sector, which, in this case, is the farmer. The focus of rural extension is to bring to the rural community from basic knowledge (such as borrowing from banks, economy, etc.) to technical knowledge in agriculture, including technology (materialization of science studied). It consists of being sure that the small farmer will know how to manage his land and his income, and creates an independence so that, in case of a problem, the farmer and his family know how to solve it without major problems and without requiring a technical assistant constantly. It is an educational measure aimed at improving production and income and, consequently, quality of life of the rural family. Technical assistance creates a certain dependence on the small farmer. It aims to solve immediate problems, with greater objectivity, but does not intend to pass on knowledge to the rural family. It is a way of using technology in a technical way, but with an individual character.

Perfil epidemiológico do SUS: enxaqueca em caráter de urgência no Brasil, entre 2017 e 2021: Epidemiological profile of SUS: emergency migraine in Brazil, between 2017 and 2021

Introdução: Segundo a Organização Mundial de Saúde (OMS), metade da população mundial sofre com dor de cabeça em alguma fase da vida, com maior prevalência em pessoas do sexo feminino. Estudos acerca da epidemiologia da cefaleia no Brasil encontraram altas prevalências na população brasileira, com variação entre 43% e 93%, equivalente e inferior quando comparadas a estimativa de prevalência no mundo, estimada em 46% da população adulta. Objetivos: O objetivo deste estudo é caracterizar o perfil sociodemográfico e investigar a situação de internações por enxaqueca e outras síndromes de algias cefálicas na população diagnosticada no Brasil, no período de 2017 a 2021. Métodos: Trata-se de um estudo epidemiológico descritivo, cujos dados foram obtidos por meio de consulta às bases de dados Sistema de Informações Hospitalares do SUS (SIH/SUS), disponibilizados pelo Departamento de Informática do Sistema Único de Saúde (DATASUS), no endereço eletrônico (http://www.datasus.gov.br), além das bases de dados PUBMED, LILACS e SCIELO, referentes ao período de 2017 até 2021. Os dados obtidos foram organizados e analisados. Resultado e Discussão: O total do número de internações por enxaqueca, por todos os caráteres de atendimento, em todas as regiões do Brasil no período de 2017-2021, foi de 50.354 novos casos. Sendo que do total dos casos notificados, houve o predomínio na região Nordeste com 15.222 casos (30,22%), seguido pela região Sudeste com 14.865 casos (29,52%), da Sul com 14.693 (29,17%), da Norte com 3.064 (6,08%) e por fim a região Centro-Oeste com 2.510 (4,98%) dos casos. Já nos atendimentos de caráter de urgência, há um predomínio da região Sudeste com 30,35% do total dos casos, seguida pela região Nordeste com 29,37%, da Sul com 29,08%, da Norte com 6,13% e finalmente a Centro-Oeste com 5,04% dos casos de internamento em caráter de urgência. Quanto a relação mulher/homem, no ano de 2017 a proporção entre mulheres diagnosticadas para um homem era de 1,94:1 (6145/3158). E, durante os anos subsequentes (2018, 2019, 2020 e 2021), manteve-se o número de casos diagnosticados no Brasil sempre maior no gênero feminino do que no gênero masculino. Quanto a distribuição do número de internações por enxaqueca no Brasil, por caráter de urgência segundo a faixa etária, foi observado que nas crianças na faixa de 1-14 anos ocorre uma porcentagem de 0,77%- 5,21% dos casos, havendo predominância da enxaqueca em adultos na faixa etária entre 20-60 anos, com o pico na faixa de 30-39 anos (18,84%), reduzindo progressivamente até chegar na faixa > que 80 anos com 2,41% dos casos. Conclusão: A alta prevalência de enxaqueca nos atendimentos de urgência no Brasil, principalmente no sexo feminino e na faixa etária economicamente ativa da população, revela a necessidade de intensificação das práticas de prevenção e diagnóstico correto e precoce, baseados nos critérios da Classificação Internacional das Cefaleias. O tratamento deve ser instituído tão logo seja firmado o diagnóstico, de forma correta e efetiva. Existe a necessidade da profilaxia e do tratamento apropriado, à proporção que promova a melhoria da qualidade de vida dos pacientes e a reorientação dos custos hoje gerados pela promoção e prevenção dos episódios incapacitantes desse importante evento epidemiológico

Phylogenetic analysis of rabies surveillance samples from north and northeast Brazil

Viruses of the Lyssavirus genus are classified into several genotypes (GT1 to GT7), of which only GT1 (classic rabies virus—RABV) has a cosmopolitan distribution and circulates in Brazil. GT1 is subdivided into several antigenic variants (AgV) maintained in independent cycles with a narrow host range and distinct geographic distributions, namely, AgV1 and AgV2 found in dogs, AgV3 in the vampire bats Desmodus rotundus, and AgV4 and AgV6 in bats non-hematophagous Tadarida brasiliensis and Lasiurus cinereus, a common variant of marmoset (Callithrix jacchus), and crab-eating fox (Cerdocyon thous). In this study, we performed phylogenetic analysis to identify at the antigenic variant level; six RABV genomes derived from the Rabies Surveillance in the north and northeast regions of Brazil. The analysis resulted in the formation of 11 monophyletic clusters, each corresponding to a particular variant, with high bootstrap support values. The samples were positioned inside the AgV3, AgV6, and Callithrix variant clades. This is the first report of the AgV6 variant found in northern Brazil, which provides valuable information for rabies surveillance in the country. The possibility of viral spillover has been much debated, as it deals with the risk of shifting transmission from a primary to a secondary host. However, more genomic surveillance studies should be performed, with a greater number and diversity of samples to better understand the transmission dynamics of each variant to detect changes in its geographic distribution and spillover events

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

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 understanding 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,5,6,7 vast areas of the tropics remain understudied.8,9,10,11 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 underrepresented in biodiversity databases.13,14,15 To worsen this situation, human-induced modifications16,17 may eliminate pieces of the Amazon's biodiversity puzzle before we can use them to understand how ecological communities 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 organism 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 neglected 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 lost

Combined effect of Cinnamomum zeylanicum blume essential oil and nystatin on Candida albicans growth and micromorphology

Introduction: The combination of a natural product and a synthetic antifungal may lead to a lower dose of each individual agent and consequent reduction of adverse effects and greater pharmacological synergism. Objective: This study investigated the antifungalactivity of the essential oil (EO) from Cinnamomum zeylanicum Blume alone and combined with nystatin on Candida albicans growth and micromorphology. Methodology: We determined the Minimum Inhibitory Concentration (MIC), Fractional Inhibitory Concentration Index (FIC) and the effect of the EO alone and combined with nystatin on the growth kinetics and production of virulence-related structures by the yeasts, such as pseudohyphae and chlamydoconidia. Results: When tested alone, the EO from C. zeylanicum andnystatin showed MIC of 312.5 μg/ml and 64 μg/ml, respectively. When combined, MIC values decreased to 39 μg/ml and 32 μg/ml for the EO and nystatin, respectively. The value of the Fractional Concentration Index (FIC) was 0.6024, indicating additivity. It could be observed that at all concentrations the products tested alone and in combination were able to reduce the number of CFU/mL, when compared to the control group (