Estratégias nutricionais parenterais no manejo da sepse: uma revisão abrangente das práticas atuais e potenciais inovações

Este artigo oferece uma análise detalhada e abrangente das estratégias de nutrição parenteral no manejo da sepse, uma condição médica crítica caracterizada por uma resposta inflamatória sistêmica desregulada a uma infecção. A sepse, sendo uma das principais causas de mortalidade em unidades de terapia intensiva (UTIs), exige um manejo nutricional preciso e eficaz, onde a nutrição parenteral desempenha um papel vital. Esta revisão compreensiva aborda as práticas atuais de nutrição parenteral na sepse, salientando a importância da escolha apropriada de macronutrientes e micronutrientes e as inovações emergentes na área. Exploramos os desafios e oportunidades na personalização da nutrição parenteral, focando em como as estratégias nutricionais podem ser adaptadas para atender às necessidades individuais dos pacientes sépticos, conforme sugerido por pesquisas recentes

Novas perspectivas no manejo da tuberculose multirresistente: avanços terapêuticos e desafios atuais

Este artigo apresenta uma análise profunda dos avanços recentes no tratamento da Tuberculose Multirresistente (TB-MDR), uma forma complexa de tuberculose que resiste aos medicamentos convencionais. A TB-MDR é uma preocupação crescente de saúde pública global, devido à sua difícil erradicação e às limitações dos tratamentos atuais. Exploramos os novos medicamentos emergentes, como bedaquilina e delamanida, que oferecem opções terapêuticas promissoras contra cepas resistentes de TB. Além disso, discutimos regimes de tratamento inovadores, menos tóxicos e de duração mais curta, que visam melhorar a adesão do paciente e reduzir os efeitos colaterais. Estratégias de gestão eficazes, incluindo terapia diretamente observada e abordagens de tratamento personalizadas, também são analisadas como meios essenciais para combater a TB-MDR

Avanços em cirurgia cardíaca minimamente invasiva: uma análise crítica das inovações em técnicas endovasculares e resultados clínicos

Este artigo apresenta uma revisão meticulosa e detalhada dos avanços em cirurgia cardíaca minimamente invasiva, focando particularmente nas técnicas endovasculares, que se destacam como um marco na evolução da cardiologia e cirurgia vascular. Examinando uma série de estudos recentes, exploramos como essas inovações revolucionárias estão remodelando o campo da cirurgia cardíaca. A adoção dessas técnicas endovasculares tem sido associada a um declínio significativo no trauma cirúrgico, evidenciando uma mudança na abordagem de tratamento de doenças cardíacas. Com as técnicas endovasculares, os pacientes agora têm acesso a procedimentos que não só reduzem o tempo de recuperação, mas também diminuem drasticamente as complicações pós-operatórias. Essa transformação é fundamental para melhorar a eficiência dos cuidados de saúde e a qualidade de vida dos pacientes após a cirurgia

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

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

The Use of Proteins, Lipids, and Carbohydrates in the Management of Wounds

Despite the fact that skin has a stronger potential to regenerate than other tissues, wounds have become a serious healthcare issue. Much effort has been focused on developing efficient therapeutical approaches, especially biological ones. This paper presents a comprehensive review on the wound healing process, the classification of wounds, and the particular characteristics of each phase of the repair process. We also highlight characteristics of the normal process and those involved in impaired wound healing, specifically in the case of infected wounds. The treatments discussed here include proteins, lipids, and carbohydrates. Proteins are important actors mediating interactions between cells and between them and the extracellular matrix, which are essential interactions for the healing process. Different strategies involving biopolymers, blends, nanotools, and immobilizing systems have been studied against infected wounds. Lipids of animal, mineral, and mainly vegetable origin have been used in the development of topical biocompatible formulations, since their healing, antimicrobial, and anti-inflammatory properties are interesting for wound healing. Vegetable oils, polymeric films, lipid nanoparticles, and lipid-based drug delivery systems have been reported as promising approaches in managing skin wounds. Carbohydrate-based formulations as blends, hydrogels, and nanocomposites, have also been reported as promising healing, antimicrobial, and modulatory agents for wound management

The Use of Proteins, Lipids, and Carbohydrates in the Management of Wounds

Despite the fact that skin has a stronger potential to regenerate than other tissues, wounds have become a serious healthcare issue. Much effort has been focused on developing efficient therapeutical approaches, especially biological ones. This paper presents a comprehensive review on the wound healing process, the classification of wounds, and the particular characteristics of each phase of the repair process. We also highlight characteristics of the normal process and those involved in impaired wound healing, specifically in the case of infected wounds. The treatments discussed here include proteins, lipids, and carbohydrates. Proteins are important actors mediating interactions between cells and between them and the extracellular matrix, which are essential interactions for the healing process. Different strategies involving biopolymers, blends, nanotools, and immobilizing systems have been studied against infected wounds. Lipids of animal, mineral, and mainly vegetable origin have been used in the development of topical biocompatible formulations, since their healing, antimicrobial, and anti-inflammatory properties are interesting for wound healing. Vegetable oils, polymeric films, lipid nanoparticles, and lipid-based drug delivery systems have been reported as promising approaches in managing skin wounds. Carbohydrate-based formulations as blends, hydrogels, and nanocomposites, have also been reported as promising healing, antimicrobial, and modulatory agents for wound management

Pharmaceutical applications of chitosan on medical implants: A viable alternative for construction of new biomaterials?

The cytocompatibility, good degradability and antimicrobial action of chitosan (CS) makes this polysaccharide a highly sought after candidate for applications in medical devices. Thus, development of biofunctional implants associated with CS has been proposed in regenerative medicine as these biomaterials can improve and accelerate the osseointegration process on the implants’ surface. The antimicrobial potential of CS has also been investigated in experiments performed on implantable materials associated with CS in different forms, since the incidence of implant-associated infections (IAIs) is increasing worldwide. Biodegradable scaffolds based on CS, and commonly developed as hydrogels, have received lots of attention as implants for controlled release and delivery of drugs. Given this scenario, the present review will focus on methodologies used to coat implant surfaces with CS as well as pharmaceutical applications of these functionalized implants, focusing on cellular, immunological, and antimicrobial responses as well as controlled drug release