AVANÇOS NA TERAPIA FARMACOLÓGICA PARA INFECÇÕES DO TRATO URINÁRIO: UMA REVISÃO BIBLIOGRÁFICA DE LITERATURA

Introduction: Urinary tract infections (UTIs) represent a global challenge, impacting quality of life and generating significant costs. Antimicrobial resistance increases the complexity of conventional antibiotic treatment. The search for innovative therapies is crucial to tackling this problem. Objective: This review analyzes recent advances in pharmacological therapy for UTIs, highlighting new antimicrobial agents and non-antibiotic therapies. We also explore advanced diagnostics, multidisciplinary approaches and the impact of the COVID-19 pandemic on UTIs. Challenges in specific populations, ethical and economic considerations, as well as prevention strategies, urinary microbiota and precision medicine are discussed. Methods: We conducted a literature review of the last 15 years, including original studies and reviews. Inclusion criteria included new therapies, antimicrobial agents and advances in diagnosis. The search involved PubMed, Web of Science, Scopus and Google Scholar. The final sample comprised studies relevant to the pharmacological therapy of UTIs. Results and Discussion: Advances in new antimicrobial agents, non-antibiotic therapies and molecular diagnostics stand out. Multidisciplinary and collaborative strategies have shown benefits, while the COVID-19 pandemic has impacted treatment patterns. Conclusion: Despite progress, persistent challenges include antimicrobial resistance, ethical and economic issues. Investing in research, prevention strategies and precision medicine is crucial to optimize the clinical management of UTIs. This review highlights the continued need for innovation in the approach to UTIs, aiming to benefit individuals and global public health.Introducción: Las infecciones del tracto urinario (ITU) representan un reto mundial, que repercute en la calidad de vida y genera costes significativos. La resistencia a los antimicrobianos aumenta la complejidad del tratamiento antibiótico convencional. La búsqueda de terapias innovadoras es crucial para abordar este problema. Objetivo: Esta revisión analiza los avances recientes en el tratamiento farmacológico de las infecciones urinarias, destacando los nuevos agentes antimicrobianos y las terapias no antibióticas. También se exploran los diagnósticos avanzados, los enfoques multidisciplinares y el impacto de la pandemia de COVID-19 en las ITU. Se discuten los retos en poblaciones específicas, las consideraciones éticas y económicas, así como las estrategias de prevención, la microbiota urinaria y la medicina de precisión. Métodos: Se realizó una revisión bibliográfica de los últimos 15 años, incluyendo estudios originales y revisiones. Los criterios de inclusión incluyeron nuevas terapias, agentes antimicrobianos y avances en el diagnóstico. La búsqueda se realizó en PubMed, Web of Science, Scopus y Google Scholar. La muestra final incluyó estudios relevantes para la terapia farmacológica de las ITU. Resultados y discusión: Destacan los avances en nuevos agentes antimicrobianos, terapias no antibióticas y diagnósticos moleculares. Las estrategias multidisciplinares y de colaboración han demostrado sus ventajas, mientras que la pandemia de COVID-19 ha repercutido en las pautas de tratamiento.Infecções do trato urinário (ITUs) representam um desafio global, impactando a qualidade de vida e gerando custos significativos. A resistência antimicrobiana aumenta a complexidade do tratamento convencional com antibióticos. A busca por terapias inovadoras é crucial para enfrentar esse problema. Objetivo: Esta revisão analisa avanços recentes na terapia farmacológica para ITUs, destacando novos agentes antimicrobianos e terapias não antibióticas. Exploramos também o diagnóstico avançado, abordagens multidisciplinares e o impacto da pandemia de COVID-19 nas ITUs. Desafios em populações específicas, considerações éticas e econômicas, além de estratégias de prevenção, microbiota urinária e medicina de precisão são discutidos. Métodos: Realizamos uma revisão bibliográfica dos últimos 15 anos, incluindo estudos originais e revisões. Critérios de inclusão abrangeram novas terapias, agentes antimicrobianos e avanços no diagnóstico. A busca envolveu PubMed, Web of Science, Scopus e Google Scholar. A amostra final compreendeu estudos relevantes para a terapia farmacológica de ITUs. Resultados e Discussão: Avanços em novos agentes antimicrobianos, terapias não antibióticas e diagnóstico molecular destacam-se. Estratégias multidisciplinares e colaborativas demonstraram benefícios, enquanto a pandemia de COVID-19 impactou padrões de tratamento. Conclusão: Apesar dos progressos, desafios persistentes incluem resistência antimicrobiana, questões éticas e econômicas. Investir em pesquisa, estratégias de prevenção e medicina de precisão é crucial para otimizar o manejo clínico das ITUs. Esta revisão destaca a necessidade contínua de inovação na abordagem de ITUs, visando benefícios individuais e a saúde pública global.Introdução: Infecções do trato urinário (ITUs) representam um desafio global, impactando a qualidade de vida e gerando custos significativos. A resistência antimicrobiana aumenta a complexidade do tratamento convencional com antibióticos. A busca por terapias inovadoras é crucial para enfrentar esse problema. Objetivo: Esta revisão analisa avanços recentes na terapia farmacológica para ITUs, destacando novos agentes antimicrobianos e terapias não antibióticas. Exploramos também o diagnóstico avançado, abordagens multidisciplinares e o impacto da pandemia de COVID-19 nas ITUs. Desafios em populações específicas, considerações éticas e econômicas, além de estratégias de prevenção, microbiota urinária e medicina de precisão são discutidos. Métodos: Realizamos uma revisão bibliográfica dos últimos 15 anos, incluindo estudos originais e revisões. Critérios de inclusão abrangeram novas terapias, agentes antimicrobianos e avanços no diagnóstico. A busca envolveu PubMed, Web of Science, Scopus e Google Scholar. A amostra final compreendeu estudos relevantes para a terapia farmacológica de ITUs. Resultados e Discussão: Avanços em novos agentes antimicrobianos, terapias não antibióticas e diagnóstico molecular destacam-se. Estratégias multidisciplinares e colaborativas demonstraram benefícios, enquanto a pandemia de COVID-19 impactou padrões de tratamento. Conclusão: Apesar dos progressos, desafios persistentes incluem resistência antimicrobiana, questões éticas e econômicas. Investir em pesquisa, estratégias de prevenção e medicina de precisão é crucial para otimizar o manejo clínico das ITUs. Esta revisão destaca a necessidade contínua de inovação na abordagem de ITUs, visando benefícios individuais e a saúde pública global

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans – anteaters, sloths, and armadillos – have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with 24 domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, ten anteaters, and six sloths. Our dataset includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data-paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the south of the USA, Mexico, and Caribbean countries at the northern portion of the Neotropics, to its austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n=5,941), and Cyclopes sp. has the fewest (n=240). The armadillo species with the most data is Dasypus novemcinctus (n=11,588), and the least recorded for Calyptophractus retusus (n=33). With regards to sloth species, Bradypus variegatus has the most records (n=962), and Bradypus pygmaeus has the fewest (n=12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other datasets of Neotropical Series which will become available very soon (i.e. Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans dataset

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Versatility of guanidoacetic acid coordination modes and synthesis of its new zinc complex

Guanidinoacetic acid (GAA) is an amino acid involved in several biological processes including renal activity since it is synthesized mainly in the kidneys, insulin metabolism, creatine/phosphocreatine synthesis and recently as experimental nutrient for multiple sclerosis treatment. Given its biological role, some interactions between GAA and its complexation with essential and toxic metal ions have been previously investigated, both in aqueous medium with Ni(II), Co(II), Cu(II), Zn(II), Cd(II), and Pb(II), as well as in the synthesis of complexes in solid phase. This study presents the versatile coordination modes of GAA and reports its novel solid zinc complex. GAA complexation ranges from the usual α-nitrogen and oxygen bidentate coordination to a paddlewheel monodentate-oxygen mode in a Cu2GAA4 complex. The novel solid GAA zinc complex has only been succeeded to be synthesized in the presence of copper(II) salt, being characterized by single-crystal structure refinement using X-ray diffraction and mid and far-Fourier Transform Infrared spectroscopy. The results showed that the synthesized complex, (HGAA)[Zn(GAA)Cl3].H2O (1) , exhibits a tetrahedral geometry with an oxygen-carboxylate GAA monodentate coordination complemented by three chloride ligands and a water bridge linked to a monoprotonated GAA species. Hydrogen bonds play a crucial role in the stabilization of 1, especially between Zn(GAA)Cl3- and its cation ion, HGAA+. Infrared spectroscopy of 1 presented a band at 412 cm-1 and three bands at 291, 273 and 239 cm-1, corresponding to Zn-O and Zn-Cl stretching modes, respectively. The different coordination modes of guanidinoacetate ion and its complexation with zinc and copper(II), as well as the way the hydrogen bonds stabilize their structures may help to further understand the diverse biochemical processes involved in this amino acid

Structural characterization of a new dioxamic acid derivative by experimental (FT-IR, NMR, and X-ray) analyses and theoretical (HF and DFT) investigations.

Very few investigations concerning the crystal structure and chemical properties of dioxamic acids have been related in the literature. This work describes the chemical properties of ortho-phenylenebis(oxamic acid) (2) and its new derivative, hydrogeno ortho-phenylenebis(oxamato) benzimidazolium (3) using experimental (FT-IR, NMR, and X-ray single crystal diffraction) and theoretical (HF/3-21G_ and B3LYP/ 6-31G_ calculations) methodologies. Compound 2 displays intramolecular hydrogen bonding between the hydrogen of an amide group and the oxygen atom of another amide group present in the structure. Compound 3 was prepared by a newly developed synthetic route involving decomposition of the dioxamic acid in solution without the presence of metallic ions. Thermodynamic calculations indicate a process via two successive hydrolyzes of the amide groups of 2, followed by condensation with formic acid and finally dehydration. The structure of 3 was solved by X-ray single-crystal diffraction and it consists of meso-helical chains stabilized by intra and intermolecular hydrogen bonds and p–p stacking interactions

Complexes with Benzoic Acid Derivatives: Structural Characterization, in Vitro Antileishmanial and Antibacterial Activities and Cytotoxicity against Macrophages

molecule

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data