Abordagens farmacológicas para a prevenção de recaídas em Depressão

As abordagens farmacológicas para a prevenção de recaídas em depressão desempenham um papel crucial na gestão contínua do transtorno. A personalização do tratamento, monitoramento atento e colaboração entre profissionais de saúde mental são elementos essenciais para otimizar os resultados e melhorar a qualidade de vida dos pacientes que enfrentam esse desafio persistente. Este estudo teve como objetivo avaliar o papel das abordagens farmacológica para a prevenção de recaídas em depressão. Para isso, se realizou uma revisão sistemática da literatura, utilizando as bases de dados Scielo, Lilacs e Medline. Com a análise qualitativa dos resultados, concluiu-se que as intervenções farmacológicas desempenham um papel significativo no cuidado mental, proporcionando benefícios em diversas situações. Contudo, o limite reside na necessidade de abordar cuidadosamente os desafios associados a essas intervenções e reconhecer a diversidade de respostas individuais à terapia farmacológica

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

Hemostatic changes in patients with chronic renal failure undergoing haemodialysis

Patients undergoing hemodialysis may show both thrombotic complications and bleeding abnormalities. Hemostatic changes in patients on hemodialysis may result from alterations in vessel wall integrity and platelet function, and reduced blood flow in the native arteriovenous fistula. Vascular complications represent 20-25% of all hospitalizations of patients on hemodialysis. Literature survey revealed that changes in the hemostatic system may play a major role in vascular complications observed in these patients. Thus, it is essential to investigate hemostatic alterations in patients on hemodialysis so that adequate regimes for anticoagulant therapy could be implemented. In this review we discuss hemostatic abnormalities in end stage renal disease patients undergoing hemodialysi

A new index to discriminate between iron deficiency anemia and thalassemia trait.

Background: The most common microcytic and hypochromic anemias are iron deficiencyanemia and thalassemia trait. Several indices to discriminate iron deficiency anemia fromthalassemia trait have been proposed as simple diagnostic tools. However, some of the bestdiscriminative indices use parameters in the formulas that are only measured in moderncounters and are not always available in small laboratories.The development of an index with good diagnostic accuracy based only on parametersderived from the blood cell count obtained using simple counters would be useful in theclinical routine. Thus, the aim of this study was to develop and validate a discriminativeindex to differentiate iron deficiency anemia from thalassemia trait. Methods: To develop and to validate the new formula, blood count data from 106 (thalassemiatrait: 23 and iron deficiency: 83) and 185 patients (thalassemia trait: 30 and iron deficiency:155) were used, respectively. Iron deficiency, _-thalassemia trait and _-thalassemia trait wereconfirmed by gold standard tests (low serum ferritin for iron deficiency anemia, HbA2> 3.5%for _-thalassemia trait and using molecular biology for the _-thalassemia trait).Results: The sensitivity, specificity, efficiency, Youden?s Index, area under receiver operatingcharacteristic curve and Kappa coefficient of the new formula, called the Matos & CarvalhoIndex were 99.3%, 76.7%, 95.7%, 76.0, 0.95 and 0.83, respectively. Conclusion: The performance of this index was excellent with the advantage of being solelydependent on the mean corpuscular hemoglobin concentration and red blood cell countobtained from simple automatic counters and thus may be of great value in underdevelopedand developing countries

Features associated with cognitive impairment and dementia in a community-based sample of illiterate elderly aged 75+ years: The Pietà study

ABSTRACT A higher level of educational attainment constitutes a protective factor against cognitive decline in the elderly. Nevertheless, the elements underpinning this association are yet not fully understood. Objective: The primary aim of this study was to compare cognitively impaired illiterate elderly subjects with cognitively preserved counterparts, according to demographics, comorbidities, lifetime habits and APOE genotype. Methods: This is a cross-sectional analysis of the illiterate subset of participants (n=174) from the Pietà study, a community-based survey of successful brain aging conducted in Caeté (MG), Brazil. Subjects were categorized into three diagnostic groups: cognitively normal (CN), cognitive impairment no-dementia (CIND) and dementia. The groups were then compared according to selected variables. Results: Subjects with dementia were older and had an increased prevalence of reported stroke or transient ischemic attack. The three groups did not differ in relation to demographics, prevalence of comorbidities, socioeconomic level, previous occupation profile and APOE-e4 allele frequency. Qualitatively evaluated lifetime habits, such as alcohol consumption, smoking and physical activity engagement were also similar across groups. Conclusion: No associations were found between cognitive impairment/dementia and the variables evaluated in this community-based sample of illiterate elderly