Microbial content recovered from diabetic foot infections: a cross-sectional study in Brazil / Conteúdo microbiano recuperado em infecções de pé diabético: um estudo transversal no Brasil

In Brazil, the prevalence of diabetes mellitus (DM) is 11.9 million cases. Diabetic foot ulcers (DFU) increase morbidity and cause hospital admissions among DM patients. In an attempt to better understand DFU, this cross-sectional study investigated microbial content and their susceptibility to antimicrobials. Secretion from foot ulcers of 30 diabetic patients were obtained in three Brazilian hospitals and submitted to microbiological evaluation. All recovered strains were identified and submitted to antimicrobial susceptibility tests. Genetic diversity was investigated by PCR coupled with denaturing gradient gel electrophoresis (PCR-DGGE). DFU exhibited a polymicrobial profile composed of 72.5% aerobic and 22.3% anaerobic bacteria, and 2.5% fungi species. A total of 91 microorganisms were isolated, and the number of recovered species per patient ranged from 1-9. Peptostreptococcus spp. was the most frequently recovered obligate anaerobic Genus and was resistant mostly to penicillin and clindamycin. A total of 37.5% S. aureus strains were methicillin resistant. E. coli were the most susceptible Gram-negative species and Pseudomonas aeruginosa were the most resistant. The present study demonstrated that almost 34% of microbial species observed on DGGE gels were not cultivable. The recovery of multidrug resistant microorganisms pointed out to the need for more attention when prescribing an empirical therapy and emphasized the relevance of this study

Amazonian plant natural products:perspectives for discovery of new antimalarial drug leads

Plasmodium falciparum and P. vivax malaria parasites are now resistant, or showing signs of resistance, to most drugs used in therapy. Novel chemical entities that exhibit new mechanisms of antiplasmodial action are needed. New antimalarials that block transmission of Plasmodium spp. from humans to Anopheles mosquito vectors are key to malaria eradication efforts. Although P. vivax causes a considerable number of malaria cases, its importance has for long been neglected. Vivax malaria can cause severe manifestations and death; hence there is a need for P. vivax-directed research. Plants used in traditional medicine, namely Artemisia annua and Cinchona spp. are the sources of the antimalarial natural products artemisinin and quinine, respectively. Based on these compounds, semi-synthetic artemisinin-derivatives and synthetic quinoline antimalarials have been developed and are the most important drugs in the current therapeutic arsenal for combating malaria. In the Amazon region, where P. vivax predominates, there is a local tradition of using plant-derived preparations to treat malaria. Here, we review the current P. falciparum and P. vivax drug-sensitivity assays, focusing on challenges and perspectives of drug discovery for P. vivax, including tests against hypnozoites. We also present the latest findings of our group and others on the antiplasmodial and antimalarial chemical components from Amazonian plants that may be potential drug leads against malaria

COLESTEATOMA DO ÁPEX PETROSO: UM RARO TUMOR

Introduction: Cholesteatoma, although relatively rare, presents significant challenges in clinical practice. Despite decades of research, its cause remains complex and elusive. Objective: This review aimed to summarize key findings on the epidemiology, pathophysiology, diagnosis and surgical management of cholesteatoma, highlighting current knowledge gaps and emerging trends in the field. Method: Narrative review carried out in the PubMed and Scielo databases. The search used the following keywords: “cholesteatoma, petros apex, minimally invasive surgical procedures”. The inclusion criteria comprised review articles, pre-clinical and clinical research published, written in Portuguese and English and available in complete text. The selected articles were analyzed based on the technologies covered, future perspectives, challenges, diseases mentioned and the central idea of the article. Result: 36 articles were included. Conclusion: Cholesteatoma is important in medical practice, despite being relatively uncommon in the general population. However, there are still doubts about its cause, but its diagnosis has been expanded through imaging tests in an attempt to reduce “second-look” operations and avoid them. Another field with constant growth is surgical treatment, since the complex anatomy requires that new techniques be managed to reduce injuries to important and vital structures in the region.Introdução: O colesteatoma, embora relativamente raro, apresenta desafios significativos na prática clínica. Apesar de décadas de pesquisa, sua causa permanece complexa e evasiva. Objetivo: Esta revisão pretendeu resumir as principais descobertas sobre a epidemiologia, fisiopatologia, diagnóstico e manejo cirúrgico do colesteatoma, destacando lacunas de conhecimento atuais e tendências emergentes no campo. Método: Revisão narrativa realizada nas bases PubMed e Scielo. A busca utilizou as seguintes palavras-chave: “colesteatoma, ápice petros, procedimentos cirúrgicos minimamente invasivos” e suas versões ao inglês Os critérios de inclusão compreenderam artigos de revisão, pesquisas pré-clínicas e clínicas publicados, escritos em português e inglês e disponíveis em texto completo. Os artigos selecionados foram analisados com base nas tecnologias abordadas, perspectivas futuras, desafios, doenças referidas e ideia central do artigo. Resultado: Foram incluídos 36 artigos. Conclusão: O colesteatoma tem importância na prática médica, apesar de ser relativamente pouco frequente na população em geral. No entanto, ainda existem dúvidas sobre sua causa, mas seu diagnóstico tem sido ampliado atavés de exames de imagem na tentativa de redução das operações de “segundo-olhar”, evitando-as. Outro campo com crescimento constante é o tratamento cirúrgico, uma vez que a anatomia complexa exige que novas técnicas sejam manejadas para diminuir lesões de estruturas importantes e vitais da região

Abuso de Substâncias e Emergências Psiquiátricas: Avaliação Integrada e Intervenções Eficazes

Objective: Emphasize the importance of an integrated approach in addressing these issues, focusing on personalized and effective interventions. Methodology: A comprehensive review of scientific literature was conducted using databases such as PubMed, Latindex, and Scielo to identify relevant studies on substance abuse in psychiatric emergency contexts using MeSH Finder: "Nerve Agents"; "Neurotransmitter Agents"; "Mental Health". Results: The focus is on personalized interventions, such as specific therapies and emotional support, highlighting the importance of ongoing education and community involvement for prevention and recovery. The ultimate goal is to promote well-being through a multidisciplinary approach in complex situations. Conclusion: Collaboration between mental health and specialists is essential to address substance abuse and psychiatric emergencies. Personalized interventions, continuous education, and community involvement are crucial for prevention and recovery, aiming to promote well-being in complex situations.Objetivo: Destacar a importância da abordagem integrada na avaliação desses problemas, enfocando intervenções personalizadas e eficazes. Metodologia: Realizou-se uma revisão abrangente da literatura científica utilizando bases de dados, como PubMed, Latindex e Scielo, para identificar estudos relevantes sobre abuso de substâncias em contextos de emergências psiquiátricas utilizando os MeSH Finder: “Nerve Agents”; “Neurotransmitter Agents”; “Mental Health”.  Resultados: O foco recai sobre intervenções personalizadas, como terapias específicas e apoio emocional, enquanto ressalta a importância da educação contínua e do envolvimento da comunidade para prevenção e recuperação. O objetivo final é promover o bem-estar por meio de uma abordagem multidisciplinar em situações complexas. Conclusão: A colaboração entre saúde mental e especialistas é essencial para enfrentar abuso de substâncias e emergências psiquiátricas. Intervenções personalizadas, educação contínua e envolvimento comunitário são cruciais para prevenção e recuperação, visando promover o bem-estar em situações complexas

PREVALÊNCIA DA PARADA CARDÍACA DURANTE A ANESTESIOLOGIA NO LAPSO INTRA-OPERATÓRIO

Cardiac arrest involves the heart not functioning properly, so our body's organs end up not receiving blood flow constantly and correctly, resulting in a lack of oxygen in other vital organs. This adverse event is commonly seen during anesthetic periods and may have several potentiating factors, such as comorbidities and the patient's clinical status. Methodology: The present study addresses a systematic review with the aim of analyzing and understanding the occurrence of these cases and their possible related causes. Comprehensive articles on this topic were selected from November 2023 without time restrictions. Results: Cardiac arrests during surgery in anesthetized patients are serious and potentially fatal events. They can be triggered by a variety of factors, including respiratory complications, electrolyte disturbances, pre-existing heart conditions, shock, excessive bleeding, medication administration errors, and major surgical procedures. Conclusion: Despite the technological advances and facilities implemented, a significant number of this type of condition still occurs.A parada cardíaca envolve o não funcionamento adequado do coração, assim os órgão do nosso organismo acabam não recebendo o fluxo sanguíneo de forma constante e correta, resultando na falta de oxigênio nos demais órgão vitais. Esse evento adverso citado enquanto o paciente está sob anestesia  é uma situação crítica e pode possuir diversos fatores potenciadores, como no caso das comorbidades e estado clínico do paciente em si. Metodologia: O presente estudo aborda uma revisão sistemática com o intuito de analisar e compreender a ocorrência desses casos e as suas possíveis causas relacionadas, foi selecionado artigos abrangentes dessa temática no período de novembro de 2023, os dados primários foram.  Resultados: As paradas cardíacas durante cirurgias em pacientes anestesiados são eventos graves e potencialmente fatais. Podem ser desencadeadas por uma variedade de fatores, incluindo complicações respiratórias, distúrbios eletrolíticos, condições cardíacas pré-existentes, choque, hemorragia excessiva, erros na administração de medicamentos e procedimentos cirúrgicos de grande porte. Conclusão: Apesar dos avanços e facilidades tecnológicas implementadas, ainda ocorre um número significativo desse tipo de quadro

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