Sinais e sintomas, diagnóstico e tratamento atual da doença do refluxo gastroesofágico no paciente pediátrico: uma revisão sistemática

Objetivo: O objetivo desta revisão bibliográfica foi relatar o conhecimento atual sobre os principais sinais e sintomas, métodos utilizados no diagnóstico e os possíveis planos terapêuticos de bebês e crianças com doença do refluxo gastroesofágico. Metodologia: As buscas foram realizadas por meio de pesquisas nas bases de dados PubMed Central (PMC) e Biblioteca Virtual de Saúde (BVS). Foram utilizados quatro descritores em combinação com o termo booleano “AND”: Pediatrics, Gastroenterology, Gastroesophageal Reflux e Gastroesophageal Reflux Disease . A estratégia de busca utilizada na base de dados PMC foi: Pediatrics AND Gastroenterology AND Gastroesophageal Reflux  and Gastroesophageal Reflux Disease AND Pediatrics e no BVS foi Pediatrics AND Gastroesophageal Reflux . Desta busca foram encontrados 157 artigos, posteriormente submetidos aos critérios de seleção. Após a associação dos descritores utilizados nas bases pesquisadas foram encontrados um total de 157 artigos, sendo utilizado 12 artigo para compor a produção desse trabalho.  Resultados: As apresentações clínicas da DRGE viriam de acordo com a idade do paciente, sendo que os sintomas mais comuns no primeiro ano de vida incluem regurgitação, vômitos, recusa alimentar, tosse e irritabilidade, sendo que o diagnóstico é clínico, sendo considerado uso de ferramentas adicionais apenas em casos duvidosos ou com suspeita de complicações.   Conclusão: Conclui-se que é fundamental a caracterização da DRGE objetivando garantir um controle sintomático e evitar a progressão para possíveis complicações, tais medidas podem ser realizadas através de um tratamento não farmacológico, farmacológico e até mesmo cirúrgico.&nbsp

Sinais e sintomas da artrite reumatoide e suas principais comorbidades: uma revisão sistemática

Objetivo: O objetivo geral do presente estudo consiste em analisar a produção científica sobre a artrite reumatoide, buscando identificar as principais manifestações clínicas, bem como as comorbidades que estão associadas com a doença.  Metodologia: as buscas foram realizadas por meio de pesquisas nas bases de dados PubMed Central (PMC). Foram utilizados três descritores em combinação com o termo booleano “AND”: Rheumatoid Arthritis,Comorbidity, Signs and Symptoms. Foram encontrados 440 artigos, posteriormente submetidos aos critérios de seleção. Foram selecionados  22 estudos Resultados:   A artrite reumatoide (AR) é uma doença inflamatória crônica caracterizada pelo acometimento poliarticular e simétrico, sendo considerada a forma mais comum de artrite inflamatória crônica. A Artrite reumatoide é uma doença sistêmica e que pode ocasionar uma variedade de manifestações extra-articulares, podendo se desenvolver durante a evolução clínica da AR em até 40% dos pacientes. Conclusão: A AR está associada a diversas comorbidades como doença cardiovascular (DCV), acometimento pulmonar como a  doença pulmonar intersticial, depressão, distúrbios do sono, fadiga, neuropatia e vasculites gastrointestinais. Considera-se a DCV uma das principais causas de morbidade e mortalidade nesta população. &nbsp

O trabalho da enfermagem em um serviço de controle de infecção hospitalar (SCIH): relato de experiência / The work of nursing in a hospital infection control service (SCIH): experience report

As infecções relacionadas à assistência à saúde (IRAS) representam um grande problema de saúde pública no Brasil e no mundo. Por isso, um dos campos que a enfermagem trabalha é no SCIH, realizando ações importantes para o combate de IRAS. Sendo assim, o artigo tem por objetivo relatar a experiência de acadêmicos de enfermagem da Universidade da Amazônia (UNAMA) em um SCIH de um hospital particular de Belém, Pará. Este estudo é descritivo com abordagem qualitativa, do tipo relato de experiência. Durante a experiência, notou-se a importância que a enfermagem possui no controle e prevenção das IRAS. De uma forma geral, percebeu-se a influência que um SCIH tem quando relacionado a qualidade do serviço do hospital, haja vista que, os profissionais seguem as normas estabelecidas, e isso influencia diretamente na segurança do paciente e do próprio trabalhador, trazendo benefícios para o paciente, colaboradores e serviços de saúde

ENDOCRINOLOGIA PEDIÁTRICA: ATUALIZAÇÕES EM DISTÚRBIOS HORMONAIS NA INFÂNCIA

  Pediatric endocrinology is a vital area of medicine that requires constant updating and research. By studying hormonal disorders in childhood and pediatric endocrinology, we can hope to improve the quality of life and care of children affected by these disorders. The aim of this study was to look at the latest updates on hormonal disorders in childhood, with a focus on pediatric endocrinology. To this end, a systematic literature review was carried out, selecting scientific studies published between 2019 and 2024, available in the Scielo, Medline and Lilacs databases. After analyzing the results, the main conclusion is that recent advances in genetic research have provided a deeper understanding of the molecular basis of pediatric hormonal disorders, such as Kallmann syndrome and Prader-Willi syndrome, paving the way for more targeted and effective therapies in the future.  A endocrinologia pediátrica é uma área vital da medicina que requer constante atualização e pesquisa. Por meio do estudo dos distúrbios hormonais na infância e da endocrinologia pediátrica, é possível esperar a melhoria da qualidade de vida e o cuidado das crianças afetadas por esses distúrbios. Trata-se de um estudo cujo objetivo foi estudar atualizações mais recentes em distúrbios hormonais na infância, com foco na endocrinologia pediátrica. Nesse sentido, realizou-se uma revisão sistemática de literatura, com a seleção de estudos científicos publicados entre os anos de 2019 e 2024, disponíveis nas bases de dados Scielo, Medline e Lilacs. Após análise dos resultados, a principal conclusão é que avanços recentes na pesquisa genética têm proporcionado uma compreensão mais profunda das bases moleculares de distúrbios hormonais pediátricos, como a síndrome de Kallmann e a Síndrome de Prader-Willi, abrindo caminho para terapias mais direcionadas e eficazes no futuro

Incidência da síndrome pré-menstrual na prática de esportes: aspectos atuais: Incidence of pre-menstrual syndrome in sports: current aspects

A síndrome pré-menstrual (SPM) é uma constelação complexa de alterações de humor, comportamentais e físicas que se limitam à fase pré-menstrual. Esses sintomas se recuperam dentro de alguns dias após o início da menstruação.  Assim, o objetivo desse estudo é demonstrar a incidência da síndrome pré-menstrual na prática de esportes a partir de uma revisão integrativa sobre o tema. Para isso, foi realizado uma revisão integrativa sobre o tema, onde foi considerado textos publicados desde 2010, em inglês e português e que estejam disponíveis para leitura, no PUBMED, LILACs e Scielo. Esta revisão sistemática fornece algum suporte adicional para diretrizes clínicas que recomendam o exercício como um tratamento eficaz para a TPM. As análises secundárias realizadas também fornecem novas evidências de que o exercício pode ser útil no alívio de sintomas psicológicos, físicos e comportamentais específicos associados à TPM, além de auxiliar no gerenciamento do perfil global de sintomas

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

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

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