Reserva cognitiva no idoso: aspectos neuropsicológicos e o papel da educação nas últimas descobertas

A população idosa está crescendo mundialmente e, portanto, declínio cognitivo e demência são um grande problema para o sistema de saúde. Contudo, muito idosos não desenvolvem demência ou algum prejuízo cognitivo significativo, mesmo que apresentem lesões cerebrais, como atrofia e/ou lesões corticais, levando ao conceito de Reserva Cogntiva (RC). O principal objetivo dessa revisão é estabelecer as descobertas recentes da RC na cognição dos idosos e explorar alguns dos marcadores cognitivos relacionados à RC. Com o intuito de conseguirmos nosso objetivo, nós realizamos uma pesquisa por artigos publicados tanto em língua inglesa quanto portuguesa, nos últimos 5 anos, na base de dados Medline usando como palavras chave: reserve cognitiva, idoso e envelhecimento. Nós filtramos 14 estudos que abordavam especificamente aspectos neuropsicológicos (p.e, memória, atenção, orientação, função executiva) e os revisamos em detalhes. Baseados nesses artigos em relação a idosos, educação parece ter várias implicações na RC por fortalecer habilidades cognitivas, contudo não parece impactar no declínio cognitivo. Além disso, notamos que performance cognitiva é uma das formas de se medir RC, embora os métodos não possam ser padronizados, o que pode ser a causa de conclusões diversas. Em relação à RC, educação foi a medida mais prevalente e RC parece ter um efeito benéfico em função executiva e memória episódica, de forma que parece agir através tanto da reserva neural quanto da compensação neural. Exposição a textos impressos parece ser uma variável em potencial relacionada com a performance cognitiva e RC.The elderly population is growing worldwide, and therefore cognitive decline and dementia is a major problem for healthcare system. However, many elders do not develop dementia or significant cognitive impairment even though present brain lesions, such as cortical atrophy and/or lesions, leading to the concept of Cognitive Reserve (CR). The main objective of this review is to establish the recent findings of CR in elderly cognition and explore some of the cognitive markers related to CR. In order to accomplish that we carried out a search for papers published either in English or Portuguese language in the last 5 years in the Medline database using as keywords cognitive reserve, elderly and aging/ageing. We filtered 14 studies that specifically approached the neuropsychological aspects (e.g, memory, attention, orientation, executive function) and reviewed them in detail. Based on these papers regarding old-aged individuals, education appears to have several implications on CR by strengthening cognitive abilities, however does not appear to impact on cognitive decline. Besides, we realized that cognitive performance is one of the form to measure CR, even though the methods cannot be standardized, which may be the cause of some varied conclusions. Regarding CR, education was the most prevalent measure, and CR seems to have a beneficial effect on executive function and episodic memory and it seems to act by both neural reserve and neural compensation. Print exposure appears as a potential variable positively related to cognitive performance and CR

CIRURGIA BARIÁTRICA: INDICAÇÕES E TÉCNICAS CIRÚRGICAS

Obesity is a complex global health issue that demands an integrated approach. Understanding its epidemiology, risk factors, progression, early diagnosis, and social and economic implications is crucial to addressing this growing challenge. Bariatric surgery in the adult population is a dynamic and intricate field where techniques, indications, contraindications, complications, and historical evolution intricately intertwine. The examined literature reveals a continuous need for personalized and multidisciplinary approaches, considering not only the physical but also the psychological and social aspects of patients undergoing this intervention. Surgical techniques in addressing obesity have specificities that should be carefully evaluated by healthcare professionals. The reviewed literature provides valuable insights to support clinical decisions, highlighting the benefits and specific considerations associated with adjustable gastric banding, vertical gastrectomy, and gastric bypass. The significance of the multidisciplinary team in bariatric surgery lies in the comprehensive approach to the patient, addressing various medical, nutritional, psychological, and social aspects involved. This collaborative approach is essential to ensure successful outcomes, patient satisfaction, and the prevention of short- and long-term complications.A obesidade é um problema de saúde global complexo que exige uma abordagem integrada. A compreensão de sua epidemiologia, fatores de risco, evolução, diagnóstico precoce e implicações sociais e econômicas é crucial para enfrentar esse desafio crescente. a cirurgia bariátrica na população adulta é um campo dinâmico e complexo, onde as técnicas, indicações, contraindicações, complicações e a evolução histórica se entrelaçam de maneira intrincada. A literatura examinada revela a necessidade contínua de abordagens personalizadas e multidisciplinares, considerando não apenas os aspectos físicos, mas também os psicológicos e sociais dos pacientes submetidos a essa intervenção. as técnicas cirúrgicas na abordagem da obesidade apresentam particularidades que devem ser cuidadosamente avaliadas pelos profissionais de saúde. A literatura revisada fornece subsídios valiosos para embasar decisões clínicas, evidenciando os benefícios e as considerações específicas associadas à banda gástrica ajustável, à gastrectomia vertical e ao bypass gástrico. A importância da equipe multidisciplinar na cirurgia bariátrica reside na abordagem integral do paciente, contemplando os diversos aspectos médicos, nutricionais, psicológicos e sociais envolvidos. Essa abordagem colaborativa é essencial para garantir resultados bem-sucedidos, a satisfação do paciente e a prevenção de complicações a curto e longo prazo

O PAPEL DA CIRURGIA BARIÁTRICA NA REDUÇÃO DA OBESIDADE E NA REMISSÃO DE DOENÇAS METABÓLICAS

This literature review investigates the impact of bariatric surgery on obesity reduction and remission of associated metabolic diseases, such as type 2 diabetes, arterial hypertension, and sleep apnea. Through a comprehensive analysis of clinical and observational studies, we identified consistent evidence of the benefits of bariatric surgery in promoting sustained weight loss and improving metabolic comorbidities in obese patients. The results indicate that bariatric surgery can lead to remission of type 2 diabetes, reduction in blood pressure, and improvement of sleep apnea symptoms. However, careful assessment of individual risks and benefits is warranted before recommending this procedure. This review highlights the importance of bariatric surgery as an effective tool in the treatment of obesity and its metabolic complications, offering new perspectives for the management of these chronic conditions.Esta revisão da literatura investiga o impacto da cirurgia bariátrica na redução da obesidade e na remissão de doenças metabólicas associadas, como diabetes tipo 2, hipertensão arterial e apneia do sono. A partir de uma análise abrangente de estudos clínicos e observacionais, identificamos consistentes evidências dos benefícios da cirurgia bariátrica na promoção da perda de peso sustentada e na melhoria das comorbidades metabólicas em pacientes obesos. Os resultados indicam que a cirurgia bariátrica pode levar à remissão do diabetes tipo 2, redução da pressão arterial e melhoria dos sintomas da apneia do sono. No entanto, ressalta-se a necessidade de uma avaliação cuidadosa dos riscos e benefícios individuais antes da indicação desse procedimento. Esta revisão destaca a importância da cirurgia bariátrica como uma ferramenta eficaz no tratamento da obesidade e suas complicações metabólicas, oferecendo novas perspectivas para a gestão dessas condições crônicas

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Uso de AAS em pacientes cardiopatas e ocorrência de Úlcera Perfurada quais as melhores soluções? uma revisão sistemática com metánalise

A administração do ácido acetilsalicílico (AAS) é uma das medidas indicadaspelos médicos em caso de suspeita de infarto agudo do miocárdio. De acordo com os especialistas, o medicamento serve para diminuir a agregação de plaquetas e inibir a formação de coágulos no interior das artérias. O objetivo deste estudo é verificar na literatura o uso do Ácido Acetilsalicílico (AAS) em pessoas cardiopatas e sua possível relação com o aparecimento de úlcera. Trata-se de uma revisão sistemática com base em publicações, dos último cinco anos, que essa temática, extraídas de bases de dados eletrônicas como Scielo, PubMed, Lilacs, BVS, Embase e Medline, em língua inglesa e portuguesa. Dos estudo que se aproximaram do objetivo da pesquisa, muitos não relataram a estreita relação entre o uso AAS e o surgimento de úlcera. Assim, espera-se que este estudo sirva de incentivo para que mais estudos sejam realizados sobre essa temática afim de estabelecer e conhecer se há alguma relação entre o fármaco e a doença

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

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

O império dos mil anos e a arte do "tempo barroco": a águia bicéfala como emblema da Cristandade

The article reveals that between the mid-17th century and the mid-18th century, in the ecclesiastical world of the religious orders (Jesuits, franciscans, Carmelites, Cistercians, Augustinian, etc.) and the episcopate, there was the progressive adoption of the imperial symbol, the double-headed eagle, attribute of the Christian Empire, the germanic Holy Roman Empire emblem. However, in the religious field, this imperial eagle of the baroque time appears without the political insignia (sword, scepter and the imperial orb), adorning altars, monstrances, trumphal archs, facades of temples, doors, walls, domes, pulpits, sacred washbasins, sculptures and paintings of the Virgin and Child, liturgical robes, etc.; therefore related to the cult and the dogmas of the Catholic faith - in artistic works, the association between the double eagle and the flesh-spirit or human-divine unity, axial principle of the Catholic faith, represented by Virgin-Mother and Christ, is often indicated directly. The research has located and identified numerous remnants of the double eagle emblem in religious field in Portugal and Spain and in their conquests and dominions in America, Asia and Africa, and also in Italy, and the historiography on painful birth of the modern era in the West has never realized this phenomenon. Symbolizing absolute power, universal power, these works with sacred significance, as the ecclesiastical discourse of the time, demonstrate movement occurred in religious plane. With the aim to assert not only spiritual but also temporal power of Christ and his mystical body, the Church was impelled by the idea of restoring the "Republica Christiana" or Christendon - disrupted by conflicts of power and faith - and of introducing a Universal Apostolic Monarchy extended to all mankind: the Empire of the Last Days, the Empire of Christ in the world, the fifth Empire