Fraturas proximais do fêmur em idosos: qual o melhor tratamento? Proximal fracture of the femur on the elderly: what's the best treatment?

As fraturas proximais do fêmur em idosos representam um sério problema dentro do contexto da saúde pública, devido aos elevados custos econômicos para o tratamento e as suas consequências, assim como pela alta taxa de morbidade e mortalidade. O objetivo desse estudo foi discutir quais os tratamentos mais indicados para esse tipo de fratura, em idosos, por meio de uma revisão da literatura. As bases de dados pesquisadas foram MEDLINE, COCHRANE e PEDro. Os critérios de inclusão foram estudos publicados nos últimos sete anos; nos idiomas português, inglês e espanhol; realizados em seres humanos, sem distinção de gênero e com idade maior que 60 anos; estudos com desenho metodológico de ensaios clínicos, ensaios clínicos aleatorizados e revisões sistemáticas com e sem meta-análise. Foram encontrados sete artigos e após a análise pode se afirmar que não existe um tratamento específico para as fraturas proximais do fêmur em idosos. O tratamento normalmente indicado na maioria dessas fraturas é cirúrgico e requer envolvimento fisioterápico para uma reabilitação adequada. Apesar da dificuldade de comparação entre os estudos, foi observado que uma equipe de profissionais da saúde parece promover uma reabilitação mais efetiva, além de prevenir complicações.<br>The proximal fractures of the femur on the elderly represent a serious problem inside the public health context, because of the high economic costs needed for the treatment and it's consequence, as the high taxes of morbidity and mortality. The goal of this study was to discuss, through a literature revision, which is the most indicated treatment for the proximal fractures of the femur, on the elderly. The researched data bases were MEDLINE, COCHRANE and PEDro. The inclusion criterions were published studies on the last seven years, only on the Portuguese, English and Spanish languages, accomplished on human beings, with no genre distinction and with ages above 60 years old, with methodology draw of clinic research, random clinical research and systematic revisions with and without meta-analyses. Seven articles were found and after the analysis, it can be affirmed that there is no specific treatment for the proximal fractures of the femur on the elderly. The normal treatment indicated in most of these fractures is chirurgic and it requires physiotherapy involvement for an adjusted rehabilitation. Despite of the difficulty to compare the studies, was observed that a team of health professionals seems to promote a more effective rehabilitation, beyond prevent complications

ESA WorldCover 10 m 2020 v100

ESA WorldCover 10 m 2020 v100 The European Space Agency (ESA) WorldCover 10 m 2020 product provides a global land cover map for 2020 at 10 m resolution based on Sentinel-1 and Sentinel-2 data. The WorldCover product comes with 11 land cover classes, aligned with UN-FAO's Land Cover Classification System, and has been generated in the framework of the ESA WorldCover project. The WorldCover product is developed by a consortium lead by VITO Remote Sensing together with partners Brockmann Consult, CS SI, Gamma Remote Sensing AG, IIASA and Wageningen Universit

ICON-Sapphire: simulating the components of the Earth System and their interactions at kilometer and subkilometer scales. In open review for Geoscientific Model Development

State-of-the-art Earth System models typically employ grid spacings of O(100 km), too coarse to explicitly resolve main drivers of the flow of energy and matter across the Earth System. In this paper, we present the new ICON-Sapphire model configuration, which targets a representation of the components of the Earth System and their interactions with a grid spacing of 10 km and finer. Through the use of selected simulation examples, we demonstrate that ICON-Sapphire can already now (i) be run coupled globally on seasonal time scales with a grid spacing of 5 km and on monthly time scales with a grid spacing of 2.5 km, (ii) resolve large eddies in the atmosphere using hectometer grid spacings on limited-area domains in atmosphere-only simulations, (iii) resolve submesoscale ocean eddies by using a global uniform grid of 1.25 km or a telescoping grid with a finest grid spacing of 530 m, the latter coupled to a uniform atmosphere and (iv) simulate biogeochemistry in an ocean-only simulation integrated for 4 years at 10 km. Comparison to observations of these various configurations reveals no obvious pitfall. The throughput of the coupled 5-km global simulation is 126 simulated days per day employing 21 % of the latest machine of the German Climate Computing Center. Extrapolating from these results, multi-decadal global simulations including interactive carbon are now possible and short global simulations resolving large eddies in the atmosphere and submesoscale eddies in the ocean are within reac