ENDOCRINOLOGIA E SUAS MANIFESTAÇÕES CLÍNICAS, SÍNDROME DE CUSHING IATROGÊNICA REVISÃO DE LITERATURA

Exogenous corticosteroids, also known as GC, were introduced into medical practice because they imitate the natural action of cortisol, the body's main corticosteroid. Although they are widely used due to their benefits, they do not require a prescription to purchase and can be used for long periods without patients being aware of the potential health risks. The indiscriminate use of exogenous corticosteroids can result in a wide variety of side effects, ranging from aesthetic problems to serious complications. A worrying condition caused by excessive or prolonged use of corticosteroids is Iatrogenic Cushing's Syndrome (ICS), with prednisone ingestion being the most common cause, commonly used in the treatment of diseases unrelated to the endocrine glands. Corticosteroids act by inhibiting the release of ACTH by the pituitary and hypothalamus, resulting in the suppression of adrenal function through negative feedback. Furthermore, they significantly impact bone metabolism, interfering with the absorption and excretion of calcium by the kidney, also affecting the functioning of other body systems, such as mood control, immune response and nutrient metabolism. The diagnosis of IBS is based on clinical findings and symptoms, and is rarely confirmed by biochemical tests. IBS treatment aims to reduce exposure to corticosteroids and adopt measures to minimize their adverse effects. This study aims to explore pathophysiological, clinical and laboratory aspects of SCI, as well as discuss pharmacological and non-pharmacological strategies for its management.Os corticoides exógenos, também conhecidos como GC, foram inseridos na prática médica por imitarem a ação natural do cortisol, principal corticoide do corpo. Embora sejam amplamente utilizados devido aos seus benefícios, não exigem receita médica para a compra e podem ser usados por longos períodos sem consciência dos potenciais riscos à saúde pelos pacientes. O uso indiscriminado de corticoides exógenos pode resultar em uma variedade extensa de efeitos colaterais, que vão desde problemas estéticos até complicações graves. Uma condição preocupante provocada pelo uso excessivo ou prolongado de corticoides é a Síndrome de Cushing Iatrogênica (SCI), sendo a ingestão de prednisona a causa mais comum, comumente utilizada no tratamento de doenças não relacionadas às glândulas endócrinas. Os corticoides atuam inibindo a liberação de ACTH pela hipófise e hipotálamo, resultando na supressão da função adrenal por meio de feedback negativo. Além disso, eles impactam significativamente no metabolismo do osso, interferindo na absorção e excreção de cálcio pelo rim, afetando também o funcionamento de outros sistemas do corpo, como o controle do humor, resposta imune e metabolismo de nutrientes. O diagnóstico da SCI é baseado em achados clínicos e sintomas, sendo raramente confirmado por testes bioquímicos. O tratamento da SCI visa reduzir a exposição aos corticoides e adotar medidas para minimizar seus efeitos adversos. Este estudo tem como objetivo explorar aspectos fisiopatológicos, clínicos e laboratoriais da SCI, assim como discutir estratégias farmacológicas e não farmacológicas para o seu manejo

PRINCÍPIOS DOS EFEITOS ANESTÉSICOS NA RAQUIMEDULAR EM FOCO NA PEDIATRIA : REVISÃO DE LITERATURA

Spinal anesthesia is a technique widely used in pediatric surgical procedures, providing effective blockage of sensation and movement in the lower limbs and pelvis, while preserving the patient's consciousness. Its application to children requires specific care due to anatomical, physiological and psychological differences compared to adults. The efficacy, safety and potential complications associated with spinal anesthesia in children have been topics of increasing interest in the medical literature. In this context, a systematic literature review becomes essential to gather and analyze the available data, in order to provide a complete overview of the scientific evidence on the use of spinal anesthesia in children. Objective: Critically considers studies published in the last 10 years on pediatric spinal anesthesia. We hope to analyze the effectiveness, safety, complications and clinical results associated with this technique in the pediatric population and contribute to improving clinical practice and safety of surgical procedures involving children.methodology: The systematic literature search was carried out according to the PRISMAS checklist guidelines, we used four databases: PubMed, Scielo, Web of Science and we searched for articles published in the last 10 years. Five descriptors were applied: “spinal anesthesia”, “pediatrics”, “effectiveness”, “safety” and “complications”. The Inclusion Criteria were: Studies published in the last 10 years; Studies that investigated spinal anesthesia in pediatric patients (age ≤ 18 years) and Studies that reported data related to the efficacy, safety or complications of spinal anesthesia in children. The Exclusion Criteria were: Studies in languages ​​other than Portuguese and English; Studies in which data were insufficient or not publicly available and Studies that focused exclusively on adults or did not present data specific to the pediatric population. Results: the systematic review included a total of 15 studies that met the inclusion criteria. The results indicate the overall effectiveness of spinal anesthesia in children, with satisfactory anesthetic success rates and an acceptable safety profile. Complications, when they occurred, were generally mild and transient. Additionally, the review identified specific risk factors that may affect the effectiveness and safety of spinal anesthesia in children. Conclusion: suggests that this technique is effective and safe in children and generally presents manageable complications. However, more studies are needed to deepen the understanding of risk factors and refine clinical practice. This review provides useful information for healthcare professionals working in pediatric anesthetics. and emphasizes the importance of adapting anesthetic methods to this specific population.A anestesia raquimedular é uma técnica amplamente utilizada em procedimentos cirúrgicos pediátricos, proporcionando bloqueio eficaz da sensação e do movimento em membros inferiores e pelve, enquanto preserva a consciência do paciente. A sua aplicação em crianças requer cuidados específicos devido às diferenças anatômicas, fisiológicas e psicológicas em relação aos adultos. A eficácia, segurança e as potenciais complicações associadas à anestesia raquimedular em crianças têm sido temas de interesse crescente na literatura médica. Neste contexto, uma revisão sistemática de literatura se torna fundamental para reunir e analisar os dados disponíveis, a fim de fornecer um panorama completo das evidências científicas sobre a utilização da anestesia raquimedular em crianças. Objetivo: Considera criticamente estudos publicados nos últimos 10 anos sobre raquianestesia pediátrica. Aguardamos analisar a efetividade, segurança, complicações e resultados clínicos associados a esta técnica na população pediátrica e contribuir para a melhoria da prática clínica e segurança dos procedimentos cirúrgicos envolvendo crianças. metodologia: A busca sistemática da literatura foi realizada de acordo com as diretrizes do checklist PRISMAS, utilizamos quatro bases de dados: PubMed, Scielo, Web of Science e buscamos artigos publicados nos últimos 10 anos. Foram aplicados cinco descritores: “raquianestesia”, “pediatria”, “efetividade”, “segurança” e “complicações”.Os Critérios de Inclusão foram: Estudos publicados nos últimos 10 anos; Estudos que investigaram a anestesia raquimedular em pacientes pediátricos (idade ≤ 18 anos) e Estudos que relataram dados relacionados à eficácia, segurança ou complicações da anestesia raquimedular em crianças. Os Critérios de Exclusão foram: Estudos em idiomas diferentes do português e do inglês; Estudos em que os dados eram insuficientes ou não estavam disponíveis publicamente e Estudos que focaram exclusivamente em adultos ou não apresentaram dados específicos para a população pediátrica. Resultados: a revisão sistemática incluiu um total de 15 estudos que atenderam aos critérios de inclusão. Os resultados indicam a eficácia global da raquianestesia em crianças, com taxas de sucesso anestésico satisfatórias e um perfil de segurança aceitável. As complicações, quando ocorriam, eram geralmente leves e transitórias. Além disso, a revisão identificou fatores de risco específicos que podem afetar a eficácia e a segurança da raquianestesia em crianças. Conclusão: sugere que esta técnica é eficaz e segura em crianças e geralmente apresenta complicações controláveis. No entanto, mais estudos são necessários para aprofundar a compreensão dos fatores de risco e refinar a prática clínica. Esta revisão oferece informações úteis para profissionais de saúde que trabalham em anestésico pediátrica. e enfatiza a importância de adequar os métodos anestésicos para esta população específica

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

NEOTROPICAL XENARTHRANS: a data set of occurrence of xenarthran species in the Neotropics

Xenarthrans—anteaters, sloths, and armadillos—have essential functions for ecosystem maintenance, such as insect control and nutrient cycling, playing key roles as ecosystem engineers. Because of habitat loss and fragmentation, hunting pressure, and conflicts with domestic dogs, these species have been threatened locally, regionally, or even across their full distribution ranges. The Neotropics harbor 21 species of armadillos, 10 anteaters, and 6 sloths. Our data set includes the families Chlamyphoridae (13), Dasypodidae (7), Myrmecophagidae (3), Bradypodidae (4), and Megalonychidae (2). We have no occurrence data on Dasypus pilosus (Dasypodidae). Regarding Cyclopedidae, until recently, only one species was recognized, but new genetic studies have revealed that the group is represented by seven species. In this data paper, we compiled a total of 42,528 records of 31 species, represented by occurrence and quantitative data, totaling 24,847 unique georeferenced records. The geographic range is from the southern United States, Mexico, and Caribbean countries at the northern portion of the Neotropics, to the austral distribution in Argentina, Paraguay, Chile, and Uruguay. Regarding anteaters, Myrmecophaga tridactyla has the most records (n = 5,941), and Cyclopes sp. have the fewest (n = 240). The armadillo species with the most data is Dasypus novemcinctus (n = 11,588), and the fewest data are recorded for Calyptophractus retusus (n = 33). With regard to sloth species, Bradypus variegatus has the most records (n = 962), and Bradypus pygmaeus has the fewest (n = 12). Our main objective with Neotropical Xenarthrans is to make occurrence and quantitative data available to facilitate more ecological research, particularly if we integrate the xenarthran data with other data sets of Neotropical Series that will become available very soon (i.e., Neotropical Carnivores, Neotropical Invasive Mammals, and Neotropical Hunters and Dogs). Therefore, studies on trophic cascades, hunting pressure, habitat loss, fragmentation effects, species invasion, and climate change effects will be possible with the Neotropical Xenarthrans data set. Please cite this data paper when using its data in publications. We also request that researchers and teachers inform us of how they are using these data