Técnicas Minimamente Invasivas em Cirurgia Geral: Benefícios, Limitações e Futuras Perspectivas.

General surgery has been undergoing a revolution with the introduction and refinement of minimally invasive techniques (MITs), which are distinguished by offering lower postoperative morbidity and faster recovery when compared to conventional open techniques. This article reviews the current state, benefits, limitations, and future perspectives of MITs in general surgery, with an emphasis on laparoscopy, robotic surgery, and endoscopy. A detailed search strategy was carried out in academic databases, focusing on studies that report the clinical outcomes of MITs. The review synthesizes findings from relevant studies, assessing the efficacy of MITs in different clinical contexts. Comprehensive discussions are provided on the outcomes, with attention to current limitations, such as the learning curve and associated costs, and recommendations for future research are offered. Notably, the analysis of studies demonstrates that laparoscopy continues to be the gold standard for many procedures, while robotic surgery is growing, although its costs remain a limiting factor. Endoscopy has proven particularly promising for diagnostic and therapeutic gastrointestinal procedures. The article concludes by emphasizing the need for ongoing training, technological development, and cost-benefit assessments to maximize the potential of MITs.A cirurgia geral tem passado por uma revolução com a introdução e aperfeiçoamento das técnicas minimamente invasivas (TMIs), que se destacam por oferecer menor morbidade pós-operatória e recuperação mais rápida quando comparadas às técnicas convencionais abertas. Este artigo revisa o estado atual, os benefícios, limitações e perspectivas futuras das TMIs em cirurgia geral, com ênfase em laparoscopia, cirurgia robótica e endoscopia. Uma estratégia de busca detalhada foi realizada em bancos de dados acadêmicos, focando em estudos que relatam os resultados clínicos de TMIs. A revisão sintetiza descobertas de estudos relevantes, avaliando a eficácia das TMIs em diferentes contextos clínicos. Discussões abrangentes são fornecidas sobre os resultados, com atenção às limitações atuais, como a curva de aprendizado e os custos associados, e são oferecidas recomendações para pesquisa futura. Notavelmente, a análise de estudos demonstra que a laparoscopia continua a ser o padrão-ouro para muitos procedimentos, enquanto a cirurgia robótica está em crescimento, embora seus custos ainda sejam um fator limitante. A endoscopia mostrou-se particularmente promissora para procedimentos diagnósticos e terapêuticos gastrointestinais. O artigo conclui enfatizando a necessidade de treinamento contínuo, desenvolvimento tecnológico e avaliações de custo-benefício para maximizar o potencial das TMIs. &nbsp

Construção de cartilha com foco em saúde mental do idoso na pandemia pelo Covid-19 / Construction of a booklet focusing on mental health of the elderly in the pandemic by Covid-19

Introdução: Durante muito tempo, o conceito de saúde era entendido apenas como o estado de ausência de doença. Depois de muitos anos, a Organização Mundial da Saúde (OMS) modificou esse conceito para um estado completo de bem-estar físico, mental e social, permitindo uma visão mais abrangente. Principalmente no contexto de isolamento social provocado pela Pandemia do COVID-19, os idosos são um grupo etário prejudicado quando se trata de saúde mental. Objetivo: Construir uma cartilha sobre a saúde mental para idosos no contexto da pandemia pelo COVID-19. Método: Por meio de matérias educacionais médicos e matérias do Ministério da Saúde e Organização Pan-Americana de Saúde (OPAS), foram construídos resumos sobre a importância da vacinação e posteriormente sedimentados por discussões em grupos e finalizados com a editoração de uma cartilha contendo as informações. O material foi enviado para diversas unidades de saúde a fim de serem estratégias de conscientização. Resultados: O manual foi construído em capítulos como a definição do coronavirus, transmissão, isolamento social e saúde mental, sintomas de alerta de prejuízo mental e medidas de melhoria (como atividade física) sendo uma estratégia importante para a sedimentação de conhecimentos em educação em saúde de unidades básicas. Conclusão: Dessa forma, a construção da cartilha obteve resultados positivos para os discentes que a construíram e para a sociedade haja vista ter ocorrido o desenvolvimento de um material de educação em saúde disponível na atenção primária.   

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

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

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

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved