ANESTESIA OBSTÉTRICA: GERENCIAMENTO DE RISCOS, MANEJO DA DOR E MELHORES PRÁTICAS

Introduction: In general, the main function of obstetric anesthesia is pain relief, in addition to mitigating the risks of possible interference that may occur during labor. In this way, in conjunction with other clinical practices, there is greater safety offered to the patient, since care strategies and risk monitoring plans are increasingly improved and efficient. The efficiency noted is due to technological advances in the pharmacological area and in the field of health in general. Objective: Understand the benefits and efficiency of obstetric anesthesia. Methodology: A systematic literature review was carried out covering the years from January 2003 to December 2023. The study was based and guided by the question mentioned throughout the article. Results: Anesthetic practice has gone through several stages of evolution and has undergone significant changes involving the substances used and the anesthetic process itself. This guarantees a more adequate, controlled and safe maternal experience. One of the advances noted was the use of regional anesthesia, such as epidural analgesia. Conclusion: Advances have a direct influence on mitigating the number of adverse events during the labor period, since births currently occur safely and more quickly due to this set of modern advances.Introdução: De maneira geral, a principal função da anestesia obstétrica é alívio da dor, além de amenizar os riscos de possíveis interferências que podem acontecer durante o trabalho de parto. Desse modo, em conjunto com outras práticas clínicas, observa-se uma maior segurança ofertada ao paciente, uma vez que as estratégias de cuidado e os planos de monitoramento de riscos estão cada vez mais aprimoradas e eficientes. A eficiência notada é por conta dos avanços tecnológicos na área farmacológica e no âmbito de saúde em geral. Objetivo: Compreender os benefícios e a eficiência da anestesia obstétrica. Metodologia: Foi realizada uma revisão sistemática de literatura abrangendo os anos de janeiro de 2003 a dezembro de 2023. O estudo teve como base e norteamento a pergunta citada no decorrer do artigo. Resultados: A prática anestésica passou por várias etapas de evolução e passou por mudanças significativas envolvendo as substâncias utilizadas e o processo anestésico em si. Garantindo dessa forma, uma experiência materna mais adequada, controlada e segura. Um dos avanços notados foi a utilização de anestesias regionais, tais como as analgesias epidurais. Conclusão: Os avanços possuem influência direta com a mitigação do número de eventos adversos no período de trabalho de parto, uma vez que atualmente os partos acontecem de forma segura e mais rápida por conta desse conjunto de avanços modernos. Palavras-chave: Trabalho de Parto, Anestesia, Avanços Tecnológicos, Eficiência

A importância do potássio na dieta sobre a regulação da pressão arterial

A Hipertensão Arterial Sistêmica (HAS) é uma Doença Crônica Não Transmissível (DCNT) que pode ser causada por fatores de risco não modificáveis e modificáveis. Dentre os minerais, o potássio tem demonstrado uma função importante no controle da pressão arterial. Diante disso, o objetivo do estudo foi realizar uma revisão narrativa de literatura acerca da importância do potássio na dieta sobre a regulação da pressão arterial. Para tanto, foram utilizadas para a pesquisa, as bases de dados Periódicos Capes e livro do período entre 2004 e 2022. Dentre os principais achados científicos, foi evidenciado que, o aumento da ingestão de potássio através do consumo de frutas, legumes e verduras que são os alimentos com maiores concentrações desse mineral contribui para a prevenção e o tratamento da HAS, pois, uma ingestão de potássio de 3,5 g/dia a 4,7 g/dia demonstra ter efeitos diretos na diminuição da pressão arterial

Cirurgia plástica: avanços e desafios na modernidade

A cirurgia plástica, um dos procedimentos estéticos mais realizados no mundo, se transforma todos os dias, especialmente por conta da tecnologia. Com o auxílio de máquinas e equipamentos inovadores, otimizou-se diversos procedimentos. Dessa maneira, a presente revisão sistemática objetivou: Descrever os avanços e desafios da cirurgia plástica na modernidade. Além disso, buscou-se elencar os principais avanços e desafios da realização desses procedimentos e também mostrar a história da cirurgia plástica. A estratégia de seleção dos artigos seguiu as seguintes etapas: busca nas bases de dados selecionadas (BVS, Google acadêmico e Scielo) com os descritores: Procedimentos estéticos, tecnologia e pacientes, ao final, 10 artigos foram selecionados para a elaboração deste estudo. Os resultados alcançados nesta revisão sistemática mostram que muitos foram os avanços da  cirurgia plástica com passar dos anos, ela recupera e devolve a autoestima e bem-estar dos pacientes

International consensus recommendations for eosinophilic gastrointestinal disease nomenclature.

BACKGROUND & AIMS Substantial heterogeneity in terminology used for eosinophilic gastrointestinal diseases (EGID), particularly the catchall term "eosinophilic gastroenteritis", limits clinical and research advances. We aimed to achieve an international consensus for standardized EGID nomenclature. METHODS This consensus process utilized Delphi methodology. An initial naming framework was proposed and refined in iterative fashion, then assessed in a first round of Delphi voting. Results were discussed in two consensus meetings, the framework was updated, and re-assessed in a second Delphi vote, with a 70% threshold set for agreement. RESULTS Of 91 experts participating, 85 (93%) completed the first and 82 (90%) completed the second Delphi surveys. Consensus was reached on all but two statements. "EGID" was the preferred umbrella term for disorders of GI tract eosinophilic inflammation in the absence of secondary causes (100% agreement). Involved GI tract segments will be named specifically and use an "Eo" abbreviation convention: eosinophilic gastritis (now abbreviated EoG), eosinophilic enteritis (EoN), and eosinophilic colitis (EoC). The term "eosinophilic gastroenteritis" is no longer preferred as the overall name (96% agreement). When >2 GI tract areas are involved, the name should reflect all of the involved areas. CONCLUSIONS This international process resulted in consensus for updated EGID nomenclature for both clinical and research use. EGID will be the umbrella term rather than "eosinophilic gastroenteritis", and specific naming conventions by location of GI tract involvement are recommended. As more data are developed, this framework can be updated to reflect best practices and the underlying science

Long-term safety and efficacy of patisiran for hereditary transthyretin-mediated amyloidosis with polyneuropathy: 12-month results of an open-label extension study

© 2020 Elsevier Ltd. All rights reserved.Background: Hereditary transthyretin-mediated amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We assessed the safety and efficacy of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Methods: This multicentre, open-label extension (OLE) trial enrolled patients at 43 hospitals or clinical centres in 19 countries as of Sept 24, 2018. Patients were eligible if they had completed the phase 3 APOLLO or phase 2 OLE parent studies and tolerated the study drug. Eligible patients from APOLLO (patisiran and placebo groups) and the phase 2 OLE (patisiran group) studies enrolled in this global OLE trial and received patisiran 0·3 mg/kg by intravenous infusion every 3 weeks with plans to continue to do so for up to 5 years. Efficacy assessments included measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress, with analysis by study groups (APOLLO-placebo, APOLLO-patisiran, phase 2 OLE patisiran) based on allocation in the parent trial. The global OLE is ongoing with no new enrolment, and current findings are based on the interim analysis of the patients who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received one or more dose of patisiran up to the data cutoff. This study is registered with ClinicalTrials.gov, NCT02510261. Findings: Between July 13, 2015, and Aug 21, 2017, of 212 eligible patients, 211 were enrolled: 137 patients from the APOLLO-patisiran group, 49 from the APOLLO-placebo group, and 25 from the phase 2 OLE patisiran group. At the data cutoff on Sept 24, 2018, 126 (92%) of 137 patients from the APOLLO-patisiran group, 38 (78%) of 49 from the APOLLO-placebo group, and 25 (100%) of 25 from the phase 2 OLE patisiran group had completed 12-month assessments. At 12 months, improvements in mNIS+7 with patisiran were sustained from parent study baseline with treatment in the global OLE (APOLLO-patisiran mean change -4·0, 95 % CI -7·7 to -0·3; phase 2 OLE patisiran -4·7, -11·9 to 2·4). Mean mNIS+7 score improved from global OLE enrolment in the APOLLO-placebo group (mean change from global OLE enrolment -1·4, 95% CI -6·2 to 3·5). Overall, 204 (97%) of 211 patients reported adverse events, 82 (39%) reported serious adverse events, and there were 23 (11%) deaths. Serious adverse events were more frequent in the APOLLO-placebo group (28 [57%] of 49) than in the APOLLO-patisiran (48 [35%] of 137) or phase 2 OLE patisiran (six [24%] of 25) groups. The most common treatment-related adverse event was mild or moderate infusion-related reactions. The frequency of deaths in the global OLE was higher in the APOLLO-placebo group (13 [27%] of 49), who had a higher disease burden than the APOLLO-patisiran (ten [7%] of 137) and phase 2 OLE patisiran (0 of 25) groups. Interpretation: In this interim 12-month analysis of the ongoing global OLE study, patisiran appeared to maintain efficacy with an acceptable safety profile in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Continued long-term follow-up will be important for the overall assessment of safety and efficacy with patisiran.info:eu-repo/semantics/publishedVersio