Case report: Psychosis in Systemic Lupus Erythematosus

RESUMO Introdução: o Lúpus Eritematoso Sistêmico (LES) é uma doença autoimune sistêmica crônica de etiologia multifatorial. Um dos focos inflamatórios da doença pode atingir o sistema nervoso central causando manifestações psiquiátricas, no caso, o transtorno psicótico. Desenvolvimento: No caso apresentado observamos um Transtorno Psicótico devido a outra condição médica, induzido pela presença do LES, doença sistêmica, autoimune e crônica. Na literatura podemos observar a concomitância do LES com diversos transtornos psiquiátricos, como psicose, ansiedade e depressão. Entretanto é necessário cautela e exclusão de outras causas para essas alterações para afirmar a influência direta do LES. Considerações finais: A paciente em questão teve o diagnóstico de LES em 2004, apresentando na atual descrição do caso uma agudização da doença induzida por provável fator estressor, apresentando assim, a recidiva do comportamento psicótico. Assim, observa-se que o caso se trata de um evento raro da clínica de LES, sendo um importante diagnóstico diferencial para casos de psicose secundária a doença clínica. PALAVRAS CHAVE: Lúpus; Manifestações neuropsiquiátricas.ABSTRACT Introduction: Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease of multifactorial etiology. One of the inflammatory focus of the disease can reach the central nervous system causing psychiatric manifestations, in the case, the psychotic disorder. Development: In the case presented we observed a Psychotic Disorder due to another medical condition, induced by the presence of a systemic disease, autoimmune and chronic, SLE. In literature we can observe the concomitance of several psychiatric disorders with SLE, such as psychosis, anxiety and depression. However, caution and exclusion of other causes for these changes is necessary to affirm the direct influence of SLE. Final considerations: The patient in question was diagnosed with SLE in 2004, presenting, in the current description of the case, a worsening of the disease induced by a probable stressor factor, thus presenting a recurrence of psychotic behavior. Therefore, it is observed that this case is a rare event of the SLE clinic, being an important differential diagnosis for cases of psychosis secondary to clinical disease.   KEYWORDS: Lupus; Neuropsychiatric manifestations

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