CUIDADOS INTENSIVOS EM PACIENTES CRÍTICOS SUBMETIDOS A CIRURGIAS COMPLEXAS

The research addressed intensive care for critically ill patients undergoing complex surgeries. The introduction outlined the importance of intensive care for postoperative recovery in critically ill patients. The objectives were to explore best practices and strategies to optimize these cares. The methodology used was an integrative review, covering studies from the last five years in the Scientific Electronic Library Online (SCIELO) and Latin American and Caribbean Health Sciences Literature (LILACS) databases. Health sciences descriptors such as “intensive care,” “critically ill patients,” and “complex surgeries” were used. The results highlighted interventions that improve recovery and reduce complications. The conclusions emphasize the need for strict protocols and continuous training for the intensive care team. A pesquisa abordou os cuidados intensivos em pacientes críticos submetidos a cirurgias complexas. A introdução delineou a importância dos cuidados intensivos para a recuperação de pacientes críticos pós-cirúrgicos. Os objetivos foram explorar as melhores práticas e estratégias para otimizar esses cuidados. A metodologia utilizada foi a revisão integrativa, abrangendo estudos dos últimos cinco anos nas bases Scientific Electronic Library Online (SCIELO) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS). Foram utilizados descritores em ciências da saúde como “cuidados intensivos”, “pacientes críticos” e “cirurgias complexas”. Os resultados destacaram intervenções que melhoram a recuperação e reduzem complicações. As conclusões enfatizam a necessidade de protocolos rigorosos e treinamento contínuo para a equipe de cuidados intensivos

SÍNDROME DE CROHN E INTERVENÇÕES CIRÚRGICAS: ENFOQUE INTEGRADO EM ANESTESIA E CIRURGIA GERAL

 Crohn's Syndrome is a chronic inflammatory disease of the gastrointestinal tract, characterized by periods of activity and remission, which can result in serious complications, such as strictures, fistulas and abscesses. Although initial treatment involves the use of medication, a significant portion of patients with Crohn's Syndrome end up requiring surgical interventions. In this context, the integrated approach between anesthesia and general surgery plays a fundamental role, ensuring not only the effectiveness of the surgical procedure, but also the safety and well-being of the patient. Objective: To discuss the main considerations involved in the anesthetic and surgical management of Crohn's Syndrome, highlighting the importance of an integrated approach to optimize clinical results and patients' quality of life. Methodology: The Cochrane, Scielo and Medline databases were used, with articles published between 2017 and 2023, available in English or Portuguese. Final Considerations: In view of the complexity of Crohn's Syndrome, an integrated approach between anesthesia and general surgery is essential to ensure successful surgical results and a better quality of life for patients. Furthermore, customizing the treatment plan, considering each patient's individual needs, and ongoing education about the disease are crucial to optimizing long-term results.A Síndrome de Crohn é uma doença inflamatória crônica do trato gastrointestinal, caracterizada por períodos de atividade e remissão, que pode resultar em complicações graves, como estenoses, fístulas e abscessos. Embora o tratamento inicial envolva o uso de medicamentos, uma parcela significativa dos pacientes com Síndrome de Crohn acabam necessitando de intervenções cirúrgicas. Nesse contexto, a abordagem integrada entre anestesia e cirurgia geral desempenha um papel fundamental, garantindo não apenas a eficácia do procedimento cirúrgico, mas também a segurança e o bem-estar do paciente. Objetivo: Discutir as principais considerações envolvidas no manejo anestésico e cirúrgico da Síndrome de Crohn, destacando a importância da abordagem integrada para otimizar os resultados clínicos e a qualidade de vida dos pacientes. Metodologia: Foram utilizadas as bases de dados Cochrane, Scielo e Medline, com artigos publicados entre os anos 2017 e 2023, disponíveis em inglês ou português.  Considerações Finais: Em vista da complexidade da Síndrome de Crohn, uma abordagem integrada entre anestesia e cirurgia geral é essencial para garantir resultados cirúrgicos bem-sucedidos e melhor qualidade de vida para os pacientes. Além disso, a personalização do plano de tratamento, considerando as necessidades individuais de cada paciente, e a educação contínua sobre a doença são cruciais para otimizar os resultados a longo prazo

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

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq