Arritmias Cardíacas em Crianças com Cardiopatias Congênitas: Desafios Diagnósticos e Terapêuticos

This condensed summary addresses the diagnostic and therapeutic challenges of cardiac arrhythmias in children with congenital heart disease. A systematic review was conducted with searches in PubMed and Google Scholar, resulting in the selection and qualitative analysis of relevant studies. The results highlight the complexity of these challenges, emphasizing the importance of a multidisciplinary and personalized approach to optimize clinical outcomes. In conclusion, the integration of diagnostic, therapeutic, and genetic strategies is crucial in this context.Este resumo aborda os desafios diagnósticos e terapêuticos das arritmias cardíacas em crianças com cardiopatias congênitas. Uma revisão sistemática foi conduzida com busca na PubMed e Google Scholar, resultando na seleção e análise qualitativa de estudos relevantes. Os resultados destacam a complexidade desses desafios, ressaltando a importância da abordagem multidisciplinar e personalizada para otimizar os desfechos clínicos. Em conclusão, a integração de estratégias diagnósticas, terapêuticas e genéticas é crucial nesse contexto

Eficácia e Segurança de Regimes Antibióticos no Tratamento da Osteomielite em Pacientes Adultos: Revisão Sistemática

This systematic review examines the efficacy and safety of different antibiotic regimens in the treatment of osteomyelitis in adult patients. Searches were conducted in electronic databases to identify relevant studies, including randomized clinical trials, prospective cohort studies, and systematic reviews. Inclusion criteria were defined to select studies that directly addressed the comparison of different antibiotic regimens. Study selection was performed independently by two reviewers. Data were extracted and tabulated in a standardized format. The methodological quality of the included studies was assessed using appropriate tools. Results were analyzed qualitatively, highlighting the main findings and trends observed in the reviewed studies. Conclusions and recommendations were developed based on the results of the systematic review.Esta revisão sistemática examina a eficácia e segurança de diferentes regimes antibióticos no tratamento da osteomielite em pacientes adultos. Foram realizadas buscas em bases de dados eletrônicas para identificar estudos relevantes, incluindo ensaios clínicos randomizados, estudos de coorte prospectivos e revisões sistemáticas. Os critérios de inclusão foram definidos para selecionar estudos que abordassem diretamente a comparação de diferentes regimes antibióticos. A seleção dos estudos foi realizada por dois revisores de forma independente. Os dados foram extraídos e tabulados em um formato padronizado. A qualidade metodológica dos estudos incluídos foi avaliada usando ferramentas apropriadas. Os resultados foram analisados qualitativamente, destacando as principais descobertas e tendências observadas nos estudos revisados. Conclusões e recomendações foram elaboradas com base nos resultados da revisão sistemática

Atualizações sobre a doença de Alzheimer e seus estágios clínicos: Update on Alzheimer's disease and its clinical stages

A doença de Alzheimer é a causa mais comum de demência e uma das principais fontes de morbidade e mortalidade no envelhecimento da população. As alterações neuropatológicas marcantes da DA são placas difusas e neuríticas, marcadas pela deposição extracelular de beta-amiloide, e emaranhados neurofibrilares, compostos pelo acúmulo intracelular de proteína tau hiperfosforilada. Os déficits cognitivos aparecem e progridem insidiosamente, o comprometimento da memória, especificamente a perda de memória de eventos recentes, é a característica mais frequente da DA e geralmente é sua primeira manifestação. Outros déficits cognitivos aparecem com ou após o desenvolvimento do comprometimento da memória. A disfunção executiva e habilidades visuoespaciais prejudicadas tendem a ser afetadas precocemente, enquanto déficits na função da linguagem e sintomas comportamentais geralmente se manifestam mais tarde. Os sintomas neuropsiquiátricos e comportamentais são comuns nos estágios intermediários e tardios da DA, mas podem ocorrer no início do curso em alguns pacientes. Os déficits neurológicos não cognitivos, sinais motores piramidais e extrapiramidais, mioclonias e convulsões podem ocorrer nos estágios finais da DA, mas são incomuns nos estágios iniciais e intermediários.  As apresentações atípicas incluem uma variante visual (atrofia cortical posterior), uma variante com afasia progressiva e uma variante com disfunção executiva progressiva como sintoma predominante. As apresentações atípicas são mais comuns em pessoas mais jovens com DA. A DA é inexoravelmente progressiva, mas a taxa de progressão pode variar. A expectativa média de vida após o diagnóstico foi relatada entre 8 e 10 anos, mas pode variar de 3 a 20 anos. A DA deve ser suspeitada em qualquer idoso com início insidioso, declínio progressivo da memória e pelo menos um outro domínio cognitivo que leve ao funcionamento prejudicado.&nbsp

Comparação da eficácia da citologia cervical versus testes de DNA de alto risco para o HPV na detecção precoce de lesões cervicais pré-cancerígenas: Uma Revisão Sistemática

This systematic review investigated the comparative effectiveness of cervical cytology (Papanicolaou) versus high-risk HPV DNA tests in the early detection of pre-cancerous cervical lesions. Methodology included electronic database search, careful study selection, and result analysis. Reviewed studies provided diverse insights, highlighting the superior sensitivity of HPV DNA tests but also concerns regarding false positives and costs. The decision regarding screening method should consider individual and contextual factors. It is concluded that there is no one-size-fits-all approach to cervical cancer screening, emphasizing the importance of individualized decisions and ongoing research to enhance screening services.Esta revisão sistemática investigou a eficácia comparativa da citologia cervical (Papanicolaou) versus testes de DNA de alto risco para o HPV na detecção precoce de lesões cervicais pré-cancerígenas. A metodologia incluiu busca em bases de dados eletrônicas, seleção criteriosa de estudos e análise dos resultados. Os estudos revisados ofereceram insights diversos, destacando a sensibilidade superior dos testes de DNA do HPV, mas também preocupações com falsos positivos e custos. A decisão sobre o método de triagem deve considerar fatores individuais e contextuais. Conclui-se que não há uma abordagem única para a triagem do câncer cervical, enfatizando a importância da individualização das decisões e da continuidade da pesquisa para aprimorar os serviços de triagem

COMPLICAÇÕES E MANEJO DO ACRETISMO PLACENTÁRIO: UMA REVISÃO INTEGRATIVA

Introduction: Placental accreta is a severe and complex obstetric condition that is becoming more common due to the increase in cesarean sections and other uterine interventions. This condition occurs when the placenta adheres abnormally to the uterine muscle, varying in severity as placenta accreta, increta, and percreta. It can cause serious complications, such as heavy bleeding and the need for a hysterectomy. Early diagnosis, made by ultrasound and magnetic resonance imaging, is crucial for proper management. The increased incidence is linked to risk factors such as previous cesarean sections, multiparity, advanced maternal age, and a history of uterine curettage. Methodology: Ten relevant scientific articles were selected, published in Portuguese, English and Spanish, found in databases such as PubMed, SciELO and Google Scholar, using terms such as "placental accreta", "diagnosis", "clinical management" and "complications". Original studies, systematic reviews, and case reports on the diagnosis, management, and complications of placental accreta were included, excluding studies with non-human populations, non-full-text articles, and publications prior to 2010. Results: The integrative review resulted in the selection of ten relevant scientific articles that address the management and complications of placental accreta. The main topics include diagnosis, clinical management and treatment, with emphasis on medical management and the multidisciplinary team. The most frequent complications identified were postpartum hemorrhage, need for hysterectomy, and damage to other organs. The introduction of multidisciplinary teams and new surgical techniques has been shown to be effective in reducing maternal morbidity. Conclusions: The creation of specialized teams has been shown to be effective in reducing maternal morbidity in severe cases. Major complications, such as postpartum hemorrhage and the need for hysterectomy, can be better managed with proper planning and timely interventions. Diagnostic tools, such as ultrasound and magnetic resonance imaging, are essential for early detection. The implementation of protocols and new surgical techniques has also shown promise. However, there is a need for further studies with larger samples to consolidate the evidence and improve management strategies for this complex condition.Introduction: Placental accreta is a severe and complex obstetric condition that is becoming more common due to the increase in cesarean sections and other uterine interventions. This condition occurs when the placenta adheres abnormally to the uterine muscle, varying in severity as placenta accreta, increta, and percreta. It can cause serious complications, such as heavy bleeding and the need for a hysterectomy. Early diagnosis, made by ultrasound and magnetic resonance imaging, is crucial for proper management. The increased incidence is linked to risk factors such as previous cesarean sections, multiparity, advanced maternal age, and a history of uterine curettage. Methodology: Ten relevant scientific articles were selected, published in Portuguese, English and Spanish, found in databases such as PubMed, SciELO and Google Scholar, using terms such as "placental accreta", "diagnosis", "clinical management" and "complications". Original studies, systematic reviews, and case reports on the diagnosis, management, and complications of placental accreta were included, excluding studies with non-human populations, non-full-text articles, and publications prior to 2010. Results: The integrative review resulted in the selection of ten relevant scientific articles that address the management and complications of placental accreta. The main topics include diagnosis, clinical management and treatment, with emphasis on medical management and the multidisciplinary team. The most frequent complications identified were postpartum hemorrhage, need for hysterectomy, and damage to other organs. The introduction of multidisciplinary teams and new surgical techniques has been shown to be effective in reducing maternal morbidity. Conclusions: The creation of specialized teams has been shown to be effective in reducing maternal morbidity in severe cases. Major complications, such as postpartum hemorrhage and the need for hysterectomy, can be better managed with proper planning and timely interventions. Diagnostic tools, such as ultrasound and magnetic resonance imaging, are essential for early detection. The implementation of protocols and new surgical techniques has also shown promise. However, there is a need for further studies with larger samples to consolidate the evidence and improve management strategies for this complex condition.Introdução: O acretismo placentário é uma condição obstétrica grave e complexa que está se tornando mais comum devido ao aumento das cesarianas e outras intervenções uterinas. Esta condição ocorre quando a placenta adere anormalmente ao músculo uterino, variando em gravidade como placenta acreta, increta e percreta. Ela pode causar complicações sérias, como hemorragias intensas e a necessidade de histerectomia. O diagnóstico precoce, feito por ultrassonografia e ressonância magnética, é crucial para um manejo adequado. O aumento da incidência está ligado a fatores de risco como cesarianas anteriores, multiparidade, idade materna avançada e histórico de curetagem uterina. Metodologia: Foram selecionados dez artigos científicos relevantes, publicados em português, inglês e espanhol, encontrados em bases de dados como PubMed, SciELO e Google Scholar, usando termos como "acretismo placentário", "diagnóstico", "manejo clínico" e "complicações". Incluíram-se estudos originais, revisões sistemáticas e relatos de casos sobre o diagnóstico, manejo e complicações do acretismo placentário, excluindo estudos com populações não humanas, artigos sem texto completo e publicações anteriores a 2010. Resultados: A revisão integrativa resultou na seleção de dez artigos científicos relevantes que abordam o manejo e as complicações do acretismo placentário. Os principais temas incluem diagnóstico, manejo clínico e tratamento, com ênfase na conduta médica e da equipe multiprofissional. As complicações mais frequentes identificadas foram hemorragia pós-parto, necessidade de histerectomia e lesões a outros órgãos. A introdução de equipes multidisciplinares e novas técnicas cirúrgicas mostrou-se eficaz na redução da morbidade materna. Conclusões: A criação de equipes especializadas mostrou-se eficaz na redução da morbidade materna em casos graves. As principais complicações, como hemorragia pós-parto e necessidade de histerectomia, podem ser melhor gerenciadas com planejamento adequado e intervenções oportunas. Ferramentas diagnósticas, como ultrassonografia e ressonância magnética, são essenciais para a detecção precoce. A implementação de protocolos e novas técnicas cirúrgicas também se mostrou promissora. No entanto, há necessidade de mais estudos com amostras maiores para consolidar as evidências e aprimorar as estratégias de manejo dessa condição complexa

NEOTROPICAL FRESHWATER FISHES: A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

Neotropical freshwater fisheries : A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

NEOTROPICAL FRESHWATER FISHES: A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

NEOTROPICAL FRESHWATER FISHES: A dataset of occurrence and abundance of freshwater fishes in the Neotropics

The Neotropical region hosts 4225 freshwater fish species, ranking first among the world's most diverse regions for freshwater fishes. Our NEOTROPICAL FRESHWATER FISHES data set is the first to produce a large-scale Neotropical freshwater fish inventory, covering the entire Neotropical region from Mexico and the Caribbean in the north to the southern limits in Argentina, Paraguay, Chile, and Uruguay. We compiled 185,787 distribution records, with unique georeferenced coordinates, for the 4225 species, represented by occurrence and abundance data. The number of species for the most numerous orders are as follows: Characiformes (1289), Siluriformes (1384), Cichliformes (354), Cyprinodontiformes (245), and Gymnotiformes (135). The most recorded species was the characid Astyanax fasciatus (4696 records). We registered 116,802 distribution records for native species, compared to 1802 distribution records for nonnative species. The main aim of the NEOTROPICAL FRESHWATER FISHES data set was to make these occurrence and abundance data accessible for international researchers to develop ecological and macroecological studies, from local to regional scales, with focal fish species, families, or orders. We anticipate that the NEOTROPICAL FRESHWATER FISHES data set will be valuable for studies on a wide range of ecological processes, such as trophic cascades, fishery pressure, the effects of habitat loss and fragmentation, and the impacts of species invasion and climate change. There are no copyright restrictions on the data, and please cite this data paper when using the data in publications

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora