Composição botânica e índice de seleção de espécies herbáceas na dieta de ovinos em caatinga raleada.

Resumo: O trabalho foi conduzido na Embrapa Caprinos, em Sobral, CE, objetivando determinar as mudancas anuais e estacionais da composicao botanica da dieta de ovinos e do estrato herbaceo de uma caatinga raleada sob pastoreio continuo. A participacao de gramineas decresceu e a das ervas cresceu na composicao do estrato herbaceo, ao longo do periodo estudado. O numero de especies herbaceas presentes na dieta aumentou no ano de menor disponibilidade de forragem. A dieta e a pastagem diferenciaram-se com relacao as suas composicoes botanicas. Por fim, os indices de selecao das gramineas decresceram, enquanto os das ervas se mantiveram identicos no periodo estudado. [Diet botanical composition of sheep and selectivity index of herbaceous species on a thinned caatinga]. Abstract: The experiment was conducted in EMBRAPA Caprinos, in Sobral Ceará, with the objective of determining the annual and the seasonal variations in the botanical composition of the sheep diet and of the herbaceous cover of a thinned caatinga under continuous grazing. The grass participation decreased while that of forbs increased in composition of the herbaceous layer. The number of species in the diet was higher in the year of lower forage availability. The diet and the pasture differred in their botanical composition. Finnaly, the selectivity index of the grasses decreased while that of the forbs mantained identical, in the studied period

Ictiose Arlequim: Caso Clínico

Harlequin ichthyosis is a rare autosomal recessive congenital disease in which neonates present generalized hyperkeratotic plaques and deep fissures, ectropion, eclabium, malformation of the auricular pavilion and typical facies. Although several complications related to the skin restriction may occur, support in intensive care and early introduction of systemic retinoids, such as acitretin, have significantly contributed to patients' survival and improved prognosis. The purpose of this report is to present a rare case of harlequin ichthyosis and to discuss strategies for early diagnosis and first supportive care.Ictiose arlequim é uma doença congênita autossómica recessiva rara, na qual os recém-nascidos apresentam placas de hiperqueratose generalizadas e fissuras profundas, ectrópio, eclábio, malformação do pavilhão auricular e fácies típicas. Embora várias complicações relacionadas à restrição cutânea possam ocorrer, o suporte em terapia intensiva e a introdução precoce de retinóides sistémicos, como a acitretina, têm contribuído significativamente para a melhoria da sobrevida e do prognóstico dos doentes. O objetivo deste relato é apresentar um raro caso de ictiose arlequim e discutir estratégias para o diagnóstico precoce e o primeiro tratamento de suporte

Recommendations of Neuroendocrinology Department from Brazilian Society of Endocrinology and Metabolism for diagnosis and treatment of acromegaly in Brazil

A acromegalia é uma doença associada à elevada morbidade e à redução da expectativa de vida. Em virtude do seu caráter insidioso e do seu não reconhecimento, o diagnóstico é frequentemente realizado com atraso, o que, associado às complicações relacionadas ao excesso do GH/IGF-I, determina elevada morbimortalidade. No entanto, um diagnóstico precoce e um tratamento efetivo minimizam a morbidade e normalizam a taxa de mortalidade. Nesta publicação, o objetivo do Departamento de Neuroendocrinologia da Sociedade Brasileira de Endocrinologia e Metabologia é divulgar quando suspeitar clinicamente da acromegalia e como diagnosticá-la. Além disso, discute-se a maneira mais eficaz e segura de realizar o tratamento da acromegalia, enfatizando que este deve ser realizado em centros de referência. Assim, com base em dados publicados em periódicos de nível científico reconhecido e na experiência dos autores, são apresentadas as recomendações para o diagnóstico e tratamento da doença.Acromegaly is a disease associated with increased morbidity and reduced life expectancy. Because of its insidious character and its non-recognition, the diagnosis is often made with delay, which, along with the complications related to GH/IGF-I excess, determines high morbidity and mortality. However, an early diagnosis and an effective treatment reduce the morbidity and normalize the mortality rate. In this publication, the goal of Neuroendocrinology Department from Brazilian Society of Endocrinology and Metabolism is to disclose which clinical set should arouse the suspicious of acromegaly and how to diagnose it. Furthermore, we discuss the most effective and safe approach to perform the treatment of acromegaly, emphasizing that it must be carried out in reference centers. Therefore, based on data published in journals with recognized scientific level and authors' experience, recommendations are presented for diagnosis and treatment of the disease

Processo participativo sobre degradação da terra em regiões do Semiárido brasileiro.

A degradação da terra é um fenômeno complexo que afeta bilhões de pessoas em todas as partes do mundo e para ser compreendida em sua totalidade necessita de uma análise integrada que considere questões sociais, econômicas e ambientais. O bioma Caatinga é suscetível ao processo de degradação, entendido como um processo de perda de produtividade biológica ou econômica das terras. O presente relatório visa apresentar os resultados obtidos a partir de oficinas participativas realizadas em novembro e dezembro de 2022 com foco em duas regiões do bioma Caatinga, que compreendem Queimadas/PB, Petrolina/PE, e municípios selecionados próximos destes dois. Estas oficinas tiveram como objetivo identificar de maneira participativa variáveis socioecológicas locais que permitam compreender as especificidades ligadas aos processos de degradação da terra, para cada região. A pesquisa é uma etapa do projeto de pesquisa PCI intitulado ?Análise sistêmica socioecológica de impactos no Cerrado e Caatinga?, financiado pelo CNPq, e está inserida no âmbito do Projeto Temático NEXUS - ?Transição para a sustentabilidade e o nexo agricultura-energia-água: explorando uma abordagem integradora com casos de estudo nos biomas Cerrado e Caatinga?, liderado pela Divisão de Impactos, Adaptação e Vulnerabilidades do INPE, com apoio financeiro da Fapesp (Processo 2017/22269-2). A pesquisa baseou-se no uso de metodologias participativas em oficinas presenciais, nas quais foram feitas perguntas apoiadas no modelo Força-Motriz, Pressão, Estado, Impacto e Resposta, discussões em grupo, realização de mapeamento participativo e encontro de validação dos dados. A partir das respostas às perguntas foi possível identificar as principais causas da degradação nas regiões, como desmatamento e queimadas; as consequências geradas por ela, como a perda de produtividade agropecuária e êxodo rural; as soluções que os grupos indicaram para reverter a degradação, como políticas e disponibilidade de crédito para estimular práticas agroecológicas e maior proximidade com a Ciência; e as iniciativas que já ocorrem no território, como ações de associações, cooperativas, organizações não-governamentais e órgãos públicos; além da espacialização das áreas mais críticas em termos de degradação na visão dos participantes. Espera-se que os resultados aqui apresentados sejam utilizados pelos gestores públicos e população como uma ferramenta de análise do território, bem como em pesquisas científicas que versam sobre o tema degradação. da terra, como em projetos do INPE e de seus parceiros.sid.inpe.br/mtc-m21d/2023/04.18.16.48-RP

Challenges in the diagnosis and management of acromegaly : a focus on comorbidities

Q2Q1Introduction: Acromegaly is a rare, insidious disease resulting from the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and is associated with a range of comorbidities. The extent of associated complications and mortality risk is related to length of exposure to the excess GH and IGF-1, thus early diagnosis and treatment is imperative. Unfortunately, acromegaly is often diagnosed late, when patients already have a wide range of comorbidities. The presence of comorbid conditions contributes significantly to patient morbidity/mortality and impaired quality of life. Methods: We conducted a retrospective literature review for information relating to the diagnosis of acromegaly, and its associated comorbidities using PubMed. The main aim of this review is to highlight the issues of comorbidities in acromegaly, and to reinforce the importance of early diagnosis and treatment. Findings and conclusions: Successful management of acromegaly goes beyond treating the disease itself, since many patients are diagnosed late in disease evolution, they present with a range of comorbid conditions, such as cardiovascular disease, diabetes, hypertension, and sleep apnea. It is important that patients are screened carefully at diagnosis (and thereafter), for common associated complications, and that biochemical control does not become the only treatment goal. Mortality and morbidities in acromegaly can be reduced successfully if patients are treated using a multimodal approach with comprehensive comorbidity management.https://orcid.org/0000-0002-8433-5435N/

Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology

OBJECTIVE: Research and clinical translation in schizophrenia is limited by inconsistent definitions of treatment resistance and response. To address this issue, the authors evaluated current approaches and then developed consensus criteria and guidelines. METHODS: A systematic review of randomized antipsychotic clinical trials in treatment-resistant schizophrenia was performed, and definitions of treatment resistance were extracted. Subsequently, consensus operationalized criteria were developed through 1) a multiphase, mixed methods approach, 2) identification of key criteria via an online survey, and 3) meetings to achieve consensus. RESULTS: Of 2,808 studies identified, 42 met inclusion criteria. Of these, 21 studies (50%) did not provide operationalized criteria. In the remaining studies, criteria varied considerably, particularly regarding symptom severity, prior treatment duration, and antipsychotic dosage thresholds; only two studies (5%) utilized the same criteria. The consensus group identified minimum and optimal criteria, employing the following principles: 1) current symptoms of a minimum duration and severity determined by a standardized rating scale; 2) moderate or worse functional impairment; 3) prior treatment consisting of at least two different antipsychotic trials, each for a minimum duration and dosage; 4) systematic monitoring of adherence and meeting of minimum adherence criteria; 5) ideally at least one prospective treatment trial; and 6) criteria that clearly separate responsive from treatment-resistant patients. CONCLUSIONS: There is considerable variation in current approaches to defining treatment resistance in schizophrenia. The authors present consensus guidelines that operationalize criteria for determining and reporting treatment resistance, adequate treatment, and treatment response, providing a benchmark for research and clinical translation

Violence and post-traumatic stress disorder in Sao Paulo and Rio de Janeiro, Brazil: the protocol for an epidemiological and genetic survey

Background: violence is a public health major concern, and it is associated with post-traumatic stress disorder and other psychiatric outcomes. Brazil is one of the most violent countries in the world, and has an extreme social inequality. Research on the association between violence and mental health may support public health policy and thus reduce the burden of disease attributable to violence. the main objectives of this project were: to study the association between violence and mental disorders in the Brazilian population; to estimate the prevalence rates of exposure to violence, post-traumatic stress disorder, common metal disorder, and alcohol hazardous use and dependence: and to identify contextual and individual factors, including genetic factors, associated with the outcomes.Methods/design: one phase cross-sectional survey carried out in São Paulo and Rio de Janeiro, Brazil. A multistage probability to size sampling scheme was performed in order to select the participants (3000 and 1500 respectively). the cities were stratified according to homicide rates, and in São Paulo the three most violent strata were oversampled. the measurements included exposure to traumatic events, psychiatric diagnoses (CIDI 2.1), contextual (homicide rates and social indicators), and individual factors, such as demographics, social capital, resilience, help seeking behaviours. the interviews were carried between June/2007 February/2008, by a team of lay interviewers. the statistical analyses will be weight-adjusted in order to take account of the design effects. Standardization will be used in order to compare the results between the two centres. Whole genome association analysis will be performed on the 1 million SNP (single nucleotide polymorphism) arrays, and additional association analysis will be performed on additional phenotypes. the Ethical Committee of the Federal University of São Paulo approved the study, and participants who matched diagnostic criteria have been offered a referral to outpatient clinics at the Federal University of São Paulo and Federal University of Rio de Janeiro