30 research outputs found
Inquérito sobre hipertensão arterial, fatores associados e práticas de controle em pessoas na região do sudeste / Survey on arterial hypertension, associated factors and control practices in people in the southeast region
A HipertensĂŁo Arterial (HA) atinge milhares de pessoas no mundo, no Brasil estimou-se que em 2019 ocorreram 388 mortes por dia em decorrĂŞncia de doenças associadas a hipertensĂŁo arterial, como infarto agudo do miocárdio, acidente vascular encefálico, insuficiĂŞncia renal e diabetes. A cerca disso, foi realizado um levantamento de dados atravĂ©s de uma pesquisa realizada por meio de um questionário online (google forms) que continha questões sĂłcio demográficas e relacionadas com a presença de hipertensĂŁo arterial, comportamentos relacionados a saĂşde e controle da doença. Participaram da pesquisa 317 indivĂduos de diferentes cidades do sudeste brasileiros (55% mulheres e 45% homens com mĂ©dia de idade de 50 anos, DP +- 21,57). Destas, 42% autorrelataram-se hipertensas, sendo em sua maioria homens (57,7%). Aproximadamente 70% dos hipertensos referiram apresentar outra doença associada, como diabetes, verificou-se tambĂ©m que 45% deles nĂŁo realizam nenhum acompanhamento mĂ©dico e apresentam hábitos de vida associados ao aumento da pressĂŁo arterial como tabagismo, consumo de bebidas alcoĂłlicas, alĂ©m de dieta rica em sĂłdio, sobrepeso, obesidade e sedentarismo. Desta forma, pode-se sugerir que a H.A apesar de ser uma doença frequente na população, por vezes sua gravidade parece ser subestimada pelos acometidos, que comumente nĂŁo realizam seu controle de forma adequada, tornando-se vulneráveis ás suas complicações, sobretudo ás doenças cardiovasculares
Effects of chronic food stress on morphometry and expression of nuclear organizing regions in the adult rats hippocampus Chronic food stress on morphometry and expression of agnor in the rats hippocampus / Efeitos do estresse alimentar crônico na morfometria e expressão das regiões de organização nuclear nos ratos adultos hipocampo Testemunho crônico de alimentação sobre morfometria e expressão do agnor no hippocampus das taxas
The aim of this study was to verify the immediate and late effects of chronic food stress on the expression of Nuclear Organizing Regions (NORs) in hippocampal neurons. Twenty Wistar rats were separated into two groups: test (n = 10) and control (n = 10). Food stress started from the 60th day of life and lasted for a month. After this time the animals were anesthetized, euthanized and had their hippocampus dissected. The obtained hippocampus were histologically processed, stained by the HE technique for morphological description and by the AgNOR technique for NOR analysis. From each image the total number of neurons, the number of neurons with NOR in Dispersion (NND), the total number of NORs (NNOR), and then performed a ratio of NNOR by the total number of neurons to obtain the number Of NOR by neuron (NNN). Of the analyzed variants, the number of neurons was higher (p <0.001) in the stressed group (41.98 ± 17), when compared with the control group (33.57 ± 14). In addition, NND was also higher in the stressed group (4.523 ± 4.04) than the control group (1.4 ± 2.20) with p <0.001. Thus, we have that chronic food stress increases the number of granular neurons in the hippocampus in rats as well as increases the number of NOR in dispersion.Â
Implicações da radiação na saúde dos profissionais que utilizam a fluoroscopia na prática diária: Implications of radiation on the health of professionals who use the fluoroscopy in daily practice
O presente estudo tem como objetivo analisar as implicações da radiação na saĂşde dos profissionais que utilizam o arco cirĂşrgico na prática diária. Neste estudo foi realizada uma revisĂŁo sistemática da literatura. Para seleção das publicações foram considerados como critĂ©rios de inclusĂŁo estar disponĂvel em formato completo, publicado nos Ăşltimos cinco anos (2018-2022), escritas em lĂngua portuguesa e inglesa. E como critĂ©rios de exclusĂŁo foram considerados estar foram do tema de pesquisa, ser revisĂŁo de literatura e repetido na base de dados. Os critĂ©rios de inclusĂŁo e exclusĂŁo foram considerados como meio de validade metodolĂłgica. Concluiu-se a partir desse estudo que apesar de baixos nĂveis de radiação emitidos por arco cirĂşrgico, os riscos ainda sĂŁo significativos, verificando-se a necessidade de conscientização dos profissionais de saĂşde sobre a proteção necessária para mitigação das implicações, principalmente, entre os menos experientes. 
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
A epidemiologia da cardiomiopatia de Takotsubo no Brasil e os principais fatores de risco da cardiomiopatia de Takotsubo: The epidemiology of Takotsubo cardiomyopathy in Brazil and the main risk factors for takotsubo cardiomyopathy
A Cardiomiopatia de Takotsubo (CTT) Ă© uma disfunção cardĂaca reversĂvel, a qual está relacionada, diretamente, ao estresse fĂsico ou emocional. Objetiva-se atravĂ©s dessa pesquisa evidenciar os principais fatores de risco da CT. Trata-se de uma revisĂŁo sistemática realizada no motor de busca Biblioteca Virtual em SaĂşde (BVS) na base de dados das “CiĂŞncias em SaĂşde em Geral” (Scielo, Medline, Lilacs). Percebeu-se que que a CT apresenta uma ocorrĂŞncia maior em mulheres na fase de pĂłs-menopausa, onde sĂŁo atingidas pelo estresse emocional, bem como a inserção de marcapasso tambĂ©m pode desencadear a doença. Entretanto, a etiologia da CT ainda Ă© marcada por controvĂ©rsias, mas há concordância acerca do surgimento da CT estar relacionado com a abundância de catecolaminas circulantes
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
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
Summary
Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally.
Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies
have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of
the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income
countries globally, and identified factors associated with mortality.
Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to
hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis,
exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a
minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical
status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary
intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause,
in-hospital mortality for all conditions combined and each condition individually, stratified by country income status.
We did a complete case analysis.
Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital
diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal
malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome
countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male.
Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3).
Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income
countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups).
Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome
countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries;
p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients
combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11],
p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20
[1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention
(ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety
checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed
(ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of
parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65
[0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality.
Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome,
middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will
be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger
than 5 years by 2030
The legal effect of the acts of the doctor in the termination of pregnancy: wrongful birth and wrongful life
From a literature review, this study seeks to understand the right of living and the concept of damage in civil liability in order to find the application of a “right not to be born” in Brazilian Law. Understanding the possibilities of damage and the details regarding the right of living, the life damage will be explained in such a way it makes possible to analyze the doctor’s liability for not informing the mother about the fetus handicaps, making it impossible to exercise the right to get an abortion and, therefore, avoid an impossible life.CAPES - Coordenação de Aperfeiçoamento de Pessoal de NĂvel SuperiorDissertação (Mestrado)A partir de uma análise bibliográfica, o presente estudo busca a compreensĂŁo do direito Ă vida e o conceito de dano em responsabilidade civil para encontrar a aplicabilidade de um “direito de nĂŁo nascer” no ordenamento jurĂdico brasileiro. Compreendendo as modalidades de dano e os detalhes sobre o direito Ă vida, o dano vida será explicado de modo a propiciar uma análise acerca da responsabilização do mĂ©dico pela falha em informar Ă mĂŁe sobre deficiĂŞncias do feto, impossibilitando o exercĂcio do direito a interromper a gravidez, impedindo uma vida inviável