Navegando pelas obsessões e compulsões: estratégias para o manejo do TOC e melhoria da qualidade de vida dos pacientes

O presente trabalho teve por objetivo avaliar, a partir de uma revisão narrativa de literatura, como ocorre o manejo do Transtorno Obsessivo Compulsivo (TOC) e quais as ferramentas utilizadas para melhorar a qualidade de vida dessas pessoas. TOC é um transtorno genético e sua sintomatologia são compulsões e obsessões, acarretando vergonha, sentimento de culpa e isolamento do portador. O tratamento dessa patologia visa melhorar a qualidade de vida desses pacientes, por meio da diminuição dos sintomas e dos sentimentos depreciativos. A terapêutica que apresenta mais resultados é a terapia cognitiva comportamental, mas não é de fácil acesso, sendo prevalente na sociedade o tratamento medicamentoso, principalmente com o uso dos inibidores seletivos da recaptação de serotonina, quando não obtém uma resposta significativa na remissão dos sintomas pode-se optar por um inibidor não seletivo da recaptação de serotonina ou a antipsicóticos, podendo ou não associá-los. Percebe-se uma remissão maior de sintomas quando associada os dois tipos de terapêutica: medicamentoso e a terapia cognitivo comportamental

THYROID CANCER: CLINICAL EVALUATION, ENDOCRINOLOGICAL MANIFESTATIONS AND SURGICAL MANAGEMENT

Thyroid cancer is more common in women and people over 40, but it can affect anyone. There are different types of thyroid cancer, the most common being differentiated carcinomas (papillary and follicular), which have a good prognosis and respond well to treatment. The clinical evaluation of thyroid cancer involves taking anamnesis, physical examination, measuring thyroid hormones and performing imaging tests and biopsy. The main symptom of thyroid cancer is the appearance of a nodule in the cervical region, which may be palpable or visible. The main surgical modalities are total thyroidectomy, which consists of complete removal of the thyroid gland; partial thyroidectomy or lobectomy, which consists of removing only part of the gland; and lymphadenectomy, which consists of removing lymph nodes affected by cancer. Objective: to synthesize the scientific evidence available on clinical assessment, endocrinological manifestations and surgical management in thyroid cancer. Methodology: based on the PRISMA checklist, the PubMed, Scielo and Web of Science databases were consulted to identify relevant studies published in the last 10 years. The descriptors used were: “thyroid cancer”, “thyroid neoplasm”, “clinical evaluation”, “surgical management” and “endocrinological manifestations”. Original studies in English or Portuguese that addressed the clinical, endocrinological or surgical aspects of thyroid cancer in humans were included. Studies that did not meet the inclusion criteria, were duplicates, had low methodological quality or did not have access to the full text were excluded. Results: 18 studies were selected, which revealed that thyroid cancer is a disease that presents different clinical, endocrinological and surgical aspects, depending on the type, stage and response to treatment. The studies analyzed provided evidence on diagnostic methods, indications and surgical techniques, the efficacy and safety of radioactive iodine therapy, and the role of suppressive hormone therapy in differentiated thyroid cancer. Conclusion: Thyroid cancer is a heterogeneous disease that requires a multidisciplinary approach for its diagnosis and treatment. The systematic review showed that there is consistent evidence on diagnostic methods, surgical modalities and radioactive iodine therapy in differentiated thyroid cancer. However, there are gaps in knowledge about the endocrinological manifestations of thyroid cancer and therapeutic alternatives for more complex or aggressive cases. Therefore, more studies are needed to clarify these aspects and improve the clinical management of patients with thyroid cancer.Thyroid cancer is more common in women and people over 40, but it can affect anyone. There are different types of thyroid cancer, the most common being differentiated carcinomas (papillary and follicular), which have a good prognosis and respond well to treatment. The clinical evaluation of thyroid cancer involves taking anamnesis, physical examination, measuring thyroid hormones and performing imaging tests and biopsy. The main symptom of thyroid cancer is the appearance of a nodule in the cervical region, which may be palpable or visible. The main surgical modalities are total thyroidectomy, which consists of complete removal of the thyroid gland; partial thyroidectomy or lobectomy, which consists of removing only part of the gland; and lymphadenectomy, which consists of removing lymph nodes affected by cancer. Objective: to synthesize the scientific evidence available on clinical assessment, endocrinological manifestations and surgical management in thyroid cancer. Methodology: based on the PRISMA checklist, the PubMed, Scielo and Web of Science databases were consulted to identify relevant studies published in the last 10 years. The descriptors used were: “thyroid cancer”, “thyroid neoplasm”, “clinical evaluation”, “surgical management” and “endocrinological manifestations”. Original studies in English or Portuguese that addressed the clinical, endocrinological or surgical aspects of thyroid cancer in humans were included. Studies that did not meet the inclusion criteria, were duplicates, had low methodological quality or did not have access to the full text were excluded. Results: 18 studies were selected, which revealed that thyroid cancer is a disease that presents different clinical, endocrinological and surgical aspects, depending on the type, stage and response to treatment. The studies analyzed provided evidence on diagnostic methods, indications and surgical techniques, the efficacy and safety of radioactive iodine therapy, and the role of suppressive hormone therapy in differentiated thyroid cancer. Conclusion: Thyroid cancer is a heterogeneous disease that requires a multidisciplinary approach for its diagnosis and treatment. The systematic review showed that there is consistent evidence on diagnostic methods, surgical modalities and radioactive iodine therapy in differentiated thyroid cancer. However, there are gaps in knowledge about the endocrinological manifestations of thyroid cancer and therapeutic alternatives for more complex or aggressive cases. Therefore, more studies are needed to clarify these aspects and improve the clinical management of patients with thyroid cancer

Erratum to: The study of cardiovascular risk in adolescents – ERICA: rationale, design and sample characteristics of a national survey examining cardiovascular risk factor profile in Brazilian adolescents

1585

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

Educomunicação e suas áreas de intervenção: Novos paradigmas para o diálogo intercultural

oai:omp.abpeducom.org.br:publicationFormat/1O material aqui divulgado representa, em essência, a contribuição do VII Encontro Brasileiro de Educomunicação ao V Global MIL Week, da UNESCO, ocorrido na ECA/USP, entre 3 e 5 de novembro de 2016. Estamos diante de um conjunto de 104 papers executivos, com uma média de entre 7 e 10 páginas, cada um. Com este rico e abundante material, chegamos ao sétimo e-book publicado pela ABPEducom, em seus seis primeiros anos de existência. A especificidade desta obra é a de trazer as “Áreas de Intervenção” do campo da Educomunicação, colocando-as a serviço de uma meta essencial ao agir educomunicativo: o diálogo intercultural, trabalhado na linha do tema geral do evento internacional: Media and Information Literacy: New Paradigms for Intercultural Dialogue

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

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