Cirurgia de Aneurisma Cerebral: Uma revisão das técnicas de tratamento de aneurismas cerebrais, incluindo a embolização endovascular e a cirurgia aberta.

This review article discusses treatment techniques for cerebral aneurysms, with a focus on endovascular embolization and open surgery. Cerebral aneurysms are serious medical conditions that require immediate intervention to prevent potentially fatal complications. Endovascular embolization is a minimally invasive approach that has demonstrated effectiveness in occluding aneurysms and reducing complications. Clinical studies have shown a complete occlusion rate of 79.3% one year after the procedure, with lower morbidity compared to open surgery. However, careful patient selection is crucial. On the other hand, open surgery, although more invasive, is highly effective, with a long-term complete occlusion rate of 95%. The choice between the techniques should be individualized, considering the aneurysm's anatomy, the patient's overall health, and other clinical variables. Continual technological advancements are shaping the evolution of these techniques, with innovative devices and approaches enhancing their effectiveness and safety. However, this review identifies some limitations, including the lack of directly comparing the two techniques in randomized controlled trials and the need for long-term studies to assess the durability of interventions. Future research is recommended to focus on prospective long-term studies with appropriate control groups, as well as the investigation of new technologies and approaches to enhance the treatment of cerebral aneurysms.Este artigo de revisão aborda as técnicas de tratamento de aneurismas cerebrais, com foco na embolização endovascular e na cirurgia aberta. Os aneurismas cerebrais são condições médicas sérias que requerem intervenção imediata para evitar complicações potencialmente fatais. A embolização endovascular é uma abordagem minimamente invasiva que demonstrou eficácia na oclusão de aneurismas e na redução de complicações. Estudos clínicos mostraram uma taxa de oclusão completa de 79,3% após um ano do procedimento, com menor morbidade em comparação com a cirurgia aberta. No entanto, a seleção criteriosa dos pacientes é fundamental. Por outro lado, a cirurgia aberta, embora mais invasiva, é altamente eficaz, com uma taxa de oclusão completa de 95% em longo prazo. A escolha entre as técnicas deve ser individualizada, considerando a anatomia do aneurisma, a saúde geral do paciente e outras variáveis clínicas. Avanços tecnológicos contínuos estão moldando a evolução dessas técnicas, com dispositivos e abordagens inovadoras melhorando sua eficácia e segurança. No entanto, esta revisão identifica algumas limitações, incluindo a falta de ensaios clínicos randomizados controlados diretamente comparando as duas técnicas e a necessidade de estudos de longo prazo para avaliar a durabilidade das intervenções. Recomenda-se que futuras pesquisas se concentrem em estudos prospectivos de longo prazo com grupos de controle apropriados, bem como na investigação de novas tecnologias e abordagens para aprimorar o tratamento de aneurismas cerebrais

Detection and phylogenetic analysis of Orf virus from sheep in Brazil: a case report

<p>Abstract</p> <p>Background</p> <p><it>Orf virus </it>(ORFV), the prototype of the genus <it>Parapoxvirus </it>(PPV), is the etiological agent of contagious ecthyma, a severe exanthematic dermatitis that afflicts domestic and wild small ruminants. Although South American ORFV outbreaks have occurred and diagnosed there are no South American PPV major membrane glycoprotein B2L gene nucleotide sequences available.</p> <p>Case presentation</p> <p>an outbreak of ovine contagious ecthyma in Midwest Brazil was investigated. The diagnosis was based on clinical examinations and molecular biology techniques. The molecular characterization of the virus was done using PCR amplification, cloning and DNA sequencing of the B2L gene. The phylogenetic analysis demonstrated a high degree of identity with ORFV strains, and the isolate was closest to the ORFV-India 82/04 isolate. Another Brazilian ORFV isolate, NE1, was sequenced for comparative analysis and also showed a high degree of identity with an Asian ORFV strain.</p> <p>Conclusion</p> <p>Distinct ORFV strains are circulating in Brazil. This is the first report on the phylogenetic analysis of an ORFV in South America.</p

Genome-Wide Analysis of Secondary Metabolite Gene Clusters in Ophiostoma ulmi and Ophiostoma novo-ulmi Reveals a Fujikurin-Like Gene Cluster with a Putative Role in Infection

The emergence of new microbial pathogens can result in destructive outbreaks, since their hosts have limited resistance and pathogens may be excessively aggressive. Described as the major ecological incident of the twentieth century, Dutch elm disease, caused by ascomycete fungi from the Ophiostoma genus, has caused a significant decline in elm tree populations (Ulmus sp.) in North America and Europe. Genome sequencing of the two main causative agents of Dutch elm disease (Ophiostoma ulmi and Ophiostoma novo-ulmi), along with closely related species with different lifestyles, allows for unique comparisons to be made to identify how pathogens and virulence determinants have emerged. Among several established virulence determinants, secondary metabolites (SMs) have been suggested to play significant roles during phytopathogen infection. Interestingly, the secondary metabolism of Dutch elm pathogens remains almost unexplored, and little is known about how SM biosynthetic genes are organized in these species. To better understand the metabolic potential of O. ulmi and O. novo-ulmi, we performed a deep survey and description of SM biosynthetic gene clusters (BGCs) in these species and assessed their conservation among eight species from the Ophiostomataceae family. Among 19 identified BGCs, a fujikurin-like gene cluster (OpPKS8) was unique to Dutch elm pathogens. Phylogenetic analysis revealed that orthologs for this gene cluster are widespread among phytopathogens and plant-associated fungi, suggesting that OpPKS8 may have been horizontally acquired by the Ophiostoma genus. Moreover, the detailed identification of several BGCs paves the way for future in-depth research and supports the potential impact of secondary metabolism on Ophiostoma genus’ lifestyle

Vaccinia Virus Infection in Monkeys, Brazilian Amazon

To detect orthopoxvirus in the Brazilian Amazon, we conducted a serosurvey of 344 wild animals. Neutralizing antibodies against orthopoxvirus were detected by plaque-reduction neutralizing tests in 84 serum samples. Amplicons from 6 monkey samples were sequenced. These amplicons identified vaccinia virus genetically similar to strains from bovine vaccinia outbreaks in Brazil

One More Piece in the VACV Ecological Puzzle: Could Peridomestic Rodents Be the Link between Wildlife and Bovine Vaccinia Outbreaks in Brazil?

BACKGROUND: Despite the fact that smallpox eradication was declared by the World Health Organization (WHO) in 1980, other poxviruses have emerged and re-emerged, with significant public health and economic impacts. Vaccinia virus (VACV), a poxvirus used during the WHO smallpox vaccination campaign, has been involved in zoonotic infections in Brazilian rural areas (Bovine Vaccinia outbreaks - BV), affecting dairy cattle and milkers. Little is known about VACV's natural hosts and its epidemiological and ecological characteristics. Although VACV was isolated and/or serologically detected in Brazilian wild animals, the link between wildlife and farms has not yet been elucidated. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we describe for the first time, to our knowledge, the isolation of a VACV (Mariana virus - MARV) from a mouse during a BV outbreak. Genetic data, in association with biological assays, showed that this isolate was the same etiological agent causing exanthematic lesions observed in the cattle and human inhabitants of a particular BV-affected area. Phylogenetic analysis grouped MARV with other VACV isolated during BV outbreaks. CONCLUSION/SIGNIFICANCE: These data provide new biological and epidemiological information on VACV and lead to an interesting question: could peridomestic rodents be the link between wildlife and BV outbreaks

Violência obstétrica: caracterização dos impactos ocasionados na vida das puérperas

Introdução: A violência obstétrica é considerada uma problemática grave de saúde pública que é silenciosa e mascarada, sendo capaz de cometer estragos consideráveis na vida das gestantes e dos seus familiares. A mesma quebra a esfera singular do parto, sem que haja respeito pela fisiologia da mulher ocasionando traumas consideráveis. Objetivo: Reconhecer os impactos ocasionados pela violência obstétrica na vida das puérperas, externalizando quais fatores contribuem para as intervenções desnecessárias. Método: Revisão bibliográfica da literatura realizada em dezembro de 2022 nas bases de dados BVS, LILACS, BDENF E MEDLINE através dos seguintes DeCS: "Episiotomia", "Saúde da mulher" e “Saúde Pública” combinados entre si pelo operador booleano AND. Foram encontrados 21 estudos e após aplicar os critérios de inclusão e exclusão, foram selecionados 8 estudos para compor a revisão. Utilizou-se como pergunta norteadora: “Quais os impactos transcendentes da violência obstétrica na vida das parturientes?”. Resultados: A mulher não é vista como protagonista do processo, há uma relação de submissão, que abre espaço para infantilização, fragilização, descaracterização e o advento da própria violência. Emprega-se um estigma em relação ao parto normal com discursos de que o mesmo é degradante ou de que a mulher não tem capacidade de ter o bebê por esse método, quando a literatura científica demonstra claramente os impactos positivos que o parto normal garante para o binômio. Conclusão: A violência obstetríca causa impactos significativos na vida das puérperas, visto que proporciona uma distorção do plano de parto anteriormente instituído, ocasionando sequelas psicológicas, sociais e emocionais

Entendendo a agitação psicomotora na sociedade brasileira: revisão de literatura

Introduction: Psychomotor agitation is a characteristic feature characterized by intense arousal, involving both psychological and motor aspects. This condition can manifest in various ways and is often associated with various mental and neurological disorders. Methodology: This literature review employed a systematic approach to identify relevant studies on psychomotor engineering in hospital settings in Brazil. The descriptors used were Psychomotor Agitation, Psychomotor Hyperactivity, Brazil, Hospitals, Psychiatric. The search was conducted in the PUBMED database, using the search filter for the last 10 years. Result: In the context of non-pharmacological management of the agitated patient, recommendations emphasize the importance of following a line of interventions, prioritizing less invasive measures before resorting to more coercive approaches. The process begins with directing the patient to a secure environment, providing a fundamental basis for improvement management. Conclusion: Psychomotor improvement is a symptom that can significantly impact a person's quality of life. Understanding the underlying causes and implementing an appropriate therapeutic approach are essential for the effective management of this state. The support of mental health professionals is crucial to assist in both the assessment and treatment of this complex condition.Introdução: A agitação psicomotora é uma característica que se caracteriza por uma intensa intensa, envolvendo tanto aspectos psicológicos quanto motores. Esta condição pode se manifestar de várias maneiras e está frequentemente associada a diversos transtornos mentais e neurológicos. Metodologia: Esta revisão bibliográfica utilizou uma abordagem sistemática para identificar estudos relevantes sobre engenharia psicomotora em contextos hospitalares no Brasil. Os descritores utilizados foram Psychomotor Agitation, Psychomotor Hyperactivity, Brazil, Hospitals, Psychiatric. A busca foi conduzida na base de dados PUBMED, utilizando o filtro de pesquisa nos últimos 10 anos. Resultado: No contexto do manejo não farmacológico do paciente agitado, as recomendações ressaltam a importância de seguir uma linha de intervenções, priorizando medidas menos invasivas antes de recorrer a abordagens mais coercitivas. O processo inicia com o encaminhamento do paciente para um ambiente protegido, proporcionando uma base fundamental para a gestão da melhoria. Conclusão: A melhoria psicomotora é um sintoma que pode impactar significativamente a qualidade de vida de uma pessoa. A compreensão das causas subjacentes e a implementação de uma abordagem terapêutica adequada são essenciais para o manejo eficaz desse estado. O suporte de profissionais de saúde mental é fundamental para auxiliar tanto na avaliação quanto no tratamento dessa condição complexa

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