Degeneração macular relacionada à idade (DMRI) e suas complicações no idoso / Age-related macular degeneration (AMD) and its complications in the elderly

A degeneração macular relacionada à idade (DMRI) é uma doença degenerativa que provoca uma perda progressiva da visão central. Ela afeta a mácula, região central da retina, que é responsável pela visão central, sendo usada na leitura, na identificação de detalhes e cores. É a causa mais comum de perda de visão em pessoas acima de 50 anos.Este estudo teve como objetivo pesquisar as publicações em base de dados de periódicos científicos PubMed, estudos que contemplam a temática “Degeneração macular relacionada à idade (DMRI) e suas complicações no idoso”, descrevendo as principais complicações; identificando e caracterizando as publicações quanto autoria, título, periódico publicado e ano de publicação e identificando os fatores que interferem ou contribuem para o desenvolvimento da doença. Após avaliação, foram identificados quatro (04) artigos, compondo, então o documento da presente pesquisa relatando as complicações em pacientes idosos portadores de DMRI. Sendo elas: ruptura espontânea do epitélio pigmentar da retina, hemorragia sub-retiniana, descolamento de retina e infarto macular. A degeneração macular relacionada à idade (DMRI) apesar de apresentar formas de prevenção satisfatórias, não demostra grande eficácia quanto ao tratamento das complicações. Dessa forma, a estratégia padrão de combate baseia-se principalmente na prevenção e na manutenção da autonomia e independência dos indivíduos acometidos

Dexmedetomidina versus outros sedativos na prevenção de Delirium nos adultos em ventilação mecânica

Delirium é uma síndrome neurocognitiva aguda relativamente comum e grave que se caracteriza por desatenção, consciência alterada, disfunção cognitiva e curso flutuante, e pode levar à mortalidade, declínio funcional, institucionalização e demência, com maior incidência nos pacientes mais velhos. Pacientes hospitalizados na Unidade de Terapia Intensiva (UTI) e em uso de ventilação mecânica (VM), quando sedados em excesso, possuem maior duração de permanência na UTI, aumento da duração da VM, maior incidência de delirium e mortalidade. Estudos apontam que a dexmedetomidina reduz a incidência de delirium em pacientes adultos hospitalizados na UTI e em uso de ventilação mecânica quando comparada com outros sedativos. Desse modo, o objetivo do estudo é comparar a dexmedetomidina e outros sedativos na prevenção de delirium nos adultos em ventilação mecânica. Trata-se de uma revisão bibliográfica integrativa, do tipo quantitativa, que utilizou as plataformas do PubMed, SciELO e Cochrane Library como bases de dados para seleção dos artigos, todos na língua inglesa. Foram utilizadas literaturas publicadas com recorte temporal de 2017 a 2022. De acordo com as literaturas analisadas, conclui-se que, quando comparado com outros sedativos gabaminérgicos, como os benzodiazepínicos e o propofol, a dexmedetomidina diminui significativamente a incidência de delirium nos pacientes adultos em ventilação mecânica na UTI, com melhora da capacidade de despertar do paciente, preservação do desempenho cognitivo e redução do risco de depressão respiratória. Desse modo, pesquisas futuras sobre as propriedades farmacológicas da dexmedetomidina podem ajudar a determinar se esta droga possui propriedades neuroprotetoras intrínsecas, sendo assim, tal descoberta facilitaria o desenvolvimento de análogos com menos efeitos colaterais cardiorrespiratórios, tendo em vista seu efeito hemodinâmico, com bradicardia e possível hipotensão associadas

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

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

Histeria: a unidade perdida - estudo dos fenómenos semelhantes e dissemelhantes das perturbações somatoformes e dissociativas.

Programa de Doutoramento em Saúde Menta

Music, ballet, mindfulness, and psychological inflexibility

Both music and dance training can be conceptualised as mindfulness-like practices due to their focus on the present moment. Mindfulness and music are associated with mental health. However, evidence from dance practice, especially among ballet students, shows an association with mental health problems. Psychological inflexibility involves cognitive fusion, which is an excessive involvement with internal events, leading to experiential avoidance. Since studies analysing these concepts are scarce in music and dance practice, we intended to examine their effects in young music and ballet students. This study involved 113 participants (9 to 16 years old), 64.4% girls, 34.5% with musical training, 29.2% with ballet training, and 36.3% with no training. All participants completed the Child and Adolescent Mindfulness Measure (CAMM) and the Avoidance and Fusion Questionnaire for Youth (AFQ-Y). AFQ-Y scores correlated with months of ballet training. Ballet students had greater psychological inflexibility than music students and students without any training. CAMM scores did not correlate with months of any practice, and did not distinguish between groups of practitioners. These data confirm prior findings that practice of ballet can have a potential impact on mental health by showing that young ballet students exhibit greater psychological inflexibility

EFEITOS DE UH PROGRAMA ESPECIFICO DE ATIVIDADES FlSICAS NO RENDIMENTO ESCOLAR DE CRIANÇAS QUE APRESENTAM OU NAO PROBLEMAS DE LATERALIDADE CRUZADA

: Este estudo foi desenvolvido a fim de averiguar o efeito de um PROGRAMA ESPECÍFICO DE EdUCAÇAO FÍSICA NO RENDIMENTO ESCOLAR DE CRI­ANÇAS PORTADORAS OU NAO DE,LATERAL IDADE CRUZADA, Os SUJEITOS FORAM 115 ESCOLARES, NA FAIXA ETÁRIA DE 7 A 9 ANOS, DE AMBOS OS SEXOS, CUR SANDO A 2! E A 3! SERIE DO l2 GRAU EM ESCOLAS PUBLICAS DE PORTO AlE~ GRE/RS. Os INSTRUMENTOS UTILIZADOS FORAM: 0 TESTE DE LATERALIDADE, 0 TESTE DE PIAGET-HEAD E OS CONCEIJOS OBTIDOS PELOS ALUNOS DURANTE 0 ANO LETIVO. 0 ESTUDO TEVE A DURAÇÃO DE 8 MESES, E_M ESCOLAS ESTADUAIS de Porto Alegre, com_eqüivalente nível sócio-econõmico e o programa ESPECÍFICO DE EDUCAÇAO FÍSICA FOI APLICADO PELA PROPRIA AUTORA. ESTA PESQUISA FOI DE,NATUREZA EXPERIMENTAL, COM MEDIDAS INICIAIS E FINAIS SOB FORMA DE PRE E PÓS-TESTE E, PARA A ANALISE DOS DADOS, FOI UTILI­ZADO o teste "t" de Student. Os resultados mostraram que os dados em píricos não confirmaram as suposições na sua totalidade. NÃO SE VERiFICOU MELHORIA NO RENDIMENTO ESCOLAR, NÃO FOI SIGNIFICATIVA A MELHO­RIA DO DESEMPENHO DO ALUNO_NO RESULTADO DO TESTE PIAGET-HEAD. 0 PRO­GRAMA ESPECÍFICO DE EDUCAÇÃO FÍSICA CAUSOU EFEITOS POSITIVOS NA DEFi NIÇÃO DA LATERALIDADE

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable