A importância do diagnóstico laboratorial para erradicação da malária: uma revisão de literatura / The importance of laboratory diagnosis for malaria eradication: a literature review

A malária é uma doença causada por parasitas do gênero Plasmodium, sendo transmitida aos humanos pela picada de uma fêmea infectada do mosquito da espécie Anopheles. No Brasil, principalmente na região Amazônica, é um dos principais problemas de saúde pública. Porém, também ocorrem casos de malária em regiões extra-amazônica. A malária é uma das principais causas de mortalidade mundialmente e o diagnóstico precoce e rápido impedem uma maior letalidade. Assim, o objetivo do trabalho é realizar uma revisão de literatura sobre a importância do diagnóstico laboratorial para erradicação da malária. Os artigos utilizados nesta revisão de literatura foram pesquisados nas bases de dados National Library of Medicine (PubMED), Google Acadêmico e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), sendo publicados entre os anos 2004 e 2021. O laboratório é necessário para o diagnóstico da malária, que começa com a identificação do parasita, através do exame microscópio do sangue que pode ser realizado de dois tipos: esfregaço delgado (distendido) ou espesso (gota espessa), sendo o último o mais utilizado. Ambos os métodos apresentam baixo custo, identificando com facilidade e exatidão a espécie do plasmódio. Além disso, técnicas mais precisas como a Reação de Cadeia em Polimerase (PCR) são utilizadas para a identificação do DNA do Plasmodium circulante, porém essa técnica tem um elevado custo e por isso, não é muito utilizada na rotina de diagnóstico laboratorial dos casos de malária, apenas em centros de pesquisa

Association of Genetic Variants With Primary Open-Angle Glaucoma Among Individuals With African Ancestry.

Importance:Primary open-angle glaucoma presents with increased prevalence and a higher degree of clinical severity in populations of African ancestry compared with European or Asian ancestry. Despite this, individuals of African ancestry remain understudied in genomic research for blinding disorders. Objectives:To perform a genome-wide association study (GWAS) of African ancestry populations and evaluate potential mechanisms of pathogenesis for loci associated with primary open-angle glaucoma. Design, Settings, and Participants:A 2-stage GWAS with a discovery data set of 2320 individuals with primary open-angle glaucoma and 2121 control individuals without primary open-angle glaucoma. The validation stage included an additional 6937 affected individuals and 14 917 unaffected individuals using multicenter clinic- and population-based participant recruitment approaches. Study participants were recruited from Ghana, Nigeria, South Africa, the United States, Tanzania, Britain, Cameroon, Saudi Arabia, Brazil, the Democratic Republic of the Congo, Morocco, Peru, and Mali from 2003 to 2018. Individuals with primary open-angle glaucoma had open iridocorneal angles and displayed glaucomatous optic neuropathy with visual field defects. Elevated intraocular pressure was not included in the case definition. Control individuals had no elevated intraocular pressure and no signs of glaucoma. Exposures:Genetic variants associated with primary open-angle glaucoma. Main Outcomes and Measures:Presence of primary open-angle glaucoma. Genome-wide significance was defined as P < 5 × 10-8 in the discovery stage and in the meta-analysis of combined discovery and validation data. Results:A total of 2320 individuals with primary open-angle glaucoma (mean [interquartile range] age, 64.6 [56-74] years; 1055 [45.5%] women) and 2121 individuals without primary open-angle glaucoma (mean [interquartile range] age, 63.4 [55-71] years; 1025 [48.3%] women) were included in the discovery GWAS. The GWAS discovery meta-analysis demonstrated association of variants at amyloid-β A4 precursor protein-binding family B member 2 (APBB2; chromosome 4, rs59892895T>C) with primary open-angle glaucoma (odds ratio [OR], 1.32 [95% CI, 1.20-1.46]; P = 2 × 10-8). The association was validated in an analysis of an additional 6937 affected individuals and 14 917 unaffected individuals (OR, 1.15 [95% CI, 1.09-1.21]; P < .001). Each copy of the rs59892895*C risk allele was associated with increased risk of primary open-angle glaucoma when all data were included in a meta-analysis (OR, 1.19 [95% CI, 1.14-1.25]; P = 4 × 10-13). The rs59892895*C risk allele was present at appreciable frequency only in African ancestry populations. In contrast, the rs59892895*C risk allele had a frequency of less than 0.1% in individuals of European or Asian ancestry. Conclusions and Relevance:In this genome-wide association study, variants at the APBB2 locus demonstrated differential association with primary open-angle glaucoma by ancestry. If validated in additional populations this finding may have implications for risk assessment and therapeutic strategies

Novas evidências na abordagem terapêutica da Nefrolitíase em pacientes pediátricos: uma revisão integrativa: New evidence on the therapeutic approach to Nephrolithiasis in pediatric patients: an integrative review

A nefrolitíase possui prevalência mundial situada entre 5% e 15%, além de recorrência em adultos de até 75% em 20 anos entre os pacientes que sofrem recidivas. Já em crianças, a nefrolitíase é relativamente infrequente, com prevalência que varia entre 2 a 2,7%, sendo o tratamento dividido entre medidas farmacológicas e medidas não farmacológicas. O presente estudo de revisão buscou avaliar novas evidências na abordagem terapêutica da nefrolitíase em pacientes pediátricos, documentados por meio de estudos clínicos e randomizados. Trata-se de uma pesquisa de revisão integrativa realizada por meio da base de dados PubMed, que levou em consideração os seguintes critérios de inclusão: ensaios clínicos e testes controlados e aleatórios; artigos publicados nos últimos quatro anos; que possuíam texto completo disponível e que abordassem acerca da terapêutica da nefrolitíase na população pediátrica. Ficou constatado que no âmbito do tratamento farmacológico, o lumasiran se mostrou útil na diminuição da taxa de eventos provocados por cálculos em crianças com hiperoxalúria tipo 1. No que se refere à terapêutica não invasiva, estudos apontaram as frequências intermediárias como as melhores a serem utilizadas durante a LECO em crianças, além do aumento da eficácia deste procedimento quando feito após hidronefrose artificial. Quanto à terapêutica invasiva, foi atestado o aumento da eficácia da NLPC quando feito sob a técnica de dilatação de passo único em crianças com nefrolitíase. Ainda sobre a NLPC, foi observado não haver diferença significativa de complicações ou dor pós-operatória da cirurgia em relação à posição da criança

"AMAMENTAÇÃO E SUAS PRINCIPAIS DIFICULDADES DENTRO DO RISCO HABITUAL" REVISÃO BIBLIOGRÁFICA

Breastfeeding should be exclusive until six months of age. Therefore, the habit of Exclusive Breastfeeding (EBF) helps the health not only of the child, but also of the mother, who benefits from many of the advantages. Many women are faced with challenges related to milk production, emotional and social issues, nutritional status and well-being of the baby, lifestyle in general, as well as discomfort and difficulty in breastfeeding and correct positioning of the baby at the breast, which can lead to the interruption of this protective behavior. It is essential that health professionals who work in primary care receive adequate training and are updated through courses, in order to offer adequate assistance to pregnant women, mothers and children in relation to breastfeeding in Primary Care. The objective of this study is to propose that health professionals provide guidance on breastfeeding during prenatal care and prevent breastfeeding complications. This research is based on an integrated review of scientific literature. Data collection was carried out in the VHL (Virtual Health Library), SciELO and PUBMED databases, between the months of October and November 2022. Several articles from the current bibliography were listed, using keywords such as: “Breastfeeding” , “Prenatal Care”, “Role of the Nurse” and “Health Education”, previously consulted in the DEC's (Health Sciences Descriptors). Results and discussion: Following the analysis of the database and descriptors, 10 studies were selected for evaluation of the full texts and were used to create the present research, and the following topics were discussed: The advantages of infant feeding with milk maternal; guidance on breastfeeding health and the participation of nurses and the multidisciplinary team in prenatal care. In summary, we also highlight the contributions relating to the subject under discussion that will be extremely useful for future professional performance in the health sector, in which the learning acquired will certainly have an influence on the establishment of effective and committed care, prioritizing comprehensive guidelines on the feeding with breast milk. O aleitamento materno deve ser exclusivo até aos seis meses de vida. Logo, o hábito do Aleitamento Materno Exclusivo (AME) auxilia para a saúde não somente da criança, mas também da mãe, que se beneficia de boa parte das vantagens. Diversas mulheres se deparam com desafios relacionados à produção de leite, questões emocionais e sociais, estado nutricional e o bem-estar do bebê, estilo de vida em geral, além de desconforto e dificuldade na amamentação e posicionamento correto do bebê no seio, o que pode levar à interrupção desse comportamento protetor. É essencial que os profissionais de saúde que trabalham na atenção básica recebam uma formação adequada e sejam atualizados por meio de cursos, a fim de oferecerem assistência adequada às gestantes, mães e crianças em relação ao aleitamento materno na Atenção Primária. O objetivo deste estudo é propor que os profissionais de saúde forneçam orientações sobre o aleitamento materno durante o pré-natal e previnam complicações na amamentação. Esta pesquisa é baseada em uma revisão integrada da literatura científica. A coleta de dados foi realizada nas bases de dados BVS (Biblioteca Virtual em Saúde), SciELO e PUBMED, entre os meses de outubro e novembro de 2022. Foram relacionados diversos artigos da bibliografia atual, utilizando palavras-chave como: “Aleitamento Materno”, “Cuidado Pré-natal”, “Papel do Enfermeiro” e “Educação em Saúde”, previamente consultados no DEC’s (Descritores em Ciências da Saúde). Resultados e discussão:Seguindo de acordo com as análises da base de dados e descritores, foram selecionados 10 estudos para avaliação dos textos completos e foram utilizados para criação da presente pesquisa, e assim foram discutidos os seguintes temas: As vantagens da alimentação infantil com leite materno; orientação sobre a saúde na amamentação e a participação do enfermeiro e também da equipe multidisciplinar no acompanhamento pré-natal. Em síntese, ressalta-se também as contribuições referentes ao assunto em discussão que serão extremamente úteis para o futuro desempenho profissional na área da saúde, em que o aprendizado adquirido certamente terá influência no estabelecimento de um cuidado eficaz e comprometido, priorizando orientações abrangentes sobre a alimentação com leite materno

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

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

Mitochondrial physiology

As the knowledge base and importance of mitochondrial physiology to evolution, health and disease expands, the necessity for harmonizing the terminology concerning mitochondrial respiratory states and rates has become increasingly apparent. The chemiosmotic theory establishes the mechanism of energy transformation and coupling in oxidative phosphorylation. The unifying concept of the protonmotive force provides the framework for developing a consistent theoretical foundation of mitochondrial physiology and bioenergetics. We follow the latest SI guidelines and those of the International Union of Pure and Applied Chemistry (IUPAC) on terminology in physical chemistry, extended by considerations of open systems and thermodynamics of irreversible processes. The concept-driven constructive terminology incorporates the meaning of each quantity and aligns concepts and symbols with the nomenclature of classical bioenergetics. We endeavour to provide a balanced view of mitochondrial respiratory control and a critical discussion on reporting data of mitochondrial respiration in terms of metabolic flows and fluxes. Uniform standards for evaluation of respiratory states and rates will ultimately contribute to reproducibility between laboratories and thus support the development of data repositories of mitochondrial respiratory function in species, tissues, and cells. Clarity of concept and consistency of nomenclature facilitate effective transdisciplinary communication, education, and ultimately further discovery

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

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