Sepse: uma discussão sobre as mudanças de seus critérios diagnósticos / Sepse: a discussion on the changes of its diagnostic criteria

No início de 2016 ocorreu o Terceiro Consenso Internacional para a Definição de Sepse e Choque Séptico (Sepsis-3), no qual algumas mudanças foram adotadas em relação aos antigos critérios diagnósticos, e com elas surgiram dúvidas e discussões a respeito de suas adequações, vantagens e desvantagens. Para melhor esclarecimento destas questões realizamos esta revisão da literatura, cujos resultados indicaram que as atualizações das definições de sepse trazem vantagens em relação ao entendimento de sua definição e fisiopatologia, além de trazer maior importância a qualquer quadro de sepse. Entretanto, o novo escore ainda apresenta problemas como: dificuldade do uso, retardo do diagnóstico, ausência de validação prospectiva do Quick Sequential Organ Failure Assessment (qSOFA), diminuição da importância do lactato e redução da sensibilidade. Desse modo, os critérios de Systemic Inflammatory Response Syndrome (SIRS) ainda não podem ser totalmente abandonados, principalmente nos países em desenvolvimento. Além disso, ainda é necessária a realização de mais estudos prospectivos sobre o assunto e que levem em consideração dados de países em desenvolvimento, como mortalidade, recursos e epidemiologia.

Investigation of protective effects of erythrina velutina extract against MMS induced damages in the root meristem cells of allium cepa

Erythrina velutina Willd., Fabaceae, is a medicinal plant that can be found in the tropics and subtropics, including in the semi-arid northeastern Brazil. It is commonly used in folk medicine to treat anxiety, agitation and insomnia. E. velutina has been known to present analgesic, anti-infl ammatory and antibacterial activities, however, it is unknown if this plant present a protective effect on DNA. We assessed the antigenotoxic effect of E. velutina against the genotoxic effects induced by MMS in the root meristem cells of Allium cepa. Three concentrations of the aqueous extract (100, 200 and 400 mg/L) of this medicinal plant were used in three different types of treatment (pre-, post- and simultaneous). The effects of the extracts on the root meristem cells of A. cepa were analyzed at both macroscopic and microscopic levels. Protective effects were observed at higher concentrations in pre-treatment and in simultaneous treatment. The results suggest that E. velutina may present antigenotoxic properties and demonstrate its chemopreventive potential

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Avaliação da concentração de bixina e norbixina em extrato de urucum obtido a partir de diferentes solventes / Evaluation of the concentration of bixin and norbixin in annatto extract obtained from different solvents

O urucuzeiro, ou Bixa orellana L., bastante conhecido por suas sementes avermelhadas, possui rica composição de carotenoides, tendo como principais compostos a bixina e a norbixina. Este trabalho teve como objetivo obter e caracterizar extrato à base de se- mentes de urucum, para futura aplicação em filmes comestíveis. A produção do extrato das sementes de urucum foi realizada em temperatura de 40oC utilizando como solventes, clorofórmio, acetona 30% e etanol. Para a seleção do melhor solvente de extração, foi calculado o rendimento de produção do extrato, além da cromatografia líquida de alta eficiência para quantificação de bixina e norbixina, tal como rendimento do extrato. O extrato de clorofórmio demonstrou os melhores resultados, apresentando as maiores médias de bixina e norbixina e um rendimento de 6,84%. O extrato selecionado foi caracterizado por Espectrometria de emissão óptica com plasma (Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, P, Pb e Zn) e absorção atômica em forno de grafite (Ag, Al, As, Hg)

Effect of lung recruitment and titrated Positive End-Expiratory Pressure (PEEP) vs low PEEP on mortality in patients with acute respiratory distress syndrome - A randomized clinical trial

IMPORTANCE: The effects of recruitment maneuvers and positive end-expiratory pressure (PEEP) titration on clinical outcomes in patients with acute respiratory distress syndrome (ARDS) remain uncertain. OBJECTIVE: To determine if lung recruitment associated with PEEP titration according to the best respiratory-system compliance decreases 28-day mortality of patients with moderate to severe ARDS compared with a conventional low-PEEP strategy. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, randomized trial conducted at 120 intensive care units (ICUs) from 9 countries from November 17, 2011, through April 25, 2017, enrolling adults with moderate to severe ARDS. INTERVENTIONS: An experimental strategy with a lung recruitment maneuver and PEEP titration according to the best respiratory-system compliance (n = 501; experimental group) or a control strategy of low PEEP (n = 509). All patients received volume-assist control mode until weaning. MAIN OUTCOMES AND MEASURES: The primary outcome was all-cause mortality until 28 days. Secondary outcomes were length of ICU and hospital stay; ventilator-free days through day 28; pneumothorax requiring drainage within 7 days; barotrauma within 7 days; and ICU, in-hospital, and 6-month mortality. RESULTS: A total of 1010 patients (37.5% female; mean [SD] age, 50.9 [17.4] years) were enrolled and followed up. At 28 days, 277 of 501 patients (55.3%) in the experimental group and 251 of 509 patients (49.3%) in the control group had died (hazard ratio [HR], 1.20; 95% CI, 1.01 to 1.42; P = .041). Compared with the control group, the experimental group strategy increased 6-month mortality (65.3% vs 59.9%; HR, 1.18; 95% CI, 1.01 to 1.38; P = .04), decreased the number of mean ventilator-free days (5.3 vs 6.4; difference, −1.1; 95% CI, −2.1 to −0.1; P = .03), increased the risk of pneumothorax requiring drainage (3.2% vs 1.2%; difference, 2.0%; 95% CI, 0.0% to 4.0%; P = .03), and the risk of barotrauma (5.6% vs 1.6%; difference, 4.0%; 95% CI, 1.5% to 6.5%; P = .001). There were no significant differences in the length of ICU stay, length of hospital stay, ICU mortality, and in-hospital mortality. CONCLUSIONS AND RELEVANCE: In patients with moderate to severe ARDS, a strategy with lung recruitment and titrated PEEP compared with low PEEP increased 28-day all-cause mortality. These findings do not support the routine use of lung recruitment maneuver and PEEP titration in these patients. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01374022

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora