GERENCIANDO A DOR DA HÉRNIA DE DISCO: EXPLORANDO AS OPÇÕES CIRÚRGICAS

Introduction: A herniated disc (HD) occurs when the intervertebral disc, the structure between the vertebrae of the spine, ruptures or dislocates, pressing on nearby nerves and causing pain. This can result in symptoms such as back pain, depending on the location of the hernia. Relevance: As this is a topic of pain associated with nerve compressions, the study reaffirms the importance of intervention therapies to resolve this latent comorbidity, as well as its more in-depth discussion. Problematic: HD sometimes presents a significant challenge to be considered a chronic condition. Even after treatments and interventions, some patients may continue to deal with persistent symptoms for the long term. Objective: Understand how to treat disc pain caused by HD, especially low back pain, and analyze therapeutic options for pain management and surgical options in the literature. Methodology: Systematic review through the platforms: Latin American and Caribbean Literature in Health Sciences (LILACS), Scientific Electronic Library Online (SciELO), Virtual Health Library (VHL), to carry out the selection of health descriptors (DECs) controlled: “Intervertebral Disc Displacement”, “Surgical Intervention”, “Pain Treatment”. Results: Treatment can range from conservative measures to more invasive surgeries, such as surgeries to alleviate nervous symptoms. The stage of the disease depends on the severity of the hernia, response to treatment, and nerve involvement. Recovery can vary and some patients experience specific improvements while others may deal with residual symptoms. Conclusion: Effective management of HD often requires a combination of approaches to control pain and improve the patient's quality of life. Although surgery may be an option in severe cases or when conservative treatments do not sufficiently resolve the problem, it is crucial to consider other original interventions.Introdução: A hérnia de disco (HD) ocorre quando o disco intervertebral, uma estrutura entre as vértebras da coluna, se rompe ou se desloca, pressionando os nervos próximos e causando dor. Isso pode resultar em sintomas como dor nas costas, dependendo da localização da hérnia. Relevância: Por ser um tema de dor associada a compressões nervosas, o estudo reintegra a importância de terapias de intervenção para resolução desta comorbidade latente bem como sua discussão mais aprofundada. Problemática: A HD, por vezes, apresenta um desafio significativo por ser considerada uma condição crônica. Mesmo após tratamentos e intervenções, alguns pacientes podem continuar a lidar com sintomas persistentes a longo prazo. Objetivo: Entender como gerenciar a  dor da HD de disco, em especial a lombar e analisar na literatura as opções terapêuticas de realização do manejo da dor até as opções cirúrgicas. Metodologia: Revisão sistemática através das plataformas: Literatura Latino-americana e do Caribe em ciências da Saúde (LILACS), Scientific Eletronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS), para conduzir a seleção foram usados os descritores em saúde (DECs)controlados: “Deslocamento do Disco Intervertebral”, “Intervenção Cirúrgica”, “Manejo da Dor”. Resultados: O tratamento pode variar desde medidas conservadoras, até intervenções mais invasivas, como cirurgia para aliviar a compressão nervosa. O desfecho da doença depende da gravidade da hérnia, da resposta ao tratamento e do comprometimento dos nervos A recuperação pode variar, e alguns pacientes experimentam melhora considerável, enquanto outros podem lidar com sintomas residuais. Conclusão: A gestão eficaz da HD muitas vezes requer uma combinação de abordagens para controlar a dor e melhorar a qualidade de vida do paciente. Embora a cirurgia possa ser uma opção em casos graves ou quando os tratamentos conservadores não proporcionam alívio suficiente, é crucial reconhecer outras intervenções originais

A influência da síndrome de ovários policísticos e síndrome metabólica na escolha do tipo de parto: revisão de literatura

Introduction: Polycystic Ovary Syndrome (PCOS) and Metabolic Syndrome (MS) are interconnected through various physiological pathways, and their coexistence may have significant implications, especially during pregnancy and the childbirth process. During pregnancy, women with PCOS and MS may face an increased risk of obstetric complications. Regarding the impact on childbirth, PCOS and MS can influence the choice of the type of delivery. Methodology: This work constitutes a literature review, following the systematization with the five pillars described below. 1) Problem statement: "What is the influence of PCOS and MS on the choice of the type of delivery?". 2) Relevant studies were identified using the PUBMED platform with the descriptors "Metabolic Syndrome, Polycystic Ovary Syndrome, Parturition, Pregnancy," PUBMED all in accordance with MESH. 3) Initially, 11 studies were selected; 4 were discarded after a thorough reading as they did not contribute to the problem statement. 4) Data extraction was performed using a text editing program. 5) Experts were consulted. Results: The studies revealed that PCOS and MS are associated with a clinically significant increase in the risk of complications during pregnancy compared to control groups. Additionally, there is a 3 to 4 times higher likelihood of developing pregnancy-induced hypertension and preeclampsia, a threefold increase in the risk of gestational diabetes, and a twofold likelihood of premature birth. The elevated obstetric risk for women with PCOS is reflected in a higher rate of spontaneous abortion. Moreover, it was observed that, compared to the general population, PCOS and MS are more associated with cesarean delivery. Conclusion: Cesarean delivery is predominant in patients with PCOS and MS. Furthermore, there is a higher risk of developing pregnancy-induced hypertension, preeclampsia, and premature birth.Introdução: A síndrome dos ovários policísticos (SOP) e a síndrome metabólica (SM) estão interligadas por várias vias físicas, e sua coexistência pode ter implicações significativas, especialmente durante a gravidez e no processo de parto. Durante a gravidez, as mulheres SOP e SM podem enfrentar um risco aumentado de complicações obstétricas. Quanto ao impacto no parto, a SOP e a SM podem influenciar a escolha do tipo de parto Metodologia: Este trabalho trata-se de uma revisão de literatura, de acordo com a sistematização com os 5 pilares descritos a seguir. 1) Questão problema: “Qual a influência da SOP e SM na escolha do tipo de parto?”. 2) Estudos relevantes foram identificados utilizando na plataforma PUBMED os descritores “Metabolic Syndrome, Polycystic Ovary Syndrome, Parturition, Pregnancy”, na PUBMED, todos de acordo com MESH. 3) 11 estudos foram selecionados inicialmente, 4 foram descartados mediante leitura completa por não contribuir com a questão problema. 4) A extração de dados foi realizada em um programa de edição de texto. 5) Especialistas foram consultados.  Resultado: Os estudos revelaram que a SOP e SM estão associadas a um aumento clinicamente significativo no risco de complicações durante a gravidez, em comparação com os grupos de controle. Além disso, há uma probabilidade de 3 a 4 vezes maior de desenvolver hipertensão causada pela gravidez e pré-eclâmpsia, um aumento de 3 vezes sem risco de diabetes gestacional e uma probabilidade duas vezes maior de parto prematuro. O risco obstétrico elevado para mulheres com SOP se reflete em uma maior taxa de aborto espontâneo. Diante disso, observou-se que em relação a população em geral, SOP e SM associam-se mais com o parto cesariano. Conclusão: O parto cesariano é predominante em pacientes com SOP e SM. Além disso, há maior risco de desenvolver hipertensão causada pela gravidez, pré-eclâmpsia e parto prematuro

PREVALÊNCIA DA PARADA CARDÍACA DURANTE A ANESTESIOLOGIA NO LAPSO INTRA-OPERATÓRIO

Cardiac arrest involves the heart not functioning properly, so our body's organs end up not receiving blood flow constantly and correctly, resulting in a lack of oxygen in other vital organs. This adverse event is commonly seen during anesthetic periods and may have several potentiating factors, such as comorbidities and the patient's clinical status. Methodology: The present study addresses a systematic review with the aim of analyzing and understanding the occurrence of these cases and their possible related causes. Comprehensive articles on this topic were selected from November 2023 without time restrictions. Results: Cardiac arrests during surgery in anesthetized patients are serious and potentially fatal events. They can be triggered by a variety of factors, including respiratory complications, electrolyte disturbances, pre-existing heart conditions, shock, excessive bleeding, medication administration errors, and major surgical procedures. Conclusion: Despite the technological advances and facilities implemented, a significant number of this type of condition still occurs.A parada cardíaca envolve o não funcionamento adequado do coração, assim os órgão do nosso organismo acabam não recebendo o fluxo sanguíneo de forma constante e correta, resultando na falta de oxigênio nos demais órgão vitais. Esse evento adverso citado enquanto o paciente está sob anestesia  é uma situação crítica e pode possuir diversos fatores potenciadores, como no caso das comorbidades e estado clínico do paciente em si. Metodologia: O presente estudo aborda uma revisão sistemática com o intuito de analisar e compreender a ocorrência desses casos e as suas possíveis causas relacionadas, foi selecionado artigos abrangentes dessa temática no período de novembro de 2023, os dados primários foram.  Resultados: As paradas cardíacas durante cirurgias em pacientes anestesiados são eventos graves e potencialmente fatais. Podem ser desencadeadas por uma variedade de fatores, incluindo complicações respiratórias, distúrbios eletrolíticos, condições cardíacas pré-existentes, choque, hemorragia excessiva, erros na administração de medicamentos e procedimentos cirúrgicos de grande porte. Conclusão: Apesar dos avanços e facilidades tecnológicas implementadas, ainda ocorre um número significativo desse tipo de quadro

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

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