Avaliação da fadiga e da qualidade de vida de pacientes com câncer colorretal em quimioterapia

Objetivo: Avaliar a fadiga e a qualidade de vida relacionada à saúde de pacientes com câncer colorretal em quimioterapia.Método:estudo descritivo, realizado com 69 pacientes entre janeiro a setembro/2019, em um hospital público de Minas Gerais. Instrumentos utilizados: questionário sociodemográfico e clínico, Quality of Life Questionnaire-Core30 e Escala de Fadiga de Piper, analisados segundo medidas de frequência, média e desvio padrão pelo softwarePSPP.Resultados: A maioria era mulheres, acima de 60 anos, casadas, aposentadas, donas de casa, com médio nível de escolaridade. Os escores de estado geral de saúde, das funções social, física, emocional e desempenho de papel foram considerados satisfatórios (médias 50-70), da função cognitiva foi boa (média>70); sintomas mais prevalentes foram perda de apetite, fadiga, dor e insônia. Quanto à fadiga, todas as dimensões tiveram média <4, considerado fadiga leve.Conclusão: A qualidade de vida apresentou escores satisfatórios e a fadiga foi classificada como leve nos pacientes em quimioterapia. Palavras-chave: Neoplasias colorretais. Qualidade de vida. Fadiga. Tratamentofarmacológico

O movimento Verde Eufémia em Silves : o que têm a dizer o Governo Português e os meios de comunicação social?

info:eu-repo/semantics/publishedVersio

Post-acute COVID-19 outcomes including participant-reported long COVID: amubarvimab/romlusevimab versus placebo in the ACTIV-2 trial

BackgroundIt is unknown if early COVID-19 monoclonal antibody (mAb) therapy can reduce risk of Long COVID. The mAbs amubarvimab/romlusevimab were previously demonstrated to reduce risk of hospitalization/death by 79%. This study assessed the impact of amubarvimab/romlusevimab on late outcomes, including Long COVID.MethodsNon-hospitalized high-risk adults within 10 days of COVID-19 symptom onset enrolled in a randomized, double-blind, placebo-controlled phase 2/3 trial of amubarvimab/romlusevimab for COVID-19 treatment. Late symptoms, assessed using a participant-completed symptom diary, were a pre-specified exploratory endpoint. The primary outcome for this analysis was the composite of Long COVID by participant self-report (presence of COVID-19 symptoms as recorded in the diary at week 36) or hospitalization or death by week 36. Inverse probability weighting (IPW) was used to address incomplete outcome ascertainment, giving weighted risk ratios (wRR) comparing amubarvimab/romlusevimab to placebo.FindingsParticipants received amubarvimab/romlusevimab (n = 390) or placebo (n = 390) between January and July 2021. Median age was 49 years, 52% were female, 18% Black/African American, 49% Hispanic/Latino, and 9% COVID-19-vaccinated at entry. At week 36, 103 (13%) had incomplete outcome ascertainment, and 66 (17%) on amubarvimab/romlusevimab and 92 (24%) on placebo met the primary outcome (wRR = 0.70, 95% confidence interval (CI) 0.53-0.93). The difference was driven by fewer hospitalizations/deaths with amubarvimab/romlusevimab (4%) than placebo (13%). Among 652 participants with available diary responses, 53 (16%) on amubarvimab/romlusevimab and 44 (14%) on placebo reported presence of Long COVID.InterpretationAmubarvimab/romlusevimab treatment, while highly effective in preventing hospitalizations/deaths, did not reduce risk of Long COVID. Additional interventions are needed to prevent Long COVID.FundingNational Institute of Allergy and Infectious Diseases of the National Institutes of Health. Amubarvimab and romlusevimab supplied by Brii Biosciences

ANÁLISE COMPARATIVA DO USO DA ESTATINA E DO ÁCIDO NICOTÍNICO NO TRATAMENTO DA SÍNDROME METABÓLICA

Considering metabolic syndrome (MS) as a pathophysiological condition characterized by arterial hypertension, central obesity, insulin resistance, dyslipidemia, and hyperglycemia, this study aims to compare the use of statins and nicotinic acid in the treatment of MS. To this end, a comparative analysis based on relevant clinical and epidemiological studies was conducted. Thus, it is observed that statins significantly reduce LDL cholesterol by about 50% and decrease the risk of cardiovascular events by 25% to 35%, with an odds ratio (OR) of improvement between 0.70 and 0.80. Statins are widely available and accessible, especially in generic versions, and have a relatively manageable adverse effect profile. In contrast, nicotinic acid reduces LDL cholesterol by 15% to 25%, increases HDL cholesterol, and reduces triglycerides, but with less consistent efficacy in preventing cardiovascular events (OR ranging from 0.90 to 1.10) and significant side effects, such as skin flushing and hepatotoxicity. The cost and availability of nicotinic acid are more limited compared to statins. It is concluded that statins are the preferred choice for the treatment of MS due to their robust efficacy and accessibility, while nicotinic acid may be considered in specific cases, with caution due to its adverse effects.Considerando a síndrome metabólica (SM) como uma condição fisiopatológica caracterizada por hipertensão arterial, obesidade central, resistência à insulina, dislipidemia e hiperglicemia, este estudo objetiva comparar o uso de estatinas e ácido nicotínico no tratamento da SM. Para tanto, procede-se a uma análise comparativa baseada em estudos clínicos e epidemiológicos relevantes. Desse modo, observa-se que as estatinas reduzem significativamente o LDL-colesterol em cerca de 50% e diminuem o risco de eventos cardiovasculares em 25% a 35%, com odds ratio (OR) de melhora entre 0,70 e 0,80. As estatinas são amplamente disponíveis e acessíveis, especialmente nas versões genéricas, e apresentam um perfil de efeitos adversos relativamente manejável. Em contraste, o ácido nicotínico reduz o LDL-colesterol em 15% a 25%, aumenta o HDL-colesterol e reduz os triglicerídeos, mas com uma eficácia menos consistente na prevenção de eventos cardiovasculares (OR variando de 0,90 a 1,10) e efeitos colaterais significativos, como rubor cutâneo e hepatotoxicidade. O custo e a disponibilidade do ácido nicotínico são mais limitados em comparação às estatinas. Conclui-se que as estatinas são a escolha preferida para o tratamento da SM devido à sua eficácia robusta e acessibilidade, enquanto o ácido nicotínico pode ser considerado em casos específicos, com precaução devido aos seus efeitos adversos

ANÁLISE COMPARATIVA DO USO DE LISDEXANFETAMINA E DE METILFENIDATO NO TRATAMENTO DO TDAH

  Considering the increasing prevalence of Attention Deficit Hyperactivity Disorder (ADHD) and the need for effective and safe therapeutic interventions, this research aimed to conduct a comparative analysis between lisdexamfetamine and methylphenidate in the treatment of ADHD. To this end, a comprehensive qualitative literature review was conducted, using sources such as Scielo, Google Scholar, scientific journals, institutional repositories, and virtual libraries, without specific time period limitations. Thus, it was observed that both medications demonstrated efficacy in reducing ADHD symptoms. Lisdexamfetamine showed a more prolonged and consistent effect on dopaminergic neurotransmission and a potentially more favorable side effect profile, with fewer reports of severe adverse effects compared to methylphenidate. Methylphenidate, in turn, showed significant efficacy, especially in the short term. It is concluded that both lisdexamfetamine and methylphenidate are valid therapeutic options for the treatment of ADHD, with specific advantages in different clinical contexts. The choice between these medications should consider the individual characteristics of patients and the available evidence of efficacy and safety, contributing to the optimization of treatment and the improvement of the quality of life of patients with ADHD.Considerando a crescente prevalência do Transtorno de Déficit de Atenção e Hiperatividade (TDAH) e a necessidade de intervenções terapêuticas eficazes e seguras, esta pesquisa objetivou realizar uma análise comparativa entre lisdexanfetamina e metilfenidato no tratamento do TDAH. Para tanto, procedeu-se a uma revisão bibliográfica qualitativa abrangente, utilizando fontes como Scielo, Google Acadêmico, revistas científicas, repositórios institucionais e bibliotecas virtuais, sem limitação de período específico. Desse modo, observou-se que ambos os medicamentos demonstraram eficácia na redução dos sintomas do TDAH. A lisdexanfetamina apresentou um efeito mais prolongado e consistente na neurotransmissão dopaminérgica e um perfil de efeitos colaterais potencialmente mais favorável, com menos relatos de efeitos adversos graves em comparação ao metilfenidato. O metilfenidato, por sua vez, mostrou eficácia significativa, especialmente em curto prazo. Conclui-se que tanto a lisdexanfetamina quanto o metilfenidato são opções terapêuticas válidas para o tratamento do TDAH, com vantagens específicas em diferentes contextos clínicos. A escolha entre esses medicamentos deve considerar as características individuais dos pacientes e as evidências de eficácia e segurança disponíveis, contribuindo para a otimização do tratamento e a melhoria da qualidade de vida dos pacientes com TDAH

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info: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 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

Tuberculose pulmonar: perfil epidemiológico do sertão Pernambucano, Brasil / Pulmonary tuberculosis: epidemiological profile of sertão Pernambucano, Brazil

Atualmente, observa-se que a tuberculose pulmonar constitui um importante problema de Saúde Pública no mundo, uma vez que esse agravo apresentou, em 2015, 10,4 milhões de casos, dos quais, mais de um milhão de pessoas vieram a óbito. Sob essa perspectiva, o presente artigo tem como objetivo traçar um perfil epidemiológico dos casos de Tuberculose Pulmonar notificados no município de Serra Talhada, entre os anos de 2007 a 2017. Foi realizado um estudo de série histórica observacional do tipo transversal, no intervalo de tempo de 2007 a 2017.  No período investigado o número de casos de tuberculose pulmonar foi de 246 casos, o local que teve a maior prevalência foi Serra Talhada, 287 por 100 mil habitantes. Diante dos dados apresentados, é imprescindível concluir, portanto, que esse estudo corrobora o perfil epidemiológico brasileiro para a Tuberculose Pulmonar, o qual indica variabilidade nos índices de acometimento durante o período analisado