Oral supplementation of L-carnitine combined with exercise and respiratory training in patients with chronic obstructive pulmonary disease: preliminary study

Avaliar os efeitos da suplementação oral de L-carnitina associada ao treinamento físico e muscular respiratório na doença pulmonar obstrutiva crônica (DPOC). Participaram 14 voluntários com idade de 65±10,4 anos e diagnóstico clínico de DPOC moderado, classificados de acordo com a espirometria prévia. Os voluntários foram divididos em grupo treino esteira (GTE) e grupo treino muscular respiratório (GTMR). Realizaram o teste de caminhada de seis minutos (TC6'), teste de caminhada com carga progressiva (TCP), avaliação nutricional do índice de massa corpórea (IMC), dose diária recomendada de L-carnitina, pressões inspiratórias (PImáx) e expiratórias máximas (PEmáx). Fizeram 30 min de caminhada em esteira, 3 vezes/semana por 10 semanas, e o GTMR realizou, ainda, 10 min de treinamento muscular inspiratório (Threshold® IMT) e 10 min de treinamento muscular expiratório (Threshold® PEP) à 50% da PImáx e PEmáx ajustados semanalmente. Após 10 semanas, foram reavaliados. No TC6' pré e pós-programa de treinamento físico, as variáveis alteradas foram: distância percorrida (DP), frequência cardíaca (FC) final, pressão arterial sistólica (PAS) final, pressão arterial diastólica (PAD) final e Borg final no GTMR, no GTE as variáveis alteradas foram FC repouso, FC final, PAS final, Borg repouso e DP. Comparando os grupos no TC6, o GTE apresentou FC final, PAD final e Borg final maiores do que o GTMR na reavaliação; já no TCP, a FC final, PAS final, Borg final foram maiores no GTE, e DP foi maior no GTMR. Na avaliação respiratória, a PEmáx foi maior no GTMR na reavaliação. O treino aeróbio e suplementação de L-carnitina na DPOC otimizou a performance, a capacidade física e a tolerância ao esforço

Utilização de tecnologias por enfermeiros no gerenciamento da Atenção Primária à Saúde

RESUMOObjetivo: Analisar as ações de gerenciamento de enfermeiros em serviços de Atenção Primária à Saúde na perspectiva das tecnologias.Método: Estudo descritivo-exploratório com abordagem quantitativa, realizado de fevereiro a abril de 2019. Através da snowball technique, a amostra foi composta por 42 enfermeiros da Atenção Primária à Saúde, utilizando-se ferramenta eletrônica para coleta de dados. Os dados foram analisados por meio de técnicas de estatística descritiva.Resultados: 54,8% dos enfermeiros utilizam tecnologias através de sistemas eletrônicos SISREG e PEC, da qualificação do cuidado relacionada a educação permanente em saúde, de cursos online e presenciais, além do uso de tecnologias do cuidado como o telessaúde e a telemedicina.Conclusão: As ações de gerenciamento voltadas a tecnologia apresentaram utilização tímida. Os enfermeiros necessitam empoderar-se destes dispositivos organizacionais, tendo em vista o aprimoramento da assistência e qualidade do cuidado ao usuário.Palavras-chave: Enfermagem. Atenção primária à saúde. Gestão em saúde. Tecnologia biomédica

Adenomiose: etiofisiopatologia, diagnóstico e tratamento

A adenomiose é uma condição uterina benigna caracterizada pela invasão do tecido endometrial na camada muscular do útero, conhecida como miométrio. Essa invasão envolve glândulas e estroma endometrial, frequentemente acompanhadas por hiperplasia e hipertrofia das células musculares uterinas, sendo identificada pela presença desses elementos nas camadas miometriais. Revisão narrativa da literatura realizada a partir da busca bibliográfica na base de dados PubMed, com os descritores  “Adenomyosis”, “Etiophysiopathology”, “Diagnosis”, “Treatment”. Os estudos pesquisados foram publicados em periódicos internacionais, sendo selecionados artigos de revisão, revisão sistemática e metanálise. A etiofisiopatologia não é completamente compreendida, mas fatores hormonais e inflamatórios podem desempenhar um papel. O diagnóstico geralmente é feito por meio de exames de imagem, como ultrassonografia ou ressonância magnética. O tratamento pode incluir opções medicamentosas, como anti-inflamatórios e hormônios, para alívio dos sintomas. Em casos mais graves, a histerectomia pode ser considerada, especialmente se os sintomas não respondem aos tratamentos conservadores. A abordagem terapêutica é adaptada às necessidades individuais, considerando a gravidade dos sintomas e a preferência da paciente. A adenomiose é uma doença de etiofisiopatologia, diagnóstico e tratamento complexos, sendo necessários avanços na literatura científica em busca de sua melhor compreensão, além de diagnóstico precoce e tratamento mais assertivo e precoce

Influence of Ecto-Nucleoside Triphosphate Diphosphohydrolase Activity on Trypanosoma cruzi Infectivity and Virulence

The protozoan Trypanosoma cruzi is the causative agent of Chagas disease, an endemic zoonosis present in some countries of South and Central Americas. The World Health Organization estimates that 100 million people are at risk of acquiring this disease. The infection affects mainly muscle tissues in the heart and digestive tract. There are no vaccines or effective treatment, especially in the chronic phase when most patients are diagnosed, which makes a strong case for the development of new drugs to treat the disease. In this work we evaluate a family of proteins called Ecto-Nucleoside-Triphosphate-Diphosphohydrolase (Ecto-NTPDase) as new chemotherapy target to block T. cruzi infection in mammalian cells and in mice. We have used inhibitors and antibodies against this protein and demonstrated that T. cruzi Ecto-NTPDases act as facilitators of infection in mammalian cells and virulence factors in mice model. Two of the drugs used in this study (Suramin and Gadolinium) are currently used for other diseases in humans, supporting the possibility of their use in the treatment of Chagas disease

Manejo Inicial do Acidente Vascular Encefálico em Unidades de Emergência: Uma Revisão Integrativa

Stroke is one of the leading causes of morbidity and mortality, requiring rapid and effective management in emergency units. This integrative review aims to synthesize best practices, therapeutic advances, and technological innovations in the initial management of stroke. Studies published between 2019 and 2024 were analyzed, covering topics from digital technologies, such as mobile applications, to emergency therapies, such as thrombolysis and mechanical thrombectomy. The results indicate that the implementation of digital technologies improves triage and communication among healthcare professionals, while emergency therapies are effective in reducing the severity of neurological deficits. Pre-hospital triage and continuous training of professionals are crucial for high-quality care. A multidisciplinary approach, including early physiotherapy intervention, contributes to better functional outcomes. It is concluded that an integrated and coordinated approach is essential to optimize clinical outcomes and reduce the burden of stroke. Effective implementation of these strategies depends on investments in infrastructure, training, and ongoing research.O acidente vascular encefálico é uma das principais causas de morbidade e mortalidade, exigindo manejo rápido e eficaz em unidades de emergência. Esta revisão integrativa visa sintetizar as melhores práticas, avanços terapêuticos e inovações tecnológicas no atendimento inicial do acidente vascular encefálico. Foram analisados estudos publicados entre 2019 e 2024, abordando desde tecnologias digitais, como aplicativos móveis, até terapias emergenciais, como a trombólise e a trombectomia mecânica. Os resultados indicam que a implementação de tecnologias digitais melhora a triagem e a comunicação entre os profissionais de saúde, enquanto as terapias emergenciais são eficazes na redução da gravidade dos déficits neurológicos. A triagem pré-hospitalar e a capacitação contínua dos profissionais são cruciais para um atendimento de alta qualidade. A abordagem multidisciplinar, incluindo a intervenção precoce da fisioterapia, contribui para melhores desfechos funcionais. Conclui-se que uma abordagem integrada e coordenada é essencial para otimizar os resultados clínicos e reduzir a carga do acidente vascular encefálico. A implementação eficaz dessas estratégias depende de investimentos em infraestrutura, treinamento e pesquisa contínua

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

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