Influência de diferentes dietas hipercalóricas sobre o estresse oxidativo cardíaco/ Influence of different hypercaloric diets on cardiac oxidative stress

A alta ingestão de dietas hipercalóricas vem sendo mundialmente observada, acarretando aumento do tecido adiposo abdominal com concomitante quadro inflamatório sistêmico de baixo grau, desequilíbrio de citocinas, complicações metabólicas e cardiovasculares. Além disso, observa-se aumento da produção de radicais livres, que associado a diminuição das defesas antioxidantes, resultam em estresse oxidativo. Essa revisão sistemática objetiva analisar estudos que utilizam intervenções nutricionais por meio de dietas hipercalóricas e sua influência no estresse oxidativo cardíaco. A busca virtual foi realizada nas bases de dados Medline, via Pubmed e Bireme, ScienceDirect, Lilacs, e Scielo utilizando como descritores “oxidative stress”, “heart”, “myocardial”, “cardiac”, “high-fat diet”, “high-carbohydrate diet” e “diet”. Foram identificados 739 artigos, os quais após critérios de elegibilidade resultaram em 19 estudos. Estes foram separados em estudos experimentais envolvendo diferentes protocolos de dietas hipercalóricas ricas em gordura e/ou carboidratos.  Os estudos demonstram relação entre consumo de dietas hipercalóricas e estresse oxidativo cardíaco, baseadas em gorduras saturadas ou insaturadas, acrescidas ou não de açúcar observado pelo aumento da lipoperoxidação, carbonilação proteica e elevação das espécies reativas de oxigênio in situ, reporta-se possível envolvimento da enzima NADPH oxidase neste processo, bem como redução das defesas antioxidantes porém há carência de informações sobre as possíveis vias sinalizadoras envolvidas nesse processo.

MEDIDAS EMPREGADAS NO MANEJO PALIATIVO DA DISPNEIA NA INSUFICIÊNCIA CARDÍACA: UMA REVISÃO SISTEMÁTICA DA LITERATURA

Introduction: Heart pump failure, a syndrome called heart failure (HF) affects 2% of adults worldwide, leading to symptoms such as dyspnea, orthopnea, edema and congestion. Its management is mainly based on symptom control, avoiding new hospitalizations. At that moment, palliative care comes into play, which consists in multidisciplinary measures to provide symptomatic optimization and quality of life. The objective of this study is to evaluate the effect of the palliative approach in the control of dyspnea caused by HF. Methodology: This is a systematic review based on the PRISMA method, being searched for clinical trials of the last 10 years that corresponded to the descriptors “palliative care”, “heart failure” and “dyspnea”. Results: 16 articles were found, which, after applying the exclusion criteria, left 5 works that corresponded to the search question, which were tabulated and compared. Discussion: Palliative care, which includes drug, educational and even multidisciplinary therapies, reduced dyspnea, improved quality of life, survival and reduced hospitalization rates. Conclusion: The palliative approach to dyspnea in the context of HF, despite being satisfactory and promising, lacks studies aimed at controlling this symptom specifically, especially considering the need for a larger sample for randomization.  Introducción: El fracaso de la bomba cardíaca, un síndrome llamado insuficiencia cardíaca (IC) afecta al 2% de los adultos en el mundo, dando lugar a síntomas como disnea, ortopnea, edema y congestión. Su manejo se basa principalmente en el control de los síntomas, evitando nuevas hospitalizaciones. En este momento, entran en juego los cuidados paliativos, que consisten en medidas multidisciplinarias de optimización sintomática y calidad de vida. El objetivo de este estudio es evaluar el efecto del abordaje paliativo sobre el control de la disnea proporcionada por la IC. Metodología: Se trata de una revisión sistemática basada en el método PRISMA, buscada por ensayos clínicos de los últimos 10 años que correspondieron a los descriptores "cuidados paliativos", "insuficiencia cardíaca" y "disnea". Resultados: Se encontraron 16 artículos que, después de aplicar los criterios de exclusión, dejaron 5 estudios que correspondían a la pregunta de búsqueda, los cuales fueron tabulados y comparados. Discusión: Los cuidados paliativos que incluyen medicamentos, terapias educativas e incluso multidisciplinarias mostraron una reducción en la disnea, mejor calidad de vida, supervivencia y menores tasas de hospitalización. Conclusión: El abordaje paliativo de la disnea en el contexto de la IC, aunque satisfactorio y prometedor, carece de estudios dirigidos a controlar este síntoma específicamente, especialmente considerando la necesidad de un mayor muestreo para la aleatorización.Introdução: A falha da bomba cardíaca, síndrome denominada de insuficiência cardíaca (IC) afeta 2% dos adultos no mundo, levando a sintomas como dispneia, ortopneia, edemas e congestão. Seu manejo é baseado principalmente no controle de sintomas, evitando novas hospitalizações. Nesse momento entra em pauta os cuidados paliativos, que consistem em medidas multidisciplinares de otimização sintomática e qualidade de vida. O objetivo do trabalho é avaliar o efeito da abordagem paliativa no controle da dispneia proporcionada pela IC. Metodologia: Trata-se de uma revisão sistemática baseada no método PRISMA, sendo buscado por ensaios clínicos dos últimos 10 anos que corresponderam aos descritores “cuidados paliativos”, “insuficiência cardíaca” e “dispneia”. Resultados: Foram encontrados 16 artigos que, após aplicados os critérios de exclusão, restaram 5 trabalhos que correspondiam à pergunta de busca, os quais foram tabelados e comparados. Discussão: Os cuidados paliativos que incluem as terapêuticas medicamentosas, educativas e até mesmo as multidisciplinares apresentaram redução da dispneia, melhora da qualidade de vida, da sobrevida e redução dos índices de hospitalização. Conclusão: A abordagem paliativa da dispneia no contexto da IC, apesar de satisfatória e promissora, carece de estudos direcionados ao controle desse sintoma especificamente, principalmente considerando a necessidade de maior amostragem para randomização.  Introdução: A falha da bomba cardíaca, síndrome denominada de insuficiência cardíaca (IC) afeta 2% dos adultos no mundo, levando a sintomas como dispneia, ortopneia, edemas e congestão. Seu manejo é baseado principalmente no controle de sintomas, evitando novas hospitalizações. Nesse momento entra em pauta os cuidados paliativos, que consistem em medidas multidisciplinares de otimização sintomática e qualidade de vida. O objetivo do trabalho é avaliar o efeito da abordagem paliativa no controle da dispneia proporcionada pela IC. Metodologia: Trata-se de uma revisão sistemática baseada no método PRISMA, sendo buscado por ensaios clínicos dos últimos 10 anos que corresponderam aos descritores “cuidados paliativos”, “insuficiência cardíaca” e “dispneia”. Resultados: Foram encontrados 16 artigos que, após aplicados os critérios de exclusão, restaram 5 trabalhos que correspondiam à pergunta de busca, os quais foram tabelados e comparados. Discussão: Os cuidados paliativos que incluem as terapêuticas medicamentosas, educativas e até mesmo as multidisciplinares apresentaram redução da dispneia, melhora da qualidade de vida, da sobrevida e redução dos índices de hospitalização. Conclusão: A abordagem paliativa da dispneia no contexto da IC, apesar de satisfatória e promissora, carece de estudos direcionados ao controle desse sintoma especificamente, principalmente considerando a necessidade de maior amostragem para randomização

Abuso de Substâncias e Emergências Psiquiátricas: Avaliação Integrada e Intervenções Eficazes

Objective: Emphasize the importance of an integrated approach in addressing these issues, focusing on personalized and effective interventions. Methodology: A comprehensive review of scientific literature was conducted using databases such as PubMed, Latindex, and Scielo to identify relevant studies on substance abuse in psychiatric emergency contexts using MeSH Finder: "Nerve Agents"; "Neurotransmitter Agents"; "Mental Health". Results: The focus is on personalized interventions, such as specific therapies and emotional support, highlighting the importance of ongoing education and community involvement for prevention and recovery. The ultimate goal is to promote well-being through a multidisciplinary approach in complex situations. Conclusion: Collaboration between mental health and specialists is essential to address substance abuse and psychiatric emergencies. Personalized interventions, continuous education, and community involvement are crucial for prevention and recovery, aiming to promote well-being in complex situations.Objetivo: Destacar a importância da abordagem integrada na avaliação desses problemas, enfocando intervenções personalizadas e eficazes. Metodologia: Realizou-se uma revisão abrangente da literatura científica utilizando bases de dados, como PubMed, Latindex e Scielo, para identificar estudos relevantes sobre abuso de substâncias em contextos de emergências psiquiátricas utilizando os MeSH Finder: “Nerve Agents”; “Neurotransmitter Agents”; “Mental Health”.  Resultados: O foco recai sobre intervenções personalizadas, como terapias específicas e apoio emocional, enquanto ressalta a importância da educação contínua e do envolvimento da comunidade para prevenção e recuperação. O objetivo final é promover o bem-estar por meio de uma abordagem multidisciplinar em situações complexas. Conclusão: A colaboração entre saúde mental e especialistas é essencial para enfrentar abuso de substâncias e emergências psiquiátricas. Intervenções personalizadas, educação contínua e envolvimento comunitário são cruciais para prevenção e recuperação, visando promover o bem-estar em situações complexas

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

Doenças endocrinológicas com repercussões psiquiátricas: revisão sistemática / Endocrinological disorders with psychiatric repercussions: a systematic review

O objetivo do estudo foi realizar uma revisão sistemática de literatura sobre doenças endocrinológicas com repercussões psiquiátricas. Para isso, realizou-se uma revisão sistemática de literatura, através de uma busca nas bases de dados Latino-Americana e do Caribe em Ciências da Saúde, Google Scholar e Scientific Electronic Library Online, utilizando-se os descritores: Endocrinology, Mental Disorders, Psychiatric Symptoms, Cushing’s syndrome, Hyperthyroidism, Hypothyroidism, Addison disease. Através disso, foram selecionados 12 artigos que compunham os critérios de inclusão e exclusão do presente estudo. Dessa forma, destaca-se que os estudos evidenciaram que diversos são as repercussões psiquiátricas em pacientes com doenças endocrinológicas, variando desde transtornos de ansiedade, depressão, transtorno de déficit de atenção/hiperatividade e psicose, cabendo aos profissionais o diagnóstico correto e em tempo hábil para auxiliar na qualidade de vida do indivíduo. 

Minimal information for studies of extracellular vesicles (MISEV2023): From basic to advanced approaches

Extracellular vesicles (EVs), through their complex cargo, can reflect the state of their cell of origin and change the functions and phenotypes of other cells. These features indicate strong biomarker and therapeutic potential and have generated broad interest, as evidenced by the steady year-on-year increase in the numbers of scientific publications about EVs. Important advances have been made in EV metrology and in understanding and applying EV biology. However, hurdles remain to realising the potential of EVs in domains ranging from basic biology to clinical applications due to challenges in EV nomenclature, separation from non-vesicular extracellular particles, characterisation and functional studies. To address the challenges and opportunities in this rapidly evolving field, the International Society for Extracellular Vesicles (ISEV) updates its 'Minimal Information for Studies of Extracellular Vesicles', which was first published in 2014 and then in 2018 as MISEV2014 and MISEV2018, respectively. The goal of the current document, MISEV2023, is to provide researchers with an updated snapshot of available approaches and their advantages and limitations for production, separation and characterisation of EVs from multiple sources, including cell culture, body fluids and solid tissues. In addition to presenting the latest state of the art in basic principles of EV research, this document also covers advanced techniques and approaches that are currently expanding the boundaries of the field. MISEV2023 also includes new sections on EV release and uptake and a brief discussion of in vivo approaches to study EVs. Compiling feedback from ISEV expert task forces and more than 1000 researchers, this document conveys the current state of EV research to facilitate robust scientific discoveries and move the field forward even more rapidly

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

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