PREVENÇÃO DO TROMBOEMBOLISMO VENOSO EM GESTANTES E PÓS-PARTO: ABORDAGEM DOS FATORES DE RISCO E ESTRATÉGIAS DE INTERVENÇÃO

This study addresses the challenges faced in preventing venous thromboembolism (VTE) in pregnant women and during the postpartum period, highlighting risk factors and intervention strategies. During pregnancy, a woman's body undergoes adaptations to accommodate the fetus, increasing the risk of blood clot formation in the veins, which can lead to serious complications such as venous gangrene. Despite medical advancements, VTE has become the leading cause of maternal mortality in locations where other causes have been controlled. The risk of VTE during pregnancy and postpartum is significantly increased, being five to ten times higher during pregnancy and up to 20 times in the postpartum period compared to non-pregnant women of the same age. Factors such as advanced age, obesity, family history of VTE, thrombophilias, multiple pregnancies, cesarean delivery, and prolonged immobility contribute to this elevated risk. Integrative literature review identified that the use of compression stockings can be effective in reducing the risk of VTE in pregnant women, as well as the use of pharmacological anticoagulants, such as low-dose heparin. Systematic evaluation of VTE risk factors in all pregnant women and postpartum women, along with the implementation of appropriate preventive measures, is recommended. In summary, the study emphasizes the importance of early identification and management of VTE risk factors in pregnant women and during the postpartum period, as well as the implementation of effective preventive strategies. These measures have the potential to significantly improve maternal and neonatal outcomes, highlighting the need for a multidisciplinary and individualized approach to VTE prevention during pregnancy and postpartum.Este estudio aborda los desafíos enfrentados en la prevención de la tromboembolia venosa (TEV) en mujeres embarazadas y durante el período posparto, destacando los factores de riesgo y las estrategias de intervención. Durante el embarazo, el cuerpo de la mujer experimenta adaptaciones para acomodar al feto, aumentando el riesgo de formación de coágulos sanguíneos en las venas, lo que puede llevar a complicaciones graves como la gangrena venosa. A pesar de los avances médicos, la TEV se ha convertido en la principal causa de mortalidad materna en lugares donde se han controlado otras causas. El riesgo de TEV durante el embarazo y el posparto aumenta significativamente, siendo de cinco a diez veces mayor durante el embarazo y hasta 20 veces en el período posparto en comparación con mujeres no embarazadas de la misma edad. Factores como la edad avanzada, la obesidad, el historial familiar de TEV, las trombofilias, los embarazos múltiples, el parto por cesárea y la inmovilidad prolongada contribuyen a este riesgo elevado. La revisión integrativa de la literatura identificó que el uso de medias elásticas de compresión puede ser efectivo para reducir el riesgo de TEV en mujeres embarazadas, al igual que el uso de anticoagulantes farmacológicos, como la heparina de baja dosis. Se recomienda la evaluación sistemática de los factores de riesgo de TEV en todas las mujeres embarazadas y en el posparto, junto con la implementación de medidas preventivas adecuadas. En resumen, el estudio enfatiza la importancia de la identificación temprana y el manejo de los factores de riesgo de TEV en mujeres embarazadas y durante el período posparto, así como la implementación de estrategias preventivas efectivas. Estas medidas tienen el potencial de mejorar significativamente los resultados maternos y neonatales, destacando la necesidad de un enfoque multidisciplinario e individualizado para la prevención de la TEV durante el embarazo y el posparto.  Este estudo aborda os desafios enfrentados na prevenção do tromboembolismo venoso (TEV) em gestantes e no período pós-parto, destacando os fatores de risco e estratégias de intervenção. Durante a gravidez, o corpo da mulher passa por adaptações para acomodar o feto, aumentando o risco de formação de coágulos sanguíneos nas veias, que podem levar a complicações graves, como a gangrena venosa. Apesar dos avanços médicos, o TEV tornou-se a principal causa de mortalidade materna em locais onde outras causas foram controladas. O risco de TEV durante a gravidez e no período pós-parto é significativamente aumentado, sendo de cinco a dez vezes maior durante a gestação e até 20 vezes no pós-parto, comparado com mulheres não grávidas da mesma faixa etária. Fatores como idade avançada, obesidade, histórico familiar de TEV, trombofilias, gestações múltiplas, parto cesáreo e imobilidade prolongada contribuem para esse risco elevado. A revisão integrativa da literatura identificou que o uso de meias elásticas de compressão pode ser eficaz na redução do risco de TEV em mulheres grávidas, assim como o uso de anticoagulantes farmacológicos, como a heparina de baixa dose. Recomenda-se a avaliação sistemática dos fatores de risco para TEV em todas as gestantes e mulheres no período pós-parto, juntamente com a implementação de medidas preventivas apropriadas. Em resumo, o estudo ressalta a importância da identificação precoce e do manejo dos fatores de risco para TEV em gestantes e no período pós-parto, assim como da implementação de estratégias preventivas eficazes. Essas medidas têm o potencial de melhorar significativamente os desfechos maternos e neonatais, evidenciando a necessidade de uma abordagem multidisciplinar e individualizada na prevenção do TEV durante a gravidez e o pós-parto

Núcleos de Ensino da Unesp: artigos 2008

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

NEOTROPICAL ALIEN MAMMALS: a data set of occurrence and abundance of alien mammals in the Neotropics

Biological invasion is one of the main threats to native biodiversity. For a species to become invasive, it must be voluntarily or involuntarily introduced by humans into a nonnative habitat. Mammals were among first taxa to be introduced worldwide for game, meat, and labor, yet the number of species introduced in the Neotropics remains unknown. In this data set, we make available occurrence and abundance data on mammal species that (1) transposed a geographical barrier and (2) were voluntarily or involuntarily introduced by humans into the Neotropics. Our data set is composed of 73,738 historical and current georeferenced records on alien mammal species of which around 96% correspond to occurrence data on 77 species belonging to eight orders and 26 families. Data cover 26 continental countries in the Neotropics, ranging from Mexico and its frontier regions (southern Florida and coastal-central Florida in the southeast United States) to Argentina, Paraguay, Chile, and Uruguay, and the 13 countries of Caribbean islands. Our data set also includes neotropical species (e.g., Callithrix sp., Myocastor coypus, Nasua nasua) considered alien in particular areas of Neotropics. The most numerous species in terms of records are from Bos sp. (n = 37,782), Sus scrofa (n = 6,730), and Canis familiaris (n = 10,084); 17 species were represented by only one record (e.g., Syncerus caffer, Cervus timorensis, Cervus unicolor, Canis latrans). Primates have the highest number of species in the data set (n = 20 species), partly because of uncertainties regarding taxonomic identification of the genera Callithrix, which includes the species Callithrix aurita, Callithrix flaviceps, Callithrix geoffroyi, Callithrix jacchus, Callithrix kuhlii, Callithrix penicillata, and their hybrids. This unique data set will be a valuable source of information on invasion risk assessments, biodiversity redistribution and conservation-related research. There are no copyright restrictions. Please cite this data paper when using the data in publications. We also request that researchers and teachers inform us on how they are using the data

NEOTROPICAL CARNIVORES: a data set on carnivore distribution in the Neotropics

Mammalian carnivores are considered a key group in maintaining ecological health and can indicate potential ecological integrity in landscapes where they occur. Carnivores also hold high conservation value and their habitat requirements can guide management and conservation plans. The order Carnivora has 84 species from 8 families in the Neotropical region: Canidae; Felidae; Mephitidae; Mustelidae; Otariidae; Phocidae; Procyonidae; and Ursidae. Herein, we include published and unpublished data on native terrestrial Neotropical carnivores (Canidae; Felidae; Mephitidae; Mustelidae; Procyonidae; and Ursidae). NEOTROPICAL CARNIVORES is a publicly available data set that includes 99,605 data entries from 35,511 unique georeferenced coordinates. Detection/non-detection and quantitative data were obtained from 1818 to 2018 by researchers, governmental agencies, non-governmental organizations, and private consultants. Data were collected using several methods including camera trapping, museum collections, roadkill, line transect, and opportunistic records. Literature (peer-reviewed and grey literature) from Portuguese, Spanish and English were incorporated in this compilation. Most of the data set consists of detection data entries (n = 79,343; 79.7%) but also includes non-detection data (n = 20,262; 20.3%). Of those, 43.3% also include count data (n = 43,151). The information available in NEOTROPICAL CARNIVORES will contribute to macroecological, ecological, and conservation questions in multiple spatio-temporal perspectives. As carnivores play key roles in trophic interactions, a better understanding of their distribution and habitat requirements are essential to establish conservation management plans and safeguard the future ecological health of Neotropical ecosystems. Our data paper, combined with other large-scale data sets, has great potential to clarify species distribution and related ecological processes within the Neotropics. There are no copyright restrictions and no restriction for using data from this data paper, as long as the data paper is cited as the source of the information used. We also request that users inform us of how they intend to use the data

Delayed colorectal cancer care during covid-19 pandemic (decor-19). Global perspective from an international survey

Background The widespread nature of coronavirus disease 2019 (COVID-19) has been unprecedented. We sought to analyze its global impact with a survey on colorectal cancer (CRC) care during the pandemic. Methods The impact of COVID-19 on preoperative assessment, elective surgery, and postoperative management of CRC patients was explored by a 35-item survey, which was distributed worldwide to members of surgical societies with an interest in CRC care. Respondents were divided into two comparator groups: 1) ‘delay’ group: CRC care affected by the pandemic; 2) ‘no delay’ group: unaltered CRC practice. Results A total of 1,051 respondents from 84 countries completed the survey. No substantial differences in demographics were found between the ‘delay’ (745, 70.9%) and ‘no delay’ (306, 29.1%) groups. Suspension of multidisciplinary team meetings, staff members quarantined or relocated to COVID-19 units, units fully dedicated to COVID-19 care, personal protective equipment not readily available were factors significantly associated to delays in endoscopy, radiology, surgery, histopathology and prolonged chemoradiation therapy-to-surgery intervals. In the ‘delay’ group, 48.9% of respondents reported a change in the initial surgical plan and 26.3% reported a shift from elective to urgent operations. Recovery of CRC care was associated with the status of the outbreak. Practicing in COVID-free units, no change in operative slots and staff members not relocated to COVID-19 units were statistically associated with unaltered CRC care in the ‘no delay’ group, while the geographical distribution was not. Conclusions Global changes in diagnostic and therapeutic CRC practices were evident. Changes were associated with differences in health-care delivery systems, hospital’s preparedness, resources availability, and local COVID-19 prevalence rather than geographical factors. Strategic planning is required to optimize CRC care