ACUTE MYOCARDIAL INFARCTION AND HEART MORPHOLOGICAL CHANGES

A síndrome do choque cardiogênico tem sido definida como incapacidade do coração em manter fluxo sanguíneo adequado aos tecidos, resultando em deficiência metabólica. Ela ocorre em pacientes com severa disfunção ventricular esquerda, onde cerca de 40% da massa ventricular é comprometida pelo infarto. O objetivo deste estudo foi relatar um caso de óbito natural mal definido em adulto com 48 anos de idade, sexo masculino, suspeito de Infarto Agudo do Miocárdio fulminante. A necropsia, associada aos informes clínicos e ao exame histopatológico evidenciou que a causa do óbito foi choque cardiogênico por provável doença coronariana aguda aterosclerótica, que culminou no infarto agudo  do miocárdio.The cardiogenic shock syndrome has been defined as the inability of the heart to maintain adequate blood flow to tissues, resulting in metabolic deficiency. It occurs in patients with severe left ventricular dysfunction, where about 40% of the ventricular mass is compromised by the infarct. The objective of this study was to report a case of ill-defined natural death in a 48 years old, male, suspected of having acute myocardial infarction. The necropsy, associated with clinical reports and histopathological examination, evidenced that the cause of death was cardiogenic shock due to atherosclerotic acute coronary disease, that culminated in acute myocardial infarction

Changes in body weight, C-reactive protein, and total adiponectin in non-obese women after 12 months of a small-volume, home-based exercise program

OBJECTIVE: Our objective was to evaluate the effects of small-volume, home-based exercise combined with slight caloric restriction on the inflammatory markers C-reactive protein and adiponectin. METHODS: In total, 54 women were randomly assigned to one of two groups for exercise intervention: the control or home-based exercise groups. Weight, waist and hip circumferences, and inflammatory markers were measured at baseline and after 6 and 12 months. Women allocated to the home-based exercise group received a booklet explaining the physical exercises to be practiced at home at least 3 times per week, 40 minutes per session, at low-to-moderate intensity. All participants received dietary counseling aimed at reducing caloric intake by 100-300 calories per day, with a normal distribution of macro-nutrients (26-28% of energy as fat). Clinicaltrials.gov: NCT01206413 RESULTS: The home-based exercise group showed a significantly greater reduction in weight and body mass index at six months, but no difference between groups was observed thereafter. With regard to the inflammatory markers, a greater but non-statistically significant reduction was found for C-reactive protein in the home-based exercise group at six months; however, this difference disappeared after adjusting for weight change. No differences in adiponectin were found at the 6- or 12-month follow-up. CONCLUSION: Small-volume, home-based exercise did not promote changes in inflammatory markers independent of weight change

Effects of Repeated Stress on Distal Airway Inflammation, Remodeling and Mechanics in an Animal Model of Chronic Airway Inflammation

Background/Aims: Epidemiological studies suggest that stress has an impact on asthmatic exacerbations. We evaluated if repeated stress, induced by forced swimming, modulates lung mechanics, distal airway inflammation and extracellular matrix remodeling in guinea pigs with chronic allergic inflammation. Methods: Guinea pigs were submitted to 7 ovalbumin or saline aerosols (1-5 mg/ml during 4 weeks; OVA and SAL groups). Twenty-four hours after the 4th inhalation, guinea pigs were submitted to the stress protocol 5 times a week during 2 weeks (SAL-S and OVA-S groups). Seventy-two hours after the 7th inhalation, guinea pigs were anesthetized and mechanically ventilated. Resistance and elastance of the respiratory system were obtained at baseline and after ovalbumin challenge. Lungs were removed, and inflammatory and extracellular matrix remodeling of distal airways was assessed by morphometry. Adrenals were removed and weighed. Results: The relative adrenal weight was greater in stressed guinea pigs compared to non-stressed animals (p < 0.001). Repeated stress increased the percent elastance of the respiratory system after antigen challenge and eosinophils and lymphocytes in the OVA-S compared to the OVA group (p < 0.001, p = 0.003 and p < 0.001). Neither collagen nor elastic fiber contents were modified by stress in sensitized animals. Conclusions: In this animal model, repeated stress amplified bronchoconstriction and inflammatory response in distal airways without interfering with extracellular matrix remodeling. Copyright (C) 2011 S. Karger AG, Base

Efeitos da utilização da reabilitação virtual nas alterações posturais de indivíduos idosos / Effects of using virtual rehabilitation on postural changes in elderly individuals

Objetivo: Analisar o efeito da utilização da realidade virtual nas alterações posturais de indivíduos idosos sedentários. Métodos: Trata-se de um estudo observacional, descritivo de corte transversal. Inicialmente foi realizada uma palestra sobre o estudo e assinatura do Termo de Consentimento Livre e Esclarecido pelos participantes. Em seguida aplicou-se o questionário socioclínico; avaliação postural na vista anterior, posterior e lateral; e, análise da descarga de peso utilizando a plataforma do Nintendo Wii antes e após intervenção. Na Intervenção utilizou-se o X-box, 5 sessões de 30min cada. Resultados: A amostra foi composta de 20 idosos, predominância feminina (80%), média de idade 65,9 ± 5,4 anos e Índice de Massa Corpórea (IMC) de 26,8 Kg/m2 (sobrepeso). As principais alterações posturais encontradas foram: Anteversão pélvica (85%), joelhos valgos (80%), ombros protusos (85%) e assimétricos (90%), e cabeça anteriorizada (80%). Após a RV houve correções positivas significantes (p<0,01). A proporção de descarga de peso melhorou, onde no membro direito a média antes era 52,9±7,9 e após passou foi 51,5±5,2; e, no membro inferior esquerdo o valor era 47,5±7,3 passando a 48,4±5,2. Conclusão: A RV demonstrou ser uma abordagem eficaz dentro do arsenal fisioterapêutico para a prevenção e correção de alterações posturais causadas pelo envelhecimento, por utilizar-se além de um espaço lúdico e dinâmico, promove bem-estar e prazer

Qualidade microbiológica e condições higiênico-sanitárias de lanches comercializados por ambulantes no município de Fernandópolis - SP / Microbiological quality and sanitary conditions of snacks sold by ambulants in the city of Fernandópolis - SP

O estudo tem o objetivo de estabelecer os riscos causados de contaminação por microrganismos que são encontrados em serviços ambulantes de alimentação do município de Fernandópolis. Através de uma análise microbiológica, identificar patógenos e condições do alimento quanto à quantidade de microrganismos transmitidas por alimentos e estabelecer medidas de boas praticas e conscientização de comerciantes e consumidores. Foram feita analise em 5 amostras de lanche tipo X-salada, coletadas de  maneira aleatória, em estabelecimentos comerciais da cidade. As amostras apresentaram resultado para Staphylococcus coagulase positiva em 20% das amostras coletadas de produção semi-artesanal. Ações de controle devem ser estabelecidas, pois através da pesquisa realizada, é evidente o risco de contaminação através da manipulação sem cuidados de higiene, sendo causas frequentes de DTA’s. 

Análise da eficácia da Tirzepatida como agente terapêutico para perda de peso em pacientes com Obesidade

A obesidade e o diabetes são doenças crônicas que afetam milhões de pessoas em todo o mundo, sendo consideradas epidemias crescentes. O tratamento da obesidade envolve uma abordagem multifacetada, incluindo mudanças no estilo de vida e intervenções farmacológicas. Nesse contexto, a tirzepatida, uma terapia combinada de dois medicamentos que atuam em diferentes vias metabólicas para reduzir o apetite e promover a perda de peso em pacientes com obesidade, tem se destacado como uma opção terapêutica promissora. O objetivo deste estudo foi avaliar a eficácia e segurança da tirzepatida como agente terapêutico para perda de peso em pacientes com obesidade. Para isso, foram selecionados quatro artigos que avaliaram o uso da tirzepatida em pacientes com obesidade, publicados entre 2018 e 2023, nas bases de dados PubMed (Medline), Scientific Electronic Library Online (SciELO) e Cochrane Library. Os resultados indicam que a tirzepatida é uma terapia promissora e segura para perda de peso em pacientes com obesidade. Todos os estudos relataram perda de peso significativa em pacientes tratados com essa terapia, variando de 8,6% a 16,0% do peso corporal inicial. Além disso, a tirzepatida também apresentou efeitos benéficos em outros parâmetros metabólicos, como redução da glicemia e melhora da função hepática. Efeitos adversos foram relatados em menor frequência e gravidade em comparação com outras terapias para perda de peso. Em resumo, a tirzepatida é uma terapia combinada de dois medicamentos que tem demonstrado eficácia e segurança para a perda de peso em pacientes com obesidade, de acordo com os resultados de quatro estudos avaliados nesta pesquisa. Essa terapia pode ser uma opção terapêutica válida para pacientes com obesidade. No entanto, é importante destacar a necessidade de mais pesquisas para avaliar sua eficácia e segurança a longo prazo e sua aplicabilidade em diferentes populações. Portanto, é fundamental que o tratamento seja realizado com acompanhamento médico e que cada caso seja avaliado individualmente

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

Alcohol use and burden for 195 countries and territories, 1990-2016 : a systematic analysis for the Global Burden of Disease Study 2016

Background Alcohol use is a leading risk factor for death and disability, but its overall association with health remains complex given the possible protective effects of moderate alcohol consumption on some conditions. With our comprehensive approach to health accounting within the Global Burden of Diseases, Injuries, and Risk Factors Study 2016, we generated improved estimates of alcohol use and alcohol-attributable deaths and disability-adjusted life-years (DALYs) for 195 locations from 1990 to 2016, for both sexes and for 5-year age groups between the ages of 15 years and 95 years and older. Methods Using 694 data sources of individual and population-level alcohol consumption, along with 592 prospective and retrospective studies on the risk of alcohol use, we produced estimates of the prevalence of current drinking, abstention, the distribution of alcohol consumption among current drinkers in standard drinks daily (defined as 10 g of pure ethyl alcohol), and alcohol-attributable deaths and DALYs. We made several methodological improvements compared with previous estimates: first, we adjusted alcohol sales estimates to take into account tourist and unrecorded consumption; second, we did a new meta-analysis of relative risks for 23 health outcomes associated with alcohol use; and third, we developed a new method to quantify the level of alcohol consumption that minimises the overall risk to individual health. Findings Globally, alcohol use was the seventh leading risk factor for both deaths and DALYs in 2016, accounting for 2.2% (95% uncertainty interval [UI] 1.5-3.0) of age-standardised female deaths and 6.8% (5.8-8.0) of age-standardised male deaths. Among the population aged 15-49 years, alcohol use was the leading risk factor globally in 2016, with 3.8% (95% UI 3.2-4-3) of female deaths and 12.2% (10.8-13-6) of male deaths attributable to alcohol use. For the population aged 15-49 years, female attributable DALYs were 2.3% (95% UI 2.0-2.6) and male attributable DALYs were 8.9% (7.8-9.9). The three leading causes of attributable deaths in this age group were tuberculosis (1.4% [95% UI 1. 0-1. 7] of total deaths), road injuries (1.2% [0.7-1.9]), and self-harm (1.1% [0.6-1.5]). For populations aged 50 years and older, cancers accounted for a large proportion of total alcohol-attributable deaths in 2016, constituting 27.1% (95% UI 21.2-33.3) of total alcohol-attributable female deaths and 18.9% (15.3-22.6) of male deaths. The level of alcohol consumption that minimised harm across health outcomes was zero (95% UI 0.0-0.8) standard drinks per week. Interpretation Alcohol use is a leading risk factor for global disease burden and causes substantial health loss. We found that the risk of all-cause mortality, and of cancers specifically, rises with increasing levels of consumption, and the level of consumption that minimises health loss is zero. These results suggest that alcohol control policies might need to be revised worldwide, refocusing on efforts to lower overall population-level consumption.Peer reviewe