REVISITANDO A TEORIA GEOSSISTÊMICA DE BERTRAND NO SÉCULO XXI: APORTES PARA O GTP (?)

A Teoria Geossistêmica como aporte teórico-metodológico urge a luz da Teoria Geral dos Sistemas, como potencialidade para a construção de uma nova geografia, antes disparatada em conhecimentos desconexos. A partir da década de 1960 com as sistematizações pioneiras de Victor Sotchava e posteriormente as de Georges Bertrand, instituem-se novos paradigmas à Geografia, por sua vez, ungidos na perspectiva de integração e construção de uma ciência una. No entanto, tem-se mostrado uma teoria estagnada, que apesar de extremamente virtuosa para a ciência geográfica no período de emergência, atualmente, frente à Geografia do século XXI, apresenta-se como alvo de críticas por mostrar-se reducionista, no tocante a inserção da sociedade na análise de interface com a natureza. Neste viés, apresenta-se neste ensaio, uma proposta de (re)leitura da Teoria Geossistêmica de Bertrand (1972), tendo em vista, reconhecê-la como virtuoso método de análise para a Geografia e, quiça contribuindo para o entendimento do GTP

Fatores de risco para o desenvolvimento de pseudoartrose: uma revisão integrativa

Introduction: Pseudarthrosis is a complication that occurs in the process of consolidation of the fractured bone, being caused, above all, by mechanical instability, deficient vascularization and inadequate or late treatment. Therefore, the objective of this study was to discuss the risk factors that permeate this clinical scenario, in order to aim for an improvement in patient’s quality of life and prevent such situation. Methodology: This is an integrative literature review. The Health Sciences Descriptors platform (DeCS/MeSH) was used, using the descriptors “pseudoarthrosis” and “risk factors” in both Portuguese and English. Therefore, a search was carried out in the databases: Pubmed, Lilacs and Scielo. A total of 363 articles were obtained. The inclusion criteria are articles from the last 5 years that answer the research question and are in Portuguese, English or Spanish, with 14 articles being included to build this research. Results: An increase in cases of pseudarthrosis was observed when related to infections, and social determinants were relevant in the complications of cases. Comorbidities proved to be possible post-surgical complications and there was a relationship between spinal deformity in adults, pseudarthrosis and nail fracture. There were also interferences from surgical techniques and the possibility of a pseudarthrosis outcome. Conclusion: Therefore, it was possible to realize that there are several risk factors for pseudarthrosis. Faced with multifactorial causes, it is necessary to understand each patient's condition, seeking to improve quality of life, in order to mitigate factors that predispose to the development of pseudarthrosis.Introdução: A pseudoartrose é uma complicação que ocorre no processo de consolidação do osso fraturado, sendo causada, sobretudo, por instabilidade mecânica, vascularização deficiente e tratamento inadequado ou tardio. Portanto, o objetivo deste estudo foi discutir os fatores de risco que permeiam tal cenário clínico, a fim de almejar melhora na qualidade de vida dos pacientes e prevenir tal quadro. Metodologia: Trata-se de uma revisão integrativa de literatura. Foi utilizada a plataforma de Descritores em Ciências da Saúde (DeCS/MeSH), utilizando os descritores “pseudoartrose” e “fatores de risco” tanto na língua portuguesa, quanto na língua inglesa. Assim, foi feita uma pesquisa nas bases de dados: Pubmed, Lilacs e Scielo.Foram obtidos um total de 363 artigos. Os critérios de inclusão são os artigos dos últimos 5 anos que respondem à pergunta de pesquisa e são de língua portuguesa, inglesa ou espanhola, sendo incluídos 14 artigos para construir essa pesquisa. Resultados: Observou-se aumento dos casos de pseudoartrose quando relacionados a infecções, bem como os determinantes sociais mostraram-se relevantes nas complicações dos casos.  As comorbidades se mostraram como possíveis complicadores no pós-cirúrgico e houve relação entre deformidade da coluna vertebral em adultos, pseudoartrose e a fratura de haste. Verificou-se também, interferências das técnicas cirúrgicas e possibilidade de desfecho em pseudoartrose. Conclusão: Logo, foi possível perceber que existem diversos fatores de risco para a pseudoartrose. Diante de causas multifatoriais, é necessário entender o quadro de cada paciente, buscando melhora da qualidade de vida, a fim de mitigar fatores que predisponham ao desenvolvimento da pseudoartrose

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

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

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

Factors Associated with Marital Satisfaction and Quality of Life in Family Caregivers of Patients with Mental Disorders

(1) Background: The aim of this research was to analyze factors associated with quality of life (QoL) and marital satisfaction in married family caregivers of patients with mental disorders. (2) Methods: A cross-sectional study was conducted in all community mental health services in Goiania municipality, Brazil, in 2016&ndash;2017. Married family caregivers of patients with severe and persistent mental disorders were recruited and their QoL and marital satisfaction was assessed by using the World Health Organization Quality of Life Instrument Abbreviated version (WHOQOL-BREF) and Marital Satisfaction Scale. Multiple linear regressions were performed to identify factors associated with QoL and marital satisfaction. (3) Results: For 163 family caregivers, the psychological and environmental QoL domains presented the best and the worst scores, respectively. Factors independently associated with better QoL for caregivers were male caregiver, the younger age of a caregiver, &gt;8 years of schooling, &ge;5 years as a caregiver who performed physical activities, caregiver without chronic disease, and no patient&rsquo;s crisis in the last 30 days. Factors independently associated with marital satisfaction of the caregiver were male caregiver, caregiver with &gt;8 years of schooling, caregiver who received support by relatives to care for the patient, caregiver who performed physical activities, no patient&rsquo;s crisis in the last 30 days, and patient hospitalization in the last six months; (4) Conclusions: The main predictor for marital satisfaction was support by relatives, and for QoL it was no patient&rsquo;s crisis in the last 30 days

Internações e mortalidade por HIV em pacientes infanto-juvenil

Introdução: Nos últimos anos, a incidência e a taxa de mortalidade causada pelo Vírus da Imunodeficiência Humana (HIV) no público infanto-juvenil no Brasil foram reduzidas, tendo como causa principal o fornecimento da Terapia Antirretroviral (TARV) pelo Sistema Único de Saúde (SUS), resultando em maior tempo e qualidade de vida das pessoas que vivem com HIV.&nbsp; Assim, visto que a evolução da infecção pelo HIV é mais rápida em crianças do que em adultos, e que o grupo etário de 0-14 anos de idade representa o menor percentual de acesso à TARV, o estudo objetivou analisar a prevalência de internações e óbitos por infecção pelo HIV no grupo infanto-juvenil nas regiões brasileiras de 2018 a 2022. Metodologia: Trata-se de um estudo transversal ecológico, quantitativo e descritivo, o qual foi realizado a partir de dados coletados no Departamento de Informática do Sistema Único de Saúde (DATASUS). Analisou-se Morbidade Hospitalar do Sistema Único de Saúde (SIH/SUS), sendo selecionado, como variável, internações e óbitos na aba conteúdo. A pesquisa foi restringida a crianças e adolescentes entre 5 e 14 anos, separados em dois grupos etários, infectados com HIV, no período de 2018 a 2022. Resultados: Foi visto que os casos de internação por HIV totalizaram 431 na população de 5 a 9 anos e 395, de 10 a 14 anos, tendo 2018 com maior número de notificações. Em relação às regiões, o Centro-Oeste teve o menor número de internações durante todos os anos analisados, não apresentando registros em 2020 e 2021. Já o Nordeste esteve mais presente no grupo mais jovem em todos os anos analisados, no quesito internações, e, entre o grupo de 10 a 14 anos, nos dois últimos anos, nestes prevaleceu a região Sudeste em 2018 a 2020. Quanto ao número de óbitos, no grupo de 5 a 9 anos, houveram 6 notificações, entre 10 e 14 anos,&nbsp; 8 casos foram notificados, no entanto, há regiões que não apresentaram registros, o que impossibilita afirmar o local com maior prevalência. Conclusão: Sendo assim, é questionável a cultura do acesso, continuidade de cuidado e adesão ao tratamento das regiões brasileiras, havendo divergência entre a alta prevalência de internações e o baixo número de óbitos em algumas regiões. Ademais, fatores socioeconômicos podem estar relacionados ao maior número de casos de internação presente nas regiões nordeste e sudeste. Logo, o baixo número de estudos sobre o tema compromete o embasamento para realização de políticas públicas

Caracterização química do óleo essencial de copaíba e estudo de sua citotoxicidade celular

Introduction: copaifera is a genus of plants that comprises several species that produce copaiba oil, which is widely used for various purposes, such as healing, antiinflammatory, antimicrobial, wound antiseptic, anti-tumor, among other functions. There are very few chemical studies to characterize copaiba oil. Aim: To characterize 3 different species of copaiba oil Subsequently, the effects of oils were estimated on neoplastic cells in a human glioma protocol (U251). Methods: 2 methods of analysis were used for the chemical characterization, GC-MS and ESI-MS. Results: Through these analytical techniques, 20 types of components were found in the oils. Obtaining the cell viability and cytotoxicity of the oil we performed two methods, the MTT (3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) and Neutral Red (NR), both assays were quantified by spectrophotometry. Concentrations of 1 to 10-5 μg/mL were used for 3 different species of copaiba oil and doxorubicin hydrochloride was used as a positive control. The 3 different species of copaiba oil from Pernambuco (oil 1) and Manaus (oils 2 and 3) were cytotoxic in U251, the IC50 value obtained was 6.171·10-2 μg/mL, 8.344·10-2 μg/mL and 1.385·10-4 μg/ mL, respectively. They also presented cytotoxic effect, with IC50, 2.4·10-1 μg/mL, 3.7·10-2 μg/mL and 4.6·10-2 μg/mL, respectively. A high correlation was evidenced between the MTT and Neutral Red studies for the three different species of copaiba oil, with α=0.05 and r values above 0.9, using the Pearson correlation coefficient. All types of resin oils positively affected cell proliferation of in vitro studies with a correspondence between concentration and effect.Introducción: copaifera es un género de plantas que comprende varias especies que producen aceite de copaiba, el cual es ampliamente utilizado para diversos fines, como cicatrizante, antiinflamatorio, antimicrobiano, antiséptico de heridas, antitumoral, entre otras funciones. Hay muy pocos estudios químicos para caracterizar el aceite de copaiba. Objetivo: caracterizar 3 especies diferentes de aceite de copaiba. Posteriormente, se estimaron los efectos de los aceites sobre las células neoplásicas en un protocolo de glioma humano (U251). Métodos: utilizamos 2 métodos de análisis para la caracterización química, GC-MS y ESI-MS. Resultados: a través de estas técnicas analíticas, se encontraron 20 tipos de componentes en los aceites. Para la obtención de la viabilidad celular y citotoxicidad del aceite se realizaron dos métodos, el MTT (3-(4,5-dimetiltiazol-2-il)-2,5-difeniltetrazolio bromuro) y el Rojo Neutro (NR), ambos ensayos fueron cuantificados por espectrofotometría. Se utilizaron concentraciones de 1 a 10-5 μg/mL para 3 especies diferentes de aceite de copaiba y se utilizó clorhidrato de doxorrubicina como control positivo. Las 3 especies diferentes de aceite de copaiba de Pernambuco (aceite 1) y Manaus (aceites 2 y 3) fueron citotóxicas en U251, el valor de IC50 obtenido fue de 6,171·10-2 μg/mL, 8,344·10-2 μg/mL y 1,385·10-4 μg/mL, respectivamente. También presentaron efecto citotóxico, con IC50, 2,4·10-1 μg/mL, 3,7·10-2 μg/mL y 4,6·10-2 μg/mL, respectivamente. Se evidenció una alta correlación entre los estudios MTT y Neutral Red para las 3 diferentes especies de aceite de copaiba, con α=0,05 y valores de r superiores a 0,9, utilizando el coeficiente de correlación de Pearson. Todos los tipos de aceites de resina afectaron positivamente la proliferación celular de estudios in vitro con una correspondencia entre concentración y efecto.Introdução: copaifera é um gênero de plantas que compreende diversas espécies produtoras de óleo de copaíba, que é amplamente utilizado para diversas finalidades, como cicatrizante, anti-inflamatório, antimicrobiano, antisséptico de feridas, antitumoral, entre outras funções. Existem poucos estudos químicos para caracterizar o óleo de copaíba. Objetivo: caracterizar 3 espécies diferentes de óleo de copaíba foram caracterizadas neste trabalho. Posteriormente, os efeitos dos óleos foram estimados em células neoplásicas em um protocolo de glioma humano (U251). Métodos: utilizamos 2 métodos de análise para a caracterização química, GC-MS e ESI-MS. Resultados: por meio dessas técnicas analíticas, 20 tipos de componentes foram encontrados nos óleos. Obtendo a viabilidade celular e a citotoxicidade do óleo realizamos dois métodos, o MTT (brometo de 3-(4,5-dimetiltiazol-2-il)-2, 5-difeniltetrazólio) e o Vermelho Neutro (NR), ambos os ensaios foram quantificados por espectrofotometria. Concentrações de 1 a 10-5 μg/mL foram usadas para 3 espécies diferentes de óleo de copaíba e cloridrato de doxorrubicina foi usado como controle positivo. As 3 espécies diferentes de óleo de copaíba de Pernambuco (óleo 1) e Manaus (óleos 2 e 3) foram citotóxicas em U251, o valor de IC50 obtido foi de 6,171·10-2 μg/mL, 8,344·10-2 μg/mL e 1,385·10-4 μg/mL, respectivamente. Também apresentaram efeito citotóxico, com IC50, 2,4·10-1 μg/mL, 3,7·10-2 μg/ mL e 4,6·10-2 μg/mL, respectivamente. Foi evidenciada uma alta correlação entre os estudos de MTT e Vermelho Neutro para as 3 diferentes espécies de óleo de copaíba, com valores de α=0,05 e r acima de 0,9, utilizando o coeficiente de correlação de Pearson. Todos os tipos de óleos de resina afetaram positivamente a proliferação celular de estudos in vitro com uma correspondência entre concentração e efeito