Fatores socioculturais que podem interferir na realização do exame citológico / Sociocultural factors that can interfere with the performance of the cytological examination

O câncer de colo de útero é o terceiro tumor que mais acomete a população feminina no mundo, atrás do câncer de mama e do colorretal, é também, a quarta causa de morte de mulheres por câncer no Brasil. Este câncer é causado pela infecção persistente por alguns tipos (chamados ontogênicos) do Papiloma Vírus Humano – HPV.  Estas alterações celulares, que podem evoluir para um câncer, são descobertas facilmente no exame de prevenção (conhecido também como Papanicolau e Citológico), e são curáveis na quase totalidade dos casos quando diagnosticado precocemente. Mesmo com sua importância comprovada para a saúde da mulher e os esforços investidos em transformar o exame ginecológico em uma experiência educativa, ainda se observa que muitas mulheres não o consideram como um procedimento rotineiro. Com isso, este estudo teve como objetivo pesquisar na literatura brasileira quais os aspectos socioculturais que podem interferir tanto positivamente quanto negativamente na realização do exame citológico. O presente estudo trata de uma revisão bibliográfica a partir do método de revisão integrativa da literatura, realizado entre os meses de novembro de 2020 a janeiro de 2021. Apesar de ser uma doença de fácil prevenção, constitui-se um problema de saúde pública em países em desenvolvimento, pois alcança altas taxas de prevalência e mortalidade em mulheres de estratos sociais e econômicos mais baixos e que se encontram em plena fase reprodutiva, dessa forma, ressalta-se a importância de se manter o vínculo paciente-enfermeiro e a realização das atividades educativas que abordem a prevenção do câncer de colo uterino, pois muitas mulheres ainda têm medo do exame, medo do resultado final do exame e vergonha por mostrar seu corpo

Prevalência de lesão no quadril em praticantes de tênis: revisão sistemática / Prevalence of hip injury in tennis players: systematic review

O Tênis é uma modalidade esportiva que cresce e ganha novos adeptos a cada dia, com isso, aumenta a incidência de lesões no quadril. O objetivo desta revisão bibliográfica é investigar estudos que demostrem a prevalência de lesões causadas pela prática do Tênis. Metodologia: O estudo é uma revisão bibliográfica. Foram utilizados para esta pesquisa as plataformas Scielo, Google acadêmico e Pubmed, com as palavras chaves “Lesões no quadril do tenista, Lesões no quadril, Síndrome da Banda Iliotibial, Tendinopatia de Isquiossurais, Impacto Femoacetabular, Disfunção Sacroilíaca”. Resultados: Foram encontrados, 29 artigos nas 3 plataformas, e após criteriosa análise de títulos e de resumos, 16 artigos foram descartados.  13 artigos foram considerados apropriados para a realização desta revisão. Após detalhada leitura desses artigos, 5 foram descartados por não se tratarem de lesão no quadril, ou no quadril de tenistas. Conclusão: A combinação do excesso de treinamento em alta intensidade e o volume elevado de repetições podem levar ao desequilíbrio muscular, causando diversos tipos de lesões no quadril como Síndrome da banda iliotibial, Tendinopatia de Isquiossurais (posterior da coxa), Impacto Femoroacetabular (IFA) e Disfunção Sacroilíaca (dor sacroilíaca)

Análise de Acidentes com Animais Peçonhentos no Estado de Pernambuco/ Analysis of Accidents with Venomous Animals in the State of Pernambuco

Animais peçonhentos injetam o veneno produzido ou modificado em suas presas através de algum aparato inoculador. Os que mais causam acidentes no Brasil são algumas espécies de serpentes, escorpiões e aranhas, principalmente em áreas rurais e constituem em emergência clínica, principalmente se a vítima for criança. Nestes casos, quanto mais rápida a assistência for dada, menor o risco de sequelas e óbitos. Sendo assim, pretende-se descrever o perfil dos acidentes por animais peçonhentos AAPs no Estado de Pernambuco. Bem como, reconhecer as intervenções imediatas às inoculações de acordo com o tipo de envenenamento. Trata-se de um estudo epidemiológico do tipo quantitativo e descritivo, sobre os AAPs no Estado de Pernambuco, entre 2013 e 2017; os dados foram obtidos no Sistema de Informação de Agravos de Notificação - SINAN do Ministério da Saúde analisando-se as variáveis tipo (serpente, escorpião e aranha), tempo até do atendimento e a porcentagem de cura. Durante o período foram registrados 896.284 casos de AAPs no Brasil. Em Pernambuco foram 65.766 casos, com uma média de atendimento de 58% nas 3 primeiras horas. Os dados obtidos identificaram para serpentes (3.945 casos) com 86,9 % de cura, escorpiões (50.793 casos) com 90,7 % de cura e aranhas (872 casos) com 90,3% de cura. Dentre as intervenções imediatas às inoculações destacou-se: lavar a região com água e sabão; entrar em contato com o Centro de Assistência Toxicológica e dirigir-se imediatamente ao centro de referência indicado, se possível levando o animal vivo ou morto, para a correta administração do soro específico. Contudo é evidente que o evento possui grande magnitude no Estado de Pernambuco, ocupando a quinta posição nacional, com destaque para os acidentes escorpiônicos, em sua maioria do gênero T.stigmurus, concluindo a necessidade de políticas públicas envolvendo profissionais e comunidade, como alvo de prevenção, diminuição e domínio sobre o assunto

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

ATLANTIC EPIPHYTES: a data set of vascular and non-vascular epiphyte plants and lichens from the Atlantic Forest

Epiphytes are hyper-diverse and one of the frequently undervalued life forms in plant surveys and biodiversity inventories. Epiphytes of the Atlantic Forest, one of the most endangered ecosystems in the world, have high endemism and radiated recently in the Pliocene. We aimed to (1) compile an extensive Atlantic Forest data set on vascular, non-vascular plants (including hemiepiphytes), and lichen epiphyte species occurrence and abundance; (2) describe the epiphyte distribution in the Atlantic Forest, in order to indicate future sampling efforts. Our work presents the first epiphyte data set with information on abundance and occurrence of epiphyte phorophyte species. All data compiled here come from three main sources provided by the authors: published sources (comprising peer-reviewed articles, books, and theses), unpublished data, and herbarium data. We compiled a data set composed of 2,095 species, from 89,270 holo/hemiepiphyte records, in the Atlantic Forest of Brazil, Argentina, Paraguay, and Uruguay, recorded from 1824 to early 2018. Most of the records were from qualitative data (occurrence only, 88%), well distributed throughout the Atlantic Forest. For quantitative records, the most common sampling method was individual trees (71%), followed by plot sampling (19%), and transect sampling (10%). Angiosperms (81%) were the most frequently registered group, and Bromeliaceae and Orchidaceae were the families with the greatest number of records (27,272 and 21,945, respectively). Ferns and Lycophytes presented fewer records than Angiosperms, and Polypodiaceae were the most recorded family, and more concentrated in the Southern and Southeastern regions. Data on non-vascular plants and lichens were scarce, with a few disjunct records concentrated in the Northeastern region of the Atlantic Forest. For all non-vascular plant records, Lejeuneaceae, a family of liverworts, was the most recorded family. We hope that our effort to organize scattered epiphyte data help advance the knowledge of epiphyte ecology, as well as our understanding of macroecological and biogeographical patterns in the Atlantic Forest. No copyright restrictions are associated with the data set. Please cite this Ecology Data Paper if the data are used in publication and teaching events. © 2019 The Authors. Ecology © 2019 The Ecological Society of Americ

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030