A IMPORTÂNCIA DOS CUIDADOS À MULHER CLIMATÉRIA NA ATENÇÃO BÁSICA DE SAÚDE: UMA ABORDAGEM NUTRICIONAL E BIOPSICOSSOCIAL

Introduction: Menopause is the phase that corresponds to the last menstrual cycle, generally around 48 to 50 years of age. In some cases, women seek hormone replacement therapy (HRT) through medication, a treatment that helps alleviate symptoms. However, it is worth highlighting that nutrition deserves special attention, along with the monitoring of a multidisciplinary team in Basic Health Care, as it is a great ally at this stage of women's lives, favoring greater efficiency of the body and improving symptoms and discomforts. caused by the moment. Objective: To identify how multidisciplinary monitoring in primary care can qualitatively help the lives of women who are going through menopause. Methodology: An integrative literature review using keywords: Nutritional Monitoring; Menopause; Climacteric; Nutrition; Women's health; Basic Care. 114 articles were found using the Virtual Health Library (VHL), Public MEDLINE (PubMed), Scientific Electronic Library Online (SciELO) and Latin American and Caribbean Health Sciences Literature (LILACS) databases, applying inclusion criteria and exclusion, 12 articles remained. Results: Studies have shown that a diet rich in grains, vegetables, fiber and fruits improves menopause symptoms and reduces the risk of heart disease and hormonal disorders. In addition to highlighting that, although there are protocols and recommendations for climacteric patients, which aim to guarantee access and comprehensive care by the multidisciplinary team, there is still weak coordination between Basic Health Care professionals and a lack of comprehensive care with these women. Conclusion: Basic Health Care plays a fundamental role in welcoming these women in the climacteric period, together with a multidisciplinary team, in which a healthy diet combined with functional therapy with a biopsychosocial focus, whether homeopathic or herbal, could help reduce the symptoms that cause discomfort of great proportions both in the pre- and post-menopausal period. However, it is important to invest in actions that can change these practices, with individual and collective activities, involving partners and the support network.Introdução: A menopausa é a fase que corresponde ao último ciclo menstrual, em geral por volta de 48 a 50 anos de idade. Em alguns casos, as mulheres buscam pela reposição hormonal (TRH) por meio de medicações, tratamento no qual é favorável em amenizar os sintomas. Entretanto, vale ressaltar que a alimentação merece uma atenção especial, junto com o acompanhamento de uma equipe multiprofissional na Atenção Básica de Saúde, pois é uma grande aliada nessa fase da vida das mulheres, favorecendo uma maior eficiência do organismo e melhorando os sintomas e desconfortos causados pelo momento. Objetivo: Identificar como o acompanhamento multiprofissional junto a atenção básica pode ajudar de forma qualitativa na vida de mulheres que estão no período da menopausa. Metodologia: Uma revisão de literatura integrativa por meio do uso de palavras-chaves: Acompanhamento Nutricional; Menopausa; Climatério; Nutrição; Saúde da mulher; Atenção Básica. Foram encontrados 114 artigos usando as bases de dados Biblioteca Virtual em Saúde (BVS), Public MEDLINE (PubMed), Scientific Electronic Library Online (SciELO) e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), aplicando critérios de inclusão e exclusão restaram 12 artigos. Resultados: Os estudos apontaram que uma dieta rica em grãos, vegetais, fibras e frutas melhoram os sintomas da menopausa e reduz o risco de doenças cardíacas e distúrbios hormonais. Além de destacar que, apesar de existirem protocolos e recomendações para pacientes no climatério, que visam garantir o acesso e o acolhimento integral pela equipe multiprofissional, ainda há uma fraca articulação entre os profissionais da Assistência Básica de Saúde e uma falta de integralidade no cuidado com essas mulheres. Conclusão: A Atenção Básica a Saúde possui um papel fundamental no acolhimento dessas mulheres em periodo climaterio, junto a equipe multiprofissional, no qual uma alimentação saudável combinada a terapia funcional com foco biopsicossocial, seja de homeopáticos ou fitoterápicos poderiam  auxiliar na diminuição de  sintomas que causam desconforto de grandes proporções  tanto no período  pré quanto pós menopausa. No entanto, é importante investir em ações que possam mudar essas práticas, com atividades individuais e coletivas, envolvendo os parceiros e a rede de apoio

Efeitos da Digoxina em doentes cardíacos

O presente estudo objetiva estudar o efeito da digoxina em doenças cardíacas, debatendo informações com relação a eficácia e toxicidade. Para tanto foi realizada uma busca na base de dados PubMed em que se utilizou os seguintes Descritores em Ciências da Saúde: effects; of; digoxin; therapy. Dessa forma foram selecionados apenas artigos publicados no ano de 2023, resultando em 24 artigos encontrados e após a análise integral dos seus conteúdos foram selecionados 8 para a confecção deste estudo. A digoxina, é um medicamento utilizado em pacientes com insuficiência cardíaca que não responderam bem a outras terapias antiarrítmicas, no entanto, este medicamento possui uma janela terapêutica muito estreita, facilitando com que doses tóxicas possam ser administradas com mais frequência e que geram sintomas graves como alterações no eletrocardiograma e disfunções sistêmicas. Dito isso, com base nas informações expostas, é necessário compreender melhor os efeitos, de eficácia e toxicidade, da digoxina nos pacientes com cardiopatias. &nbsp

Multicenter validation of PIM3 and PIM2 in Brazilian pediatric intensive care units

ObjectiveTo validate the PIM3 score in Brazilian PICUs and compare its performance with the PIM2.MethodsObservational, retrospective, multicenter study, including patients younger than 16 years old admitted consecutively from October 2013 to September 2019. We assessed the Standardized Mortality Ratio (SMR), the discrimination capability (using the area under the receiver operating characteristic curve – AUROC), and the calibration. To assess the calibration, we used the calibration belt, which is a curve that represents the correlation of predicted and observed values and their 95% Confidence Interval (CI) through all the risk ranges. We also analyzed the performance of both scores in three periods: 2013–2015, 2015–2017, and 2017–2019.Results41,541 patients from 22 PICUs were included. Most patients aged less than 24 months (58.4%) and were admitted for medical conditions (88.6%) (respiratory conditions = 53.8%). Invasive mechanical ventilation was used in 5.8%. The median PICU length of stay was three days (IQR, 2–5), and the observed mortality was 1.8% (763 deaths). The predicted mortality by PIM3 was 1.8% (SMR 1.00; 95% CI 0.94–1.08) and by PIM2 was 2.1% (SMR 0.90; 95% CI 0.83–0.96). Both scores had good discrimination (PIM3 AUROC = 0.88 and PIM2 AUROC = 0.89). In calibration analysis, both scores overestimated mortality in the 0%–3% risk range, PIM3 tended to underestimate mortality in medium-risk patients (9%–46% risk range), and PIM2 also overestimated mortality in high-risk patients (70%–100% mortality risk).ConclusionsBoth scores had a good discrimination ability but poor calibration in different ranges, which deteriorated over time in the population studied

Datasheet1_Multicenter validation of PIM3 and PIM2 in Brazilian pediatric intensive care units.pdf

ObjectiveTo validate the PIM3 score in Brazilian PICUs and compare its performance with the PIM2.MethodsObservational, retrospective, multicenter study, including patients younger than 16 years old admitted consecutively from October 2013 to September 2019. We assessed the Standardized Mortality Ratio (SMR), the discrimination capability (using the area under the receiver operating characteristic curve – AUROC), and the calibration. To assess the calibration, we used the calibration belt, which is a curve that represents the correlation of predicted and observed values and their 95% Confidence Interval (CI) through all the risk ranges. We also analyzed the performance of both scores in three periods: 2013–2015, 2015–2017, and 2017–2019.Results41,541 patients from 22 PICUs were included. Most patients aged less than 24 months (58.4%) and were admitted for medical conditions (88.6%) (respiratory conditions = 53.8%). Invasive mechanical ventilation was used in 5.8%. The median PICU length of stay was three days (IQR, 2–5), and the observed mortality was 1.8% (763 deaths). The predicted mortality by PIM3 was 1.8% (SMR 1.00; 95% CI 0.94–1.08) and by PIM2 was 2.1% (SMR 0.90; 95% CI 0.83–0.96). Both scores had good discrimination (PIM3 AUROC = 0.88 and PIM2 AUROC = 0.89). In calibration analysis, both scores overestimated mortality in the 0%–3% risk range, PIM3 tended to underestimate mortality in medium-risk patients (9%–46% risk range), and PIM2 also overestimated mortality in high-risk patients (70%–100% mortality risk).ConclusionsBoth scores had a good discrimination ability but poor calibration in different ranges, which deteriorated over time in the population studied.</p

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora