Diagnóstico e Tratamento da Diabetes Mellitus Tipo 1 em Pediatria: Uma abordagem abrangente

Significant advances in the diagnosis and treatment of Type 1 Diabetes Mellitus (T1DM) in pediatric patients represent pivotal milestones in the professional realm, providing a comprehensive view of emerging therapeutic approaches. Among the discussed strategies, the crucial role of pancreas transplantation, as evidenced by recent studies, stands out. The success of this procedure in highly selected cases offers an optimistic outlook, albeit with the caveat that it should be considered as a last resort, administered in specialized centers, reinforcing the need for a judicious approach. Additionally, the effectiveness of technological innovations such as closed-loop therapy systems, analog insulins, and automatic infusion devices is examined. Positive outcomes from these interventions indicate a significant shift in the management of T1DM in children, with substantial improvements in glycemic control and quality of life. However, the critical analysis of studies underscores the importance of considering the specific nuances of the pediatric age group in the development of therapeutic strategies. Relevant aspects related to cutaneous reactions associated with the use of devices such as insulin pumps and glucose monitors are of paramount importance in the multidisciplinary context. By identifying the prevalence of these reactions and their implications, the urgent need for guidelines for the prevention and management of these cutaneous issues in children with T1DM is emphasized. A multidisciplinary approach, involving diabetologists, dermatologists, and other healthcare professionals, emerges as essential to ensure enhanced cutaneous tolerability and, consequently, the long-term effectiveness of treatment for this pediatric population. Finally, the continuous importance of research and innovation in building a promising future for children facing the complexity of T1DM is underscored. The personalized approach to early diagnosis, coupled with therapeutic interventions tailored to individual needs, promotes not only clinical advancements but also a compassionate approach in managing this chronic condition in pediatric patients. The study concludes by emphasizing the ongoing need for collaboration among healthcare professionals, researchers, and the industry to drive significant advances in the field of diagnosis and treatment of T1DM in Pediatrics.Avanços significativos no diagnóstico e tratamento da Diabetes Mellitus Tipo 1 (DM1) em pacientes pediátricos representam marcos cruciais no âmbito profissional, proporcionando uma visão abrangente das abordagens terapêuticas emergentes. Dentre as estratégias discutidas, destaca-se o papel fundamental do transplante de pâncreas, como evidenciado por estudos recentes. O sucesso desse procedimento em casos altamente selecionados oferece uma perspectiva otimista, embora a ressalva de que deve ser considerado como última opção, tratado em centros especializados, reforce a necessidade de uma abordagem criteriosa. Adicionalmente, examina-se a eficácia de inovações tecnológicas, como sistemas de terapia de circuito fechado, insulinas análogas e dispositivos de infusão automática. Resultados positivos dessas intervenções indicam uma mudança significativa no manejo da DM1 em crianças, com melhorias substanciais no controle glicêmico e na qualidade de vida. No entanto, a análise crítica dos estudos ressalta a importância de considerar as nuances específicas da faixa etária pediátrica no desenvolvimento de estratégias terapêuticas. Aspectos relevantes relacionados às reações cutâneas associadas ao uso de dispositivos como bombas de insulina e monitores de glicose são de extrema importância no contexto multidisciplinar. Ao identificar a prevalência dessas reações e suas implicações, destaca-se a necessidade urgente de diretrizes para prevenção e manejo desses problemas cutâneos em crianças com DM1. Uma abordagem multidisciplinar, envolvendo diabetologistas, dermatologistas e outros profissionais de saúde, emerge como essencial para garantir uma tolerabilidade cutânea aprimorada e, por conseguinte, a eficácia do tratamento em longo prazo para essa população pediátrica. Por fim, ressalta-se a importância contínua da pesquisa e inovação na construção de um futuro promissor para crianças enfrentando a complexidade da DM1. O enfoque personalizado no diagnóstico precoce, juntamente com intervenções terapêuticas adaptadas às necessidades individuais, promove não apenas avanços clínicos, mas também uma abordagem compassiva na gestão dessa condição crônica em pacientes pediátricos. O estudo conclui enfatizando a necessidade de colaboração contínua entre profissionais de saúde, pesquisadores e a indústria para impulsionar avanços significativos no campo do diagnóstico e tratamento da DM1 em Pediatria

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

ATLANTIC-PRIMATES: a dataset of communities and occurrences of primates in the Atlantic Forests of South America

Primates play an important role in ecosystem functioning and offer critical insights into human evolution, biology, behavior, and emerging infectious diseases. There are 26 primate species in the Atlantic Forests of South America, 19 of them endemic. We compiled a dataset of 5,472 georeferenced locations of 26 native and 1 introduced primate species, as hybrids in the genera Callithrix and Alouatta. The dataset includes 700 primate communities, 8,121 single species occurrences and 714 estimates of primate population sizes, covering most natural forest types of the tropical and subtropical Atlantic Forest of Brazil, Paraguay and Argentina and some other biomes. On average, primate communities of the Atlantic Forest harbor 2 ± 1 species (range = 1–6). However, about 40% of primate communities contain only one species. Alouatta guariba (N = 2,188 records) and Sapajus nigritus (N = 1,127) were the species with the most records. Callicebus barbarabrownae (N = 35), Leontopithecus caissara (N = 38), and Sapajus libidinosus (N = 41) were the species with the least records. Recorded primate densities varied from 0.004 individuals/km 2 (Alouatta guariba at Fragmento do Bugre, Paraná, Brazil) to 400 individuals/km 2 (Alouatta caraya in Santiago, Rio Grande do Sul, Brazil). Our dataset reflects disparity between the numerous primate census conducted in the Atlantic Forest, in contrast to the scarcity of estimates of population sizes and densities. With these data, researchers can develop different macroecological and regional level studies, focusing on communities, populations, species co-occurrence and distribution patterns. Moreover, the data can also be used to assess the consequences of fragmentation, defaunation, and disease outbreaks on different ecological processes, such as trophic cascades, species invasion or extinction, and community dynamics. There are no copyright restrictions. Please cite this Data Paper when the data are used in publications. We also request that researchers and teachers inform us of how they are using the data. © 2018 by the The Authors. Ecology © 2018 The Ecological Society of Americ

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

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

PROTOCOLOS DE SEGURANÇA EM CIRURGIA PLÁSTICA

<p>A cirurgia plástica visa uma bela harmonia. Logo, é crucial que o cirurgião plástico oriente seu paciente  a encontrar o equilíbrio entre o que é harmônico e o que é possível intervir. Para aqueles que  possuem necessidade de mudança, é possível, através da arte estética e da competência do cirurgião  plástico, melhorar sua autoestima por meio de técnicas cirúrgicas. Somente quando está é realizada  mediante padronização e com o cuidado continuado necessário, através de protocolos instituídos  por um conjunto de órgãos regulamentadores, assegura-se a segurança nos referidos procedimentos. Cita-se três aspectos redutores da mortalidade e garantias de segurança: a criação da especialidade  Cirurgia Plástica a partir da Segunda Guerra Mundial, sendo necessários 6 anos de graduação em  medicina, 3 anos de residência em cirurgia geral e 3 anos em especialização em cirurgia plástica; a  classificação dos tipos de cirurgias em Menor, Pequeno, Médio e Grande Portes e dos serviços em  que as mesmas poderão ser realizadas com diferentes exigências anestésicas; e o respeito à  autonomia do paciente somada ao consentimento esclarecido, em que o médico é obrigado a  esclarecer as dúvidas e explicar todos os riscos que tal procedimento acarreta. Sendo assim, o  paciente constrói a relação de confiança com seu profissional da saúde e os índices de mortalidade  em procedimentos estéticos reduzem significativamente.  </p&gt

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved

Resumos em andamento - Educação

Resumos em andamento - Educaçã

Resumos em andamento - Educação

Resumos em andamento - Educaçã