DIAGNÓSTICO PRECOCE DA DOENÇA DE ALZHEIMER: IMPORTÂNCIA E DESAFIOS.

Alzheimer's disease is a neurodegenerative disorder common in older people and its pathophysiology is not yet well explained, but it is known that genetic factors are involved in its development.  It is a chronic pathology that presents senile plaques and is characterized by a progressive decline in cognitive function, with damage mainly to short-term memory, language, reasoning and critical judgment. In view of the epidemiological impact of Alzheimer's disease, this paper aims to address the importance of early diagnosis of the disease, in order to highlight the challenges faced in its diagnosis. The study was based on a literature review. The articles were selected for the study after searching the SciELO, PubMed and VHL databases.  The descriptors used to find the related studies were "Alzheimer's Disease" and "Early Diagnosis".  As a result, it was observed that early diagnosis of Alzheimer's disease is of paramount importance for adequate access to treatment, planning and preparing the family for future challenges, seeking emotional support, safety and adequate care. However, challenges such as intra-laboratory variability, overlap with other forms of dementia and high cost mean that early diagnosis using biomarkers is limited.A Doença de Alzheimer é um acometimento neurodegenerativo comum em pessoas com mais idade e sua fisiopatologia ainda não é bem explicada, mas sabe-se da carga genética envolvida em seu desenvolvimento.  Trata-se de uma patologia crônica, que apresenta placas senis e é caracterizada pelo declínio progressivo da função cognitiva, com prejuízo principalmente da memória a curto prazo, linguagem, raciocínio e juízo crítico. Tendo em vista o impacto epidemiológico da Doença de Alzheimer, o presente trabalho objetiva abordar a importância do diagnóstico precoce da doença, de modo a evidenciar os desafios enfrentados em seu diagnóstico. O estudo foi desenvolvido a partir da revisão de literatura. Os artigos foram selecionados para compor o estudo após buscas das bases de dado SciELO, PubMed e BVS.  Os descritores utilizados para encontrar os estudos relacionados foram “Doença de Alzheimer” e “Diagnóstico Precoce”.  Como resultado, observou-se que diagnóstico precoce da Doença de Alzheimer é de suma importância para acesso adequado ao tratamento, planejamento e preparação da família para desafios futuros, busca por suporte emocional, segurança e cuidados adequados. No entanto, desafios como variabilidade intralaboratorial, sobreposição com outras formas de demência e alto custo fazem com que o diagnóstico precoce a partir do uso de biomarcadores seja limitado

PREVENÇÃO E TRATAMENTO DAS PRINCIPAIS COMPLICAÇÕES PÓS-CIRURGICAS EM TRANSPLANTES CARDÍACOS: UMA REVISÃO DE LITERATURA

The aim of this article is to take a look at the current medical literature on ways of preventing and treating possible post-surgical complications in heart transplants. The Scientific Electronic Library Online (SciELO), Virtual Health Library (VHL), Medline and LILACS were used as search engines. The terms "Heart Transplant", "Prevention", "Treatment" and "Complications" were chosen as the study keywords. It was concluded that the main acute manifestations are humoral and cellular responses, generally managed with immunosuppressive therapy. In the case of late manifestations, the therapy instituted varies according to the patient's degree of involvement. In terms of prevention, the first measure is the appropriate choice of donor.  Este artigo tem por objetivo realizar uma abordagem da literatura médica vigente sobre os meios de prevenção e tratamento de possíveis complicações pós-cirúrgicas em transplantes cardíacos. Foram utilizados como motores de busca os indexadores Scientific Electronic Library Online (SciELO), Biblioteca Virtual em Saúde (BVS), Medline e LILACS. Optou-se pelos termos “Transplante Cardíaco”, “Prevenção”, “Tratamento” e “Complicações” como palavras-chave do estudo. Conclui-se que as principais manifestações agudas são resposta humoral e celular, geralmente manejadas com terapia imunossupressora. No caso das manifestações tardias, a terapêutica instituída varia de acordo com o grau de acometimento do paciente. Em termos de prevenção, a primeira medida é a escolha adequada do doador

Restrição alimentar de glúten e caseína em pacientes com Transtorno do Espectro Autista

O Transtorno do Espectro Autista (TEA) é enquadrado nos transtornos do neurodesenvolvimento, e cursa com sintomas centrais no comprometimento de, principalmente, três áreas: comunicativa, social e comportamental. Trata-se de um transtorno mais prevalente no sexo masculino e geralmente manifestado até o terceiro ano de vida. O objetivo desse estudo foi abordar os aspectos da restrição alimentar de glúten e caseína em pacientes com o transtorno, tendo em vista a complexidade de manejo terapêutico do TEA desde seu diagnóstico. Foi realizada revisão de literatura, a partir da busca por artigos nas bases de dados: Biblioteca Virtual de Saúde (BVS), Scientific Eletronic Online (Scielo) e PubMed, por meio dos descritores: “Transtorno do Espectro Autista”, “Caseína”, “Glúten”, “Restrição”, e 8 artigos foram utilizados para o desenvolvimento do trabalho. Os resultados evidenciaram a falta de dados comprobatórios para a eficácia da restrição alimentar de glúten e caseína na melhora dos sintomas em pacientes com TEA. Ademais, foi visto que tal restrição só deve ser considerada em casos de intolerância ou alergia, pois as restrições alimentares sem indicação efetiva podem estar relacionadas a rejeição social, estigmatização e dificuldades de socialização e integração e potencializar efeitos do transtorno. Conclui-se, portanto, a necessidade de novos estudos com metodologia eficaz e organizada para, então, considerar tal prática como medida terapêutica

PREVENÇÃO DA TRANSMISSÃO VERTICAL DA SÍFILIS: ABORDAGENS DE RASTREIO E TRATAMENTO DA GESTANTE

Syphilis in pregnant women is a disease on the list of compulsorily notifiable diseases. This obligation is aimed at controlling the transmission of Treponema pallidum and monitoring the behavior of the infection in pregnant women, in order to plan and evaluate treatment, prevention and control measures. Given the complexity and seriousness of the clinical manifestations in the life of the newborn, this study aims to elucidate how vertical transmission of syphilis is prevented, including screening and treatment of pregnant women. The article was developed through a systematic literature review, and the articles selected for the study were taken from the SciELO, PubMed and VHL databases. Prevention of congenital syphilis begins in prenatal care, with testing in the first and last trimesters of pregnancy. Treatment should be carried out with intramuscular benzylpenicillin benzathine if active syphilis is confirmed and the criteria for assessing whether treatment has been carried out properly should be applied during outpatient follow-up. It is important to emphasize that, even given the seriousness of the repercussions of congenital syphilis, the country still faces inadequate conditions for the diagnosis and treatment of syphilis, thus preventing the early identification and correct treatment of pregnant women with acquired syphilis.A sífilis em gestantes é uma doença que faz parte da lista de agravos de notificação compulsória. Tal obrigatoriedade tem como objetivo controlar a transmissão do Treponema pallidum e acompanhar o comportamento da infecção na gestante, para planejar e avaliar as medidas de tratamento, prevenção e controle. Tendo em vista a complexidade e gravidade das manifestações clínicas na vida do recém nascido, o presente estudo objetiva elucidar como se dá a prevenção da transmissão vertical da sífilis, contemplando o rastreio e o tratamento da gestante. O artigo foi desenvolvido por meio de uma revisão sistemática da literatura, e os artigos selecionados para compor o estudo foram retirados das bases de dado SciELO, PubMed e BVS. A prevenção da sífilis congênita tem início no pré-natal, com testagens no primeiro e no último trimestre da gestação. O tratamento deve ser realizado com benzilpenicilina benzatina intramuscular se sífilis ativa confirmada e os critérios para avaliar se o tratamento foi realizado adequadamente devem ser aplicados no seguimento ambulatorial. É importante ressaltar que, mesmo diante das gravidade da repercussão da sífilis congênita, o país ainda enfrenta condições inadequadas para o diagnóstico e tratamento da sífilis, impedindo, assim, a identificação precoce e o tratamento correto das gestantes com sífilis adquirida

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

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