31 research outputs found
Consenso da Sociedade Brasileira de Cefaleia sobre o tratamento da migrânea crônica
Chronic migraine poses a significant personal, social and economic burden and is characterized by headache present on 15 or more days per month for at least three months, with at least eight days of migrainous headache per month. It is frequently associated with analgesic or acute migraine medication overuse and this should not be overlooked. The present consensus was elaborated upon by a group of members of the Brazilian Headache Society in order to describe current evidence and to provide recommendations related to chronic migraine pharmacological and nonpharmacological treatment. Withdrawal strategies in medication overuse headache are also described, as well as treatment risks during pregnancy and breastfeeding. Oral topiramate and onabotulinum toxin A injections are the only treatments granted Class A recommendation, while valproate, gabapentin, and tizanidine received Class B recommendation, along with acupuncture. biofeedback, and mindfulness. The anti-CGRP or anti-CGRPr monoclonal antibodies, still unavailable in Brazil, are promising new drugs already approved elsewhere for migraine prophylactic treatment, the efficacy of which in chronic migraine is still to be definitively proven777509520A migrânea (enxaqueca) crĂ´nica determina uma carga pessoal, social e econĂ´mica significativa e Ă© caracterizada por dor de cabeça presente em quinze ou mais dias por mĂŞs por ao menos trĂŞs meses, com no mĂnimo oito dias de cefaleia migranosa a cada mĂŞs. É frequentemente associada ao uso excessivo de medicação analgĂ©sica ou antimigranosa aguda e isso nĂŁo deve ser negligenciado. Este consenso foi elaborado por um grupo de membros da Sociedade Brasileira de Cefaleia, para descrever as evidĂŞncias atualmente disponĂveis e fornecer recomendações relacionadas ao tratamento farmacolĂłgico e nĂŁo farmacolĂłgico da migrânea crĂ´nica. EstratĂ©gias de retirada na cefaleia por uso excessivo de medicamentos tambĂ©m sĂŁo descritas, assim como os riscos dos tratamentos durante a gravidez e a amamentação. O topiramato oral e as injeções de toxina onabotulĂnica A sĂŁo os Ăşnicos tratamentos que receberam a recomendação classe A, enquanto que o valproato, a gabapentina e a tizanidina receberam recomendação classe B, juntamente com acupuntura, biofeedback e mindfulness. Os anticorpos monoclonais anti-CGRP ou anti-CGRPr, ainda nĂŁo disponĂveis no Brasil, sĂŁo novos fármacos promissores, já aprovados em outros paĂses para o tratamento profilático da migrânea, cuja eficácia na migrânea crĂ´nica ainda está por ser definitivamente comprovad
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
Post-craniotomy headache after surgery for treatment of cerebral aneurysms
A cefalĂ©ia pĂłs-craniotomia foi estudada em pacientes submetidos a craniotomia para tratamento de aneurismas cerebrais. Os pacientes foram avaliados no prĂ©-operatĂłrio e seguidos por seis meses apĂłs a cirurgia. Observamos que a cefalĂ©ia pĂłs-craniotomia teve incidĂŞncia alta, inĂcio precoce, caracterĂsticas diferentes e maior freqĂĽĂŞncia do que a cefalĂ©ia prĂ©via, e esteve associada Ă disfunção temporomandibular, sintomas depressivos e ansiosos, e significativa repercussĂŁo sobre a qualidade de vida. A freqĂĽĂŞncia da cefalĂ©ia diminuiu com o tempo de seguimento. Maior intensidade de dor foi observada no sexo feminino, em pacientes ansiosos e naqueles submetidos a craniotomias frontais e fronto-orbito-zigomáticasPost-craniotomy headache was studied in patients after craniotomy for treatment of cerebral aneurysms. Patients were evaluates at the pre-surgical period and followed up to six months after surgery. We observed that post-craniotomy headache had a high incidence, a precocious beginning, different features and higher frequency than previous headaches, and was associated with temporomandibular disorders, depression and anxiety symptoms, and determined significant repercussion on the patient's quality of life. Headache frequency decreased during follow-up. Pain intensity was higher in females, in anxious patients and in those with frontal and orbitozygomatic craniotomie
Depression and anxiety disorders among patients with human T-cell lymphotropic virus type-1: a cross-sectional study with a comparison group
Abstract INTRODUCTION: Studies have linked human T-cell lymphotropic virus type-1 (HTLV-1) to psychiatric disease. METHODS: Patients with HTLV-1 were compared to patients seen by family doctors using a semi-structured questionnaire and the Hospital Anxiety and Depression Scale. RESULTS: Participants with (n=58) and without (n=340) HTLV were compared. Anxiety and depression were associated with greater age, being a woman, spastic paraparesis (depression: PR=4.50, 95% CI: 3.10-6.53; anxiety: PR=2.96, 95% CI: 2.08-4.21), and asymptomatic HTLV (depression: PR=4.34, 95% CI: 3.02-6.24; anxiety: PR=2.81, 95% CI: 2.06-3.85). CONCLUSIONS: Symptomatic and asymptomatic patients with HTLV-1 experienced more anxiety and depression than uninfected patients