Relação entre causas obstétricas diretas e mortalidade fetal no Brasil / Relationship between direct obstetric causes and fetal mortality in Brazil

Objetivos: Quantificar a prevalência dos óbitos fetais decorrentes de causas obstétricas diretas ocorridos entre o período de 2010 e 2018 no Brasil. Métodos: Estudo transversal, de caráter descritivo, com abordagem quantitativa, que utilizou dados do Sistema de Informações sobre Nascidos Vivos e do Sistema de Informação sobre Mortalidade fornecidos pelo banco de dados do Departamento de Informática do Sistema Único de Saúde. O estudo consiste na análise dos óbitos fetais decorrentes de causas obstétricas diretas, ocorridos entre 2010 e 2018 no Brasil. Resultados: No Brasil, entre 2010 e 2018, ocorreram 283.411 óbitos fetais, sendo grande parte relacionada a causas obstétricas diretas, com predominância de 264.068 mortes decorrentes de algumas afecções originadas no período perinatal. Observou-se prevalência em: gravidez única (90,2%), parto vaginal (66,1%), antes do trabalho de parto (90,1%) e em hospitais (92,6%), em fetos do sexo masculino (52,74%), com idade gestacional entre 32 e 36 (23,73%) e entre 37 e 41 semanas de gestação (23%) e peso entre 500 e 999g (23,41%) e entre 1.500 a 2.499g (23,30%). Conclusões: A mortalidade fetal é considerada como um desafio, principalmente para países em desenvolvimento como o Brasil. Portanto, o estudo da natimortalidade, de suas variáveis e de sua relação com as causas obstétricas diretas é de extrema importância para ampliação do conhecimento sobre o tema e, consequentemente, declínio do número dos casos considerados evitáveis através da prevenção

Pré-eclâmpsia: importante causa de óbitos maternos no Brasil entre os anos de 2010-2017 / Pre-eclampsia: important cause of maternal deaths in Brazil between the years 2010-2017

Objetivo: Investigar as particularidades sociodemográficas e suas as associações dos óbitos maternos de mulheres com pré-eclâmpsia, durante o período de 2010 a 2017 no Brasil. Métodos: Estudo epidemiológico de caráter quantitativo com abordagem descritiva, que consistiu na análise de óbitos maternos por Pré-eclâmpsia ocorridos entre os anos de 2010-2017 no Brasil segundo o banco de dados do departamento de informática do Sistema Único de Saúde (DATASUS). As variáveis avaliadas foram: óbitos maternos, período dos óbitos, ano do óbito, e faixa etária, cor/raça, estado civil e escolaridade das gestantes nas regiões brasileiras, o local de ocorrência e o CID-10. Resultados: Entre os anos de 2010 a 2017 houveram 8992 mortes por causas obstétricas diretas advindas de 65 categorias de patologias da CID-10. A pré-eclâmpsia ocupou a segunda posição com 942 óbitos (10,48%) com uma média de 117,75 mortes ao ano, com prevalência nas regiões Sudeste e Nordeste, concentrando-se principalmente na faixa etária entre 20 a 39 anos, com maior incidência em mulheres de cor parda (51,38%) e nas solteiras (43,31%). O hospital foi o local com maiores ocorrências das mortes por pré-eclâmpsia com 96,71% dos óbitos. Conclusão: A pré-eclâmpsia contribui de forma significativa com a mortalidade materna, apresentando-se como a segunda maior causa de óbitos no Brasil

A crise entre o modo de produção capitalista e a finitude dos recursos naturais: a ascensão de um novo modelo ético como alicerce de um estado ambiental de direito

A alta velocidade com que se desenvolve a sociedade no campo da tecnologia é contrária à garantia do mínimo existencial, desencadeando, assim, o processo de desequilíbrio ambiental, pois a contínua exploração desenfreada acarretará a falta de condições para a existência humana. Sendo necessário notar a enorme importância que a preservação da biodiversidade representa aos cidadãos. No que concerne à diversidade das espécies, a sua funcionalidade destaca-se no fornecimento de recursos para os seres humanos, além de representar o alcance das adaptações evolucionárias e ecológicas das espécies em determinados ambientes. Desta forma, o presente trabalho busca analisar a crise entre o modo de produção capitalista e a finitude dos recursos naturais trazendo a ascensão de um novo modelo ético como alicerce de um estado ambiental de direito

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

Long-term safety and efficacy of patisiran for hereditary transthyretin-mediated amyloidosis with polyneuropathy: 12-month results of an open-label extension study

© 2020 Elsevier Ltd. All rights reserved.Background: Hereditary transthyretin-mediated amyloidosis is a rare, inherited, progressive disease caused by mutations in the transthyretin (TTR) gene. We assessed the safety and efficacy of long-term treatment with patisiran, an RNA interference therapeutic that inhibits TTR production, in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Methods: This multicentre, open-label extension (OLE) trial enrolled patients at 43 hospitals or clinical centres in 19 countries as of Sept 24, 2018. Patients were eligible if they had completed the phase 3 APOLLO or phase 2 OLE parent studies and tolerated the study drug. Eligible patients from APOLLO (patisiran and placebo groups) and the phase 2 OLE (patisiran group) studies enrolled in this global OLE trial and received patisiran 0·3 mg/kg by intravenous infusion every 3 weeks with plans to continue to do so for up to 5 years. Efficacy assessments included measures of polyneuropathy (modified Neuropathy Impairment Score +7 [mNIS+7]), quality of life, autonomic symptoms, nutritional status, disability, ambulation status, motor function, and cardiac stress, with analysis by study groups (APOLLO-placebo, APOLLO-patisiran, phase 2 OLE patisiran) based on allocation in the parent trial. The global OLE is ongoing with no new enrolment, and current findings are based on the interim analysis of the patients who had completed 12-month efficacy assessments as of the data cutoff. Safety analyses included all patients who received one or more dose of patisiran up to the data cutoff. This study is registered with ClinicalTrials.gov, NCT02510261. Findings: Between July 13, 2015, and Aug 21, 2017, of 212 eligible patients, 211 were enrolled: 137 patients from the APOLLO-patisiran group, 49 from the APOLLO-placebo group, and 25 from the phase 2 OLE patisiran group. At the data cutoff on Sept 24, 2018, 126 (92%) of 137 patients from the APOLLO-patisiran group, 38 (78%) of 49 from the APOLLO-placebo group, and 25 (100%) of 25 from the phase 2 OLE patisiran group had completed 12-month assessments. At 12 months, improvements in mNIS+7 with patisiran were sustained from parent study baseline with treatment in the global OLE (APOLLO-patisiran mean change -4·0, 95 % CI -7·7 to -0·3; phase 2 OLE patisiran -4·7, -11·9 to 2·4). Mean mNIS+7 score improved from global OLE enrolment in the APOLLO-placebo group (mean change from global OLE enrolment -1·4, 95% CI -6·2 to 3·5). Overall, 204 (97%) of 211 patients reported adverse events, 82 (39%) reported serious adverse events, and there were 23 (11%) deaths. Serious adverse events were more frequent in the APOLLO-placebo group (28 [57%] of 49) than in the APOLLO-patisiran (48 [35%] of 137) or phase 2 OLE patisiran (six [24%] of 25) groups. The most common treatment-related adverse event was mild or moderate infusion-related reactions. The frequency of deaths in the global OLE was higher in the APOLLO-placebo group (13 [27%] of 49), who had a higher disease burden than the APOLLO-patisiran (ten [7%] of 137) and phase 2 OLE patisiran (0 of 25) groups. Interpretation: In this interim 12-month analysis of the ongoing global OLE study, patisiran appeared to maintain efficacy with an acceptable safety profile in patients with hereditary transthyretin-mediated amyloidosis with polyneuropathy. Continued long-term follow-up will be important for the overall assessment of safety and efficacy with patisiran.info:eu-repo/semantics/publishedVersio