Efficacy of HPA Lanolin® in treatment of lip alterations related to chemotherapy

The side effects of chemotherapy on the lips may cause esthetic and functional impact and increase the risk of infection. HPA Lanolin® is an option for supportive therapy because it has anti-inflammatory, antimicrobial and moisturizing properties. Objective: To evaluate the efficacy of this product in the prevention of lip alterations in a population of patients undergoing chemotherapy. Material and Methods: Patients undergoing chemotherapy (n = 57) were examined and distributed into two groups: study (used HPA Lanolin®) and control (without supportive therapy on the lips). We evaluated the patients two weeks after chemotherapy, registering oral alterations, symptoms of pain, discomfort, limitation of mouth opening and dehydration, classified according to a visual analogue scale. Results: Patients who used HPA Lanolin® had lower dehydration and experienced improvement of lip dryness (

Compreensão acerca dos fatores de risco de lesão por pressão em idosos internados em unidade de terapia intensiva

The aim of this study is to identify and analyze the main risk factors for pressure injuries related to hospitalization in the Intensive Care Unit. This is a bibliographical review of exploratory, quantitative and qualitative scientific literature. To select the sample, a search was made of the electronic databases LILACS and BDENF, from which a careful analysis was carried out, enabling the selection of twenty articles to be used to identify the risks of pressure injury in the elderly in the intensive care unit. The data was collected between March and May of this year. It is understood that there is a high probability of PPI developing in elderly patients after 60 years of age. The average length of hospitalization and pathologies such as hypertension and diabetes mellitus are key factors in the appearance of PI. According to the publications researched, it can be concluded that PPLs are a problem in hospital units that care for critically ill patients due to the permanent or temporary reduction in motility that exists in many cases.El objetivo de este estudio es identificar y analizar los principales factores de riesgo de las lesiones por presión relacionadas con la hospitalización en la Unidad de Cuidados Intensivos. Se trata de una revisión bibliográfica de la literatura científica exploratoria, cuantitativa y cualitativa. Para seleccionar la muestra, se realizó una búsqueda en las bases de datos electrónicas LILACS y BDENF, a partir de la cual se llevó a cabo un cuidadoso análisis que permitió seleccionar veinte artículos para identificar los riesgos de lesiones por presión en ancianos en la Unidad de Cuidados Intensivos. Los datos se recogieron entre marzo y mayo de este año. Se entiende que existe una alta probabilidad de que se desarrolle una IPP en pacientes ancianos después de los 60 años. La duración media de la hospitalización y patologías como la hipertensión y la diabetes mellitus son factores clave en la aparición de la IPP. Según las publicaciones investigadas, se puede concluir que las IPP son un problema común en las unidades hospitalarias que atienden a pacientes críticos debido a la reducción permanente o temporal de la motilidad que existe en muchos casos.Este trabalho tem como objetivo identificar e analisar os principais fatores de risco para lesão por pressão, relacionados a internação em Unidade de Terapia Intensiva. Trata-se de uma revisão bibliográfica em literatura científica exploratória, quantitativa e qualitativa. Para a seleção da amostragem foi feita uma busca a partir dos bancos de dados eletrônicos LILACS e BDENF, a partir disso foi realizada uma análise criteriosa que possibilitou através de uma leitura a seleção de vinte artigos para serem utilizados na identificação dos riscos de lesão por pressão em idosos na unidade de terapia intensiva. Os dados foram coletados entre os meses março a maio deste ano. Entende-se uma alta probabilidade de crescimento de LPP em pacientes idosos após 60 anos de idade. O tempo médio de internação e as patologias como hipertensão arterial e diabetes mellitus apresenta-se como fator primordial ao aparecimento de LPP. De acordo com as publicações pesquisadas, conclui-se que as LPP são agravos presentes em unidades hospitalares que cuidam de pacientes críticos devido a redução permanente ou temporária de motilidade existente em muitos casos. &nbsp

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

Rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART): Study protocol for a randomized controlled trial

Background: Acute respiratory distress syndrome (ARDS) is associated with high in-hospital mortality. Alveolar recruitment followed by ventilation at optimal titrated PEEP may reduce ventilator-induced lung injury and improve oxygenation in patients with ARDS, but the effects on mortality and other clinical outcomes remain unknown. This article reports the rationale, study design, and analysis plan of the Alveolar Recruitment for ARDS Trial (ART). Methods/Design: ART is a pragmatic, multicenter, randomized (concealed), controlled trial, which aims to determine if maximum stepwise alveolar recruitment associated with PEEP titration is able to increase 28-day survival in patients with ARDS compared to conventional treatment (ARDSNet strategy). We will enroll adult patients with ARDS of less than 72 h duration. The intervention group will receive an alveolar recruitment maneuver, with stepwise increases of PEEP achieving 45 cmH(2)O and peak pressure of 60 cmH2O, followed by ventilation with optimal PEEP titrated according to the static compliance of the respiratory system. In the control group, mechanical ventilation will follow a conventional protocol (ARDSNet). In both groups, we will use controlled volume mode with low tidal volumes (4 to 6 mL/kg of predicted body weight) and targeting plateau pressure <= 30 cmH2O. The primary outcome is 28-day survival, and the secondary outcomes are: length of ICU stay; length of hospital stay; pneumothorax requiring chest tube during first 7 days; barotrauma during first 7 days; mechanical ventilation-free days from days 1 to 28; ICU, in-hospital, and 6-month survival. ART is an event-guided trial planned to last until 520 events (deaths within 28 days) are observed. These events allow detection of a hazard ratio of 0.75, with 90% power and two-tailed type I error of 5%. All analysis will follow the intention-to-treat principle. Discussion: If the ART strategy with maximum recruitment and PEEP titration improves 28-day survival, this will represent a notable advance to the care of ARDS patients. Conversely, if the ART strategy is similar or inferior to the current evidence-based strategy (ARDSNet), this should also change current practice as many institutions routinely employ recruitment maneuvers and set PEEP levels according to some titration method.Hospital do Coracao (HCor) as part of the Program 'Hospitais de Excelencia a Servico do SUS (PROADI-SUS)'Brazilian Ministry of Healt

Efeito do laser de baixa intensidade na cicatrização de defeitos críticos preenchidos com osso autógeno aos 30 e 60 dias pós-operatórios: estudo in vivo

The success of various dental interventions depends on an efficient tissue repair process. In many cases of oral rehabilitation with implants and repair of periodontal bone defects, there is a need for grafting procedures. Autogenous bone remains the gold standard grafting material according to the literature because it presents the characteristics of osteogenesis, osteoconduction and osteoinduction. In order to improve the knowledge about the process of bone repair with autogenous bone and to study the effects of low intensity laser on bone healing, this study aims to evaluate the effect of low intensity laser on critical defect bone healing treated with Autogenous bone (AB) at 30 and 60 postoperative days. 80 adult male rats (Rattus norvegicus, albinus, Wistar) weighing between 250 and 300 g were used. A criticalsize bone defect with a diameter of 5 mm was created in the calvaria of each animal. The animals were randomly divided into 4 groups (n = 20) of treatment: 1) Group C (filled with blood clot), 2) LLL group (low intensity laser - GaAlAs, 780 nm, 100mW, 210J/cm2, 6J), 3) Group AB (autogenous graft), 4) Group ABL (autogenous graft + laser of low intensity) euthanized at 30 and 60 days. An amount of new bone (NBF) was calculated as a percentage of the original defect area. Data were submitted to statistical analysis (ANOVA, Tukey test, p 0.05). There was only statistically significant difference (p 0,05). Houve diferença estatisticamente significativa (p < 0,05) quando AB, LLL e ABL foram comparados aos grupos C aos 30 dias e o grupo AB comparado com C aos 60 dias. Dentro dos limites deste estudo, o LLL não apresentou capacidade biomudolatória no aumento da NBF quando associado ou não ao enxerto autógeno. Além disso, não foi observada diferença estatisticamente significativa quando se comparou a mesma técnica em tempos de 30 e 60 dias de cicatrização. O grupo LLL mostrou maior formação óssea em relação ao grupo C somente em análise de 30 dias, sugerindo capacidade apenas de acelerar a formação óssea

Efficacy of HPA Lanolin&#174; in treatment of lip alterations related to chemotherapy

The side effects of chemotherapy on the lips may cause esthetic and functional impact and increase the risk of infection. HPA Lanolin&#174; is an option for supportive therapy because it has anti-inflammatory, antimicrobial and moisturizing properties. Objective: To evaluate the efficacy of this product in the prevention of lip alterations in a population of patients undergoing chemotherapy. Material and Methods: Patients undergoing chemotherapy (n = 57) were examined and distributed into two groups: study (used HPA Lanolin&#174;) and control (without supportive therapy on the lips). We evaluated the patients two weeks after chemotherapy, registering oral alterations, symptoms of pain, discomfort, limitation of mouth opening and dehydration, classified according to a visual analogue scale. Results: Patients who used HPA Lanolin&#174; had lower dehydration and experienced improvement of lip dryness (p<0.001). The main symptoms were dehydration, discomfort, limitation of mouth opening, pain. The main clinical signs were dry lips, mucositis, cheilitis, hematoma, swelling and cracking. We found no difference concerning the variables of pain, discomfort, and limitation of mouth opening between the study and control group. Conclusions: We suggest that HPA Lanolin&#174; is effective in reducing the symptoms of dehydration and the signs of lip dryness resulting from toxicity of chemotherapy, proving to be an interesting alternative supportive therapy for cancer patients