PRINCÍPIOS ANESTÉSICOS NO CENTRO CIRÚRGICO REVISÃO DE LITERATURA

Introduction: In cases of diseases such as acute cholecystitis or gallstones, removal of the gallbladder is a common surgical procedure known as cholecystectomy. The correct anesthetic technique is essential for the success of the surgery and the patient's well-being. Spinal anesthesia appears as a compatible option in this context, as it can offer benefits in terms of anesthetic efficacy and postoperative recovery. Objective: This study examines the literature to evaluate the effectiveness and technique of spinal anesthesia in cholecystectomy. We investigated the ability of spinal anesthesia to provide adequate sensory and motor blockade, the frequency of intraoperative and postoperative complications, and how it affects the postoperative recovery of patients undergoing this surgery. Methodology: An integrative review of the literature was carried out using searches in electronic databases with terms related to spinal anesthesia and cholecystectomy. The inclusion criteria were studies published in the last ten years in scientific journals that examined the effectiveness of spinal anesthesia in this context. Data was synthesized and analyzed to find patterns and trends related to the application of spinal anesthesia in cholecystectomy. Results and Discussion: This review clearly showed that spinal anesthesia can severely block sensors and motors during cholecystectomy, making the surgery precise and comfortable for the patient. Spinal anesthesia is also associated with fewer intra- and postoperative complications, which highlights its safety and tolerability.These results show that spinal anesthesia is a safe and effective anesthetic option for cholecystectomy, as it significantly reduces pain, reduces complications and allows for faster recovery. Conclusion: Spinal anesthesia is a safe and highly effective anesthetic option for cholecystectomy based on the results and discussions. A more comprehensive understanding of the role of this anesthetic method in these common surgeries was achieved through an integrative literature review. Spinal anesthesia offers patients a safer, more comfortable and more effective surgical intervention.Introdução:Em casos de doenças como colecistite aguda ou cálculos biliares, a remoção da vesícula biliar é um procedimento cirúrgico comum conhecido como colecistectomia. A técnica anestésica correta é fundamental para o sucesso da cirurgia e o bem-estar do paciente. A raquianestesia aparece como uma opção compatível nesse contexto, pois pode oferecer benefícios em termos de eficácia anestésica e recuperação pós-operatória. Objetivo: Este estudo examina a literatura para avaliar a eficácia e a técnica da raquianestesia na colecistectomia. Investigamos a capacidade da raquianestesia de fornecer um bloqueio sensorial e motor adequado, a frequência de complicações intra e pós-operatórias, e como afeta a recuperação pós-operatória de pacientes submetidos a essa cirurgia. Metodologia: Uma revisão integrativa da literatura foi realizada utilizando pesquisas em bases de dados eletrônicas com termos relacionados à raquianestesia e colecistectomia. Os critérios de inclusão foram estudos publicados nos últimos dez anos em periódicos científicos que examinaram a eficácia da raquianestesia nesse contexto. Os dados foram sintetizados e analisados ​​para encontrar padrões e tendências relacionados à aplicação da raquianestesia na colecistectomia. Resultados e Discussão: Esta revisão mostrou claramente que a raquianestesia pode bloquear severamente os sensores e os motores durante a colecistectomia, tornando a cirurgia precisa e confortável para o paciente. A raquianestesia também está associada a um menor número de complicações intra e pós-operatórias, o que destaca sua segurança e tolerabilidade. Esses resultados mostram que a raquianestesia é uma opção anestésica segura e eficaz para a colecistectomia, pois reduz significativamente a dor, diminui as complicações e permite uma recuperação mais rápida. Conclusão: A raquianestesia é uma opção anestésica segura e altamente eficaz para a colecistectomia com base nos resultados e discussões. Uma compreensão mais abrangente do papel desse método anestésico nessas cirurgias comuns foi alcançada por meio de uma revisão integrativa da literatura. A raquianestesia oferece aos pacientes uma intervenção cirúrgica mais segura, confortável e eficaz

RASTREAMENTO E TRATAMENTO DAS INFECÇÕES SEXUALMENTE TRANSMISSÍVEIS (ISTS) NA GESTANTE

Introduction: Diseases transmitted in pregnant women can cause adverse effects on pregnancy due to vertical transmission, increasing morbidity and mortality in pregnant women and their babies. STIs in pregnant women can cause stillbirths, premature birth, low birth weight, sepsis, blindness, pneumonia and birth defects. Objective: By reviewing the literature on the epidemiology of STIs in pregnant women in Brazil, we aim to reduce STI cases and protect the fetus from the various consequences that can result from vertical transmission. Methods: This study was carried out through an integrated literature review, focusing on scientific articles published in the databases MEDLINE (Medical Literature Analysis and Online Retrieval System), LILACS (Latin American and Caribbean Literature in Health Sciences) and BDENF ). The following terms were used in the study (“STI” and “pregnancy” and “vertical transmission”). Results: As a result of the analysis of the selected works, the deficiencies in prenatal care related to the prevention of syphilis and other sexually transmitted diseases during pregnancy and without the use of condoms, show the importance of early diagnosis and treatment, thus reducing the transmission rate vertical. Conclusion: It is clear that the adequate treatment of pregnant women with STIs focuses on issues related to their impact on neonatal mortality. This is because these diseases have negative effects on the pregnant woman, the fetus and development after birth.Introdução: Doenças transmitidas em gestantes podem causar efeitos adversos na gravidez devido à transmissão vertical, aumentando a morbimortalidade em gestantes e seus bebês. As IST em mulheres grávidas podem causar nados-mortos, parto prematuro, baixo peso à nascença, sépsis cegueira, pneumonia e defeitos congénitos. Objetivo: Ao revisar a literatura sobre a epidemiologia das ISTs em gestantes no Brasil, pretendemos reduzir os casos de ISTs e proteger o feto das diversas consequências que podem resultar da transmissão vertical. Métodos: Este estudo foi realizado por meio de uma revisão integrada da literatura, com foco em artigos científicos publicados nas bases MEDLINE (Medical Literature Analysis and Online Retrieval System), LILACS (Literatura Latino-Americana e do Caribe em Ciências da Saúde) e BDENF). Os seguintes termos foram utilizados no estudo (“IST” e “gravidez” e “transmissão vertical”). Resultados: Como resultado da análise dos trabalhos selecionados, as deficiências da assistência pré-natal relacionadas à prevenção da sífilis e outras doenças sexualmente transmissíveis durante a gravidez e sem uso de preservativo, mostram a importância do diagnóstico e tratamento precoce, reduzindo assim a taxa transmissão vertical. Conclusão: Fica claro que o tratamento adequado das gestantes com IST centra-se nas questões relacionadas ao seu impacto na mortalidade neonatal. Isso ocorre porque essas doenças têm efeitos negativos na gestante, no feto e no desenvolvimento após o nascimento

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

A social and ecological assessment of tropical land uses at multiple scales: the Sustainable Amazon Network

Science has a critical role to play in guiding more sustainable development trajectories. Here, we present the Sustainable Amazon Network (Rede Amazonia Sustentavel, RAS): a multidisciplinary research initiative involving more than 30 partner organizations working to assess both social and ecological dimensions of land-use sustainability in eastern Brazilian Amazonia. The research approach adopted by RAS offers three advantages for addressing land-use sustainability problems: (i) the collection of synchronized and co-located ecological and socioeconomic data across broad gradients of past and present human use; (ii) a nested sampling design to aid comparison of ecological and socioeconomic conditions associated with different land uses across local, landscape and regional scales; and (iii) a strong engagement with a wide variety of actors and non-research institutions. Here, we elaborate on these key features, and identify the ways in which RAS can help in highlighting those problems in most urgent need of attention, and in guiding improvements in land-use sustainability in Amazonia and elsewhere in the tropics. We also discuss some of the practical lessons, limitations and realities faced during the development of the RAS initiative so far.Keywords: Social–ecological systems, Tropical forests, Land use, Interdisciplinary research, Sustainability, Trade-off

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

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

TRY plant trait database – enhanced coverage and open access

Plant traits - the morphological, anatomical, physiological, biochemical and phenological characteristics of plants - determine how plants respond to environmental factors, affect other trophic levels, and influence ecosystem properties and their benefits and detriments to people. Plant trait data thus represent the basis for a vast area of research spanning from evolutionary biology, community and functional ecology, to biodiversity conservation, ecosystem and landscape management, restoration, biogeography and earth system modelling. Since its foundation in 2007, the TRY database of plant traits has grown continuously. It now provides unprecedented data coverage under an open access data policy and is the main plant trait database used by the research community worldwide. Increasingly, the TRY database also supports new frontiers of trait‐based plant research, including the identification of data gaps and the subsequent mobilization or measurement of new data. To support this development, in this article we evaluate the extent of the trait data compiled in TRY and analyse emerging patterns of data coverage and representativeness. Best species coverage is achieved for categorical traits - almost complete coverage for ‘plant growth form’. However, most traits relevant for ecology and vegetation modelling are characterized by continuous intraspecific variation and trait–environmental relationships. These traits have to be measured on individual plants in their respective environment. Despite unprecedented data coverage, we observe a humbling lack of completeness and representativeness of these continuous traits in many aspects. We, therefore, conclude that reducing data gaps and biases in the TRY database remains a key challenge and requires a coordinated approach to data mobilization and trait measurements. This can only be achieved in collaboration with other initiatives

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others