Avaliação da qualidade do sono em pacientes com rinossinusite crônica submetidos à cirurgia endoscópica nasossinusal : uma meta-análise

Introdução: A rinossinusite crônica pode levar a uma má qualidade do sono nos indivíduos afetados. A cirurgia endoscópica nasal tem sido indicada para pacientes com rinossinusite crônica, resulta em melhoria da qualidade de vida, mas ainda não se sabe se há melhoria semelhante na qualidade do sono após o procedimento cirúrgico. Objetivo: Estimar a qualidade do sono em pacientes com rinossinusite crônica após serem submetidos à cirurgia endoscópica nasossinusal. Método: A busca na literatura foi feita nas bases de dados indexadas PubMed, Embase, Lilacs, SciELO, Google Scholar, Web of Science, Scopus, Banco de Teses e Dissertações da Capes, Cochrane Library, Clinical Trials e na literatura cinzenta. Foram incluídos estudos que relataram a qualidade do sono de pacientes com rinossinusite crônica após ser submetidos à cirurgia endoscópica nasossinusal, com base em questionários que avaliaram a qualidade de vida. Dois pesquisadores conduziram independentemente a seleção e extração dos estudos. O modelo de efeitos aleatórios foi escolhido para conduzir a meta-análise que foi feita com o pacote estatístico STATA, versão 11. Resultados: No total, 4 estudos e 509 indivíduos foram incluídos na revisão sistemática. Melhora na qualidade do sono foi observada em 90% dos pacientes. Houve melhora (em média, de 57% a 67%) em cada um dos cinco sintomas relacionados à qualidade do sono. Os resultados da meta-análise apresentaram alta heterogeneidade. Conclusões: Esta revisão mostra que uma grande porcentagem de indivíduos relata melhoria na qualidade do sono após a cirurgia endoscópica nasossinusal.Introduction: Chronic rhinosinusitis can lead to poor sleep quality in affected individuals. Endoscopic nasal surgery has been indicated for patients with chronic rhinosinusitis, resulting in improved quality of life, but it is still unknown if there is a similar improvement in sleep quality after the surgical procedure. Objective: To estimate the sleep quality of patients with chronic rhinosinusitis after undergoing endoscopic sinus surgery. Methods: The literature search was conducted in the indexed databases PubMed, Embase, Lilacs, SciELO, Google Scholar, Web of Science, Scopus, Database of Thesis and Dissertations of CAPES, Cochrane Library, Clinical Trials and in the grey literature. It included studies that reported the sleep quality of patients with chronic rhinosinusitis after undergoing endoscopic sinus surgery based on questionnaires assessing quality of life. Two researchers independently conducted the study selection and extraction. The random effects model was chosen to conduct the meta-analysis that was performed using the statistical package STATA, version 11. Results: Overall, 4 studies and 509 subjects were included in the systematic review. Improved sleep quality was observed in 90% of the patients. There was an improvement (on average, from 57% to 67%) in each of the five symptoms related to sleep quality. The results of the meta-analysis revealed high heterogeneity. Conclusions: This review shows that a large percentage of patients report improved sleep quality after endoscopic sinus surgery

Contribuição de aspectos psicossociais no reganho de peso em pacientes submetidos a cirurgia bariátrica

Resumo: A obesidade é uma doença que vem apresentando um crescimento epidemiológico alarmante que compromete a saúde do indivíduo. Está muito além de problemas estéticos e requer tratamentos especializados. O método mais utilizado para obesidade classe II e III é a cirurgia bariátrica com derivação em Y de Roux. Porém, uma possibilidade real após a cirurgia é o reganho de peso, condição multifatorial que tem afetado muitos pacientes, principalmente depois de dois ou mais anos do procedimento. O presente estudo teve por objetivo identificar os fatores psicossociais que contribuem para o reganho de peso em pacientes submetidos à técnica de derivação em Y de Roux. Trata-se de um estudo transversal descritivo com abordagem qualitativa e exploratória, utilizando entrevistas semiestruturadas. Foram entrevistados nove pacientes, sendo cinco mulheres e quatro homens que se submeteram à cirurgia há dois ou mais anos, sendo finalizadas quando ocorreu a recorrência das falas. A análise das entrevistas foi feita a partir da Teoria Fundamentada nos Dados (Grounded Theory). Identificou-se nas entrevistas que a falta de adesão à equipe multiprofissional, principalmente nutrição e psicologia, está associada ao reganho de peso. No estilo de vida, a má alimentação e a falta da atividade física foram relatadas. O apoio social, retratado em questões familiares e alterações na rotina de trabalho também contribuíram para o reganho de peso. Conclui-se ressaltando a relevância do acompanhamento multiprofissional, da reeducação alimentar e da atividade física, bem como do apoio social na manutenção do peso perdido após a cirurgia.. Palavras-chave: Cirurgia Bariátrica. Ganho de Peso. Obesidade

Being physically active leads to better recovery prognosis for people diagnosed with COVID-19: A cross-sectional study

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 +/- 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirao Preto, Sao Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.info:eu-repo/semantics/publishedVersio

Fractional Distillation of Bio-Oil Produced by Pyrolysis of Açaí (Euterpe oleracea) Seeds

In this work, the seeds of açaí (Euterpe oleracea, Mart), a rich lignin-cellulose residue, has been submitted to pyrolysis to produce a bio-oil-like fossil fuels. The pyrolysis carried out in a reactor of 143 L, 450°C, and 1.0 atm. The morphology of Açaí seeds in nature and after pyrolysis is characterized by SEM, EDX, and XRD. The experiments show that bio-oil, gas, and coke yields were 4.38, 30.56, and 35.67% (wt.), respectively. The bio-oil characterized by AOCS, ASTM, and ABNT/NBR methods for density, kinematic viscosity, and acid value. The bio-oil density, viscosity, and acid value were 1.0468 g/cm3, 68.34 mm2/s, and 70.26 KOH/g, respectively. The chemical composition and chemical functions of bio-oil are determined by GC-MS and FT-IR. The GC-MS identified in bio-oil 21.52% (wt.) hydrocarbons and 78.48% (wt.) oxygenates (4.06% esters, 8.52% carboxylic acids, 3.53% ketones, 35.16% phenols, 20.52% cresols, 5.75% furans, and 0.91% (wt.) aldehydes), making it possible to apply fractional distillation to obtain fossil fuel-like fractions rich in hydrocarbons. The distillation of bio-oil is carried out in a laboratory-scale column, according to the boiling temperature of fossil fuels. The distillation of bio-oil yielded fossil fuel-like fractions (gasoline, kerosene, and light diesel) of 4.70, 28.21, and 22.35% (wt.), respectively

Diagnóstico pré-natal de coarctação de aorta crítica em neonatos: revisão integrativa/ Prenatal diagnosis of critical aortic coarctation in neonates: an integrative review

A coarctação de aorta (CoA) crítica é uma cardiopatia congênita (CC) comum, que traz risco à vida e que tem diagnóstico, frequentemente, postergado. Sem diagnóstico, o neonato pode ter várias complicações da patologia. Por esse motivo, o estudo visa analisar perspectivas do diagnóstico pré-natal, de CoA, em neonatos. Trata-se de revisão sistemática das Diretrizes Brasileira de Cardiologia Fetal 2019 e de artigos selecionados nas bases de dados: PubMed, Google Acadêmico, BVS e SciELO, de 2002 a 2020, com os descritores: “coarctation of the aorta”, “newborn” e “diagnosis”, sem filtro de idioma. Assim, oito artigos foram considerados elegíveis para o presente estudo. A ultrassonografia não é eficaz para identificação de CoA, portanto, é necessária: a ecocardiografia, nas condições corretas; uma dopplerfluxometria; e, provavelmente, translucência nucal e biometria cardíaca fetal. O diagnóstico pré-natal não antecipa todos os casos de CoA, pela ausência de sinais clássicos. Nesse caso, é importante a suspeita de malformações cardíacas, no pré-natal, para a realização de exames cardíacos específicos, apesar de não existir exame padrão-ouro. Faz-se necessária a realização de estudos para a validação do diagnóstico pré-natal de CoA, porém a atual perspectiva é de que haja otimização do manejo, com melhor prognóstico, e elevar a acurácia é o principal desafio

Sugarcane (Saccharum X officinarum): A Reference Study for the Regulation of Genetically Modified Cultivars in Brazil

Global interest in sugarcane has increased significantly in recent years due to its economic impact on sustainable energy production. Sugarcane breeding and better agronomic practices have contributed to a huge increase in sugarcane yield in the last 30 years. Additional increases in sugarcane yield are expected to result from the use of biotechnology tools in the near future. Genetically modified (GM) sugarcane that incorporates genes to increase resistance to biotic and abiotic stresses could play a major role in achieving this goal. However, to bring GM sugarcane to the market, it is necessary to follow a regulatory process that will evaluate the environmental and health impacts of this crop. The regulatory review process is usually accomplished through a comparison of the biology and composition of the GM cultivar and a non-GM counterpart. This review intends to provide information on non-GM sugarcane biology, genetics, breeding, agronomic management, processing, products and byproducts, as well as the current technologies used to develop GM sugarcane, with the aim of assisting regulators in the decision-making process regarding the commercial release of GM sugarcane cultivars

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