EFEITO DA PRÁTICA DE YOGA NA PRESSÃO ARTERIAL DE PESSOAS COM HIPERTENSÃO ARTERIAL: REVISÃO SISTEMÁTICA E METANÁLISE DE ENSAIOS CLÍNICOS RANDOMIZADOS

Hypertension is one of the main causes of death in Brazil and in the world. On the other side, studies suggest that yoga practice can be an interesting complementary strategy for the treatment of the disease. The aim of this study was to carry out a systematic review and meta-analysis on the effects of this practice on the blood pressure of people with hypertension. Two reviewers performed searches in Pubmed, Embase, Cochrane and LILACS databases. Randomized clinical trials that evaluated the effect of yoga on blood pressure in adult volunteers diagnosed with arterial hypertension were included. Random effects meta-analysis was conducted to determine the effect of yoga on blood pressure, using Stata software (version 16.0, StataCrop, College Station, Texas, USA). A total of 945 articles were found and, after verifying the eligibility criteria, 10 were included. Of these 10 studies, 8 reported a significant reduction in blood pressure levels after the yoga intervention period. Through meta-analysis, yoga physical training significantly reduced systolic blood pressure (MD = -7.28; 95% IC = -11.32; -3.23 mmHg) and diastolic blood pressure (MD = -4.81; 95% CI = -8.22; -1.40 mmHg) in people with hypertension. Yoga training is an effective treatment for arterial hypertension.La hipertensión es una de las principales causas de muerte en Brasil y en el mundo. Por otra parte, las investigaciones sugieren que practicar yoga puede ser una estrategia interesante para el tratamiento de la enfermedad. El objetivo de este estudio fue realizar una revisión sistemática y un metanálisis sobre los efectos de esta práctica en la presión arterial de personas con hipertensión. Dos revisores realizaron la búsqueda en las bases de datos Pubmed, Embase, Cochrane y LILACS. Se incluyeron ensayos controlados aleatorios que investigaron el efecto de la práctica de yoga sobre los niveles de presión arterial de voluntarios adultos con hipertensión. Se realizó un metanálisis de efectos aleatorios para determinar el efecto del yoga sobre la presión arterial, utilizando el software Stata (versión 16.0, StataCrop, College Station, Texas, EE.UU.). Se encontraron 945 artículos y, tras comprobar los criterios de elegibilidad, se incluyeron 10 estudios. De estos 10 estudios, 8 informaron de una reducción significativa de los niveles de presión arterial tras el periodo de intervención con yoga. Mediante el metanálisis, el entrenamiento físico con yoga redujo significativamente la presión arterial sistólica (DM = -7,28; IC del 95% = -11,32; -3,23 mmHg) y la presión arterial diastólica (DM = -4,81; IC del 95% = -8,22; -1,40 mmHg) en personas con hipertensión. La práctica del yoga es eficaz para reducir la presión arterial en personas con hipertensión.A hipertensão arterial é uma das principais causas de óbito no Brasil e no mundo. Investigações sugerem que a prática de yoga pode ser estratégia complementar interessante para o tratamento da doença. O objetivo deste estudo foi realizar revisão sistemática e metanálise sobre os efeitos dessa prática na pressão arterial de pessoas com hipertensão arterial. Dois revisores realizaram as buscas nas bases de dados Pubmed, Embase, Cochrane e LILACS. Foram incluídos ensaios clínicos randomizados controlados que investigaram o efeito da prática de yoga nos níveis de pressão arterial de voluntários adultos com hipertensão arterial. A Metanálise de efeitos aleatórios foi conduzida para determinar o efeito do yoga na pressão arterial, utilizando o software Stata (version 16.0, StataCrop, College Station, Texas, USA). Foram encontrados 945 artigos e, após verificar os critérios de elegibilidade, foram incluídos 10 estudos. Destes 10 estudos, 8 relataram redução significativa nos níveis pressóricos após o período de intervenção com yoga. Por meio da metanálise, o treinamento físico yoga reduziu significativamente a pressão arterial sistólica (MD = -7,28; 95% IC = -11,32; -3,23 mmHg) e a pressão arterial diastólica (MD = -4,81; 95% CI = -8,22; -1,40 mmHg) de pessoas com hipertensão arterial. A prática de yoga é eficaz para redução da pressão arterial em indivíduos com hipertensão arterial

Uzgoj bakterije Methylobacterium organophilum u metanolu za istodobnu proizvodnju proteina i korisnih metabolita

Research background. This study aims to monitor the growth of the methylotrophic bacteria Methylobacterium organophilum in a culture medium with methanol as a carbon source and to verify the production of unicellular proteins and other biomolecules, such as carotenoids, exopolysaccharides and polyhydroxyalkanoates, making them more attractive as animal feed. Experimental approach. Bacterial growth was studied in shake flasks using different carbon/nitrogen (C:N) ratios to determine their best ratio for achieving the highest volumetric productivity of cells and substrate consumption rate. This optimal parameter was further used in a fed-batch operating bioreactor system to define the kinetic profile of cell growth. Methanol consumption was measured by HPLC analysis and the extracted pigments were analyzed by liquid chromatography/mass spectrometry. Chemical composition and rheological properties of the produced exopolysaccharides were also determined. Results and conclusions. The best experimental parameters were verified using an initial methanol concentration of 7 g/L in the culture medium. The same initial substrate concentration was used in the fed-batch operation and after 60 h of cultivation 5 g/L of biomass were obtained. The accumulation of carotenoids associated with cell growth was monitored, reaching a concentration of 1.6 mg/L at the end of the process. These pigments were then analyzed and characterized as a set of xanthophylls (oxidized carotenoids). In addition, two other product types were identified during the fed-batch operation: exopolysaccharides, which reached a concentration of 8.9 g/L at the end of the cultivation, and an intracellular granular structure that was detected by transmission electron microscopy (TEM), suggesting the accumulation of polyhydroxyalkanoate (PHA), most likely polyhydroxybutyrate. Novelty and scientific contribution. Methylobacterium organophilum demonstrated a unique ability to produce compounds of commercial interest. The distinct metabolic diversity of this bacterium makes room for its use in biorefineries.Pozadina istraživanja. Svrha je ovoga istraživanja bila pratiti rast metilotrofne bakterije Methylobacterium organophilum u podlozi s metanolom kao izvorom ugljika, te potvrditi sposobnost tog jednostaničnog organizma da proizvodi proteine i druge biomolekule, kao što su karotenoidi, egzopolisaharidi i polihidroksialkanoati, a koji se mogu upotrijebiti u proizvodnji stočne hrane. Eksperimentalni pristup. Rast bakterije ispitan je na tresilici pri različitim omjerima ugljika i dušika (C:N), radi utvrđivanja njihovog optimalnog omjera za postizanje najveće volumetrijske produktivnosti stanica i najboljeg iskorištenja supstrata. Zatim je pomoću tog optimalnog omjera hranjiva određen kinetički profil rasta stanica u šaržnom bioreaktoru. Potrošnja metanola mjerena je metodom HPLC, a izolirani su pigmenti ispitani tekućinskom kromatografijom spregnutom s masenom spektrometrijom. Također su određeni kemijski sastav i reološka svojstva dobivenih egzopolisaharida. Rezultati i zaključci. Najbolji eksperimentalni parametri potvrđeni su pri početnoj koncentraciji metanola u podlozi od 7 g/L. Ista je početna koncentracija korištena u šaržnom bioreaktoru, gdje je nakon 60 h uzgoja dobiveno 5 g/L biomase. Tijekom uzgoja je praćena akumulacija karotenoida, čija je koncentracija pri završetku procesa bila 1,6 mg/L. Pigmenti su zatim ispitani i okarakterizirani kao ksantofili (podvrsta karotenoida). Osim toga, tijekom šaržne fermentacije identificirana su još dva proizvoda: egzopolisaharidi, čija je koncentracija na kraju uzgoja bila 8,9 g/L; te granularna struktura otkrivena pomoću transmisijskog elektronskog mikroskopa, koja upućuje na to da je u stanici došlo do nakupljanja polihidroksialkanoata (PHA), i to najvjerojatnije polihidroksibutirata. Novina i znanstveni doprinos. Bakterija Methylobacterium organophilum ima jedinstveno svojstvo proizvodnje spojeva od komercijalnog interesa. Iznimna metabolička raznolikost ove bakterije omogućuje njezinu primjenu u biorafinerijama

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

O perfil semiológico do paciente portador de hemorragia digestiva alta

OBJETIVO: O seguinte estudo objetivou descrever a semiologia do paciente portador de hemorragia digestiva alta, considerando como determinante na avaliação de potencias focos hemorrágicos. METODOLOGIA: Foram realizadas buscas nas plataformas do SciELO, LILACS, PubMed, Scopus e Google Scholar,utilizando os descritores gastrointestinal bleeding, peptic ulcerous disease e varicose hemorrhage, sendo identificados 35 estudos, dos quais foram incluídos 13 artigos completos. Desses estudos, 5 avaliaram as principais etiologias, 2 o surgimento de novos testes diagnósticos, 2 analisaram os aspectos epidemiológicos e 1 a sintomatologia apresentada pelo acometimento da hemorragia digestiva alta. Observou-se inicialmente a abundâncias de informações conceituais sobre o sangramento, como um transtorno clínico comum, acompanhada de inúmeras manifestações, considerando que o foco hemorrágico pode ocorrer em qualquer porção do trato gastrointestinal. Neste estudo, todas as publicações eleitas apresentaram o quadro semiológico composto por algia abdominal, indícios de choque hipovolêmico e taquicardia, alguns exibiram quedas abruptas da pressão arterial, odinofagia, êmese, náuseas e estado ictérico. Os pacientes implicados, cronicamente, já manifestaram ocorrências prévias, devido ao caráter recidivante torna-se essencial investigar a existência de varizes, fístula aorto-entérica, angiodisplasia e doença ulcerosa. CONCLUSÃO: Elucida-se que a hemorragia digestiva alta representa a principal causa de sangramento do trato gastrointestinal, majoritamente manifesta-se como hematêmese ou melena e cursam com o quadro sintomatológico que auxilia na avaliação da gravidade deste e o embasamento de potenciais focos de sangramento e que contribuam para disseminação de informações e intervenções futuras

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

Clinical characteristics and outcomes of hospital-manifested COVID-19 among Brazilians

ABSTRACT: Objectives: To analyze the clinical characteristics and outcomes of admitted patients with the hospital- versus community-manifested COVID-19 and to evaluate the risk factors related to mortality in the first population. Methods: This retrospective cohort included consecutive adult patients with COVID-19, hospitalized between March and September 2020. The demographic data, clinical characteristics, and outcomes were extracted from medical records. Patients with hospital-manifested COVID-19 (study group) and those with community-manifested COVID-19 (control group) were matched by the propensity score model. Logistic regression models were used to verify the risk factors for mortality in the study group. Results: Among 7,710 hospitalized patients who had COVID-19, 7.2% developed symptoms while admitted for other reasons. Patients with hospital-manifested COVID-19 had a higher prevalence of cancer (19.2% vs 10.8%) and alcoholism (8.8% vs 2.8%) than patients with community-manifested COVID-19 and also had a higher rate of intensive care unit requirement (45.1% vs 35.2%), sepsis (23.8% vs 14.5%), and death (35.8% vs 22.5%) (P <0.05 for all). The factors independently associated with increased mortality in the study group were increasing age, male sex, number of comorbidities, and cancer. Conclusion: Hospital-manifested COVID-19 was associated with increased mortality. Increasing age, male sex, number of comorbidities, and cancer were independent predictors of mortality among those with hospital-manifested COVID-19 disease

ABC-SPH risk score for in-hospital mortality in COVID-19 patients : development, external validation and comparison with other available scores

The majority of available scores to assess mortality risk of coronavirus disease 2019 (COVID-19) patients in the emergency department have high risk of bias. Therefore, this cohort aimed to develop and validate a score at hospital admission for predicting in-hospital mortality in COVID-19 patients and to compare this score with other existing ones. Consecutive patients (≥ 18 years) with confirmed COVID-19 admitted to the participating hospitals were included. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients admitted between March-July, 2020. The model was validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Median (25-75th percentile) age of the model-derivation cohort was 60 (48-72) years, and in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. Seven significant variables were included in the risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein, SpO/FiO ratio, platelet count, and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829-0.859), which was confirmed in the Brazilian (0.859 [95% CI 0.833-0.885]) and Spanish (0.894 [95% CI 0.870-0.919]) validation cohorts, and displayed better discrimination ability than other existing scores. It is implemented in a freely available online risk calculator (https://abc2sph.com/). An easy-to-use rapid scoring system based on characteristics of COVID-19 patients commonly available at hospital presentation was designed and validated for early stratification of in-hospital mortality risk of patients with COVID-19