Apendicite aguda: aspectos fisiopatológicos e manejo terapêutico

A Apendicite Aguda (AA) é caracterizada pela inflamação do apêndice. Sua prevalência é mais frequente em homens quando comparado às mulheres. O risco de desenvolver a doença ao longo da vida é de aproximadamente 1 em cada 11 pessoas. A teoria mais consistente a respeito da etiologia da AA gira em torno de uma obstrução luminal do fundo cego do apêndice. Os principais sintomas da doença são dor em cólica periumbilical que se intensifica por um período de 24 horas e se irradia para a fossa ilíaca direita, acompanhada de náuseas, vômitos, febre e perda de apetite. Alguns sinais como o de Romberg, de Rosving, e o de Psoas são descritos para investigação da doença. Ademais, sistemas de pontuação clínica, como o escore de Alvarado, associado a exames de imagem, como a ultrassonografia e a tomografia computadorizada, podem ser muito úteis para comprovação diagnóstica, além de contribuírem para a diferenciação entre apendicite complicada e não complicada. No que se refere ao diagnóstico diferencial, existem importantes doenças que precisam ser lembradas e que possuem uma sintomatologia parecida, como a Doença Inflamatória Pélvica, torção de cisto ovariano, linfadenite mesentérica e intussuscepção intestinal. O tratamento da AA, na apendicite não complicada, possui como padrão ouro a apendicectomia. Todavia, na AA complicada, com exceção dos pacientes com peritonite difusa, existem indicações para o tratamento conservador com antibioticoterapia, apesar de não ser um consenso

Aneurisma de Aorta Abdominal - Aspectos epidemiológicos, fisiopatológicos e manejo terapêutico

O aneurisma de aorta abdominal (AAA) é uma doença multifatorial, que ocorre quando há dilatação focal da aorta abdominal - mais de 50% do diâmetro normal - e é mais comum em homens acima de 65 anos de idade. Ademais, os principais fatores de risco associados são: idade avançada, sexo masculino, tabagismo, aterosclerose sistêmica, hipertensão arterial sistêmica (HAS), histórico familiar e existência de outros aneurismas. O mecanismo de desenvolvimento da doença envolve uma inflamação mediada por macrofágos e linfócitos T, causando o remodelamento da túnica média e adventícia da aorta. Na maioria dos casos, os pacientes são assintomáticos e geralmente diagnosticados incidentalmente. O exame físico pode detectar o aneurisma quando é grande, mas a ultrassonografia (US) abdominal é o exame padrão ouro para rastreio da doença. Outrossim, o rompimento do AAA é a complicação mais frequente e temida, representando uma emergência cirúrgica. O tratamento conservador é recomendado para aneurismas assintomáticos de diâmetro < 5,5 cm; por outro lado, tratamento cirúrgico é indicado em aneurismas maiores e pode envolver duas modalidades: o reparo aberto ou endovascular, sendo a segunda com menor mortalidade perioperatória e menor morte relacionada ao aneurisma em seis meses. As complicações mais frequentes se relacionam à lesão do vaso ao realizar o acesso vascular, posicionamento inadequado da endoprótese, síndrome pós-implante, migração, vazamento interno, oclusão ou infecção da endoprótese. É necessário conhecimento das diversas possibilidades de endopróteses para o sucesso da técnica cirúrgica e o tratamento deve ser realizado precocemente para evitar complicações, como o rompimento do aneurisma

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

The complete genome sequence of Chromobacterium violaceum reveals remarkable and exploitable bacterial adaptability

Chromobacterium violaceum is one of millions of species of free-living microorganisms that populate the soil and water in the extant areas of tropical biodiversity around the world. Its complete genome sequence reveals (i) extensive alternative pathways for energy generation, (ii) ≈500 ORFs for transport-related proteins, (iii) complex and extensive systems for stress adaptation and motility, and (iv) wide-spread utilization of quorum sensing for control of inducible systems, all of which underpin the versatility and adaptability of the organism. The genome also contains extensive but incomplete arrays of ORFs coding for proteins associated with mammalian pathogenicity, possibly involved in the occasional but often fatal cases of human C. violaceum infection. There is, in addition, a series of previously unknown but important enzymes and secondary metabolites including paraquat-inducible proteins, drug and heavy-metal-resistance proteins, multiple chitinases, and proteins for the detoxification of xenobiotics that may have biotechnological applications

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

Guerras culturais em verde e amarelo

Queridos/as leitores/as, bem-vindos/as ao nosso campo de batalha – e de estudos. Vocês estão prestes a ler um livro perigoso. Ele fala sobre muito do que estamos vivendo no Brasil dos últimos anos, olhando esse nosso estranho país pelo ângulo cultural, da imagem e da comunicação. Vivemos uma guerra interna, desleal em muitos sentidos, em que a dimensão simbólica e cultural tem sido decisiva. Por isso é preciso decifrá-la ou, ao menos, ter mais elementos para debatê-la. 29 estudantes da Unifesp passaram os últimos 4 meses estudando o combate que levou à polarização e radicalização da sociedade brasileira e escreveram seus achados para vocês. Para entrar neste campo de batalha das Guerras Culturais vocês não precisarão de uniformes militares nem coletes à prova de bala. Nossas únicas armas serão, a reflexão, a inteligência, a colaboração, o espírito crítico e a capacidade de narrar com voz coletiva. Vocês vão ler 15 pequenas histórias, que são estudos de casos ou notícias do front (para usar o termo de um dos autores que lemos), cada uma entrando em uma trincheira dessa guerra e olhando o campo de batalha por um ângulo diferente.- Apresentação: no campo de batalha / Pedro Fiori Arantes André Okuma. - Capas de combate: a guerra contra o PT Giulia dos Santos Nascimento / Keyla Vasconcelos de Melo. - Um míssil para destruir Brasília: arte de guerrilha a partir dos infláveis / Diego Lorena Amanda Alves. - Moda bolsonarista: identidade e propaganda / Ana Laura Brait Gustavo Almeida Alves. - Memetização da política: imagens e humor na extrema direita / Cristina Naiara Fernandes Larissa Avelino Paloma Oliveira. - A direita no universo gamer: repercussões do jogo Last of Us 2 / André Zaparoli Bertellotti Rebeca Nieves Inostroza Carreño. - Masculinidade tóxica e o corpo bombado bolsonarista / Amanda Feo Bruna Andrade. - Ataques ao movimento feminista e criminalização do aborto / Josiane Garotti Larissa Flauto Melissa Tavares. - O Templo de Salomão e a estética da teologia da prosperidade / Ana Beatriz Tavares Barbosa Melissa Maria dos Santos Alejarra. - Agronejo e o sertanejo como braço cultural do bolsonarismo / Nicole Pinheiro Santos. - Apropriação da estética de periferia em “funk de direita”: MC Reaça e O proibidão do Bolsonaro / Kamilla Dourado Pamela Silva. - A pintura bolsonarista: entre o kitsch e a arte de propaganda / Lucius Goyano. - A construção do inimigo político nas obras de Lucimary Billhardt / Maria Luiza Meneses. - Brasil Paralelo e a guerra cultural da educação / Gabriela Ferreira Paloma Monteiro. - Primavera secundarista X Escola sem partido Marcelo Lauton de Oliveira Patrícia Pinheiro Antunes de Paula - Simbolismo nazifascista na comunicação bolsonarista Isabella Mendes dos Santos Júlia Rodrigues Borge

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

Characterisation of microbial attack on archaeological bone

As part of an EU funded project to investigate the factors influencing bone preservation in the archaeological record, more than 250 bones from 41 archaeological sites in five countries spanning four climatic regions were studied for diagenetic alteration. Sites were selected to cover a range of environmental conditions and archaeological contexts. Microscopic and physical (mercury intrusion porosimetry) analyses of these bones revealed that the majority (68%) had suffered microbial attack. Furthermore, significant differences were found between animal and human bone in both the state of preservation and the type of microbial attack present. These differences in preservation might result from differences in early taphonomy of the bones. © 2003 Elsevier Science Ltd. All rights reserved