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1.
Sci Total Environ ; 950: 175179, 2024 Aug 06.
Artículo en Inglés | MEDLINE | ID: mdl-39097007

RESUMEN

Extreme weather events driven by climate change threaten the resilience of urban structures and urban dwellers. Nature-based Solutions (NbS) are an effective tool to reduce urban vulnerability to climate risks and, at the same time, develop more liveable urban areas. Despite the acknowledged positive impacts of individual observed NbS, numerous questions persist unanswered. While existing research supports NbS' positive influence on urban climate adaptation, the extent of their impact remains insufficiently studied. Understanding the magnitude of NbS impact is crucial for justifying their preference over non-NbS alternatives and, consequently, for securing public investment. Via a meta-analysis, this paper aims to contribute to research and practice by providing a more systematic assessment of NbS effects, offering urban planners and decision-makers a robust justification for their incorporation in climate change adaptation, urban resilience, and enhanced liveability. The results of the meta-analytic model indicate that the effect of NbS is indeed positive. When assessing the impact on temperature and flood protection, there is a general positive effect across the studied NbS. However, when evaluating an average effect, the task appears to be more complex due to methodological issues and limitations. The need to increase the formalisation of how the impact of NbS is measured and reported also emerges as a result. Replicable protocols would positively impact the formalisation of the literature on the topic and positively affect the evidence-based support for the implementation of NbS by urban decision-makers.

2.
Int J Pharm ; 661: 124440, 2024 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-38972521

RESUMEN

Medicines remain ineffective for over 50% of patients due to conventional mass production methods with fixed drug dosages. Three-dimensional (3D) printing, specifically selective laser sintering (SLS), offers a potential solution to this challenge, allowing the manufacturing of small, personalized batches of medication. Despite its simplicity and suitability for upscaling to large-scale production, SLS was not designed for pharmaceutical manufacturing and necessitates a time-consuming, trial-and-error adaptation process. In response, this study introduces a deep learning model trained on a variety of features to identify the best feature set to represent drugs and polymeric materials for the prediction of the printability of drug-loaded formulations using SLS. The proposed model demonstrates success by achieving 90% accuracy in predicting printability. Furthermore, explainability analysis unveils materials that facilitate SLS printability, offering invaluable insights for scientists to optimize SLS formulations, which can be expanded to other disciplines. This represents the first study in the field to develop an interpretable, uncertainty-optimized deep learning model for predicting the printability of drug-loaded formulations. This paves the way for accelerating formulation development, propelling us into a future of personalized medicine with unprecedented manufacturing precision.


Asunto(s)
Aprendizaje Profundo , Rayos Láser , Polvos , Medicina de Precisión , Impresión Tridimensional , Medicina de Precisión/métodos , Composición de Medicamentos/métodos , Tecnología Farmacéutica/métodos , Química Farmacéutica/métodos
3.
Eur J Case Rep Intern Med ; 11(5): 004298, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38715878

RESUMEN

Introduction: Sarcoidosis has many possible clinical presentations since it can affect any organ, most commonly the lungs. The hallmark of the disease consists of the formation of non-necrotising granulomas. Pathogenesis is thought to rely on the interplay of genetic, environmental and epigenetic factors. This case highlights the importance of a thorough clinical history and physical examination, and the correlation with imaging findings in the diagnostic work-up of the non-ischaemic cardiomyopathy. Case description: A 57-year-old woman was admitted due to the sudden onset of malaise, dizziness, and chest discomfort. Sustained monomorphic ventricular tachycardia was evidenced and the patient rapidly evolved with haemodynamic instability; she underwent successful electrical cardioversion. The electrocardiogram afterwards showed a high-risk electrocardiographic pattern. Invasive coronary angiography excluded obstructive epicardial coronary lesions. Physical examination revealed skin lesions on the lower limbs which raised suspicion for erythema nodosum and therefore a biopsy was performed. Transthoracic echocardiography and cardiac magnetic resonance imaging revealed features consistent with an inflammatory cardiomyopathy, and an implantable cardioverter-defibrillator was placed. The histologic examination of the cutaneous lesions showed a non-necrotising granulomatous inflammatory process. Radionuclide imaging was inconclusive. The patient underwent an endomyocardial biopsy, which confirmed the diagnosis of systemic sarcoidosis with cardiac involvement. Conclusions: Systemic sarcoidosis with cardiac involvement is a challenging diagnosis. The role of imaging techniques such as transthoracic echocardiography, cardiac magnetic resonance imaging and radionuclide imaging is essential in raising suspicion and diagnosing this pathology. Endomyocardial biopsy is the 'gold standard' for its diagnosis; however, it has a low diagnostic yield. LEARNING POINTS: Systemic sarcoidosis with cardiac involvement is a challenging diagnosis as it may present in many different ways.The case presented highlights the importance of a thorough clinical history and physical examination, and the correlation with imaging findings.Imaging techniques such as transthoracic echocardiogram, cardiac magnetic resonance and radionuclide imaging are essential in raising suspicion and diagnosing cardiac sarcoidosis.

5.
Sci Total Environ ; 917: 170165, 2024 Mar 20.
Artículo en Inglés | MEDLINE | ID: mdl-38242475

RESUMEN

The "climate extremes hypothesis" is a major assumption of geographic studies of heat tolerance and climatic vulnerability. However, this assumption remains vastly untested across taxa, and multiple factors may contribute to uncoupling heat tolerance estimates and geographic limits. Our dataset includes 1000 entries of heat tolerance data and maximum temperatures for each species' known geographic limits (hereafter, Tmax). We gathered this information across major animal taxa, including marine fish, terrestrial arthropods, amphibians, non-avian reptiles, birds, and mammals. We first tested if heat tolerance constrains the Tmax of sites where species could be observed. Secondly, we tested if the strength of such restrictions depends on how high Tmax is relative to heat tolerance. Thirdly, we correlated the different estimates of Tmax among them and across species. Restrictions are strong for amphibians, arthropods, and birds but often weak or inconsistent for reptiles and mammals. Marine fish describe a non-linear relationship that contrasts with terrestrial groups. Traditional heat tolerance measures in thermal vulnerability studies, like panting temperatures and the upper set point of preferred temperatures, do not predict Tmax or are inversely correlated to it, respectively. Heat tolerance restricts the geographic warm edges more strongly for species that reach sites with higher Tmax for their heat tolerance. These emerging patterns underline the importance of reliable species' heat tolerance indexes to identify their thermal vulnerability at their warm range edges. Besides, the tight correlations of Tmax estimates across on-land microhabitats support a view of multiple types of thermal challenges simultaneously shaping ranges' warm edges for on-land species. The heterogeneous correlation of Tmax estimates in the ocean supports the view that fish thermoregulation is generally limited, too. We propose new hypotheses to understand thermal restrictions on animal distribution.


Asunto(s)
Artrópodos , Termotolerancia , Animales , Aclimatación , Cambio Climático , Temperatura , Anfibios , Peces , Mamíferos
6.
Mol Phylogenet Evol ; 192: 108008, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38181828

RESUMEN

Two main landscapes emerge from the Guiana Shield: the highlands to the west called the Pantepui region and the Amazonian lowlands to the east, both harbouring numerous endemic species. With 32 currently recognized species, the genus Anomaloglossus stands out among Neotropical frogs as one that diversified only within the Guiana Shield both in the highlands and the lowlands. We present a time-calibrated phylogeny obtained by using combined mitogenomic and nuclear DNA, which suggests that the genus originates from Pantepui where extant lineages started diversifying around 21 Ma, and subsequently (ca. 17 Ma) dispersed during the Miocene Climatic Optimum to the lowlands of the eastern Guiana Shield where the ability to produce endotrophic tadpoles evolved. Further diversification within the lowlands in the A. stepheni group notably led to an evolutionary reversal toward exotrophy in one species group during the late Miocene, followed by reacquisition of endotrophy during the Pleistocene. These successive shifts of reproductive mode seem to have accompanied climatic oscillations. Long dry periods might have triggered evolution of exotrophy, whereas wetter climates favoured endotrophic forms, enabling colonization of terrestrial habitats distant from water. Acquisition, loss, and reacquisition of endotrophy makes Anomaloglossus unique among frogs and may largely explain the current species diversity. The micro evolutionary processes involved in these rapid shifts of reproductive mode remain to be revealed.


Asunto(s)
Anuros , Ecosistema , Animales , Anuros/genética , Filogenia , Filogeografía
7.
J Fungi (Basel) ; 9(12)2023 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-38132800

RESUMEN

Lentinula edodes, commonly known as shiitake mushroom, is renowned for its potential health advantages. This research delves into the often-overlooked by-product of shiitake cultivation, namely spent mushroom substrate (SMS), to explore its nutraceutical properties. The SMS samples were collected and subjected to different extraction methods, namely short or long agitation, and ultrasound-assisted extractions using different temperatures and distilled water or a 50% (v/v) ethanol as solvents. The extracts were tested for phenolic content (total phenols, ortho-diphenols, and flavonoids), antioxidant capacity (DPPH, 2,2-diphenyl-1 picrylhydrazyl; ABTS, 2,2'-azino-bis-3-ethylbenzothiazoline-6-sulfonic acid; and FRAP, ferric reducing antioxidant power), and antibacterial activity. The different extraction methods revealed substantial variations (p < 0.05) in phenolic composition and antioxidant capacity. The highest phenolic content and antioxidant capacity were achieved using 24 h extraction, agitation, 50 °C, and ethanol as the solvent. Furthermore, the extracted compounds displayed antibacterial activity in specific tested bacterial strains. This study highlights the nutraceutical potential of L. edodes' SMS, positioning it as a valuable dietary supplement for animal nutrition, with emphasis on its prebiotic properties. Hence, this research unveils the promising health benefits of SMS in both human and animal nutrition.

8.
Biota Neotrop. (Online, Ed. ingl.) ; 20(3): e20190882, 2020. tab, graf
Artículo en Inglés | LILACS-Express | LILACS | ID: biblio-1131928

RESUMEN

Abstract The Atlantic Forest (AF) is one of the biodiversity hotspots of the world, and the most fragmented biome of Brazil. This biome includes different phytophysiognomies, as riparian, slope, cloudy forests, and grasslands. Such complexity, allied to huge latitudinal and high elevational range, provides diverse habitats and conditions for amphibian speciation. As a result, there are over 600 amphibian species known to occur in the AF. Within this biome the Caparaó National Park (CNP) is relevant, as it includes the highest peak of the biome, the Pico da Bandeira at almost 3,000 m above sea level, as well as different phytophysiognomies as rocky fields and humid forests. In spite of that, its amphibian fauna is still poorly described. We inventoried amphibians at the CNP and surrounding areas from 2016 to 2018 and recorded 47 anuran species, of which two are locally endemic and at least six have not been described yet. Additionally, we compiled data from previous surveys (2004 to 2008) and secondary data from scientific collections. All together, we registered a total of 61 anuran species from 12 families for the CNP and surroundings, placing this area among the 10 amphibian richest sites in the AF. Some of these species are represented by only one or two collected specimens and have not been registered in the CNP since the 1980's, such as Thoropa lutzi and Hylodes vanzolinii. These species could be examples of population declines or even past local extinctions, highlighting the need of further sampling efforts in that highly biodiverse site.


Resumo A Mata Atlântica (MA) é considerada um dos hotspots de biodiversidade do mundo, sendo o bioma mais degradado no Brasil. Este bioma compreende muitas fitofisionomias, como floresta ombrófila, semidecidual, e campos de altitude. Esta complexidade, aliada à enorme variação latitudinal e altitudinal, disponibiliza habitats e condições diversas à especiação dos anfíbios. Como resultado, atualmente são conhecidas mais de 600 espécies de anfíbios que ocorrem na MA. Dentro deste bioma o Parque Nacional do Caparaó (PNC) é relevante, pois inclui o ponto mais alto da Mata Atlântica, o Pico da Bandeira com cerca de 3000 m de elevação, assim como diferentes fitofisionomias, como campos rupestres e florestas úmidas. Apesar disso, sua fauna de anfíbios é ainda pobremente descrita. Realizamos inventários de anfíbios no PNC e entorno de 2016 a 2018 e registramos 47 espécies de anuros, das quais duas são endêmicas e pelo menos seis ainda não foram descritas. Adicionalmente, compilamos dados de coletas anteriores (2004 a 2008) e dados secundários de coleções científicas. Ao juntar todos os dados registramos um total de 61 espécies de anuros de 12 famílias para o PNC e arredores, colocando esta área entre as 10 áreas mais ricas em anfíbios da MA. Algumas destas espécies estão representadas apenas por um ou dois exemplares em coleções e não foram registradas no PNC desde a década de 1980, como Thoropa lutzi e Hylodes vanzolinii. Estas espécies podem ser exemplos de declínios populacionais ou mesmo de extinções locais, destacando a necessidade de maiores esforços amostrais neste local altamente biodiverso.

9.
Arq. bras. cardiol ; 109(4): 299-306, Oct. 2017. tab, graf
Artículo en Inglés | LILACS, SES-SP, SESSP-IDPCPROD, SES-SP | ID: biblio-887941

RESUMEN

Abstract Background: Frailty is identified as a major predictor of adverse outcomes in older surgical patients. However, the outcomes in pre-frail patients after cardiovascular surgery remain unknown. Objective: To investigate the main outcomes (length of stay, mechanical ventilation time, stroke and in-hospital death) in pre-frail patients in comparison with no-frail patients after cardiovascular surgery. Methods: 221 patients over 65 years old, with established diagnosis of myocardial infarction or valve disease were enrolled. Patients were evaluated by Clinical Frailty Score (CFS) before surgery and allocated into 2 groups: no-frailty (CFS 1~3) vs. pre-frailty (CFS 4) and followed up for main outcomes. For all analysis, the statistical significance was set at 5% (p < 0.05). Results: No differences were found in anthropometric and demographic data between groups (p > 0.05). Pre-frail patients showed a longer mechanical ventilation time (193 ± 37 vs. 29 ± 7 hours; p<0.05) than no-frail patients; similar results were observed for length of stay at the intensive care unit (5 ± 1 vs. 3 ± 1 days; p < 0.05) and total time of hospitalization (12 ± 5 vs. 9 ± 3 days; p < 0.05). In addition, the pre-frail group had a higher number of adverse events (stroke 8.3% vs. 3.9%; in-hospital death 21.5% vs. 7.8%; p < 0.05) with an increased risk for development stroke (OR: 2.139, 95% CI: 0.622-7.351, p = 0.001; HR: 2.763, 95%CI: 1.206-6.331, p = 0.0001) and in-hospital death (OR: 1.809, 95% CI: 1.286-2.546, p = 0.001; HR: 1.830, 95% CI: 1.476-2.269, p = 0.0001). Moreover, higher number of pre-frail patients required homecare services than no-frail patients (46.5% vs. 0%; p < 0.05). Conclusion: Patients with pre-frailty showed longer mechanical ventilation time and hospital stay with an increased risk for cardiovascular events compared with no-frail patients.


Resumo Fundamentos: A fragilidade é reconhecida como um importante preditor de eventos adversos em pacientes cirúrgicos idosos. Entretanto, os desfechos em pacientes com pré-fragilidade após a cirurgia cardiovascular ainda permanecem desconhecidos. Objetivos: Investigar os principais desfechos (tempo de internação, tempo de ventilação mecânica, incidência de acidente vascular cerebral e óbito intra-hospitalar) após cirurgia cardiovascular em pacientes com pré-fragilidade em comparação a pacientes sem fragilidade. Métodos: 221 pacientes acima de 65 anos de idade, com diagnóstico de infarto do miocárdio ou doença valvar foram recrutados no estudo. Os pacientes foram avaliados pela escala de fragilidade clínica (CFS, Clinical Frailty Score) antes da cirurgia e separados em 2 grupos: sem-fragilidade (CFS 1~3) vs. pré-fragilidade (CFS 4). Para todas as análises, foi considerada diferença significativa quando p < 0,05. Resultados: Não foram observadas diferenças nos dados antropométricos e demográficos entre os grupos. Os pacientes com pré-fragilidade apresentaram maior tempo de ventilação mecânica em comparação a pacientes sem fragilidade (193 ± 37 vs. 29 ± 7 horas; p < 0,05); resultados similares foram observados para tempo de permanência na unidade de terapia intensiva (5 ± 1 vs. 3 ± 1 days; p < 0,05) e tempo total de internação hospitalar (12 ± 5 vs. 9 ± 3 dias; p < 0,05). Além disso, os pacientes com pré-fragilidade apresentaram maior número de eventos adversos (acidente vascular cerebral-AVC 8,3% vs. 3,9%; óbito intra-hospitalar 21,5% vs. 7,8%; p<0,05) com risco aumentado para AVC (OR: 2,139, IC 95%: 0,622-7,351, p = 0,001; HR: 2,763, IC 95%: 1,206-6,331, p = 0,0001) e morte intra-hospitalar (OR: 1,809, IC 95%: 1,286-2,546, p = 0,001; HR: 1,830, IC 95%: 1,476-2,269, p = 0,0001). Além disso, um maior número de pacientes com pré-fragilidade necessitaram de fisioterapia domiciliar que pacientes sem fragilidade (46,5% vs. 0%; p< 0,05). Conclusão: Pacientes com pré-fragilidade apresentaram maior tempo de ventilação mecânica e maior tempo de internação hospitalar, com maior risco de desenvolverem eventos cardiovasculares adversos em comparação a pacientes sem fragilidade.


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Complicaciones Posoperatorias/etiología , Procedimientos Quirúrgicos Cardiovasculares/efectos adversos , Fragilidad/complicaciones , Complicaciones Posoperatorias/mortalidad , Respiración Artificial , Procedimientos Quirúrgicos Cardiovasculares/mortalidad , Factores de Tiempo , Índice de Severidad de la Enfermedad , Estudios Prospectivos , Factores de Riesgo , Factores de Edad , Resultado del Tratamiento , Estadísticas no Paramétricas , Medición de Riesgo , Accidente Cerebrovascular/etiología , Accidente Cerebrovascular/mortalidad , Estimación de Kaplan-Meier , Fragilidad/mortalidad , Unidades de Cuidados Intensivos , Tiempo de Internación
10.
Biota neotrop. (Online, Ed. port.) ; 16(3): e20150105, tab, graf
Artículo en Inglés | LILACS | ID: lil-787377

RESUMEN

Abstract Different physiognomies at Parque Nacional da Serra das Confusões (PNSCo) were intensively sampled aiming to access the distribution pattern of its herpetofauna. Sixty six species were found in the park (47 reptiles and 19 amphibians); the rarefaction curve for lizards, although not fully stabilized in an asymptote, indicates that the sampling effort was enough to reveal most lizard species occurring in the area; and richness estimators recovered values close to observed. For amphibians, the curve shows a weak tendency to stabilization with richness estimators indicating that additional records could be done. Field work carried out at PNSCo has highlighted an unique herpetofauna: five new species were described and there are three candidates as new species. The regional list including Cerrados's units - Estação Ecológica Serra Geral do Tocantins (EESGT) and Estação Ecológica de Uruçuí-Una (EEUU) with Caatinga's ones - PNSCo and Parque Nacional da Serra da Capivara (PNSCa), shows a high herpetofaunal diversity (191 species) to the region. The cluster analysis recovered the Cerrados's units and Caatinga's ones, in separate clusters evidencing a species turnover between domains, despite its geographical proximity. Thus, although there is widespread fauna throughout region shared by the units, each reserve holds its own faunal identity, harboring a singular assemblage of species.


Resumo Diferentes fisionomias foram intensivamente amostradas no Parque Nacional da Serra das Confusões (PNSCo) com o objetivo de acessar o padrão de distribuição da sua herpetofauna. Sessenta e seis espécies foram encontradas no parque (47 répteis e 19 anfíbios); a curva de rarefação de lagartos, embora não totalmente estabilizada em uma assíntota, indica que o esforço amostral foi suficiente para revelar a maioria das espécies de lagartos que ocorrem na área; e estimadores de riqueza recuperaram valores perto dos observados. Para os anfíbios, a curva mostra uma fraca tendência para a estabilização com estimadores de riqueza indicando que registros adicionais podem ser feitos. O trabalho de campo realizado no PNSCo destacou uma herpetofauna única: cinco novas espécies foram descritas e há três candidatos como novas espécies. A lista regional, incluindo unidades de Cerrado - Estação Ecológica Serra Geral do Tocantins (EESGT) e Estação Ecológica Uruçuí-Una (EEUU) com aqueles da Caatinga - PNSCo e Parque Nacional da Serra da Capivara (PNSCa), mostra uma alta diversidade da herpetofauna (191 espécies) para a região. A análise de agrupamento recupera as unidades do Cerrado e as da Caatinga em grupos separados, evidenciando uma substituição de espécies entre os domínios, apesar da sua proximidade geográfica. Assim, embora haja fauna ocorrente em toda a região e compartilhada pelas unidades, cada uma das reservas mantém a sua própria identidade, abrigando um conjunto singular de espécies.

11.
Braz. j. microbiol ; 46(2): 551-555, Apr-Jun/2015. tab, graf
Artículo en Inglés | LILACS | ID: lil-749710

RESUMEN

Many microorganisms are able to cause diseases in amphibians, and in the past few years one of the most reported has been Batrachochytrium dendrobatidis. This fungus was first reported in Brazil in 2005; following this, other reports were made in specimens deposited in museum collections, captive and free-living frogs. The aim of this study was to compare singleplex and nested-PCR techniques to detect B. dendrobatidis in free-living and apparently healthy adult frogs from the Brazilian Atlantic Forest. The sample collection area was a protected government park, with no general entrance permitted and no management of the animals there. Swabs were taken from the skin of 107 animals without macroscopic lesions and they were maintained in ethanol p.a. Fungal DNA was extracted and identification of B. dendrobatidis was performed using singleplex and nested-PCR techniques, employing specific primers sequences. B. dendrobatidis was detected in 61/107 (57%) and 18/107 (17%) animals, respectively by nested and singleplex-PCR. Nested-PCR was statistically more sensible than the conventional for the detection of B. dendrobatidis (Chi-square = 37.1; α = 1%) and the agreement between both techniques was considered just fair (Kappa = 0.27). The high prevalence obtained confirms that these fungi occur in free-living frogs from the Brazilian Atlantic Forest with no macroscopic lesions, characterizing the state of asymptomatic carrier. We concluded that the nested-PCR technique, due to its ease of execution and reproducibility, can be recommended as one of the alternatives in epidemiological surveys to detect B. dendrobatidis in healthy free-living frog populations.


Asunto(s)
Animales , Anfibios/microbiología , Portador Sano/veterinaria , Quitridiomicetos/aislamiento & purificación , Micosis/veterinaria , Reacción en Cadena de la Polimerasa/métodos , Brasil , Portador Sano/microbiología , Quitridiomicetos/genética , Técnicas Microbiológicas/métodos , Técnicas de Diagnóstico Molecular/métodos , Micosis/microbiología , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Medicina Veterinaria/métodos
12.
Rev. bras. ter. intensiva ; 27(2): 161-169, Apr-Jun/2015. tab, graf
Artículo en Portugués | LILACS | ID: lil-750766

RESUMEN

RESUMO Objetivo: Avaliar a evolução funcional dos pacientes submetidos a um protocolo de reabilitação precoce do paciente grave da admissão até a alta da unidade de terapia intensiva. Métodos: Foi conduzido um estudo transversal retrospectivo, incluindo 463 pacientes adultos com diagnóstico clínico e/ou cirúrgico, submetidos a um protocolo de reabilitação precoce. A força muscular global foi avaliada na admissão da unidade de terapia intensiva por meio da escala Medical Research Council. De acordo com a pontuação da Medical Research Council os pacientes foram alocados em um dos quatro planos de intervenção, de acordo com a adequação ou não desses parâmetros, com a escala crescente do plano significando melhor status funcional. Os pacientes não colaborativos foram alocados nos planos de intervenção, conforme seu status funcional. A força muscular global e/ou o status funcional foram reavaliados na alta da unidade de terapia. Por meio do comparativo entre o plano de Intervenção na admissão (Planoinicial) e na alta (Planofinal). Os pacientes foram categorizados em três grupos, de acordo com a melhora ou não do status funcional: respondedores 1 (Planofinal > Planoinicial), respondedores 2 (Planofinal = Planoinicial) e não respondedores (Planofinal < Planoinicial). Resultados: Dos 463 pacientes submetidos ao protocolo, 432 (93,3%) pacientes responderam positivamente à estratégia de intervenção, apresentando manutenção e/ou melhora do status funcional inicial. Os pacientes clínicos classificados como não respondedores apresentaram idade superior (74,3 ± 15,1 anos; p = 0,03) e maior tempo de internação na unidade de terapia intensiva (11,6 ± 14,2 dias; p = 0,047) e no hospital (34,5 ± 34,1 dias; p = 0,002). Conclusão: A manutenção e/ou melhora do status funcional admissional esteve associada com menor tempo de internação na unidade de terapia intensiva e hospitalar. Os resultados sugerem que o tipo de diagnóstico, clínico ou cirúrgico, ...


ABSTRACT Objective: Evaluation of the functional outcomes of patients undergoing an early rehabilitation protocol for critically ill patients from admission to discharge from the intensive care unit. Methods: A retrospective cross-sectional study was conducted that included 463 adult patients with clinical and/or surgical diagnosis undergoing an early rehabilitation protocol. The overall muscle strength was evaluated at admission to the intensive care unit using the Medical Research Council scale. Patients were allocated to one of four intervention plans according to the Medical Research Council score, the suitability of the plan’s parameters, and the increasing scale of the plan expressing improved functional status. Uncooperative patients were allocated to intervention plans based on their functional status. The overall muscle strength and/or functional status were reevaluated upon discharge from the intensive care unit by comparison between the Intervention Plans upon admission (Planinitial) and discharge (Planfinal). Patients were classified into three groups according to the improvement of their functional status or not: responsive 1 (Planfinal > Planinitial), responsive 2 (Planfinal = Planinitial) and unresponsive (Planfinal < Planinitial). Results: In total, 432 (93.3%) of 463 patients undergoing the protocol responded positively to the intervention strategy, showing maintenance and/or improvement of the initial functional status. Clinical patients classified as unresponsive were older (74.3 ± 15.1 years of age; p = 0.03) and had longer lengths of intensive care unit (11.6 ± 14.2 days; p = 0.047) and hospital (34.5 ± 34.1 days; p = 0.002) stays. Conclusion: The maintenance and/or improvement of the admission functional status were associated with shorter lengths of intensive care unit and hospital stays. The results suggest that the type of diagnosis, clinical or surgical, fails to define the positive response to an ...


Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Enfermedad Crítica/rehabilitación , Recuperación de la Función/fisiología , Unidades de Cuidados Intensivos , Alta del Paciente , Estudios Transversales , Estudios Retrospectivos , Factores de Edad , Fuerza Muscular/fisiología , Hospitalización , Tiempo de Internación , Persona de Mediana Edad
13.
Biota neotrop. (Online, Ed. port.) ; 11(4): 67-81, Oct.-Dec. 2011. ilus, tab
Artículo en Portugués | LILACS-Express | LILACS | ID: lil-651612

RESUMEN

Elaboramos uma lista das espécies de répteis do Estado de São Paulo com base nos registros confirmados de exemplares depositados nas três maiores coleções científicas do estado, complementando esta informação com a bibliografia disponível. Registramos a presença de 212 espécies de répteis no Estado de São Paulo, distribuídas em 23 famílias, incluindo 12 quelônios, três crocodilianos e 197 Squamata (142 serpentes, 44 "lagartos" e 11 anfisbenas). Destas, onze são endêmicas do Estado de São Paulo (Mesoclemmys cf. vanderhaegei, Amphisbaena sanctaeritae, Mabuya caissara, Mabuya macrorhyncha, Liotyphlops caissara, Liotyphlops schubarti, Corallus cropanii, Atractus serranus, Phalotris lativittatus, Bothropoides alcatraz, Bothropoides insularis). Entre os Squamata, quatro lagartos e uma serpente correspondem a espécies ainda não descritas. Destas 212 espécies, 32 estão incluídas na Lista das Espécies Ameaçadas do Estado de São Paulo, enquanto que apenas nove constam na Lista das Espécies Ameaçadas do Brasil. A riqueza de répteis atualmente registrada no Estado de São Paulo representa cerca de 30% da riqueza conhecida para o grupo em todo o território brasileiro, que abrange 721 espécies. Entretanto, concluímos que estudos mais detalhados sobre a taxonomia e a distribuição de espécies bem como os esforços de coleta em áreas com lacunas de amostragem devem ainda aumentar o número de espécies de répteis no estado.


The present study provides a list of species of reptiles known to occur in the State of São Paulo, based on specimens with confirmed localities, housed in the three largest scientific collections of the state, and published information. We registered the presence of 212 species of reptiles within the boundaries of the state that belong to 23 families and include 12 chelonians, three crocodilians, and 197 squamates (142 snakes, 44 "lizards," and 11 amphisbenians). Eleven species are endemic to the State of São Paulo (Mesoclemmys cf. vanderhaegei, Amphisbaena sanctaeritae, Mabuya caissara, Mabuya macrorhyncha, Liotyphlops caissara, Liotyphlops schubarti, Corallus cropanii, Atractus serranus, Phalotris lativittatus, Bothropoides alcatraz, Bothropoides insularis). Within Squamata, four lizards and one snake correspond to valid species that are still in need of formal description. Thirty-two species are included in the List of Threatened Species from the State of São Paulo, while only nine belong to the Brazilian List of Threatened Species. Reptile species richness for the state represents already approximately 30% of species richness known to occur in all the Brazilian territory, which includes 721 species. However, we conclude that more detailed taxonomic and distributional studies as well as more surveys targeting poorly known localities will have the effect of augmenting the number of species for the state.

14.
Biota neotrop. (Online, Ed. port.) ; 11(1): 251-261, jan.-mar. 2011. ilus, graf, mapas, tab
Artículo en Portugués | LILACS | ID: lil-599701

RESUMEN

A porção norte do domínio do Cerrado é uma das áreas historicamente menos conhecidas com relação à sua biodiversidade. Recentemente, alguns estudos tem revelado valores de riqueza comparáveis a outras regiões dentro do domínio. A Estação Ecológica Serra Geral do Tocantins (EESGT) está localizada na região do Jalapão, porção Nordeste do Cerrado, e faz parte do maior bloco de áreas protegidas neste domínio. Neste estudo descrevemos a riqueza e composição de espécies de anfíbios da EESGT, discutindo-as em um contexto biogeográfico, e caracterizamos o uso de sítios reprodutivos pelas espécies de anfíbios registradas em relação às fitofisionomias e aos tipos de corpos d'água. Utilizamos os métodos de busca ativa e armadilhas de queda, no período considerado como o auge da estação reprodutiva para a maior parte das espécies do Cerrado. Foram registradas 36 espécies de anfíbios na EESGT, totalizando 39 espécies conhecidas para a região do Jalapão. Aplicando o estimador Jackknife, sugerimos uma riqueza potencial de 42 espécies para a EESGT. A maior parte das espécies registradas é endêmica ou fortemente associada ao Cerrado, seguidas pelas espécies de ampla distribuição no Brasil ou América do Sul. A maior parte da espécies se reproduz em poças temporárias localizadas em áreas abertas, embora existam espécies que ocorrem exclusivamente em matas de galeria e utilizem corpos d'água lóticos para se reproduzir.


The Northern part of Cerrado is one of the biologically poorest known areas in the domain. Recent studies revealed richness values that are as high as those from other sites in the domain. The Estação Ecológica Serra Geral do Tocantins is located in a region known as Jalapão, in Northeastern Cerrado, and it is included in the largest set of protected areas in the domain. We describe amphibian richness and species composition in EESGT, and discuss it in a biogeographic context. We also describe breeding sites focusing on phytophysiognomy and types of water bodies. We sampled amphibians through active search and pitfall traps, during the peak of breeding season for most of the anuran species in Cerrado. We registered 36 species, which coupled with former studies results in a regional richness of 39 species known for Jalapão. After applying Jackknife estimator, we suggest a potential richness of 42 species for the EESGT. Most registered species are endemic or strongly associated to Cerrado, followed by species widespread in Brazil or South America, and those associated with Caatinga. Most species breed in temporary ponds located in open areas, although there are some forest specialists, and stream-breeding species.

15.
Biota neotrop. (Online, Ed. port.) ; 11(1): 263-281, jan.-mar. 2011. ilus, graf, mapas, tab
Artículo en Portugués | LILACS | ID: lil-599702

RESUMEN

Os Cerrados sul-americanos abrigam alta diversidade de répteis, incluindo elevado número de endemismos. No entanto, o conhecimento desta diversidade é ainda incompleto frente à acelerada transformação das paisagens naturais no Brasil central. Constituem, portanto, uma das regiões prioritárias para estudo e conservação da biodiversidade mundial. Estudos intensivos sobre a fauna de répteis do Cerrado são necessários e urgentes para melhor compreensão dos processos que levaram à sua origem e distribuição e para subsidiar ações de conservação. Por meio de métodos padronizados, amostramos duas regiões ainda inexploradas da Estação Ecológica Serra Geral do Tocantins, situada na região do Jalapão. Registramos 45 espécies de répteis para a EESGT e entorno, o que representa uma riqueza alta e comparável à de outras regiões bem amostradas do Cerrado. Curvas de acumulação e estimadores indicam que a riqueza local de lagartos e anfisbenídeos aproxima-se da riqueza real enquanto a de serpentes é subestimada. A distribuição não-aleatória das espécies na paisagem concorda com evidências anteriores sugerindo utilização diferencial dos hábitats pelos répteis. Reunindo os resultados do presente estudo com os de levantamentos prévios realizados na região, registramos 88 espécies de répteis para o Jalapão sendo oito registros novos que incluem Bachia oxyrhina uma espécie recém descrita da região. As espécies da área apresentam três padrões gerais de distribuição: (1) espécies endêmicas do Cerrado, (2) espécies compartilhadas com domínios da diagonal de formações abertas sul-americanas, e (3) espécies de ampla ocorrência, compartilhadas também com ecossistemas florestais. Prevalecem espécies de ampla distribuição, porém é grande o número de espécies típicas do Cerrado, incluindo cinco possivelmente endêmicas do Jalapão, e há contribuição importante da fauna da Caatinga. A distribuição dos répteis em escala local e regional demonstra a necessidade de considerar a heterogeneidade paisagística para o planejamento de diretrizes visando à conservação em regiões do Cerrado. Por sua grande extensão, posição biogeográfica e complexidade de relevo e tipos de hábitat, a EESGT tem papel fundamental para a preservação e conhecimento da diversidade de répteis do Cerrado.


The South American Cerrado harbors a rich reptilian fauna with high number of endemics. However, knowledge of this diversity is still incipient in front of accelerated transformation of natural landscapes, which makes the domain a "hotspot" for study and conservation of global biodiversity. Studies on the reptile fauna of Cerrado are urgently needed for a better understanding of the processes that led to their origin and distribution and to support conservation planning. We used standard methods to sample two unexplored regions of the Serra Geral do Tocantins Ecological Station (EESGT), located in the Jalapão region of the Cerrado domain. We recorded 45 species of reptiles for the EESGT and surroundings, which represents high species richness, comparable to other well-sampled regions of the Cerrado. Accumulation curves and estimators indicate that sampled richness of lizards and amphisbaenas are close to real values. However, current sampling underestimates snake richness. The non-random distribution of species in the landscape agrees with previous evidence suggesting differential use of habitats by Cerrado reptiles. Combining the results of this study with those of previous surveys conducted in the region, we recorded 88 species of reptiles for the Jalapão region with eight new records, including Bachia oxyrhina, a recent described species of this region. We found three general patterns of distribution: (1) species endemic of the Cerrado domain, (2) species shared with the domains of the South American diagonal of tropical open formations, (3) species widely distributed, also shared with forest ecosystems. Species of wide distribution prevails in the region, but there is large number of species typical of the Cerrado, possibly including five endemics to Jalapão, and there is an important contribution of the Caatinga fauna. The distribution of reptile species in local and regional scales shows the need to consider the landscape heterogeneity for adequate conservation planning in the Cerrado region. Because of the physical and biotic characteristics, EESGT has a key role in the preservation and knowledge of the diversity of Cerrado reptiles.

16.
Biota neotrop. (Online, Ed. port.) ; 11(1): 329-338, jan.-mar. 2011. mapas, tab
Artículo en Portugués | LILACS | ID: lil-599706

RESUMEN

Inventários e estudos faunísticos detalhados sobre vertebrados são uma das fontes mais relevantes de dados para interpretações de padrões detalhados de diversidade biológica. Dados básicos e de boa qualidade sobre faunística são ainda mais urgentes em regiões pouco estudadas e sob intensa ameaça antrópica, tais como a região do Cerrado, um dos 34 hotspots globais para a conservação da biodiversidade. Apresentamos aqui uma síntese dos resultados dos inventários de vertebrados na Estação Ecológica Serra Geral do Tocantins (~716.000 ha), a segunda maior unidade de conservação em todo o Cerrado. Foram registradas 450 espécies de vertebrados na EESGT e entorno imediato, incluindo 17 espécies ameaçadas, 50 espécies endêmicas do Cerrado e 11 espécies com distribuição potencialmente restrita. Do total de espécies amostradas, 180 são novos registros para a região do Jalapão. Ao menos 12 espécies amostradas foram consideradas potenciais espécies novas, das quais quatro foram descritas recentemente, a partir do material obtido no inventário. Os resultados evidenciam que a EESGT é uma das mais importantes áreas protegidas no Brasil central, contribuindo para a persistência de espécies ameaçadas, dependentes dos últimos grandes blocos contínuos de vegetação nativa de Cerrado. Nossos resultados indicam ainda que a conservação da EESGT e suas principais subunidades é crucial para a representatividade do sistema de áreas protegidas do Cerrado, protegendo potenciais endemismos restritos que aliam alta vulnerabilidade intrínseca e valor como indicadores de padrões e processos biogeográficos formadores da rica e cada vez mais ameaçada fauna Neotropical.


Basic taxonomic and distributional data on vertebrates are one of the most useful and reliable sources of information for conservation planning. Biological data are even more relevant in rich and highly threatened regions such as the Brazilian Cerrado, one of the least studied global biodiversity hotspots. Herein we provide a summary of the results of a vertebrate survey at Estação Ecológica Serra Geral do Tocantins (~716.000 ha), the second largest protected area in the Cerrado region. We recorded 450 species in EESGT and surroundings, including 17 threatened species, 50 Cerrado endemics and 11 potential restricted-range species. Our results also added 180 new vertebrate records for the Jalapão region. At least 12 species were considered potential undescribed taxa; four of these were recently described based on specimens obtained in the present study. Our results indicate that EESGT is among the most biologically relevant protected areas in the Cerrado. Proper management will favor the persistence of threatened vertebrates dependent on the last remaining large blocks of pristine Cerrado savannas. Moreover, EESGT and its major biological subunits contribute decisively to the representativeness of the reserve system in the Cerrado, conserving presumed narrow endemics with high intrinsic vulnerability and high potential value as indicators of biogeographic processes of diversification in rich and complex Neotropical biotas.

17.
Genet. mol. biol ; 33(1): 57-61, 2010. ilus, tab
Artículo en Inglés | LILACS | ID: lil-566130

RESUMEN

The karyotype of Amphisbaena ridleyi, an endemic species of the archipelago of Fernando de Noronha, in State of Pernambuco, Brazil, is described after conventional staining, Ag-NOR impregnation and fluorescence in situ hybridization (FISH) with a telomeric probe. The diploid number is 46, with nine pairs of macrochromosomes (three metacentrics, four subtelocentrics and two acrocentrics) and 14 pairs of microchromosomes. The Ag-NOR is located in the telomeric region of the long arm of metacentric chromosome 2 and FISH revealed signals only in the telomeric region of all chromosomes. Further cytogenetic data on other amphisbaenians as well as a robust phylogenetic hypothesis of this clade is needed in order to understand the evolutionary changes on amphisbaenian karyotypes.

18.
Biota neotrop. (Online, Ed. port.) ; 9(2): 117-123, Apr.-June 2009. ilus, graf, tab
Artículo en Portugués | LILACS | ID: lil-529214

RESUMEN

Apresentamos aqui dados sobre a composição de espécies, o uso de hábitat e as estações reprodutivas dos anuros da floresta de restinga da Estação Ecológica Juréia-Itatins, sudeste do Brasil. Entre fevereiro e dezembro de 1993, foram realizadas visitas mensais à área de estudo, com permanência de três ou quatro dias, totalizando 28 dias de trabalhos de campo. Três poças pré-selecionadas foram investigadas diariamente entre 18:00 e 22:30 horas, quando foi estimado o número de machos vocalmente ativos nas agregações observadas, tentando-se localizá-los visualmente em seus substratos característicos de vocalização. A fauna é composta por 20 espécies, a maior riqueza já registrada em um ambiente de restinga do Brasil. De acordo com os critérios da IUCN, oito dessas espécies possuem populações em declínio, devido principalmente à perda de hábitat. Onze espécies apresentaram machos em atividade de vocalização e reprodução nas poças monitoradas mensalmente durante todo o período de estudo; a maioria dos hilídeos apresentou segregação vertical em seus sítios de vocalização sobre a vegetação marginal. Scinax hayii e S. littoralis foram consideradas de reprodução contínua, mas o período reprodutivo da maior parte das espécies mostrou-se associado à estação chuvosa. A alta riqueza de espécies observada na área e a indicação de declínios populacionais de algumas espécies em outras regiões sugerem que a região da Juréia apresenta uma grande relevância como área de preservação de anuros.


Herein we present data on species composition, habitat use, and calling seasons of anurans from the Restinga forest of the Estação Ecológica Juréia-Itatins, Southeastern Brazil. The study site was visited monthly (3 to 4 days) between February and December 1993, a total of 28 days of field work. Three previously selected puddles were searched for anurans between 6:00 and 10:30 PM, when the number of calling males of each species was estimated and the positions of their calling sites were recorded. Anuran fauna is composed by 20 species, the highest richness ever recorded in a Brazilian restinga habitat. According to IUCN criteria, eight of these species have populations declining mainly due to habitat loss. Eleven species showed calling males in the three pools monitored during the study period; most hylids showed some vertical segregation on the marginal vegetation used as calling sites. Scinax hayii and S. littoralis were considered continuous breeders, but the calling and breeding period of most species was associated to the rainy season. The high species richness recorded and the indication of declining populations for some species outside the area suggest the E.E. Juréia-Itatins has a high potential to preserve anuran fauna.


Asunto(s)
Anfibios , Anuros , Ecosistema , Fauna/análisis , Fauna/clasificación , Estación Lluviosa , Reproducción
19.
J. pediatr. (Rio J.) ; 82(2): 157-160, Mar.-Apr. 2006. ilus, graf
Artículo en Inglés | LILACS | ID: lil-428497

RESUMEN

OBJECTIVE: To report a pediatric case of central pontine and extrapontine myelinolysis, a rare neurological disease often associated with rapid correction of hyponatremia.DESCRIPTION: A 15 year-old female adolescent developed locked-in syndrome during severe hyponatremia. Brain magnetic resonance imaging was consistent with the diagnosis of central pontine and extrapontine myelinolysis.COMMENTS: Serum sodium correction should proceed slowly and cautiously, based upon a careful calculation of sodium deficit, in order to minimize metabolic stress and avoid the occurrence of this dreadful complication, which has a tragic outcome in most cases. There is no scientifically proved effective treatment for myelinolysis, and severe cases usually have a dismal prognosis.


Asunto(s)
Humanos , Femenino , Adolescente , Hiponatremia/diagnóstico , Mielinólisis Pontino Central/diagnóstico , Cerebro/patología , Resultado Fatal , Hiponatremia/etiología , Hiponatremia/terapia , Imagen por Resonancia Magnética , Mielinólisis Pontino Central/etiología , Sodio/sangre
20.
Genet. mol. biol ; 28(4): 700-709, Dec. 2005. ilus, tab
Artículo en Inglés | LILACS | ID: lil-451009

RESUMEN

Cytogenetic studies were performed on five closely related microteiid lizards (Gymnophthalmini), three Calyptommatus species and Psilophthalmus paeminosus from the sand dunes of the middle São Francisco river in the semiarid caatinga of the Brazilian state of Bahia and Tretioscincus oriximinensis from the Brazilian Amazon region. The diploid chromosome number in Calyptommatus species was 2n = 58 in females and 2n = 57 in males due to a multiple X1X1X2X2:X1X2Y sex chromosomes system, while P. paeminosus was 2n = 44 (20M+24m): where M = macrochromosomes and m = microchromosomes) and T. oriximinensis 2n = 42 (18M+24m). A single pair of silver staining nucleolar organizing regions (Ag-NORs) characterizes all five species. Incorporation of 5-BrdU (Bromodeoxyuridine) followed by replication R-banding (RBG) karyotyping allowed the identification of the larger pairs of chromosomes through longitudinal bands and the late replicating regions. Our data reinforce the remarkable chromosomal variability that has been found in the Gymnophthalmidae and the importance of using differential staining for comparative cytogenetics within this group of lizards. Chromosomal evolution in Gymnophthalmini seems to have included chromosomal fission and fusion, pericentric inversions and variation in the amount and localization of constitutive heterochromatin and the Ag-NOR pattern. Different mechanisms of sex determination also evolved independently in this radiation.


Asunto(s)
Animales , ADN , Reptiles/genética , Brasil , Bandeo Cromosómico , Citogenética , Cariotipificación , Cromosomas Sexuales
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