RÉSUMÉ
Com o crescente índice de transtornos ansiosos na população mundial, cresce a necessidade de se investigar psicofármacos que possibilitem experiências de tratamento, segurança e sustentabilidade ao paciente. Dessa forma, o objetivo desta pesquisa é realizar uma revisão sistemática metodológica acerca da eficácia dos benzodiazepínicos (BZ) para o tratamento de transtornos ansiosos (TA). Os estudos foram pesquisados nas bases de dados da PubMed e ScienceDirect, a partir dos descritores: "benzodiazepines" e "anxiety disorder". Será utilizado o operador booleano "AND". Foram revisados 27 artigos científicos, com amostra total de 120.418 pacientes de estudos publicados entre os anos de 2011 e 2021, sendo 15 revisões sistemáticas, 5 revisões sistemáticas com meta-análise, 2 meta-análises, 1 revisão sistemática com estudo original, 1 ensaio clínico, 1 ensaio clínico com caso controle, 1 ensaio clínico com estudo prospectivo e 1 estudo duplo cego com ensaio clínico utilizando placebo. Percebeu-se que os BZ se mostraram efetivos no tratamento de transtornos ansiosos (ansiedade generalizada e fobia social), mas inviável em termos de qualidade e seguridade em relação ao seu potencial de dependência a longo prazo. Novos medicamentos foram considerados como possível substituição do BZ para os TA. Novos estudos considerando outros transtornos ansiosos são necessários, além dos que foram abordados nesta pesquisa.
With the increasing rate of anxiety disorders in the world population, there is a growing need for research on psychotropic drugs that provide treatment experience, safety, and sustainability to the patient. Thus, this research aims to conduct a systematic methodological review of the effectiveness of benzodiazepines (BZD) in the treatment of anxiety disorders (AD). The studies were searched in the PubMed and ScienceDirect databases, using the descriptors: "benzodiazepines" and "anxiety disorder". The Boolean operator "AND" will be used. Twenty-seven studies were reviewed, with a total sample of 120,418 patients from studies published between 2011 and 2021, including 15 systematic reviews, 5 systematic reviews with meta-analysis, 2 meta-analyses, 1 systematic review with the original study, 1 clinical trial, 1 clinical trial with a case-control study, 1 clinical trial with a prospective study and 1 double-blind clinical trial with placebo. BZD are effective in the treatment of anxiety disorders generalized anxiety and social phobia, but are impractical in terms of quality and safety related to their long-term dependence potential. New drugs have been considered as a possible replacement for BZD for AD. Studies considering other anxiety disorders are needed, in addition to those addressed in this research.
RÉSUMÉ
Objective To describe the endoscopic and microsurgical anatomy of the cavernous sinus (CS) with focus on the surgical landmarks in microsurgical anatomy. Materials and methods Ten formalin-fixed central skull base specimens (20 CSs) with silicone-injected carotid arteries were examined through an extended endoscopic transsphenoidal approach. Fifteen formalin-fixed heads were dissected to simulate the surgical position in CS approaches. Results Endoscopic access enables identification of the anterior and posterior surgical corridors. Structures within the CS and on its lateral wall could be visualized and studied, but none of the triangular areas relevant to the transcranial microsurgical anatomy were fully visible through the endoscopic approach. Conclusion The endoscopic approach to the CS is an important surgical technique for the treatment of pathological conditions that affect this region. Correlating endoscopic findings with the conventional (transcranial)microsurgical anatomy is a useful way of applying the established knowledge into a more recent operative technique. Endoscope can provide access to the CS and to the structures it harbors.