Importancia del ultrasonido a la cabecera del paciente en el manejo urgente de la disnea

Point-of-care ultrasonography (POCUS) is an important tool in the initial assessment of critical patients. In this report, we describe the case of an 83-year-old woman admitted to the emergency room due to a sudden unclear change of consciousness. She was confused, hypoxemic, tachycardic, and had signs of poor perfusion. The POCUS showed dilatation of the right ventricle, raising a solid suspicion of pulmonary thromboembolism. This case supports the importance of including POCUS in the assessment of critically ill patients, as it reduces the time for diagnosis and treatment, improving the patient's prognosis.El ultrasonido a la cabecera del paciente (UCP) es una herramienta esencial en la evaluación inicial del paciente crítico. Presentamos el caso de una mujer de 83 años que ingresó por un cuadro de alteración súbita del estado de consciencia. A su llegada estaba confusa, con hipoxemia, taquicardia y signos de mala perfusión periférica. El UCP mostró dilatación del ventrículo derecho compatible con la fuerte sospecha clínica de tromboembolismo pulmonar. Este caso demuestra la importancia de incluir el UCP en la evaluación de pacientes críticos, pues permite reducir el tiempo para el diagnóstico y tratamiento, mejorando su pronóstico

Repercussões da pandemia de COVID-19 para a enfermagem: relato de experiência de uma Unidade de Terapia Intensiva Pediátrica

Introduction: Nursing professionals represent the driving force of health work in Brazil and in the world. However, there is ample evidence that adversarial working conditions are frequent in the routine of these professionals. Such adversities were worsened in the context of the COVID-19 pandemic, which required a quick and effective response from the health sector, supported by the performance of health professionals in the management and care of the new disease. Objective: Report the working conditions of nursing professionals in pediatric intensive care and reflect on the repercussions of the COVID-19 pandemic. Methodology: This is an experience report of nurses from a pediatric intensive care unit in the care of children and adolescents with suspected or confirmed COVID. Experience report: The main vulnerabilities experienced by the team were: the fear of contagion by COVID-19; increased demand for monitoring and paramentation for care for children/adolescents in respiratory isolation; skin lesions and pain resulting from the constant use of personal protective equipment; concern and frustration in the face of anxiety and fear of children/adolescents and their accompanying person in isolation in the private room; increase in stressors at work, reducing the possibility of leisure and rest due to social isolation; workload due to health leave. Conclusion: With the spread of COVID-19, health services were overwhelmed. This exacerbated the adverse working conditions that already existed and brought even greater stressors, which affected the work environment and brought additional biological risks to the health of frontline care workers. This type of report contributes to the elaboration of valuation actions, better working conditions with centrality in the well-being of employees, bringing benefits for the category and for the quality of care provided.Introdução: Os profissionais de enfermagem representam a força motriz do trabalho em saúde no Brasil e no mundo. Contudo, são vastas as evidências de que condições de trabalho adversas são frequentes na rotina destes profissionais. Tais adversidades agravaram-se no contexto da pandemia de COVID-19, que demandou uma resposta rápida e efetiva do setor saúde, sustentado pela atuação dos profissionais de saúde no manejo e cuidado à nova doença. Objetivo: Relatar as condições de trabalho de profissionais de enfermagem em cuidado intensivo pediátrico e refletir sobre as repercussões da pandemia de COVID-19. Metodologia: Trata-se de um relato de experiência de enfermeiras de uma unidade de terapia intensiva pediátrica na assistência de crianças e adolescentes com suspeita ou com COVID-19 confirmado. Relato de Experiência:  As principais vulnerabilidades vivenciadas pela equipe foram: o medo de contágio por COVID-19; maior demanda de monitorização e paramentação para assistência às crianças/adolescentes em isolamento respiratório; lesões de pele e dor decorrentes do uso constante de equipamentos de proteção individual; preocupação e frustração diante da ansiedade e medo das crianças/adolescentes e seu acompanhante em isolamento no quarto privativo; aumento dos estressores no trabalho com redução das possibilidade de lazer e descanso devido ao isolamento social; e aumento da carga de trabalho devido às licenças saúde. Conclusão: Com a disseminação da COVID-19 os serviços de saúde ficaram sobrecarregados. Isso potencializou as condições adversas de trabalho já existentes e trouxe fatores estressores ainda maiores, que afetaram o ambiente laboral e trouxeram riscos biológicos adicionais para saúde dos trabalhadores da linha de frente do cuidado. Este tipo de relato pode contribuir para o desenvolvimento de estratégias que visem melhores condições de trabalho, propiciando o bem-estar dos profissionais e favorecendo a qualidade da assistência

MAMMALS IN PORTUGAL : A data set of terrestrial, volant, and marine mammal occurrences in P ortugal

Mammals are threatened worldwide, with 26% of all species being includedin the IUCN threatened categories. This overall pattern is primarily associatedwith habitat loss or degradation, and human persecution for terrestrial mam-mals, and pollution, open net fishing, climate change, and prey depletion formarine mammals. Mammals play a key role in maintaining ecosystems func-tionality and resilience, and therefore information on their distribution is cru-cial to delineate and support conservation actions. MAMMALS INPORTUGAL is a publicly available data set compiling unpublishedgeoreferenced occurrence records of 92 terrestrial, volant, and marine mam-mals in mainland Portugal and archipelagos of the Azores and Madeira thatincludes 105,026 data entries between 1873 and 2021 (72% of the data occur-ring in 2000 and 2021). The methods used to collect the data were: live obser-vations/captures (43%), sign surveys (35%), camera trapping (16%),bioacoustics surveys (4%) and radiotracking, and inquiries that represent lessthan 1% of the records. The data set includes 13 types of records: (1) burrowsjsoil moundsjtunnel, (2) capture, (3) colony, (4) dead animaljhairjskullsjjaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8),observation in shelters, (9) photo trappingjvideo, (10) predators dietjpelletsjpine cones/nuts, (11) scatjtrackjditch, (12) telemetry and (13) vocalizationjecholocation. The spatial uncertainty of most records ranges between 0 and100 m (76%). Rodentia (n=31,573) has the highest number of records followedby Chiroptera (n=18,857), Carnivora (n=18,594), Lagomorpha (n=17,496),Cetartiodactyla (n=11,568) and Eulipotyphla (n=7008). The data setincludes records of species classified by the IUCN as threatened(e.g.,Oryctolagus cuniculus[n=12,159],Monachus monachus[n=1,512],andLynx pardinus[n=197]). We believe that this data set may stimulate thepublication of other European countries data sets that would certainly contrib-ute to ecology and conservation-related research, and therefore assisting onthe development of more accurate and tailored conservation managementstrategies for each species. There are no copyright restrictions; please cite thisdata paper when the data are used in publications.info:eu-repo/semantics/publishedVersio

Mammals in Portugal: a data set of terrestrial, volant, and marine mammal occurrences in Portugal

Mammals are threatened worldwide, with ~26% of all species being included in the IUCN threatened categories. This overall pattern is primarily associated with habitat loss or degradation, and human persecution for terrestrial mammals, and pollution, open net fishing, climate change, and prey depletion for marine mammals. Mammals play a key role in maintaining ecosystems functionality and resilience, and therefore information on their distribution is crucial to delineate and support conservation actions. MAMMALS IN PORTUGAL is a publicly available data set compiling unpublished georeferenced occurrence records of 92 terrestrial, volant, and marine mammals in mainland Portugal and archipelagos of the Azores and Madeira that includes 105,026 data entries between 1873 and 2021 (72% of the data occurring in 2000 and 2021). The methods used to collect the data were: live observations/captures (43%), sign surveys (35%), camera trapping (16%), bioacoustics surveys (4%) and radiotracking, and inquiries that represent less than 1% of the records. The data set includes 13 types of records: (1) burrows | soil mounds | tunnel, (2) capture, (3) colony, (4) dead animal | hair | skulls | jaws, (5) genetic confirmation, (6) inquiries, (7) observation of live animal (8), observation in shelters, (9) photo trapping | video, (10) predators diet | pellets | pine cones/nuts, (11) scat | track | ditch, (12) telemetry and (13) vocalization | echolocation. The spatial uncertainty of most records ranges between 0 and 100 m (76%). Rodentia (n =31,573) has the highest number of records followed by Chiroptera (n = 18,857), Carnivora (n = 18,594), Lagomorpha (n = 17,496), Cetartiodactyla (n = 11,568) and Eulipotyphla (n = 7008). The data set includes records of species classified by the IUCN as threatened (e.g., Oryctolagus cuniculus [n = 12,159], Monachus monachus [n = 1,512], and Lynx pardinus [n = 197]). We believe that this data set may stimulate the publication of other European countries data sets that would certainly contribute to ecology and conservation-related research, and therefore assisting on the development of more accurate and tailored conservation management strategies for each species. There are no copyright restrictions; please cite this data paper when the data are used in publications

A Rare Case of Second-degree Atrioventricular Block and Takotsubo Syndrome

Background: Takotsubo cardiomyopathy is characterized by transient left systolic dysfunction that can mimic acute myocardial infarction. Atrioventricular (AV) block associated with Takotsubo is rare, but a few cases have been reported in recent years.Methods: We present the case of a 77-year-old woman presenting with second-degree AV and Takotsubo syndrome. Results: The diagnosis of Takotsubo syndrome was based on echocardiogram changes and the absence of coronary artery obstruction on coronary angiography.Conclusions: We describe a patient with a diagnosis of Takotsubo syndrome and AV conduction defect. These conditions rarely occur simultaneous, but when they do, a dilemma arises regarding pacemaker implantation

Direct antiviral therapy for treatment of hepatitis C: A real-world study from Brazil

Introduction and objectives: Direct antiviral agents (DAAs) including sofosbuvir (SOF), daclatasvir (DCV), simeprevir (SIM) and ombitasvir, paritaprevir and dasabuvir were introduced 2015 in Brazil for treatment of hepatitis C virus (HCV) infection. The aims of this study were to assess effectiveness and safety of HCV treatment with DAA in real-life world in a highly admixed population from Brazil. Materials and methods: All Brazilian reference centers for HCV treatment were invited to take part in a web-based registry, prospectively conducted by the Brazilian Society of Hepatology, to assess outcomes of HCV treatment in Brazil with DAAs. Data to be collected included demographics, disease severity and comorbidities, genotype (GT), viral load, DAA regimens, treatment side effects and sustained virological response (SVR). Results: 3939 patients (60% males, mean age 58 ± 10 years) throughout the country were evaluated. Most had advanced fibrosis or cirrhosis, GT1 and were treated with SOF/DCV or SOF/SIM. Overall SVR rates were higher than 95%. Subjects with decompensated cirrhosis, GT2 and GT3 have lower SVR rates of 85%, 90% and 91%, respectively. Cirrhosis and decompensated cirrhosis in GT1 and male sex and decompensated cirrhosis in GT3 were significantly associated with no SVR. Adverse events (AD) and serious AD occurred in 18% and 5% of those subjects, respectively, but less than 1% of patients required treatment discontinuation. Conclusion: SOF-based DAA regimens are effective and safe in the heterogeneous highly admixed Brazilian population and could remain an option for HCV treatment at least in low-income countries

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