Vulnerable victims in court: from childhood to senescence

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Elder abuse: the hidden face of domestic violence

Abstract in proceedings of the Fourth International Congress of CiiEM: Health, Well-Being and Ageing in the 21st Century, held at Egas Moniz’ University Campus in Monte de Caparica, Almada, from 3–5 June 2019.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.info:eu-repo/semantics/publishedVersio

Brain Neoplasms in Elderly Dogs

Background: The prevalence of intracranial neoplasms in dogs represents 2.1 to 4.0% of the cases. Brain tumors may be primary or metastatic. The objective of this study was to describe two cases of intra encephalic neoplasia in elderly dogs received for necropsy by the Veterinary Oncology Service in the Federal University of Pelotas.Cases: Case 1: A 12-year-old female canine, without breed and medium size, was received for necropsy. The animal has had behavioral changes. Macroscopic examination of the encephalus revealed asymmetry and congestion. The organs were collected and fixed in 10% formalin. In the brain cleavage we noticed an extensive brown-gray mass with reddish areas, expansive, moderately demarcated, soft to cut and discrete hydrocephalus. Serial fragments of the brain and fragments of the organs were sent for processing. The slides were stained with the hematoxylin and eosin technique for histopathological analysis. At the microscopic examination, cuboidal cells were observed in the encephalus sometimes in acinar arrangements, of extensive and very limited pattern, diagnosed as ependymoma. Case 2: It is a 15-year-old, female poodle dog, with several tumors. During necropsy multiple subcutaneous nodules, mesentery, intestinal serosa, stomach and liver were noticed. At the cut these were firm and whitish. No macroscopic changes were observed in the other organs. Fragments of organs and brain were collected and a serial section of the encephalus was performed for further processing and histological analysis. In the histopathological analysis the masses were constituted by proliferation of sometimes rounded cells, elongated, with rounded nuclei and eosinophilic cytoplasm, allowing the diagnosis of mesothelioma. The same cell pattern was observed in other organs. In the frontal cortex of the encephalus there were small foci of cells similar to those observed in the mesentery, as well as metastatic emboli in the meningeal and encephalic vessels, characterizing the diagnosis of metastatic mesothelioma.Discussion: Neoplasms of the central nervous system may be primary or metastatic. The ependymoma observed in case 1 was only diagnosed after visualization of the encephalic mass during necropsy, pointing to the importance of postmortem examination. Brain neoplasms in dogs occur with a frequency and variety similar to that of humans. Most of these are found in older dogs, and 95% of those affected are over five years of age. One situation that may occur in ependymomas is the development of obstructive hydrocephalus by the expansion of the neoplasm into the ventricular system. The animal studied in case 1 presented behavioral changes for weeks before death, and at necropsy ventricular dilation was evidenced, suggesting that hydrocephalus had occurred and the behavioral changes due to tumor localization. Metastatic brain neoplasms occur due to the hematogenous spread of many tumors. The species in which the metastatic neoplasms are most commonly described is the canine. Metastases of mesotheliomas in the central nervous system are rare, which reinforces the need for a thorough postmortem examination, as evidenced in the second case of this study, since the animal did not manifest clinically signs of neurological involvement and the metastasis was only identified microscopically by serial cuts of the encephalon. It can be concluded that detailed, systematic and serial post-mortem examination of the central nervous system should be part of the diagnostic routine even if no clinical neurological signs are evident. The reports presented here are of importance since they are considered rare diagnoses of primary and metastatic brain tumors

AS PRINCIPAIS REAÇÕES ADVERSAS DAS MEDICAÇÕES UTILIZADA NA PARADA CARDIORRESPIRATÓRIA, NO HOSPITAL REGIONAL DO SERTÃO CENTRAL

Recebe o nome de parada cardiorrespiratória (PCR) a abrupta e inesperada interrupção da circulação sanguínea, consequente da parada dos batimentos cardíacos que são responsáveis pela manutenção do débito cardíaco. Após a ocorrência deste fenômeno, o indivíduo perde a consciência dentro de 10 a 15 segundos, em decorrência da ausência de circulação sanguínea no cérebro. Os fatores capazes de causar PCR são Afogamento; Patologias cardiovasculares; Engasgo (OVACE); Choque Hemodinâmico; Choque séptico; Traumas; Choque elétrico. O socorro básico é feito por meio de compressões torácica onde consiste na manobra realizada inicialmente, em muitos casos, apresenta resultado positivo. Na maioria das vezes é feita a tórax fechado ou a tórax aberto em locais adequados e executados por médicos. Relatar as principais reações adversas das medicações usadas na parada cardiorrespiratória – PCR. Cloridrato de Epinefrina (adrenalina): A epinefrina é uma catecolamina endógena que atua estimulando os receptores alfa e beta-adrenérgicos. É o principal fármaco a ser usado em todas as modalidades da parada cardiorrespiratória. Os principais efeitos são, aumento da resistência vascular sistêmica, aumento da frequência cardíaca, aumento da atividade elétrica miocárdica. Efeitos Colaterais: Aumenta o consumo de oxigênio pelo miocárdio, Inativa quando administrada com soluções alcalinas; Cloridrato de amiodarona: O cloridrato de amiodarona é o um fármaco da classe dos antiarrítmicos sendo recomendo como primeiro antiarrítmico a ser utilizado no tratamento de parada cardiorrespiratório, sendo indicado nos ritmos chocáveis (taquicardia ventricular sem pulso e fibrilação ventricular sem pulso), sendo a dose inicial de 300 mg IV em bolus, seguida, se necessário, por uma nova dose de 150 mg IV, após 5 minutos. Efeitos Colaterais: Comum: bradicardia geralmente moderada; reações no local da aplicação, tais como: dor, eritema, edema, necrose, extravasamento, infiltração, inflamação, endurecimento, tromboflebite, flebite, celulite, infecção e modificação na pigmentação; Lidocaína: A lidocaína é o fármaco de escolha para a supressão das arritmias associadas ao infarto agudo do miocárdio e cirurgias cardíacas. Atua preferencialmente sobre o miocárdio isquêmico. Indicações Taquicardia ventricular; Fibrilação ventricular depois da desfibrilação e adrenalina; Efeitos Colaterais - Reações tóxicas são manifestadas através de sintomas ligados ao sistema nervoso central, como: alteração do nível de consciência, contrações musculares, dislalia; Sabendo se que a poluição atmosférica proveniente de fontes fixas como indústrias de transformação, mineração e termoelétricas e móveis como veículos automotores, trens, embarcações e aviões, além da queima de biomassa florestal e agrícola, é a responsável pelo incremento de diversos problemas de saúde, principalmente os relacionados ao sistema cardiorrespiratório, onde cada vez mais é evidente o aumento desses fatores para a contribuição da doença. Visto que, é necessária uma conscientização da população para melhoria da saúde pública nesse âmbito

A Cross-Sectional Survey-Based Study of Medical Oncologists

Funding Information: We would like to thank Andrea Bothwell who wrote the manuscript outline and first draft on behalf of Springer Healthcare Communications. We also thank Prof. Carina Silva (ESTEsL – Escola Superior de Tecnologias de Saúde de Lisboa) who performed the preliminary statistical analysis of this study. This medical writing assistance and statistical analysis was funded by CUF Oncologia. Funding Information: Diogo Alpuim Costa has received honoraria from the Portuguese Navy, CUF Oncologia, and NTT DATA, and has served as a speaker, advisory board member, or has received research or education funding from CUF Oncologia, AstraZeneca, Hoffmann-La Roche, Merck KGaA, Novartis, Pfizer, Uriage, Daiichi Sankyo, Gilead, Merck Sharp & Dohme, Nanobiotix, Puma Biotechnology Inc., Sanofi, and Seagen Inc. Margarida Brito has participated as advisory board member for Roche, Novartis, Merck Sharp & Dohme, and Pfizer. Mário Fontes-Sousa has served as a speaker or advisory board member for Bristol Myers Squibb, Daiichi Sankyo, Gilead, Lilly, Merck Sharp & Dohme, Novartis, Pfizer, Roche, and Servier. Diogo Martins-Branco received honoraria and advisory board fees from Janssen, Pfizer, Merck Sharp & Dohme, Angelini, AstraZeneca, and Novartis, meeting and travel grants from LEO Farmacêuticos, Merck Sharp & Dohme, Ipsen, Janssen, and Roche, and institutional grants from F. Hoffmann-La Roche Ltd. José Guilherme Gonçalves Nobre, João Paulo Fernandes, Marta Vaz Batista, Ana Simas, Carolina Sales, Helena Gouveia, Leonor Abreu Ribeiro, Andreia Coelho, Mariana Inácio, André Cruz, Mónica Mariano, Joana Savva-Bordalo, Ricardo Fernandes, André Oliveira, Andreia Chaves, Mafalda Sampaio-Alves, and Noémia Afonso have nothing to declare. Publisher Copyright: © 2022, The Author(s).Introduction: Cancer care providers have faced many challenges in delivering safe care for patients during the COVID-19 pandemic. This cross-sectional survey-based study investigated the impact of the pandemic on clinical practices of Portuguese medical oncologists caring for patients with breast cancer. Methods: An anonymous online survey comprising 42 questions gathered information regarding COVID-19 testing, treatment in (neo)adjuvant and metastatic settings, and other aspects of breast cancer management. Practices before and during the pandemic were compared, and potential differences in outcomes according to respondents’ regions, case volumes, and practice type were explored. Results: Of 129 respondents, 108 worked in the public health system, giving a representative national picture of the impact of the COVID-19 pandemic on breast cancer management. Seventy-one percent of respondents reported a reduction in visits for new cases of breast cancer, and there was a shift towards increased use of telemedicine. Clinical decision-making was largely unaffected in the most aggressive indications (i.e., triple-negative, HER2-positive, visceral crisis). The use of neoadjuvant therapy increased when access to surgery was difficult, whereas dose-dense regimens decreased, and cyclin-dependent kinase 4/6 inhibitor treatment decreased for less aggressive disease and increased for more aggressive disease. The use of oral formulations and metronomic chemotherapy regimens increased, and clinical trial participation decreased. Some differences by respondents’ region and case volume were noted. Conclusion: Medical oncologists in Portugal implemented many changes during the COVID-19 pandemic, most of which were logical and reasonable responses to the current healthcare emergency; however, the true impact on patient outcomes remains unknown.publishersversionepub_ahead_of_prin

AVALIAÇÃO DAS PRÁTICAS HIGIÊNICO SANITÁRIAS NA PRODUÇÃO DE AÇAÍ NA TIGELA: DIAGNÓSTICO E INTERVENÇÃO

The aim of this work was to evaluate the nutritional and microbiological quality of ready-to-eat açai, the physical and functional conditions of establishments that market this product and to verify the presence of microorganisms at handlers’ hands and nostrils. Twenty-three establishments in the city of Goiânia–Goiás were evaluated and açaí samples were obtained in two steps: before and after the training of handlers about good manufacturing practices. A decrease in the counts of total coliforms (from 26.08% to 8.7% of samples), coagulase positive staphylococci (from 78.26% to 65.2% of samples) and aerobic mesophiles (from 100% to 73.91% of samples) was observed between steps. The presence of microorganisms at handlers’ hands and nostrils did not present statistical difference between the two steps. According to the applied checklist, six items showed reduced compliance. After the training of handlers, the microbiological contamination of açaí decreased, and the presence of E coli in handlers’ nostrils was no longer observed, which highlights the importance of training about the implementation Good Manufacturing Practices to ensure food sanitary quality.El objetivo de este trabajo fue evaluar la calidad nutricional y microbiológica del açai listo para comer, las condiciones físicas y funcionales de los establecimientos que comercializan este producto y verificar la presencia de microorganismos en las manos y fosas nasales de los manipuladores. Se evaluaron 23 establecimientos en la ciudad de Goiânia – Goiás y se obtuvieron muestras de açaí en dos pasos: antes y después de la capacitación de los manipuladores sobre las buenas prácticas de fabricación. Se observó una disminución en los recuentos de coliformes totales (del 26.08% al 8.7% de las muestras), estafilococos coagulasa positivos (del 78.26% al 65.2% de las muestras) y mesófilos aeróbicos (del 100% al 73.91% de las muestras) entre los pasos. La presencia de microorganismos en las manos y fosas nasales de los manipuladores no presentó diferencias estadísticas entre los dos pasos. Según la lista de verificación aplicada, seis ítems mostraron un cumplimiento reducido. Después de la capacitación de los manipuladores, la contaminación microbiológica del açaí disminuyó y ya no se observó la presencia de E. coli en las fosas nasales de los manipuladores, lo que resalta la importancia de la capacitación sobre la implementación de Buenas Prácticas de Manufactura para garantizar la calidad sanitaria de los alimentos.O objetivo deste trabalho foi avaliar a qualidade nutricional e microbiológica do açaí pronto para consumo, as condições físicas e funcionais dos estabelecimentos que comercializam esse produto e verificar a presença de microrganismos nas mãos e nas narinas dos manipuladores. Foram avaliados 23 estabelecimentos da cidade de Goiânia-Goiás e as amostras de açaí foram obtidas em duas etapas: antes e após o treinamento dos manipuladores sobre as boas práticas de fabricação. Observou-se uma diminuição nas contagens de coliformes totais (de 26,08% para 8,7% das amostras), estafilococos positivos para coagulase (de 78,26% para 65,2% das amostras) e mesófilos aeróbicos (de 100% para 73,91% das amostras). A presença de microrganismos nas mãos e nas narinas dos manipuladores não apresentou diferença estatística entre as duas etapas. De acordo com a lista de verificação aplicada, seis itens apresentaram conformidade reduzida. Após o treinamento dos manipuladores, a contaminação microbiológica do açaí diminuiu e a presença de E. coli nas narinas dos manipuladores não foi mais observada, o que destaca a importância do treinamento sobre a implementação de Boas Práticas de Fabricação para garantir a qualidade sanitária dos alimentos

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

A database of freshwater fish species of the Amazon Basin

The Amazon Basin is an unquestionable biodiversity hotspot, containing the highest freshwater biodiversity on earth and facing off a recent increase in anthropogenic threats. The current knowledge on the spatial distribution of the freshwater fish species is greatly deficient in this basin, preventing a comprehensive understanding of this hyper-diverse ecosystem as a whole. Filling this gap was the priority of a transnational collaborative project, i.e. the AmazonFish project - https://www.amazon-fish.com/. Relying on the outputs of this project, we provide the most complete fish species distribution records covering the whole Amazon drainage. The database, including 2,406 validated freshwater native fish species, 232,936 georeferenced records, results from an extensive survey of species distribution including 590 different sources (e.g. published articles, grey literature, online biodiversity databases and scientific collections from museums and universities worldwide) and field expeditions conducted during the project. This database, delivered at both georeferenced localities (21,500 localities) and sub-drainages grains (144 units), represents a highly valuable source of information for further studies on freshwater fish biodiversity, biogeography and conservation

Assessment of risk scores to predict mortality of COVID-19 patients admitted to the intensive care unit

ObjectivesTo assess the ABC2-SPH score in predicting COVID-19 in-hospital mortality, during intensive care unit (ICU) admission, and to compare its performance with other scores (SOFA, SAPS-3, NEWS2, 4C Mortality Score, SOARS, CURB-65, modified CHA2DS2-VASc, and a novel severity score).Materials and methodsConsecutive patients (≥ 18 years) with laboratory-confirmed COVID-19 admitted to ICUs of 25 hospitals, located in 17 Brazilian cities, from October 2020 to March 2022, were included. Overall performance of the scores was evaluated using the Brier score. ABC2-SPH was used as the reference score, and comparisons between ABC2-SPH and the other scores were performed by using the Bonferroni method of correction. The primary outcome was in-hospital mortality.ResultsABC2-SPH had an area under the curve of 0.716 (95% CI 0.693–0.738), significantly higher than CURB-65, SOFA, NEWS2, SOARS, and modified CHA2DS2-VASc scores. There was no statistically significant difference between ABC2-SPH and SAPS-3, 4C Mortality Score, and the novel severity score.ConclusionABC2-SPH was superior to other risk scores, but it still did not demonstrate an excellent predictive ability for mortality in critically ill COVID-19 patients. Our results indicate the need to develop a new score, for this subset of patients