Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Differential clinical characteristics and prognosis of intraventricular conduction defects in patients with chronic heart failure

Intraventricular conduction defects (IVCDs) can impair prognosis of heart failure (HF), but their specific impact is not well established. This study aimed to analyse the clinical profile and outcomes of HF patients with LBBB, right bundle branch block (RBBB), left anterior fascicular block (LAFB), and no IVCDs. Clinical variables and outcomes after a median follow-up of 21 months were analysed in 1762 patients with chronic HF and LBBB (n = 532), RBBB (n = 134), LAFB (n = 154), and no IVCDs (n = 942). LBBB was associated with more marked LV dilation, depressed LVEF, and mitral valve regurgitation. Patients with RBBB presented overt signs of congestive HF and depressed right ventricular motion. The LAFB group presented intermediate clinical characteristics, and patients with no IVCDs were more often women with less enlarged left ventricles and less depressed LVEF. Death occurred in 332 patients (interannual mortality = 10.8%): cardiovascular in 257, extravascular in 61, and of unknown origin in 14 patients. Cardiac death occurred in 230 (pump failure in 171 and sudden death in 59). An adjusted Cox model showed higher risk of cardiac death and pump failure death in the LBBB and RBBB than in the LAFB and the no IVCD groups. LBBB and RBBB are associated with different clinical profiles and both are independent predictors of increased risk of cardiac death in patients with HF. A more favourable prognosis was observed in patients with LAFB and in those free of IVCDs. Further research in HF patients with RBBB is warranted

Pervasive gaps in Amazonian ecological research

Biodiversity loss is one of the main challenges of our time, and attempts to address it require a clear understanding of how ecological communities respond to environmental change across time and space. While the increasing availability of global databases on ecological communities has advanced our knowledge of biodiversity sensitivity to environmental changes, vast areas of the tropics remain understudied. In the American tropics, Amazonia stands out as the world's most diverse rainforest and the primary source of Neotropical biodiversity, but it remains among the least known forests in America and is often underrepresented in biodiversity databases. To worsen this situation, human-induced modifications 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, 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

Identification of SNP c.-22G>A in the melanophilin gene from a dog with color dilution alopecia: case report

ABSTRACT Mutant color alopecia is an ectodermical defection of color dilution, characterized by partial alopecia, dry, shine-less hair, and peeling and papule. Melanization damages also occur on the cortical structure of the affected hair. The animals affected have big melanin grains with irregular shape on the basal keratinocytes, also on the hair matrix cells and rod. Therefore, there is not a specific treatment that makes any difference on the syndrome evolution. Although in some animals, it is possible to use weekly showers with benzyl peroxide to reduce seborrhea formation and secondary infections. There is evidence that the condition in dogs is caused by a single nucleotide polymorphism in the gene encoding the melanophilin protein. In the present study the identification of the SNP c.-22G>A in the melanophilin gene of a Dachshund breed dog with clinical and histopathologic evidence of color dilution alopecia is reported

Intoxicação por Trema micrantha (Ulmaceae) em caprinos no Estado de Santa Catarina Poisoning by Trema micrantha (Ulmaceae) in goats in the State of Santa Catarina

Vinte e cinco caprinos, criados em piquetes, morreram nos cinco dias subsequentes ao fornecimento de folhas de Trema micrantha (fam.Ulmaceae), uma árvore com nome comum de grandiúva. Quatro caprinos foram necropsiados e amostras de vísceras foram coletadas para exame histológico. As principais alterações clínicas foram: apatia, anorexia, cabeça apoiada contra obstáculos, decúbito e morte. Achados macroscópicos incluíram sufusões no epicárdio e endocárdio; fígado levemente amarelado e com padrão lobular evidente e, em um caso, acompanhado de hemorragias multifocais. Na histologia observou-se necrose hepática, que variava de centrolobular a massiva, compatível com hepatopatia tóxica. No SNC havia satelitose, tumefação neuronal, edema periaxonal, perivascular. O diagnóstico de intoxicação por Trema micrantha foi baseado no quadro clínico e lesional de hepatite tóxica associado ao uso da planta para alimentação de caprinos.<br>Twenty five goats, maintained in paddocks, had died in five subsequent days after have been offered leaves, mixed in the ration, of Trema micrantha, a tree commonly called grandiúva. Four animals were necropsied and samples were collected for histopathology. Clinical signs included apathy, anorexia, head pressing against obstacles, decubitus and death. Macroscopic findings included suffusions in the epi- and endocardium, a yellowish liver with pronounced lobular pattern, in one goat, the liver presented additionally multiple visible hemorrhages. Histological examination revealed centrilobular to massive hepatic necrosis consistent with acute liver toxicosis. In the brain, satelitosis, neuronal swelling, and perineuronal and perivascular edema was found. The diagnosis of poisoning by Trema micrantha was based in the clinical picture characteristic of toxic hepatitis associated in the feeding of the plant to the goats