Complicações do cateter de artéria pulmonar: relato de caso de formação de nó verdadeiro revisão da literatura

A particular event concerning a Swan-Ganz catheter complication is reported. A 41-year-old woman was admitted at the emergency room of our hospital with massive gastrointestinal bleeding. A total gastrectomy was performed. During the postoperative period in the intensive care unit , the patient maintained hemodynamic instability. Invasive hemodynamic monitoring with a pulmonary artery catheter was then indicated. During the maneuvers to insert the catheter, a true knot formation was identified at the level of the superior vena cava. Several maneuvers by radiological endovascular invasive techniques allowed removal of the catheter. The authors describe the details of this procedure and provide comments regarding the various techniques that were employed in overcoming this event. A comprehensive review of evidence regarding the benefits and risks of pulmonary artery catheterization was performed. The consensus statement regarding the indications, utilization, and management of the pulmonary artery catheterization that were issued by a consensus conference held in 1996 are also discussed in detail.É relatada uma complicação infreqüente , associada ao uso do Cateter de Artéria Pulmonar. Uma paciente de 41 anos foi admitida no Pronto Socorro do nosso hospital com hemorragia digestiva alta grave. A doente foi submetida à gastrectomia total. Na Unidade de Terapia Intensiva, evoluiu com instabilidade hemodinâmica, sendo indicada a monitorização hemodinâmica invasiva com cateter de artéria pulmonar. Durante as manobras para o correto posicionamento do cateter na artéria pulmonar, foi diagnosticado formação de nó verdadeiro, ao nível da veia cava superior. Os autores discutem as várias opções técnicas empregadas para a resolução desta complicação, através do emprego da radiologia intervencionista endovascular. Extensa revisão da literatura procurando discutir os benefícios e riscos envolvidos na monitorização hemodinâmica invasiva com o cateter de artéria pulmonar, no período peroperatório, foi realizada. Assim como as orientações práticas emitidas pela Conferência de Consenso sobre o cateter de artéria pulmonar, realizada nos EUA em 1996, são discutidas com profundidade

Climate change will reduce suitable Caatinga dry forest habitat for endemic plants with disproportionate impacts on specialized reproductive strategies

Global climate change alters the dynamic of natural ecosystems and directly affects species distributions, persistence and diversity. The impacts of climate change may lead to dramatic changes in biotic interactions, such as pollination and seed dispersal. Life history traits are extremely important to consider the vulnerability of a species to climate change, producing more robust models than those based primarily on species distributions. Here, we hypothesized that rising temperatures and aridity will reduce suitable habitats for the endemic flora of the Caatinga, the most diverse dry tropical forest on Earth. Specifically, species with specialized reproductive traits (e.g. vertebrate pollination, biotic dispersal, obligatory cross-pollination) should be more affected by climate change than those with generalist traits. We performed two ecological niche models (current and future) to simulate the effects of climate change on the distribution area of endemic species in relation to life-history traits. We used the MIROC-ESM and CCSM4 models for both intermediate (RCP4.5) and highest predicted (RCP8.5) GHG emission scenarios, with a resolution of 30' (~1 km2). Habitat with high occurrence probability (>80%) of endemic species will be reduced (up to ~10% for trees, ~13% for non-arboreous, 10-28% for species with any pollination/reproductive system), with the greatest reductions for species with specialized reproductive traits. In addition, the likely concentration of endemic plants in the extreme northeastern portion of the Caatinga, in more mesic areas, coincides with the currently most human-modified areas of the ecosystem, which combined with climate change will further contract suitable habitats of endemic species. In conclusion, plant species endemic to the Caatinga are highly vulnerable to even conservative scenarios of future climate change and may lose much of their climatic envelopes. New protected areas should be located in the northeastern portion of the Caatinga, which hosts a more favorable climate, but is currently exposed to escalating agricultural intensification

DESENVOLVIMENTO DE UM RECURSO INTERDISCIPLINAR CAPAZ DE COLOCAR EM CONFLITO AS CONCEPÇÕES ALTERNATIVAS DE PESO E MASSA

Concepções alternativas tem norteado a pesquisa na área de ensino de ciências, pois há evidencias acadêmicas que o conhecimento prévio do saber do aluno sobre certo tema colabora para um aprendizado mais eficiente. Partindo deste princípio foi elaborado uma prática interdisciplinar capaz de colocar em antagoniedade os conceitos de peso e massa. O aparato foi construído a partir dos conhecimentos básicos de física, engenharia elétrica e engenharia de softwares. Posteriormente foi aplicada a metodologia em duas instituições de diferentes níveis de ensino, onde pode-se perceber qualitativamente o interesse dos alunos pelo aparato e a facilidade de compreensão do assunto proposto. Pretende-se com a utilização desta prática interdisciplinar colaborar para formação de alunos com uma visão global de mundo, capaz de articular e contextualizar os conhecimentos adquiridos além de contribuir para compreensão correta dos conceitos de peso e massa

Differences and similarities in the milk production chain: a comparative analysis with the states of Minas Gerais and Paraná

Brazilian agriculture has played a prominent role all over the world, being milk production one of the exponents of the national agribusiness. The states of Minas Gerais and Paraná are protagonists in the milk production business in the country. The objective of this study was to evaluate the differences and similarities of the milk production chain in these two states, considering the period from 2008 to 2017, in order to investigate their dynamics and their competitiveness. The methodological approach adopted in the research was of a quantitative nature, with the use of the software “Statistical Package for the Social Sciences” (SPSS), which allowed the analysis to be carried out with the statistical techniques of analysis of variance (Anova) and cluster analysis. Ward’s agglomerative method and discriminant analysis were also adopted. The state of Minas Gerais presented a superior milk production chain in comparison with Paraná in every year analyzed; however, statistically there was no significant difference in the milk production from 2009 to 2017. Paraná presented better milk productivity averages as compared to Minas Gerais; it was highly significant (1%) from 2008 to 2016 and significant (5%) in 2017. The results of the cluster analysis indicated that, due to the fact that Paraná has higher productivity indexes in relation to Minas Gerais, its limits are better in relation to Minas Gerais in the analyzed aspects. It was found that some municipalities that are considered to have high productivity in Minas Gerais do not enter this same group in Paraná. It can be said that Paraná was shown to be more efficient in the milk production chain as compared to Minas Gerais in the analyzed time period. The article indicates the need to improve the technology used in the milk production chain, so that the numbers related to productivity can be improved. In addition, it was found that it is necessary to invest in genetics and technical assistance so that milk producers in the states surveyed can become more competitive

Mesophotic ecosystems : distribution, impacts and conservation in the South Atlantic

Unidad de excelencia María de Maeztu MdM-2015-0552Aim: this study reviews recent research on the South Atlantic Mesophotic ecosystems (MEs) and the pressures threatening them, and offers suggestions for their management and conservation. - Location: the South Atlantic Ocean. - Methods: a comprehensive compilation of the scientific literature was performed to examine the distribution, human impacts and conservation status of the South Atlantic MEs. - Results: our review indicated that the South Atlantic Ocean (SAO) is one of the major MEs areas in the world's oceans. The South Atlantic MEs are composed of a mosaic of distinct seascapes, mainly rhodolith beds, mesophotic reefs (i.e., rocky and biogenic) and marine animal forests (e.g., sponge aggregations, octocoral and black coral forests) that occur along the East South American and West African coasts, seamounts and oceanic islands. Throughout the SAO, the distinct seascapes of MEs are usually formed on the middle and outer continental shelves, shelf-edge, seamounts, submarine canyons, incised valleys and paleochannels, reef structures and insular shelves. We highlighted sea temperature anomalies, ocean acidification, extreme floods and droughts, fisheries, invasive species, marine debris, mining, and oil and gas exploitation as major threats to these ecosystems. - Main conclusions: given the threats to the South Atlantic MEs, growing human pressures may degrade these ecosystems in the next years and undermine their unique biodiversity as well as their potential to provide connectivity between regions and depths. Our review revealed the existence of some extensive and unprotected formations, which urgently demand in-depth investigations and conservation action

Ações de Vigilância Sanitária na pandemia COVID-19

Introduction: In times of the COVID-19 pandemic, health surveillance, as well as other health sectors, needed to adapt to develop its activities in a new challenging context. Objective: To describe the actions of health surveillance professionals in tackling the COVID-19 pandemic. Method: This is an experience report about the work in the sector of health surveillance during the pandemic in a Regional Health Center in the state of Bahia. Results: Actions undertaken in a health barrier were reported, including: welcoming, lectures, respiratory symptoms testing and notifcation, as well as the offer of continuing health education activities, in person and on-line, meetings with municipal managers, and other actions performed by the team, highlighting the intersectoral and intersectoral nature. Conclusions: The experience of the work conducted is consistent with the proposals of the Contingency Plan. Partnerships are of paramount importance for the professionals working in the sector of health surveillance and others, given the complexity of the pandemic moment. The experience also represents a learning process in dealing with new technological tools and allowed the creation of spaces for reflecting on work processes, as well as on new possibilities of approaching in light of the current challenges.Introdução: Em tempos de pandemia de COVID-19, a vigilância sanitária, assim como outros setores da saúde, precisou se adaptar para desenvolver suas atividades em um novo contexto desafador. Objetivo: Descrever a atuação de profssionais da Vigilância Sanitária (Visa) no enfrentamento da pandemia da COVID-19. Método: Trata-se de um relato de experiência acerca do trabalho em Visa durante a pandemia em um Núcleo Regional de Saúde do estado da Bahia. Resultados: Foram relatadas ações realizadas em uma barreira sanitária, com acolhimento, palestra, testagem dos sintomáticos respiratórios e notifcação, bem como a oferta de atividades de educação permanente em saúde, de forma presencial e on-line, por meio de reunião com os gestores municipais e demais ações realizadas pela equipe, tendo-se como destaque o caráter intrasetorial e intersetorial. Conclusões: A experiência do trabalho realizado coaduna com as propostas do Plano Estadual de Contingências para Enfrentamento do Novo Coronavírus. Salientamse as parcerias como de fundamental importância para os profssionais da Visa e de outros setores, frente à complexidade do momento pandêmico. A experiência ainda representa um aprendizado em lidar com novas ferramentas tecnológicas, que permitiram criar espaços de reflexão dos processos de trabalho, bem como de novas possibilidades de abordagem diante dos desafos atuais

Multisystem inflammatory syndrome drug treatment in countries with different income profiles: a scoping review

Objective: The purpose of this study was to map and describe the studies that have investigated therapeutic alternatives for the management of paediatric multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. Considering the origin of the studies performed (low-, middle- and high-income countries), a systematic scoping review was conducted with primary studies that reported the use of medications for the treatment of patients with MIS-C.Sources: The searches were performed in MEDLINE, Embase, Lilacs, Epistemonikos, CINAHL, and CENTRAL, in the grey literature (theses and dissertations from CAPES, ProQuest, and PROSPERO) and in clinical trial databases until May 2022. The selection and extraction of studies were performed independently by two reviewers.Summary of the findings: A total of 173 studies were included, most of which were published as case reports or series. No randomized controlled clinical trials (RCTs) were identified. The investigated drugs were immunoglobulins, glucocorticoids, monoclonal antibodies, anticoagulants, and antiplatelet agents.Conclusion: The dosages, when reported, were heterogeneous among the studies. The ethnicity and comorbidity of the participants were poorly reported. Monoclonal antibodies, drugs with higher costs, were mostly described in studies of high-income countries

Tendência genética para peso adulto, escores visuais e características de crescimento em bovinos de corte da raça Nelore

Mature weight (MW) of cows is related to the costs of their production. Usually, cows with moderate MW are more efficient in challenging environments, such as those available in the production systems in Brazil. In the present study, the selection index comprises the following traits: conformation, finishing precocity, musculature at weaning (WC, WP, WM) yearling (YC, YP and YM), scrotal circumference at yearling (SC), days to gain 160kg from birth to weaning (D160) and 240kg after weaning (D240). This are related to birth weight gain at weaning (WG) and from weaning to yearling (YG). The mature (MW) and birth weight (BW) traits were not considered in the selection index. The aim of this study was to estimate the values for the genetic trends (GT) of some important selection (MW) and economic traits (BW). A bi-character analysis of MW and other characteristics was performed to estimate the (co)variance components and genetic parameters. The GT results obtained for MW were null (0.0065% or 0.02718kg per year) in the period 1990-2007. The GT values were determined for BW (-0.0650% or -0.02017kg), WG (0.0758% or 0.0865kg), YG (0.1051% or 0.11377kg), and MW (0.0393% or 0.11276kg) per year. The visual score values (in score units) were also determined for GTat weaning [WC (0.2310%; 0.00707), WP (0.3624%; 0.3623%),aWM (0.01149; 0.01087)] yearling [YC (0.3256%; 0.00990), YP (0.4795%; 0.01496),YM (0.5041%; 0.01457)] per year. Index-based selection was effective to promote genetic progress in WG, WC, WP, WM, YG, YC, YP, and YM characteristics keeping BW and MW constant.O peso adulto das vacas (PV) está relacionado com os custos de produção. Em geral, vacas com PV moderados são mais eficientes em ambientes desafiadores, como aqueles disponíveis nos sistemas de produção no Brasil. No presente estudo, o índice de seleção compreende as seguintes características: conformação, precocidade e musculatura nas fases da desmama (CD, PD e MD) e sobreano (CS, PS e MS), circunferência escrotal no sobreano (CE), dias para ganhar 160kg do nascimento até a desmama (D160) e 240kg pós-desmama (D240), que estão relacionadas com os ganhos de peso do nascimento à desmama (GD) e, da desmama ao sobreano (GS). As características PV e PN não foram consideradas no índice de seleção. O objetivo deste estudo foi estimar os valores das tendências genéticas (TG) das importantes características de seleção (PV) e econômicas (PN). Para estimar os componentes de (co)variâncias e os dados genéticos, foram realizadas análises bi-caracter de PV com as demais características. Os resultados de TG obtidos para PV foram nulos (0,0065% ou 0,02718kg por ano) no período de 1990 á 2007. Os valores de TG foram estimados para PN (-0,0650% ou -0,02017kg), GD (0,0758% ou 0,0865kg), GS (0,1051% ou 0,11377kg) e PF (0,0393% ou 0,11276kg) por ano. Os valores dos escores visuais (em unidades de escore) foram determinados para TG à desmama [CD (0,2310%; 0,00707), PD (0,3624%; 0,3623%) e MD (0,01149; 0,01087)] e sobreano [CS (0,3256%; 0,00990), PS (0,4795%; 0,01496) e MS (0,5041%; 0,01457)] ao ano. A seleção baseada no índice foi efetiva para promover o progresso genético nas características de GD, CD, PD, MD, GS, CS, PS e mantendo PN e PV constantes

Neglected diversity of crop pollinators: Lessons from the world’s largest tropical country

We draw attention to potential pollinator species that have not yet been reported as crop pollinators but could likely contribute to agricultural productivity. We refer to this as the neglected diversity of crop pollinators, which we argue should not be excluded from conservation strategies and land-use planning. We used Brazil as case study for at least five main reasons: (1) Brazil is one of the world’s largest food producers and exporters; (2) Tropical agricultural production is highly dependent on pollinators; (3) Brazil is almost certainly the most biologically megadiverse country; (4) Brazil has high diversity of pollinators; (5) Brazil has played a leading international role in environmental sustainability. We estimated that the neglected diversity of bees as potential crop pollinators in Brazil is 88.4%. For vertebrates, the neglected diversity is 95.2%. This means that many yet to be observed plant–pollinator interactions are entirely off the radar in terms of the conservation agenda for agricultural stability

Validação da curva de calibração (linearidade e homocedasticidade) do ?-pineno por cromatografia em fase gasosa com detecção por ionização em chama (CG-DIC) no óleo essencial de Schinus Terebenthifolius Raddi / Validation of the calibration curve (linearity and homocedasticity) of ?-pinene by gas chromatography with flame ionization detection (CG-DIC) in the essential oil of Schinus Terebenthifolius Raddi

A espécie Schinus terebenthifolius Raddi. (Aroeira) é bastante conhecida por apresentar diversas atividades biológicas. Alguns autores descrevem que o a- pineno é o componente majoritário presente no óleo essencial dos frutos de S. terebenthifolius. Apesar da importância econômica e biológica do a- pineno verificamos na literatura a ausência de métodos analíticos que validem intralaboratorial, sob diferentes condições, em um intervalo de tempo justificado a função de calibração. Este trabalho teve como objetivo avaliação de linearidade e homocedasticidade através da preparação de três curvas de calibração em três dias distintos afim de verificar possíveis diferenças de comportamento linear do a-pineno, do óleo essencial de S. terebenthifollius, com variação diária da análise, um dos requisitos mínimos para a validação de métodos analíticos. Verificamos que porcentagem do ?-pineno presente neste óleo essencial foi de 25,4 % ± 0,7. O teste de Levene indicou homogeneidade duvidosa dos dados do segundo dia e variâncias constantes no primeiro e terceiro dia de análise. A distribuição de probabilidade apresentou-se normal somente para o primeiro dia de avaliação. A regressão se mostrou significativa para os três dias de avaliação. Verificamos também que a linearidade foi comprovada na faixa de concentração avaliada, porém através do modelo linear obtido pelo MMQP. Concluímos que para cada dia de avaliação do óleo essencial deve-se preparar uma curva de calibração para quantificação do a- pineno, devido a significância estatística do intercepto em um dos três dias de avaliação.