SARS-CoV-2 Translocate from Nasopharyngeal to Bronchoalveolar Site: A Case Presentation

The nasopharyngeal swab is commonly used for the diagnosis of SARS-CoV-2 infection. Since the swab is performed in this site, of course, it cannot detect the presence of the virus in other tissue districts such as the lung, brain, or bowel. In the present case report, the nasopharyngeal swab was negative twice. From this, the patient discontinued antiviral therapy. Nasopharyngeal swabs were maintained negative until five days later, when we recorded a severe impairment of the patient's clinical condition. At this time, the bronchoalveolar lavage was positive for SARS-CoV-2. The purpose of the case herein described is to suggest paying attention to the nasopharyngeal swab result. A negative detection in nasopharyngeal swab could not be indicative of COVID-19 recovery

Bivalirudin vs. Enoxaparin in Intubated COVID-19 Patients: A Pilot Multicenter Randomized Controlled Trial

(1) Background: In COVID-19 patients, the occurrence of thromboembolic complications contributes to disease progression and mortality. In patients at increased risk for thrombotic complications, therapeutic enoxaparin should be considered. However, critically ill COVID-19 patients could develop resistance to enoxaparin. Bivalirudin, a thrombin inhibitor, may be an alternative. This pilot multicenter randomized controlled trial aims to ascertain if bivalirudin may reduce the time spent under invasive mechanical ventilation, as compared to enoxaparin. (2) Methods: Intubated COVID-19 patients at risk for thrombo-embolic complications were randomized to receive therapeutic doses of enoxaparin or bivalirudin. We ascertained the time spent under invasive mechanical ventilation during the first 28 days from Intensive Care Unit (ICU) admission. A standardized weaning protocol was implemented in all centers. In addition, we assessed the occurrence of thromboembolic complications, the number of patients requiring percutaneous tracheostomy, the gas exchange, the reintubation rate, the ICU length of stay, the ICU and 28-days mortalities. (3) Results: We enrolled 58 consecutive patients. Bivalirudin did not reduce the time spent under invasive mechanical ventilation as compared to enoxaparin (12 [8; 13] vs. 13 [10; 15] days, respectively; p = 0.078). Thrombotic (p = 0.056) and embolic (p = 0.423) complications, need for tracheostomy (p = 0.423) or reintubation (p = 0.999), the ICU length of stay (p = 0.076) and mortality (p = 0.777) were also similar between treatments. Patients randomized to bivalirudin showed a higher oxygenation at day 7 and 15 after randomization, when compared to enoxaparin group. (4) Conclusions: In intubated COVID-19 patients at increased risk for thromboembolic complications, bivalirudin did not reduce the time spent under invasive mechanical ventilation, nor improved any other clinical outcomes

SARS-CoV-2 Translocate from Nasopharyngeal to Bronchoalveolar Site: A Case Presentation

The nasopharyngeal swab is commonly used for the diagnosis of SARS-CoV-2 infection. Since the swab is performed in this site, of course, it cannot detect the presence of the virus in other tissue districts such as the lung, brain, or bowel. In the present case report, the nasopharyngeal swab was negative twice. From this, the patient discontinued antiviral therapy. Nasopharyngeal swabs were maintained negative until five days later, when we recorded a severe impairment of the patient’s clinical condition. At this time, the bronchoalveolar lavage was positive for SARS-CoV-2. The purpose of the case herein described is to suggest paying attention to the nasopharyngeal swab result. A negative detection in nasopharyngeal swab could not be indicative of COVID-19 recovery

Estimativa do número de frutos por amostragem de parte da copa em laranjeiras Proposal of a sampling method to estimate the number of fruits in an orange orchard

Estudou-se um método objetivo para a estimativa do número de frutos em pomares de laranja baseado na contagem dos frutos em ramos de 5 cm de diâmetro. Foram realizados levantamentos em laranjeiras durante três safras, obtendo-se o número de frutos produzidos em um ramo terminal, tomado ao acaso, bem como o número total na árvore. Consideraram-se nove estratos, constituídos pelas cultivares de laranja-doce, Hamlin, Pêra, Natal e Valência (as duas últimas analisadas conjuntamente) e três faixas etárias (três a cinco, seis a 10 e mais que 10 anos de idade). Foram ajustados modelos de regressão linear para o número total de frutos da árvore em função do número de frutos no ramo, obtendo-se coeficientes de determinação variando de 0,79 a 0,94. Com exceção da cultivar Hamlin, verificou-se coincidência entre as curvas das faixas etárias correspondentes. Esses resultados permitem estimar a produção média de frutos em um pomar de laranja, com base em amostragem de ramos com tamanho fixo, com precisão satisfatória, sem o uso de métodos de amostragem mais laboriosos e onerosos.<br>A study was conducted viewing the establishment of a sampling method which would allow to calculate the number of fruits of an orange orchard. Based on the counting of fruits borne by 5 cm diameter branches, the study was conducted during three successive agricultural seasons. The fruits in one single 5 cm diameter branch, randomly taken from a tree, were counted and this number multiplied by the total number of trees in the orchard. Three to five, six to ten and more than 10 year old orange trees from orchards of the 'Hamlin', 'Pera', 'Natal', and 'Valência' varieties were used for the experiment. 'Natal' and 'Valência' varieties were analysed in conjunction so that the total number of treatment combinations was 9. Models of linear regression for the total number of fruits borne by a tree were adjusted as a function of the number of fruits per branch and this resulted in determination coefficients varying between 0.79 and 0.94. With the exception of the 'Hamlin' cultivar, plants of the same age range presented similar results. It was thus concluded that the sampling method here devised is economical, quick, simple and permits the estimation of the total number of fruits in an orange orchard with acceptable accuracy