Improvisation in times of pandemic, a reason for reflection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been one of the most significant health crises worldwide in the last decades. This new pandemic has brought to light the strengths and weaknesses of current health care systems worldwide, even in countries that pride themselves on being at the forefront in terms of clinical, scientific, and technological capacity and development. Crises such as these are also opportunities to reflect and learn. Coronavirus disease 2019 (COVID-19) has provided us with several valuable lessons that involve the whole spectrum of medical practice: human, scientific, technical, and social

Trasplante pulmonar

A lung transplant is usually the final therapeutic option for patients with respiratory insufficiency. In spite of the many advances in immunology and the management of complications, mortality and morbidity associated with this transplant are far higher than with others. Acute rejection is an almost universal problem in the first year, while obliterative bronchitis reduces long term survival. Respiratory infections also play a significant role in the complications associated with lung transplants due to the constant exposure of the graft to the outside. However, the success of this therapeutic option, which basically depends on a suitable selection of donor and recipient, are evident, above all with respect to quality of life

Tobacco use worldwide: Legislative efforts to curb consumption

Tobacco smoking is recognized as a major preventable cause of disease worldwide and is linked to 6 million deaths annually, 30% of which are due to cancer. The negative health consequences of smoking currently represent one of the greatest public health challenges. Secondhand smoke, declared carcinogenic by the International Agency for Research on Cancer in 2004, is also a major source of morbidity and premature death in nonsmokers, particularly children. Negative health effects associated with exposure to secondhand smoke have been well documented and include lung cancer, cardiovascular disease, asthma, and other respiratory diseases. International and national policies to implement cost-effective strategies to curtail smoking will have a significant impact on population health and will protect nonsmokers. Effective interventions, such as a combination of smoke-free laws, tobacco price increases, easy access to tobacco cessation treatments, and anti-tobacco media campaigns, should continue. Reducing tobacco use would be a major step towards the goal of decreasing health disparities by 2030 as 80% of the projected tobaccorelated deaths will occur in low- and middle-income countries

Tobacco Use Worldwide: Legislative Efforts to Curb Consumption

Tobacco smoking is recognized as a major preventable cause of disease worldwide and is linked to 6 million deaths annually, 30% of which are due to cancer. The negative health consequences of smoking currently represent one of the greatest global public health challenges. Additionally, secondhand smoke, which was declared carcinogenic by the International Agency for Research on Cancer in 2004, is a major source of morbidity and premature death in nonsmokers, particularly children. Negative health effects associated with exposure to secondhand smoke have been well documented and include lung cancer, cardiovascular disease, asthma, and other respiratory diseases. International and national policies to implement cost-effective strategies to curtail smoking will have a significant impact on population health and will protect nonsmokers. Effective interventions, such as smoking bans, tobacco price increases, easy access to tobacco cessation treatments, and anti-tobacco media campaigns, should continue. Reducing tobacco use would be a major step towards the goal of decreasing health disparities by 2030, as 80% of the projected tobacco-related deaths will occur in low and middle-income countries

Crops on the edge of a cliff: Storage at Castro S. João das Arribas (Northwest Iberia) in the Late Antiquity

The site of Castro S. João das Arribas is placed on the edge of a cliff over the Douro river (Miranda do Douro, Northeast of Portugal). Archaeological interventions in its highest area uncovered a main occupation from Late Antiquity. On its western part a functional space was recorded, which included two small above-ground structures and abundant charred carpological remains. These were found inside ceramic vessels and spread throughout the area, suggesting its destruction occurred after a fire event. A radiocarbon date places such episode in some moment between the late 6th and the first half of the 7th century CE. Carpological results revealed an assemblage dominated by cereal grains, mostly rye (Secale cereale). Naked wheat (Triticum aestivum/durum), barley (Hordeum vulgare), common millet (Panicum miliaceum) and foxtail millet (Setaria italica) were also found but in smaller amounts. The large amount of carpological remains in the above-mentioned contexts, suggests the space was used for storage, at least between the 6th and 7th centuries CE. Although some uncertainties remain regarding how crops were stored, evidence points that they were kept in ceramic vessels, outside and inside the small storage facilities, but also in other types of containers, eventually made of perishable materials. At Castro S. João das Arribas, past communities chose a diversity of crops, however, most of them show undemanding features in terms of soil and climatic conditions. The agricultural choices could have been motivated by several factors, but cereals like rye were certainly well-suited to the environmental conditions around the settlement.LS was financially supported by a PhD grant (Norte-08-5369-FSE000057) from the University of Porto (Faculty of Sciences) and the European Social Fund, through the North Portugal Regional Operational Program “Norte 2020”, under the announcement “Aviso Norte-69-2015-15-Formaç˜ao Avançada (Programas Doutorais)”. MMS was funded by the Beatriz Galindo program as Junior Distinguished Researcher (BG20/00076). JPT was supported by national funds through the Foundationfor Science and Technology (FCT)

Outpatient Management of Malignant Pleural Effusion Using a Tunneled Pleural Catheter: Preliminary Experience

Inpatient management of malignant pleural effusion includes the placement of a conventional thoracostomy tube for drainage and talc slurry pleurodesis and/or a surgical approach consisting of video-assisted thoracoscopic talc insufflation. Both techniques require prolonged hospital stays of up to 1 week. Unfortunately, life expectancy in patients with this disease does not usually exceed 6 months, and so the primary aim of any palliative intervention intended to improve quality of life should be to avoid hospital admissions and to relieve pain as far as possible. Of the few outpatient alternatives to hospital management the most frequently used is repeated thoracentesis. We describe the outpatient management of malignant pleural effusion by placement of a tunneled pleural catheter in a patient with stage IIIB lung adenocarcinoma. In our opinion, the use of this catheter offers a viable alternative to conventional therapy and is better tolerated

{Bis[2-(diphenyl­phosphino)eth­yl]phenyl­phosphine-κ3 P,P′,P′′}chloridopalladium(II) hexa­fluoridophosphate

In the title compound, [PdCl(C34H33P3)]PF6, the PdII atom adopts a distorted PdP3Cl square-planar geometry arising from the P,P′,P′′-tridentate triphos ligand and a chloride ion