Impact of the COVID-19 Pandemic on Gastroenterology Department Activity: The Gastroenterologist's Perspective Nationwide and the Real Impact in a Portuguese Center.

BACKGROUND: Several gastroenterology societies have created recommendations in order to reduce nonessential exposure to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. Our aim is to evaluate the national gastroenterologists' perspective on the impact of COVID-19 and the impact of reorganization of a gastroenterology department during the COVID-19 pandemic. METHODS: For the first purpose, an online survey was distributed to gastroenterologists nationwide. For the second purpose, the authors conducted an analysis of some endoscopic procedures performed at the Gastroenterology Department of the Centro Hospitalar Vila Nova de Gaia/Espinho (CHVNG/E) between March 16 and May 8 during the years 2019 and 2020. RESULTS: Sixty-seven gastroenterologists answered our survey. Only 14.9% were residents and 86.6% worked in a hospital with COVID-19 patients, with 16.4% assigned to assist those patients. All of the departments suffered modifications. Ninety percent of the residents affirmed that their activity had changed. Ninety-four percent declared having nonessential endoscopic procedures postponed, and 85.1% maintained in-person medical visits, 88.1% were already having remote consultations, and 11.9% did not have any clinical visit. In our gastroenterology unit, the number of endoscopic procedures decreased by 73.1% from 2019 to 2020. In 2020, the proportion of urgent procedures was higher compared to 2019. CONCLUSION: The advent of COVID-19 has led to important changes in gastroenterology activities in Portugal, and national gastroenterology units are complying with the recommendations. Furthermore, Portuguese gastroenterologists believed that the decrease in endoscopic activity can compromise residents' education and training. The gastroenterology department at CHVNG/E has shown a significant reduction in the number of endoscopic procedures.

INTRODUÇÃO: As sociedades de Gastroenterologia criaram recomendações de modo a reduzir a exposição não necessária ao vírus da síndrome respiratória aguda grave (SARS-CoV-2). O nosso objetivo é avaliar a perspectiva nacional dos gastroenterologistas sobre o impacto da COVID-19 e avaliar o impacto da reorganização do nosso serviço de Gastroenterologia durante a pandemia. MÉTODOS: Para o 1° objetivo, um inquérito online foi disponibilizado aos gastroenterologistas de todo o país. Para o 2° objetivo, os autores realizaram uma análise dos procedimentos endoscópicos do serviço de Gastroenterologia do Centro Hospitalar Vila Nova de Gaia/Espinho (CHVNG/E) entre 16 de Março e 8 de Maio durante os anos de 2019 e 2020. RESULTADOS: 67 gastroenterologistas responderam o inquérito. Destes, 14.9% eram internos. 86.6% trabalharam num hospital com doentes com COVID-19, e 16.4% dos médicos prestavam cuidados a esses doentes. Todos os departamentos sofreram alterações. 90% dos internos referiram que a atividade tinha sido alterada. 94% dos médicos afirmaram que os procedimentos endoscópicos não-essenciais foram adiados. 85.1% mantinham algumas consultas médicas presenciais, 88.1% estavam a realizar consultas não presenciais, e 11.9% não tinham nenhum tipo de consulta. No nosso serviço, o número de procedimentos endoscópicos diminui em 73.1% de 2019 para 2020. Em 2020, a proporção de procedimentos endoscópicos de urgência foi superior em relação a 2019. CONCLUSÃO: A pandemia da COVID-19 conduziu a alterações importantes dentro das atividades da Gastroenterologia em Portugal, e os serviços de Gastroenterologia mostraram cumprir as recomendações. Além disso, os gastroenterologistas portugueses acreditam que a diminuição da atividade endoscópica dos internos pode comprometer a sua futura formação. O serviço de gastroenterologia do CHVNG/E mostrou uma redução significativa do número de procedimentos endoscópicos.

Blue sharks (Prionace glauca) as bioindicators of pollution and health in the Atlantic Ocean: Contamination levels and biochemical stress responses.

Marine ecosystems are constantly being threatened by contaminants produced by human activities. There is an urge to better understand their impacts on marine organisms and develop reliable tools for biomonitoring studies, while also assessing their potential impacts on human health. Given their position on top of food webs, sharks are particularly susceptible to bioaccumulation, making them potential sentinel species of marine contamination. The main objective of this study was to find suitable biomarkers for future marine pollution biomonitoring studies by correlating biochemical responses with tissue contaminant body burden in blue sharks (Prionace glauca), a species heavily caught and consumed by humans, while also addressing their general health. The chemical contaminants analysed comprised different persistent organic pollutants (POPs) families from polychlorinated compounds to brominated flame retardants (BFRs) and perfluorinated compounds (PFCs) and different trace and heavy metals. Concentrations of some contaminants in sharks' tissues were found to be above the legally allowed limits for human consumption. A canonical correspondence analysis (CCA) was performed and some strong associations were found between biochemical responses and contaminants' accumulation levels. DNA damage and lipid peroxidation levels, as well as the inhibition of the antioxidant enzyme glutathione peroxidase, were the main effects and consequences of contamination. The impact of contamination on these vital macromolecules underlines the suboptimal conditions of the sampled P. glauca, which can ultimately lead to the degradation of core ecological aspects, such as swimming, feeding, and reproduction. It can be concluded that P. glauca demonstrates great potential to be used as environmental sentinel and suitable biomarker candidates were identified in this work. Moreover, this study also highlights the risks that the consumption of blue shark derived products can pose to human health, which is of upmost interest as the sampled organisms were still juveniles and already presented values above regulatory limits.

Long-term transportation, by road and air, of chub mackerel (Scomber japonicus) and atlantic bonito (Sarda sarda).

During the second semester of 2009, three trips were made from Olhão (Southern Portugal) to Stralsund (Northern Germany) carrying 2.122 animals, which included multiple teleosts, elasmobranchs and invertebrates. This group included scombrids, such as 1.869 Scomber japonicus and 9 Sarda sarda, which are notoriously difficult to transport. However, multiple adaptations to transport regimes adopted regularly have allowed the authors to successfully move these animals by road and air over a total of up to 25 hr. Such adaptations included maintaining oxygen saturation rates at approximately 200%, and also the constant addition of AmQuel(®) , sodium bicarbonate, and sodium carbonate. Different formulations were used during the three trips, with the best results corresponding to 20/30/30 ppm of the three aforementioned chemicals, respectively. The authors suggest, however, that a modified formula of 20/40/40 ppm will allow for an even more stable pH on future trips.

Long-term transportation, by road and air, of Devil-ray (Mobula mobular), Meagre (Argyrosomus regius), and Ocean Sunfish (Mola mola).

Between September 2006 and April 2007 the authors transported one 0.9 m wingspan Mobula mobular from Olhão (South of Portugal) to Valencia (East of Spain), 12 approximately 1.0 m long Argyrosomus regius to Tarragona (Northeast of Spain) and four approximately 0.4 m long Mola mola to Atlanta (GA, USA). These journeys had a total "water to water" duration of 17, 22 and 33 hr, respectively. The first two transports were conducted by road whereas the third involved a combination of road and air travel. Water quality parameters-specifically dissolved oxygen, temperature, pH and ammonia-were monitored continuously throughout the duration of the trips and were maintained at optimum levels through the use of battery-powered filtration and chemical supplements. All animals arrived alive and well at their destinations. This paper reports on the specific transport regime adopted in each case and provides some insight for potential improvements in future similar transports.

Role of sensory cues on food searching behavior of a captive Manta birostris (Chondrichtyes, Mobulidae).

This study reports on the first experimental research designed specifically for Manta birostris behavior. The authors attempted to learn about the feeding behavior and environmental cues influencing this behavior, as well as general cognitive ability. The preconditioned Manta's ability to identify food, on the basis of a fraction of the ordinary food signal complex, was tested. The opening of cephalic fins was considered a good indicator of feeding motivation level. The study subject animal used its biological clock to predict time and also associated a specific location with food, suggesting an ability to build up a cognitive map of its environment. Both underwater visual stimuli and olfactory stimuli had a very intense effect on food searching behavior over a 30 m distance, in contrast to visual signs from above the water surface. In addition, although an underwater visual signal resulted in a more intense response than from an olfactory signal, the specimen did not discriminate between different objects tested on the basis of visual sensation. It could therefore be suggested that food searching behavior of Mantas are governed by triggering stimuli, including smell or visual recognition, and modulated by the cognitive spatial map stored in their long-term memory. These findings will hopefully prove useful while devising protecting policies in the natural environment and/or while keeping these animals in captivity. Zoo Biol 27:294-304, 2008. (c) 2008 Wiley-Liss, Inc.