Dynamic computed tomography angiography for noninvasive diagnosis of bow Hunter's syndrome: a case report.

The focus of this case report is to technically describe a noninvasive diagnostic evaluation of bow Hunter's syndrome using a dynamic computed tomography angiography protocol and discuss its advantages. In addition, we aimed to exemplify the quality of the study by presenting images of a 3D-printed model generated to help plan the surgical treatment for the patient. The dynamic computed tomography angiography protocol consisted of a first image acquisition with the patient in the anatomic position of the head and neck. This was followed by a second acquisition with the head and neck rotated to the side that triggered the symptoms, with technical parameters similar to the first acquisition. The acquired images were used to print a 3D model to better depict the findings for the surgical team. The dynamic computed tomography angiography protocol developed in this study helped visualize the vertebrobasilar arterial anatomy, detect vertebral artery stenosis produced by head and neck rotation, depict the structure responsible for artery stenosis (e.g., bony structure or membranes), and study possible complications of the disease (e.g., posterior cerebral circulation infarction). Additionally, the 3D-printed model better illustrated the findings of stenosis, aiding in surgical planning. In conclusion, dynamic computed tomography angiography for the evaluation of bow Hunter's syndrome is a feasible noninvasive technique that can be used as an alternative to traditional diagnostic methods.

Dynamic computed tomography angiography for noninvasive diagnosis of bow Hunter's syndrome: a case report

ABSTRACT The focus of this case report is to technically describe a noninvasive diagnostic evaluation of bow Hunter's syndrome using a dynamic computed tomography angiography protocol and discuss its advantages. In addition, we aimed to exemplify the quality of the study by presenting images of a 3D-printed model generated to help plan the surgical treatment for the patient. The dynamic computed tomography angiography protocol consisted of a first image acquisition with the patient in the anatomic position of the head and neck. This was followed by a second acquisition with the head and neck rotated to the side that triggered the symptoms, with technical parameters similar to the first acquisition. The acquired images were used to print a 3D model to better depict the findings for the surgical team. The dynamic computed tomography angiography protocol developed in this study helped visualize the vertebrobasilar arterial anatomy, detect vertebral artery stenosis produced by head and neck rotation, depict the structure responsible for artery stenosis (e.g., bony structure or membranes), and study possible complications of the disease (e.g., posterior cerebral circulation infarction). Additionally, the 3D-printed model better illustrated the findings of stenosis, aiding in surgical planning. In conclusion, dynamic computed tomography angiography for the evaluation of bow Hunter's syndrome is a feasible noninvasive technique that can be used as an alternative to traditional diagnostic methods.

Stingless bees: uses and management by meliponiculturist women in the Chaco region of Bolivia.

BACKGROUND: Stingless bees have a great value as main pollinators of wild flowering and cultivated plants, thus playing a fundamental role in the maintenance of biodiversity and food security in Latin America. Despite their importance, stingless bees face numerous threats causing alarming population declines. Moreover, stingless bees have a great cultural and traditional value, since most products from the hive are used for a wide variety of purposes. A growing number of initiatives are encouraging the breeding of these bees, through training courses and modern management techniques. This study documents the knowledge on stingless bees and their products that meliponiculturists from the Chaco region of Bolivia have, as well as the influence that meliponiculture initiatives have on the management and general knowledge of the bees. METHODS: Local richness and diversity of stingless bees was calculated using Hill numbers. Structured interviews were conducted with 59 meliponiculturists in order to characterize traditional and formal knowledge on stingless bees and meliponiculture. Generalized linear models were applied to assess the influence of training courses on the management of the bees. Also, a relative cultural importance index was calculated for each species. RESULTS: Twelve Meliponini species were identified, and 15 local names were reported with morphological, defensiveness behavior, and nest description. There was no significant difference in the knowledge between different ethnical backgrounds or ages. A significant difference was observed in the use of supplementary feeding and assisted division, but none in the success in racking hives or in pest management, regarding the number or courses taken. The relative cultural importance index recorded 30 specific uses for bee products grouped in four categories, from which 29 were attributed (but not exclusively) to Tetragonisca angustula, making it the most versatile species. CONCLUSIONS: The products of the hive, especially honey, are used for a wide variety of purposes, mostly in medicine. These uses are mostly attributed to just one species, T. angustula, in coincidence with what was taught in meliponiculture training courses by NGOs. The influence of formal knowledge is mostly positive, but it is recommended that other meliponini species are taken into account as well.

Serial Mediation Model of Social Capital Effects over Academic Stress in University Students.

Background: Although several studies have shown that social capital and social support decreases academic stress (AS), there has been lack of atheoretical model to explain how this occurs. This study aims to verify a model that explains the effect of bonding social capital (BSC) over academic stress psychological symptoms (PsyS), considering the multiple sequential mediation of socio-emotional support (SES), self-efficacy (sEffic) and self-esteem (sEstee). Methods: In a transversal study, 150 undergraduate volunteer students were recruited using non-probabilistic purposive sampling. Data were collected using psychological questionnaires and were processed through partial least squares structural equation modeling (PLS-SEM). Results: Goodness of fit of the models (SRMR = 0.056, 0.057,

Pollen Preference Patterns by Tetragonisca angustula (Apidae: Meliponini) in a Boliviano-Tucumano Forest.

Native bees are important pollinators in neotropical forests. Tetragonisca angustula (Latreille) (Apidae: Meliponini) is a stingless bee widely distributed from the south of Mexico to Argentina. We characterized the patterns of preference of T. angustula for pollen in relation to the richness and abundance of plant species in the Tucumano-Boliviano Forest. During two field campaigns in different seasons (winter and spring), six colonies of T. angustula were studied. Pollen from flowers of plant species in the study area (pollen offer) and pot-pollen in each hive (pollen demand) were collected and their plant family of origin identified. Pollen from Asteraceae was more abundant in the winter than in the spring. Pollen of Solanaceae in the winter and Bignoniaceae in the spring were the most selected by the worker bees. Pollen from plants outside the sampling area was also found in the pots; it was mainly from Asteraceae. Tetragonisca angustula workers showed a polylectic foraging behavior, being able to use in a dynamic way the resources that are present in their environment at different times of the year; occasionally, it selected less abundant specific resources likely based on their nutritional value. More studies are needed to evaluate aspects of pollen quality consumed by this bee.

Smoke of Capsicum baccatum L. var. baccatum (Solanaceae) repels nymphs of triatoma infestans (Klug) (Hemiptera: Reduviidae) / Humo de capsicum baccatum L. var. baccatum (Solanaceae) repele las ninfas de Triatoma infestans (Klug) (Hemiptera: Reduviidae)

Control of the Chagas disease vector, Triatoma infestans (Klug) (Hemiptera: Reduviidae) with synthetic pesticides in Bolivia has become increasingly inefficient due to the development of resistance in the insects. In the Chaco region of Bolivia, guaraní populations have approached the problem by fumigating their houses with the smoke of native plants. Through interviews and field work with local guides, the main plant used by the guaraníes was collected and later identified as Capsicum baccatumL. var. baccatum (Solanaceae). In choice bioassays, filter papers exposed to the smoke of the plant repelled nymphs of T. infestans. Activity remained significant after storing the exposed filter papers for 9 days. Chemical analysis of smoke and literature data suggested that capsaicinoids present in the smoke were responsible for the repellent effect. The data presented provide a rationale for the use of C. baccatumvar. baccatumto control the Chagas vector bythe guaraní populations.

El control del vector de la enfermedad de Chagas, Triatoma infestans (Klug) (Hemiptera: Reduviidae) con plaguicidas sintéticos en Bolivia se ha vuelto cada vez más ineficiente debido al desarrollo de resistencias en los insectos. En la región del Chaco de Bolivia, las poblaciones guaraníes han abordado el problema fumigando sus casas con el humo de las plantas nativas. A través de entrevistas y trabajo de campo con guías locales, se recogió la principal planta utilizada por los guaraníes y posteriormente se identificó como Capsicum baccatumL. var. baccatum (Solanaceae). En bioensayos selectos, los papeles de filtro expuestos al humo de la planta repelieron a las ninfas de T. infestans. La actividad siguió siendo significativa después de almacenar los papeles de filtro expuestos durante 9 días. El análisis químico del humo y los datos de la literatura sugieren que los capsaicinoides presentes en el humo eran responsables del efecto repelente. Los datos presentados proporcionan una justificación para el uso de C. baccatum var. baccatum para el control del vector Chagas por las poblaciones guaraníes.

Floral Scent Chemistry and Pollinators of a Sexually Dimorphic Neotropical Orchid.

Catasetum is a speciose Neotropical orchid genus of which male and female flowers emit scents acting both as attractant and reward for their exclusive pollinators, male orchid bees (Euglossini: Apidae). In Catasetum, it is well known that flowers display a remarkably morphological sexual dimorphism. However, it remains poorly investigated whether this is also true for floral scents. Here, we investigated the pollination ecology and floral scent traits (chemistry and total emission) of C. maranhense, a species endemic to the Brazilian N/NE region. Males of Euglossa securigera are the only pollinators of C. maranhense. The floral scent of C. maranhense is composed of 29 volatile compounds, with eucalyptol, indole, (E)-Methyl p-methoxycinnamate, and (Z)-Methyl p-methoxycinnamate accounting for more than 80% of the scent bouquet. No sexual dimorphism was detected in any of the traits investigated. We discuss the ecological and evolutionary significance of our findings to Catasetum species and other unisexual perfume plants.

A Educação Permanente em Saúde nos hospitais estaduais do estado do Rio de Janeiro / Permanent education in health in state hospitals in the state of Rio de Janeiro

A pesquisa teve como objetivo analisar a Política Estadual de Educação Permanente em Saúde (PEEPS) no âmbito dos hospitais da Secretaria de Estado de Saúde do Estado do Rio de Janeiro (SES/RJ). Defendeu a seguinte tese: mostrar que as ações de EPS direcionadas aos profissionais de saúde dos hospitais da SES/RJ, gerenciados por Organizações Sociais (OSS) e pela Fundação Saúde do Estado do Rio de Janeiro (FSERJ), são ações de educação que divergem das concepções de EPS expressas na Política nacional de EPS e na PEEPS/RJ. A metodologia utilizada foi a análise documental, a partir da técnica de análise de conteúdo, usando os documentos do PlanejaSUS do ERJ e dos contratos de gestão da SES/RJ celebrados com OSS e FSERJ, todos publicados no período de 2007 a 2020. A pesquisa evidenciou ausência de indicadores para EPS em diversos contratos de gestão, diferentes indicadores de EPS em um único contrato de gestão e inexistência de relatos sobre ações de EPS em diversas prestações de contas anuais. O estudo aponta sugestões que possibilitam melhorar a capilaridade e gestão da PEEPS/RJ para os hospitais estaduais da SES/RJ.

The research aimed to analyze the State Policy of Permanent Education in Health (PEEPS) in the scope of hospitals of the State Department of Health of the State of Rio de Janeiro (SES/RJ). He defended the following thesis: to show that EPS actions aimed at health professionals at SES/RJ hospitals, managed by Social Organizations (OSS) and by the Fundação Saúde do Estado do Rio de Janeiro (FSERJ), are educational actions that diverge of the EPS concepts expressed in the national EPS Policy and in the PEEPS/RJ. The methodology used was document analysis, based on the content analysis technique, using the documents of PlanningSUS do ERJ and the SES/RJ management contracts signed with OSS and FSERJ, all published between 2007 and 2020. The research evidenced the absence of indicators for EPS in several management contracts, different indicators of EPS in a single management contract and inexistence of reports on EPS actions in several annual accounts. The study points out suggestions that make it possible to improve the capillarity and management of PEEPS/RJ for the state hospitals of SES/RJ.

A gauze-pad wrapping of the heart can save a patient's life

Abstract We describe one case of iatrogenic rupture of the left ventricle after mitral valve replacement and myectomy of the outflow tract. The cause and site of the rupture could not be identified, neither from the internal nor from the external examination. After unsuccessful use of hemostatic patches in the surface of the ruptured area, wrapping of the ventricles with a surgical gauze pad controlled the hemorrhage, hence saving the patient's life.

Flora of Ferruginous Outcrops Under Climate Change: A Study in the Cangas of Carajás (Eastern Amazon).

Climate change has impacted biodiversity, affecting species and altering their geographical distribution. Besides understanding the impact in the species, it has been advocated that answering if different traits will be differently impacted could allow refined predictions of how climate change will jeopardize biodiversity. Our aim was to evaluate if climate change will potentially impact plant species differently, considering their traits. We evaluated 608 plant species that occur in the naturally open areas of ferruginous outcrops (namely, cangas) in the National Forest of Carajás (Eastern Amazon). Firstly, we estimated the effects of climate change on each species using species distribution modeling, and analyzed this impact in the set containing all species. Secondly, we classified plant species considering the following traits: (i) pollination syndromes (melittophily, phalaenophily, psychophily, cantharophily, entomophily, ornithophily, chiropterophily, anemophily); (ii) habit (tree, shrub, herb, liana, parasite); and (iii) the main habitat of occurrence (open areas and forests). Thirdly, we investigated if the effects of climate change could be significantly more intense considering all the different traits quoted. Our results showed that most plant species will potentially face reduction of suitable habitats under future climate and the scenarios showed that 42% of them may not find suitable areas in the cangas of Carajás. We found no significant difference within each analyzed trait, considering the potential impact of climate change. The most climatically suitable areas (i.e., areas with high probability of species occurrence in the future) are those in the southwest of the study area. These areas can be considered as priority areas for species protection against climate change.

A Gauze-Pad Wrapping of the Heart Can Save a Patient's Life.

We describe one case of iatrogenic rupture of the left ventricle after mitral valve replacement and myectomy of the outflow tract. The cause and site of the rupture could not be identified, neither from the internal nor from the external examination. After unsuccessful use of hemostatic patches in the surface of the ruptured area, wrapping of the ventricles with a surgical gauze pad controlled the hemorrhage, hence saving the patient's life.

Incidence, diagnosis, treatment methods, and outcomes of clinically suspected venous thromboembolic disease in patients with COVID-19 in a quaternary hospital in Brazil.

BACKGROUND: Prothrombotic states have been associated with viral infections and the novel Sars-COV-2 infection has been associated with elevated D-dimer levels, although no causal relation has been clearly established. OBJECTIVES: This study presents an epidemiological analysis of manifest VTE episodes in a group of patients hospitalized because of COVID-19. METHODS: Medical records of patients who presented symptomatic deep vein thrombosis and/or pulmonary embolism in concomitance with confirmed COVID-19 were retrospectively studied. Demographic characteristics, prevalence of VTE, site of occurrence, D-dimer variation over time, management, and outcomes were analyzed. RESULTS: During the study period, 484 confirmed cases of COVID-19 were admitted, 64 of which displayed VTE symptoms and 13 of which had confirmed symptomatic VTE(2.68% of total sample and 20.31% of symptomatic cases). Most cases (76.92%) occurred in intensive care. On the day attributed to VTE onset, D-dimer levels were over 3,000 ng/mL in 8 (80%) patients, a significant increase from baseline admission levels (p < 0.05). A significant decrease was also observed in D-dimer values at hospital discharge (p < 0.05). All patients received pharmacological thromboprophylaxis and/or anticoagulation as indicated. Two deaths occurred during the study, both patients with severe comorbidities. At the end of our study protocol, nine patients had been discharged and two remained hospitalized, but had no signs of VTE worsening. CONCLUSIONS: VTE prevalence in hospitalized COVID-19 patients was 2.7%, and higher in intensive care units. Early institution of prophylaxis and immediate full anticoagulation when VTE is diagnosed should be the goals of those who treat this kind of patient.

CONTEXTO: Os estados pró-trombóticos têm sido associados a infecções virais. A nova infecção pela síndrome respiratória aguda grave do coronavírus 2 (SARS-CoV-2) sabidamente eleva os níveis de D-dímero, embora a relação causal não tenha sido bem estabelecida. OBJETIVOS: Este estudo apresenta uma análise epidemiológica de episódios sintomáticos de tromboembolismo em um grupo de pacientes hospitalizados pela doença do novo coronavírus (COVID-19). MÉTODOS: Foi realizada uma revisão retrospectiva de prontuários de pacientes internados por COVID-19 que apresentaram trombose venosa profunda e/ou embolia pulmonar sintomáticas. Foram avaliados os dados demográficos, a prevalência de tromboembolismo, a variação do D-dímero ao longo do tempo, o manejo e os desfechos. RESULTADOS: Dos 484 casos confirmados de COVID-19 admitidos entre março e julho de 2020, 64 apresentaram sintomas de tromboembolismo, que foram investigados, e 13 tiveram tromboembolismo confirmado (2,68% do total e 20,31% dos sintomáticos). A maioria dos casos ocorreu em regime de terapia intensiva (76,92%). Houve um aumento significativo no número de pacientes com D-dímero acima de 3.000 ng/mL no dia atribuído ao diagnóstico de tromboembolismo com relação aos níveis do momento da admissão (80%, p < 0,05).Uma queda significativa de pacientes nesse limiar também foi observada no momento da alta (p < 0,05). Todos os pacientes receberam tromboprofilaxia ou anticoagulação conforme indicado. Houve dois óbitos na amostra, ambos pacientes com comorbidades severas. Ao fim do protocolo, nove pacientes receberam alta e dois permaneceram hospitalizados, mas sem sinais de piora. CONCLUSÕES: A prevalência de tromboembolismo em pacientes hospitalizados por COVID-19 foi de 2,7%, sendo mais frequente em regime de terapia intensiva. A instituição precoce de profilaxia e anticoagulação imediata ao diagnóstico é primordial nesse grupo de pacientes.

Age-related anomalies of electrocardiograms in patients from areas with differential Seroprevalence of Chagas disease in Southern Bolivia.

INTRODUCTION: Chagas disease currently affects some 6 million people around the world. At the chronic stage, cardiomyopathy occurs in about 20-30% of infested people. Most prevalence studies have focused on young to adult people due to the drastic consequences of acquiring the pathogen and the possibility to cure the disease at this age; the prevalence of this disease, the effect of patients' sex and the consequences to senescent people have been largely neglected. This study looks to characterize the seroprevalence of Chagas disease and its relation with occurrence of electrocardiographic anomalies associated with sex and age, and to compare rural and urban populations in Bolivia. METHODOLOGY: Seroprevalence of Chagas disease was determined in blood samples and electrocardiograms were performed on seropositive individuals. RESULTS: The rural population showed higher seroprevalence than the urban population (92% and 40%, respectively). The proportion of Chagasic cardiac anomalies in seropositive persons was highest in patients of the 50-59 age group (36%) as compared with the 40-49 (8%) and the ≥60 (17%) age groups. CONCLUSIONS: Higher seroprevalence in rural population was attributable to a higher probability to encounter the vector in rural areas. Increased exposure to infection and to development of the disease symptoms together with increased lethality of the disease as patients age explains the age-related Chagasic electrocardiographic anomalies. Since rural and urban populations showed different reactions under Chagas disease and the rural population was mainly of guaraní stock, the genetic and environmental determinants of the results should be further explored.

Unraveling the Morphological Variation of Triatoma infestans in the Peridomestic Habitats of Chuquisaca Bolivia: A Geometric Morphometric Approach.

Morphometrics has been used on Triatomines, a well-known phenotypically variable insect, to understand the process of morphological plasticity and infer the changes of this phenomenon. The following research was carried out in two regions of the inter-Andean valleys and two Chaco regions of Chuquisaca-Bolivia. Triatoma infestans adults were collected from the peridomestic (pens and chicken coops) along a geographic gradient in order to evaluate the morphological differentiation between groups and their pattern of sexual shape dimorphism. Geometric morphometric methods were applied on the wings and heads of T. infestans. The main findings include that we proved sexual dimorphism in heads and wings, determined the impact of environmental factors on size and shape and validated the impact of nutrition on head shape variation. These results show that geometric morphometric procedures can be used to provide key insight into the biological adaptation of T. infestans on different biotic (nutrition) and abiotic (environment) conditions, which could serve in understanding and evaluating infestation processes and further vector control programs.

Edible Fruit Plant Species in the Amazon Forest Rely Mostly on Bees and Beetles as Pollinators.

Edible fruit plants of tropical forests are important for the subsistence of traditional communities. Understanding the most important pollinators related to fruit and seed production of these plants is a necessary step to protect their pollination service and assure the food security of these communities. However, there are many important knowledge gaps related to floral biology and pollination in megadiverse tropical rainforests, such as the Amazon Forest, due mainly to the high number of plant species. Our study aims to indicate the main pollinators of edible plants (mainly fruits) of the Amazon forest. For this, we adopted a threefold strategy: we built a list of edible plant species, determined the pollination syndrome of each species, and performed a review on the scientific literature searching for their pollinator/visitors. The list of plant species was determined from two specialized publications on Amazon fruit plants, totaling 188 species. The pollination syndrome was determined for 161 species. The syndromes most frequently found among the analyzed species were melittophily (bee pollination), which was found in 101 of the analyzed plant species (54%) and cantharophily (beetle pollination; 26 species; 14%). We also found 238 pollinator/visitor taxa quoted for 52 (28%) plant species in previous publications, with 124 taxa belonging to Apidae family (bees; 52%), mainly from Meliponini tribe (58 taxa; 47%). Knowledge about pollinators is an important step to help on preserving their ecosystem services and maintaining the productivity of fruit trees in the Amazon.

[Argentine consensus on the diagnosis and therapeutics of treatment resistant schizophrenia]. / Consenso argentino sobre diagnóstico y tratamiento de la esquizofrenia resistente al tratamiento.

Approximately 30% of people with schizophrenia fail to respond to first-line antipsychotic treatment which impacts the burden of the disease. Treatment-resistant schizophrenia (TRS) denotes patients with failure to respond to at least two adequate trials of different antipsychotics. Clozapine is a unique drug approved for treating treatment-resistant schizophrenia, however 1/3 of patients fail to respond to clozapine. Even though different strategies have been proposed for treating clozapine-resistant schizophrenia, the evidence is very limited, unclear, and of poor quality. A formal literature search was conducted and then, panel members were asked to complete 35 questions addressing different aspects of TRS. A modified Delphi method was used to unify expert opinion and achieve consensus. The expert consensus in diagnostic and treatment of TRS is the result of experts from the main national scientific societies under the organization of the Argentine Association of Biological Psychiatric (AAPB). The consensus statement aims to guide on diagnosis and treatment.

Incidence, diagnosis, treatment methods, and outcomes of clinically suspected venous thromboembolic disease in patients with COVID-19 in a quaternary hospital in Brazil / Incidência, diagnóstico, métodos terapêuticos e desfechos de eventos tromboembólicos venosos em pacientes com COVID-19 em um hospital quaternário do Brasil

Abstract Background Prothrombotic states have been associated with viral infections and the novel Sars-COV-2 infection has been associated with elevated D-dimer levels, although no causal relation has been clearly established. Objectives This study presents an epidemiological analysis of manifest VTE episodes in a group of patients hospitalized because of COVID-19. Methods Medical records of patients who presented symptomatic deep vein thrombosis and/or pulmonary embolism in concomitance with confirmed COVID-19 were retrospectively studied. Demographic characteristics, prevalence of VTE, site of occurrence, D-dimer variation over time, management, and outcomes were analyzed. Results During the study period, 484 confirmed cases of COVID-19 were admitted, 64 of which displayed VTE symptoms and 13 of which had confirmed symptomatic VTE(2.68% of total sample and 20.31% of symptomatic cases). Most cases (76.92%) occurred in intensive care. On the day attributed to VTE onset, D-dimer levels were over 3,000 ng/mL in 8 (80%) patients, a significant increase from baseline admission levels (p < 0.05). A significant decrease was also observed in D-dimer values at hospital discharge (p < 0.05). All patients received pharmacological thromboprophylaxis and/or anticoagulation as indicated. Two deaths occurred during the study, both patients with severe comorbidities. At the end of our study protocol, nine patients had been discharged and two remained hospitalized, but had no signs of VTE worsening. Conclusions VTE prevalence in hospitalized COVID-19 patients was 2.7%, and higher in intensive care units. Early institution of prophylaxis and immediate full anticoagulation when VTE is diagnosed should be the goals of those who treat this kind of patient.

Resumo Contexto Os estados pró-trombóticos têm sido associados a infecções virais. A nova infecção pela síndrome respiratória aguda grave do coronavírus 2 (SARS-CoV-2) sabidamente eleva os níveis de D-dímero, embora a relação causal não tenha sido bem estabelecida. Objetivos Este estudo apresenta uma análise epidemiológica de episódios sintomáticos de tromboembolismo em um grupo de pacientes hospitalizados pela doença do novo coronavírus (COVID-19). Métodos Foi realizada uma revisão retrospectiva de prontuários de pacientes internados por COVID-19 que apresentaram trombose venosa profunda e/ou embolia pulmonar sintomáticas. Foram avaliados os dados demográficos, a prevalência de tromboembolismo, a variação do D-dímero ao longo do tempo, o manejo e os desfechos. Resultados Dos 484 casos confirmados de COVID-19 admitidos entre março e julho de 2020, 64 apresentaram sintomas de tromboembolismo, que foram investigados, e 13 tiveram tromboembolismo confirmado (2,68% do total e 20,31% dos sintomáticos). A maioria dos casos ocorreu em regime de terapia intensiva (76,92%). Houve um aumento significativo no número de pacientes com D-dímero acima de 3.000 ng/mL no dia atribuído ao diagnóstico de tromboembolismo com relação aos níveis do momento da admissão (80%, p < 0,05).Uma queda significativa de pacientes nesse limiar também foi observada no momento da alta (p < 0,05). Todos os pacientes receberam tromboprofilaxia ou anticoagulação conforme indicado. Houve dois óbitos na amostra, ambos pacientes com comorbidades severas. Ao fim do protocolo, nove pacientes receberam alta e dois permaneceram hospitalizados, mas sem sinais de piora. Conclusões A prevalência de tromboembolismo em pacientes hospitalizados por COVID-19 foi de 2,7%, sendo mais frequente em regime de terapia intensiva. A instituição precoce de profilaxia e anticoagulação imediata ao diagnóstico é primordial nesse grupo de pacientes.

Forest Matrix Fosters High Similarity in Bee Composition Occurring on Isolated Outcrops Within Amazon Biome.

Most studies analyze fragmentation due to habitat loss caused by anthropogenic activities and few of them analyzed fragmentation on naturally fragmented areas. In the Eastern Amazon, it is possible to find areas naturally open and surrounded by pristine forest. Understanding how species respond to isolation in these areas is an important challenge for decision-making processes aiming conservation and restoration. Using standardized methods of bee collection (entomological nets, bait trap, pan trap, and nest trap), the objective of this study was to analyze the composition and diversity of bees occurring on six isolated outcrops located in two protected areas within Amazon biome. More specifically, we tested 1) if the dissimilarity in bee species composition is explained by the isolation of outcrops and 2) if bee richness, abundance, and Shannon diversity can be explained by the outcrop size. We found 118 species, with the Meliponini and Euglossini (Hymenoptera: Apidae) tribes representing the highest number of species. The similarity in species composition across all outcrops is high and is not explained by the isolation. In addition, the richness, abundance, and Shannon diversity are not explained by outcrop size. Forest does not seem to be a barrier to bee movement, and although most species probably nest in the forests, they use the highly diverse plants of the outcrops as a complementary food source.

Size and isolation of naturally isolated habitats do not affect plant-bee interactions: A case study of ferruginous outcrops within the eastern Amazon forest.

Pollination may be severely affected by the decreasing size and increasing isolation of habitat patches. However, most studies that have considered the effects of these two variables on plant-pollinator interactions have been carried out in areas that have undergone anthropogenic fragmentation, and little is known about their effects in natural habitats. The Carajás National Forest and Campos Ferruginosos National Park are two protected areas in the eastern Amazon where one can find isolated ferruginous outcrops characterized by iron-rich soil and herbaceous-shrub vegetation surrounded by Amazon forest. These patches of canga provide an opportunity to analyze plant-pollinator interactions in naturally fragmented areas. Our objective was to test whether the size and isolation of naturally isolated outcrops located in Carajás affect plant-pollinator interactions by using pollination syndromes and interaction networks. We determined the pollination syndromes of 771 plant species that occurred in eleven canga patches and performed field work to analyze plant-pollinator networks in nine canga patches. The structure of the plant-pollinator networks was not affected by the size or isolation of the canga patches. Generalist species were present in all canga areas, indicating that they are important in maintaining the plant communities in isolated canga patches. The lack of significance related to the distance between canga patches suggests that the forest does not prevent pollinator movement between canga patches.

Assessment of Shape Variation Patterns in Triatoma infestans (Klug 1834) (Hemiptera: Reduviidae: Triatominae): A First Report in Populations from Bolivia.

The morphological variations of four populations of geographically isolated Triatoma infestans located in the area of inter-Andean valleys and Chaco of Chuquisaca, Bolivia, were evaluated. Fifty-three females and sixty-one males were collected in the peri-domicile and analyzed with geometric morphometrics tools to study the patterns of the head and wing shape variation. The principal component analysis and canonical variate analysis revealed morphological variations between the populations studied, which were then confirmed by the permutation test of the differences between populations using Mahalanobis and Procustes distances. The multivariate regression analysis shows that the centroid size influences the shape of the heads and wings. T. infestans of the inter-Andean valleys are longer in the head and wings compared to the population of the Chaco. We propose that the geometric shape variation may be explained by geographical changes in climatic conditions, peri-domiciliar habitats, food source quality, and the use of insecticides.