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Objetivos: Relatar um caso de uma paciente de meia-idade com púrpura trombocitopênica trombótica e ressaltar a importância de reconhecer e diagnosticar esta patologia. Material e métodos: Paciente do sexo feminino, 46 anos, previamente hígida, iniciou quadro de epigastralgia associada a vômitos. Ao exame, apresentava-se hipocorada, com petéquias, equimoses e dor à palpação abdominal. Hemograma evidenciou plaquetopenia (13.000 uL) e anemia (Hb de 9,8 g/dL). Levantada a hipótese de PTI, foi internada para investigação e iniciado corticoterapia, sem melhora. Evoluiu com quadro neurológico agudo e focal (confusão mental, afasia mista, astenia e mímica facial assimétrica). AngioTC de crânio sem alterações. Resultados: Após avaliação da equipe da hematologia, feita nova investigação laboratorial que evidenciou anemia hemolítica microangiopática (Coombs direto negativo, DHL aumentado, reticulocitose, bilirrubina indireta aumentada, presença de esquizócitos em sangue periférico e hemoblobinúria), sendo levantada a hipótese diagnóstica de Púrpura Trombocitopênica Trombótica (PTT). Coletado dosagem de ADAMST13. Corticoide 1mg/kg/dia mantido, prescrito transfusão de plasma fresco congelado e monitorização de hipervolemia com diurético. Foi solicitado acompanhamento em UTI devido à gravidade do quadro e encaminhamento para serviço que faça plasmaférese. Discussão: A Púrpura Trombocitopênica Trombótica é uma doença autoimune rara que envolve a coagulação sanguínea. Na maioria dos casos, o sistema imunológico reage contra a enzima ADAMSTS13, o que faz com que o von Willebrand não seja clivado, causando trombos ricos em plaquetas e von Willebrand, levando a oclusão da microcirculação, principalmente do SNC e rins. A doença cursa com anemia hemolítica microangiopática, plaquetopenia, alterações em SNC, insuficiência renal e febre. Em adultos, o tratamento com eficácia comprovada é a realização de plasmaférese, a qual deve ser instituída o mais precocemente possível e mantida até a normalização da contagem de plaquetas, a interrupção da hemólise e a resolução dos sintomas. O uso de glicocorticoides também pode ser associado. Conclusão: Trata-se de um caso de Púrpura Trombocitopênica Trombótica, em paciente com quadro inicial de epigastralgia associada a vômitos. Em um primeiro momento foi tratada como PTI, sendo que após evolução com sintomas neurológicos foi solicitada avaliação da hematologia e feito o diagnóstico. Reforçamos aqui a importância da avaliação criteriosa do hemograma em casos de plaquetopenia associada a outras alterações e sintomatologias. Lembrando que o diagnóstico e tratamento precoce da PTT é fundamental para o sucesso terapêutico. A paciente relatada foi transferida para serviço que realiza plasmaferese, evoluindo com piora clínica e refratariedade ao tratamento, evoluindo para óbito poucos dias após.

IntroductionThe Eurasian beaver (Castor fiber) is a native species to Britain that after being absent for 400 years has been restored to the English countryside. The first beavers were released into a reserve in Kent in 2001/02, making this one of the first beaver release areas in the UK. This paper examines attitudes towards beaver presence in the landscape as well as public perception of beaver benefits and impacts with respect to the environment and human society.MethodsQualitative questionnaires were utilised to investigate factors influencing social attitudes and support for beaver reintroduction, as well as the relationship between sociodemographic variables and attitudes. Inhabitants of Kent and its immediate surroundings were surveyed during June and July of 2020 (n=407) with a focus on three interest groups – environmentalists, farmers and the general public.ResultsPerceptions included mostly beneficial impacts on nature and biodiversity, whereas less positive impacts were associated with economics, agriculture and fisheries. In general, local attitudes towards beavers were positive, mainly sustained by feelings of liking this wildlife species and valuing their presence. People´s attitudes positively influence willingness to support the reintroduction of beavers. Twenty years after their initial release, results indicate broad support for the beaver reintroduction in Kent and people´s tolerance of beavers. The majority of respondents were in favour of nonintrusive management techniques to mitigate beavers’ undesirable impacts.DiscussionThese findings suggest the need to develop an optimal management strategy that incorporates public views and gives advice on the best approach to manage this wildlife species. This research provides theoretical and practical underpinning for beaver management and conservation in Britain.

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Species reintroductions and translocations are widely used management interventions to restore locally extinct or augment severely depleted species. In such projects, the human dimension issues that influence the success of these conservation interventions are encountered at five different stages of the project life cycle: (1) planning, (2) initiation, (3) implementation, (4) ending stage, and (5) post-exit. Overlooking or failing to consider the human dimension in any of these phases could jeopardise the conservation translocation project's success. When the human dimensions are included there is greater possibility of community involvement, peers' acceptance and support from various interest groups and avoidance of conflict situations. The Human-Wildlife Interactions Working Group (HWIWG) was formed in 2018 by members of the IUCN Conservation Translocation Specialist Group (CTSG). HWIWG has facilitated online discussions and workshops with practitioners, researchers and academics from across the globe, on a range of aspects of human-wildlife interactions in conservation translocations, as well as leading discussion sessions during international research conferences. These events have provided a rich source of material from which to draw a series of recommendations. In this paper we discuss findings from the HWIWG that illustrate how, in each of the five stages of the project life cycle, human-dimensions influenced conservation translocation projects. Our aim is to provide useful and multidimensional insights for those working in species' reintroductions and translocations.

Despite mounting evidence of global environmental stress, many educationalists appear to be discounting warnings of ecological collapse from scientists, futurists and community leaders. One way of promoting sustainability awareness may be to combine cognitive reasoning with emotional awareness. This article considers the complex dynamics relating to attitudinal and behavioural institutional change by exploring the impact of a large-scale exhibition called 'Whole Earth?' on the staff and students at a UK university over a 15-month period. The exhibition contained a wide range of powerful visual images and drew on a famous protest song to frame its wider message. Although there were a variety of responses, the exhibition had the overall effect of raising the profile of sustainability across the university. Could initiatives of this kind, which are open-ended in character and which harness the arts to engender an emotional response, offer a model which could be used more widely?

Addressing the biodiversity crisis requires renewed collaborative approaches. Large carnivores are ambassador species, and as such they can aid the protection of a wide range of species, including evolutionarily distinct and threatened ones, while being popular for conservation marketing. However, conflicts between carnivores and people present a considerable challenge to biodiversity conservation. Our cross disciplinary essay brings together original research to discuss key issues in the conservation of large carnivores as keystone species for biodiversity rich, healthy ecosystems. Our findings suggest the need to promote coexistence through challenging ‘wilderness’ myths; to consider coexistence/conflict as a continuum; to include varied interest groups in decision making; to address fear through positive mediated experiences, and to explore further partnerships with zoos. As wide-reaching institutions visited by over 700 million people/year worldwide, zoos combine knowledge, emotion and social context creating ideal conditions for the development of care towards nature, pro-environmental behaviors and long-term connections between visitors and carnivores. Based on current research, we provide evidence that large carnivores and zoos are both powerful catalysts for public engagement with biodiversity conservation, recognizing barriers and suggesting future ways to collaborate to address biodiversity loss.

Abstract Background Infections caused by multidrug-resistant Enterobacteriaceae are hard to treat and life-threatening due to reduced therapeutic options. Systemic infections caused by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae strains have increased in many European regions, becoming frequent in many clinical settings, and are associated with high mortality. The co-formulation of ceftazidime, a third-generation cephalosporin, with avibactam, a new suicide inhibitor beta-lactamase inhibitor able to block most Klebsiella pneumoniae carbapenemases, has been recently licensed, with promising results in patients with limited or absent therapeutic options. Little is known, however, as to the efficacy of such a combination in patients with soft tissue infections caused by multidrug-resistant Klebsiella pneumoniae carbapenemase-producing strains of Klebsiella pneumoniae. Case presentation A Caucasian 53-year-old man with paraplegia suffered multiple vertebral fractures due to a car crash. He was treated with external fixators that became infected early after insertion and were repeatedly and inefficiently treated with multiple antibiotics. He suffered repeated septic episodes caused by Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae strains with a multidrug-resistant profile. Meropenem, tigecycline, and colistin combinations allowed only temporary improvements, but septic shock episodes recurred, in spite of removal of infected external fixators. After approval of pre-marketing prescription by our local Ethics Committee, full clinical resolution was obtained with a compassionate treatment using meropenem and ceftazidime/avibactam in combination for 16 days. Conclusions Our experience provides additional evidence that ceftazidime/avibactam, possibly in combination with meropenem rescued by avibactam, may be an efficacious treatment option also for complicated skin and soft tissue infections caused by multidrug-resistant strains of Klebsiella pneumoniae carbapenemase-producing Klebsiella pneumoniae.

O presente trabalho apresenta discussões sobre a Tractriz, um caso particular do conjunto de curvas de perseguição. A Tractriz é a curva que decorre do movimento de um bloco sendo puxado por meio de uma corda de comprimento constante. Essa corda, inicialmente posicionada na vertical, quando deslocada sua extremidade oposta ao bloco, na direção horizontal, o caminho descrito pelo bloco será a curva de perseguição Tractriz. A curva descrita pelo caminho desse bloco pode ser observada em diversas situações cotidianas, tais como o simples passeio com um cão, até em rastros de carros, possuindo aplicações tais como a fabricação de trompetes. Com o objetivo de ampliar as discussões sobre as curvas de perseguição, em especial da Tractriz, apresentamos aqui a obtenção da equação característica dessa curva e a verificação de seu comportamento por meio de uma atividade experimental realizada com uma bicicleta. Diante disso discutimos uma possível variação da curva de perseguição descrita pela roda traseira de uma bicicleta, a partir da variação do ângulo de giro do guidom, bem como possíveis aplicações para sistemas de estacionamentos e sua representação em fenômenos naturais.

A diversidade humana, temática de origem e por isto mesmo crucial da Antropologia, tem sido objeto de inúmeras abordagens ao longo da história da nossa disciplina. Quer se trate da diversidade física ou biológica, quer se trate de costumes ou modos de ser ou existir, o interesse em compreender suas origens, suas relações e suas razões de ser tem motivado antropólogos das mais diversas orientações teóricas. Palavras-chave: Etnicidade; Raça; Etnia.

Copyright of Estudios Penales y Criminológicos is the property of Universidad de Santiago de Compostela, Servicio de Publicaciones and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)