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Therapeutic plasmapheresis is a therapeutic procedure in which the patient's blood is passed through a medical device which separates out plasma from other components of blood. The plasma is removed and replaced with a replacement solution. Studies on the use of plasmapheresis in critically ill patients are scarce. The aim of this study was to review all therapeutic plasmapheresis sessions carried out in the Hospital Beatriz Ângelo intensive care unit.An observational retrospective study was conducted between April 2012 and March 2019. All patients who underwent therapeutic plasmapheresis in the intensive care unit were included, and plasmapheresis sessions held outside the intensive care unit were excluded.Of 46 patients, 63% were men (n = 29), with a median age of 53 years. The most frequent diagnoses were hypertriglyceridemia-induced pancreatitis, vasculitis, autoimmune haemolytic anaemia, and atypical haemolytic-uremic syndrome. A total of 198 plasmapheresis sessions were carried out in the intensive care unit. Most of the used replacement solutions were fresh frozen plasma (34.4%), albumin/crystalloid (24.2%), and albumin/fresh frozen plasma (19.2%). The most common complications were hydroelectrolytic changes (84; 42.4%) and coagulation disorders/thrombocytopenia (65; 32.8%). There was no need to interrupt any plasmapheresis session due to complications related to the patient.Therapeutic plasmapheresis is an urgent procedure that can reduce morbidity and mortality in critically ill patients. This justifies that 37% of patients started the technique before the diagnostic confirmation. The indications for plasmapheresis and the choice of replacement solution were in agreement with the guidelines. Despite the risk of bleeding, no haemorrhagic complications were recorded.Therapeutic plasmapheresis is a complex technique that requires specific training. The indications are diverse, and some are not consensual. Complications were frequent, but they did not increase morbidity.Introdução: A plasmaferese terapêutica é um procedimento em que o sangue passa por um circuito extracorpóreo que separa o plasma dos outros componentes do sangue. O plasma removido é substituído por soluções de reposição. Os estudos sobre a utilização de plasmaferese terapêutica no doente crítico são escassos. O objetivo do estudo foi rever todas as sessões de plasmaferese realizadas no serviço de Medicina Intensiva do Hospital Beatriz Ângelo. Material e Métodos: Estudo observacional retrospetivo de todos os doentes admitidos no serviço de Medicina Intensiva entre abril de 2012 e março de 2019. Foram selecionados os doentes submetidos a plasmaferese e excluídas as sessões realizadas fora do serviço de Medicina Intensiva. Resultados: No período de estudo foram incluídos 46 doentes. A maioria eram homens (n = 29; 63%) com uma idade mediana de 53 anos. Os diagnósticos mais frequentes foram pancreatite secundária a hipertrigliceridemia, vasculite, anemia hemolítica autoimune e síndrome hemolítica urémica atípica. Foram realizadas 198 sessões de plasmaferese no serviço de Medicina Intensiva. As soluções de substituição mais utilizadas foram plasma fresco congelado (34,4%), albumina/cristalóide (24,2%) e albumina/plasma (19,2%). As complicações mais comuns foram alterações hidroeletrolíticas (84; 42,4%), e distúrbios da coagulação/plaquetas (65; 32,8%). Em nenhum dos casos a técnica teve que ser interrompida por complicações relacionadas com o doente. Discussão: A plasmaferese terapêutica é um procedimento urgente capaz de reduzir a morbilidade e mortalidade no doente crítico. Isto justifica que 37% dos doentes tenham iniciado a técnica antes da confirmação diagnóstica. As indicações e soluto de reposição escolhido foram de acordo com as recomendações. Apesar do risco hemorrágico, nenhuma complicação desta natureza foi reportada. Conclusão: A plasmafere terapêutica é uma técnica complexa que requer treino específico. As indicações são diversas e algumas não consensuais. As complicações foram frequentes, mas não condicionaram morbilidade associada.

Os bioindicadores ambientais são espécies de organismos que podem ser utilizados para monitorar a qualidade do meio ambiente e dessa forma monitorar o impacto das ações antrópicas sobre os ecossistemas. O objetivo deste trabalho foi identificar a contribuição brasileira nos últimos 5 anos sobre as pesquisas à respeito de bioindicadores ambientais. Para possibilitar tal identificação foram realizadas buscas no portal de Periódicos da CAPES no período de 2018 a 2023, selecionando as contribuições mais recentes referentes ao tema. Foram identificados 29 trabalhos, observando os critérios de inclusão e exclusão estabelecidos como artigos duplicados; artigos que estivessem disponíveis para download; artigos do tipo estudo de caso de algum bioindicador ambiental e artigos que apresentassem estudos de caso em território brasileiro. Destaca-se grande contribuição de pesquisas desenvolvidas no estado de Minas Gerais, além de maior incidência de resultados em invertebrados bentônicos como bioindicadores de qualidade da água.

Open Access funding enabled and organized by Projekt DEAL. This study was endorsed by the ESICM. Free support for running the electronic database and was granted from the dep. of Epidemiology, University of Aarhus, Denmark. Bruno et al. Annals of Intensive Care (2022) 12:26 Page 10 of 11 The support of the study in France by a grant from Fondation Assistance Publique-Hôpitaux de Paris pour la recherche is greatly appreciated. In Norway, the study was supported by a grant from the Health Region West. In addition, the study was supported by a grant from the European Open Science Cloud (EOSC). EOSCsecretariat.eu has received funding from the European Union’s Horizon Programme call H2020-INFRAEOSC-05-2018-2019, grant agreement number 831644. This work was supported by the Collaborative Research Center SFB 1116 (German Research Foundation, DFG) and by the Forschungskommission of the Medical Faculty of the Heinrich-Heine-University Düsseldorf and No. 2020–21 to RRB for a Clinician Scientist Track. No (industry) sponsorship has been received for this investigator-initiated study. PURPOSE: Critically ill old intensive care unit (ICU) patients suffering from Sars-CoV-2 disease (COVID-19) are at increased risk for adverse outcomes. This post hoc analysis investigates the association of the Activities of Daily Living (ADL) with the outcome in this vulnerable patient group. METHODS: The COVIP study is a prospective international observational study that recruited ICU patients ≥ 70 years admitted with COVID-19 (NCT04321265). Several parameters including ADL (ADL; 0 = disability, 6 = no disability), Clinical Frailty Scale (CFS), SOFA score, intensive care treatment, ICU- and 3-month survival were recorded. A mixed-effects Weibull proportional hazard regression analyses for 3-month mortality adjusted for multiple confounders. RESULTS: This pre-specified analysis included 2359 patients with a documented ADL and CFS. Most patients evidenced independence in their daily living before hospital admission (80% with ADL = 6). Patients with no frailty and no disability showed the lowest, patients with frailty (CFS ≥ 5) and disability (ADL

Resumo Descreve-se uma atividade pedagógica com estudantes do Mestrado e Pós-Licenciatura em Enfermagem de Saúde Materna e Obstetrícia, aplicando princípios da prática simulada na realização da sutura perineal após o parto. Este procedimento causa muita insegurança e gera grande ansiedade nos estudantes, quando iniciam estágio em bloco de partos. Os objetivos deste artigo são desenvolver competências psicomotoras nos estudantes para a reconstituição cirúrgica perineal; aumentar a autoconfiança dos estudantes para o procedimento. Metodologia qualitativa, com 2 momentos de recolha de dados aplicados a dois cursos. Questionário com perguntas abertas, sessão de “focus group” e filmagem. Análise de conteúdo das respostas às perguntas abertas e verbatim do “focus group”. Como Resultados destaca-se uma estreita relação entre a simulação e o desenvolvimento de competências. Os estudantes salientaram a importância da atividade pedagógica na aquisição de competências de sutura, reforço da autoconfiança e na diminuição da ansiedade inicial. O uso da investigação qualitativa permitiu identificar o impacto da prática simulada no desenvolvimento de competências dos estudantes, identificar aspetos a aperfeiçoar na metodologia, contribuindo para a melhoria das práticas pedagógicas. Abstract A pedagogical activity with Master’s Degree and Postgraduate students in Maternal Health and Obstetrics Nursing is described, applying principles of simulated practice in perineal suturing after delivery. This procedure causes a lot of insecurity and generates great anxiety in the students, when they start the internship in a delivery room. Objectives: to develop the psychomotor skills in students for perineal surgical reconstruction; increase students’ self-confidence to perform the procedure. Methodology: qualitative, with 2 moments of data collection applied to two courses. Questionnaire with open questions, focus group session and filming. Content analysis of the answers to the questions and verbatim of the focus group. Results: a close relationship was observed between simulation and skills development. Conclusion: the students emphasized the importance of the pedagogical activity in the acquisition of suturing skills, improving their self-confidence and reducing the initial anxiety. The use of the qualitative research allowed identifying the impact of the simulated practice on the development of the students’ skills and to identify aspects to be improved, contributing to the progress of pedagogical practices.

Carcinomas de glândula acrircrina são neoplasias malignas raras que ocorrem em gatos. O tratamento disponível é cirúrgico, e geralmente recorrente [1,2] e, neste caso, levaria à ablação total do meatus acústico externo. Em dezembro de 2020, foi relatada uma consulta homeopática do felino, masculino, persa, 13 anos, histórico da doença, iniciada em 2015, somando seis recidivas dos processos tumorais nas pálpebras e formação recente no canal auditivo esquerdo. Análise histopatológica do adenocarcinoma acritorino. Intervenções cirúrgicas e aplicação de ácido tricloroacético para prevenir recidivas. No entanto, foram observadas formações remanescentes nas pálpebras e no canal auditivo. Tem uma forma arredondada enevada na pálpebra superior direita medindo 0,4 cm e a inferior de 0,2 cm, redonda. No canal auditivo esquerdo, cerca de 1,6 cm, além de 4 pontos espalhados nas dobras auditivas. O tratamento homeopático foi iniciado por dois meses com o álbum Arsênico 30 cH, duas vezes ao dia; Carcinosinum 200 cH, uma vez por dia, e complexo contendo Avena sativa 4 cH, Echinacea angustifolia 4 cH, Conium maculatum 6 cH, Thuja officinalis 6 cH e Silicea terra 6 cH, quatro vezes ao dia. A cada dois meses, o quadro era reavaliado, poderes e frequências reajustados. Em poucos meses, houve remissão completa do tumor, recuperação do bem-estar e melhora no humor e apetite. O termo de consentimento livre e informado foi assinado. Não houve recidiva de tumores e cistite até março de 2022. Este estudo mostrou-se eficaz, documentado com fotos e exames. Abordar um caso raro pode fornecer uma nova possibilidade terapêutica. A credibilidade dos relatos de casos homeopáticos de qualidade vem aumentando devido às exigências metodológicas utilizando ferramentas desenvolvidas em estudos recentes. Tais critérios acabam extinguindo relatórios por não atingirem alta qualidade devido a variáveis não controláveis pelo pesquisador.

Isotherapics prepared from toxic substances have been described as attenuation factors for heavy metal intoxication in aquatic animals. Herein, Artemia salina and mercury chloride were used as a model to identify treatment-related bioresilience. The aim was to describe the effects of Mercurius corrosivus (MC) in different potencies on Artemia salina cyst hatching and on mercury bioavailability. Artemia salina cysts were exposed to 5.0 µg/mL of mercury chloride during the hatching phase. MC 6cH, 30cH, and 200cH were prepared and poured into artificial seawater. Different controls were used (nonchallenged cysts and challenged cysts treated with water, succussed water, and Ethilicum 1cH). Four series of nine experiments were performed for 4 weeks to evaluate the percentage of cyst hatching considering all moon phases. Soluble total mercury (THg) levels and precipitated mercury content were also evaluated. Solvatochromic dyes were used to check for eventual physicochemical markers of MC biological activity. Two-way analysis of variance (ANOVA) with mixed models was used for evaluating the effect of different treatments and the simultaneous influence of the moon phases on the cysts hatching rate, at both observation times (24 and 48 hours). When necessary, outliers were removed, using the Tukey criterion. The level of significance α was set at 5%. Significant delay (p

Introduction: Artemia salina, an ecotoxicity bioindicator, is a microcrustacean belonging to the order Anostraca. Glyphosate is an herbicide widely used to control weeds. However, its intoxication can cause serious damage to human health and the balance of the environment, given its effects as an endocrine disruptor. Objective: verify the possible protection of the artemia exposed to glyphosate by the addition of its isotherapic into water, by means of the evaluation of the behavioral and morphological features of nauplii and of the physical properties of remedies and treated water, to elucidate the involved mechanisms. Methods: Artemia salina cysts were kept in culture bottles containing artificial seawater containing glyphosate at LC 10 (lethal concentration 10%), to promote hatching within 48 hours. The isotherapic preparations were inserted in each bottle in a 10% of the total water volume. Part of the nauplii was distributed in transparent tubes, being 10 nauplii per tube and 6 tubes per group, for behavioral analysis, and part were collected for a detailed morphological analysis, under an optical microscope. About 80 to 270 nauplii were analyzed per group. The reserved water was divided into aliquots for physicochemical analysis, that is, evaluation of the water dipole behavior by Cartwright´s method. Results: Gly 6cH presented selective effects on nauplii hatching (p=0.02) and on defected/healthy ratio (p=0.001), representing some protective action. This result was dependent of the salinity of water and presented correspondence with the effects on solvatochromic dyes, indicating that charges and ions can be critical factors involved in the mechanism of action. We concluded that the use of isotherapics could be a plausible tool to reduce the environmental impact of the indiscriminate use of glyphosate, since these results can be reproduced in further studies.

Introduction: Different environmental conditions can influence the effects of toxic agents on living beings. Recently, a series of experiments performed in Artemia salina submitted to different kinds of intoxication have shown that both, isotherapic and succussed water can change Artemia salina´s bio resilience at different levels. Moreover, it seems to vary according to the circalunar cycle. Objective: To verify if circalunar phases and water agitation can modify the toxicity of lead chloride on Artemia salina in vitro. Methodology: Artemia salina cysts were exposed to seawater containing 0.04% of lead chloride (equal to EC10 or 10% effective concentration, previously determined in a pilot study) in 96-well culture plates. Thirty-six experimental repetitions were performed in four series to observe the possible effects of adding stirred water, the so-called succussed water, and the moon phases. The hatched cysts were recorded after 48 hours using a digital microscope (1000x magnification) to identify the hatching percentage and the viability and mobility of the born nauplii. Results: The exposition of cysts to PbCl2 led to an increase in the hatching rate, and it was more evident during the full moon (p = 0.00014) The addition of succussed water into the seawater medium reduced this effect to the baseline levels. An increase in mobility was seen in nauplii born from exposed cysts during the full moon (p = 0.00077), but this effect was not affected by the treatment with succussed water. Discussion: Although the effects of lead chloride EC10 on the increase of nauplii hatching were expected, two environmental variables changed the sensitivity of cysts to this harmful stimulus. The circalunar cycle varied the hatching rate according to the moon phase, even in laboratory conditions, and the addition of succussed water into the medium reduced the hatching rate, even with different intensities according to the moon phase. The organization of nano and microbubbles generated after the succussion of water could be related to this protective effect and can explain, at least partially the effects of high diluted preparations on this biological context. Conclusion: Environmental factors, such as the circalunar cycle and products of water agitation, can modulate the adaptative control of hatching in Artemia salina exposed to lead chloride at EC10.

Introduction: Solvatochromic dyes are probes to detect variations on the dipole moment of solvents after the insertion of homeopathic potencies. Recent studies have shown they can be useful tools in laboratory and field studies to detect the activity of homeopathic remedies. Objective: Determine whether solvatochromic dyes can be a diagnostic tool for cells infected by different agents and/or markers to identify the activity of homeopathic medicines. Methods: Ethilicum 1cH, Silicea terra 6, 30, 200cH; Zincum metallicum 6, 30, 200cH and Phosphorus 6, 30 and 200cH were analyzed by pouring the samples (in a 1:60 rate) into a series of seven dyes (rhodamine, ET 33, ET 30, coumarin 7, NN DMIA, Nile red, methylene violet) diluted in absolute ethanol using pre-established working concentrations. Oscillations of dye absorbance were observed at visible light spectrophotometry according to the remedy and potency. Water and succussed water were used as controls. In a second moment, the absorbance profile of the remedies will be compared with those of biological samples (supernatants) and checked with the biological effect previously obtained from each treatment. Supernatants of RAW 264.7 macrophages stimulated by Calmette-Guérin bacilli (BCG) or infected with Encephalitozoon cuniculi will be analyzed. Results: Preliminary results have shown that Silicea terra 6cH, Phosphorus 30 and 200cH and Zincum metallicum 6, 30 and 200cH reduced the absorbance of methylene violet (p=0.01). Repetitions and analysis of supernatants are expected to be performed in the next steps of the study. Future perspectives: Establish a pattern of reactivity of the studied medicines with different dyes and the putative relation with the corresponding supernatants, as an attempt to obtain a “physicochemical signature” for each kind of infection and/or treatment.

Considering that there are few published studies that specifically address the exclusive use of Carcinosinum in different potencies and, most of them focused on genotypic and clinical effects, the present study was proposed to identify possible phenotypic changes, including viability, expression of HER-2 and metastatic abilities, using 4T1 cells in vitro as a model. Carcinosinum was tested in different homeopathic potencies (12cH; 30cH; 200cH) mechanically prepared using sterile pure water. The time space between preparing the potencies and using them was 24 hours.The final dilutions were inserted into the culture medium in a volume equal to 10%, at the time of cell seeding. The same succussed vehicle used to prepare the drugs (70% ethanol) diluted 1:100 in sterile pure water was used as control. All treated cells were cultured in 25 mL flasks, with cell density of 5 x 105 cells/mL. After 24 hours of treatment, cells were analyzed for apoptosis index using Annexin V kit and the Countess® system. The morphology of 4T1 cells was monitored by staining cell smears with hematoxylin-eosin and Giemsa methods. HER-2 expression was assessed by immunocytochemistry and metalloproteinase activity was assessed by zymography. The determination of the cytokine profile was performed using Cytometric Bead Array (CBA). The samples were evaluated in quadruplicate and the data were analyzed by one-way ANOVA. Carcinosinum 30cH presented the highest apoptotic index and reduction of MMP-9-Pro expression; Carcinosinum 200cH produced the highest positivity for HER-2 and no specific effect was seen after the treatment with Carcinosinum 12cH. No change in cytokine expression was seen among treatments. We conclude that Carcinosinum 30cH and 200cH can change phenotypic features important to tumor development in vitro. The clinical meaning of these data deserves further investigation.

A pedagogical activity with Master's Degree and Postgraduate students in Maternal Health and Obstetrics Nursing is described, applying principles of simulated practice in perineal suturing after delivery. This procedure causes a lot of insecurity and generates great anxiety in the students, when they start the internship in a delivery room.to develop the psychomotor skills in students for perineal surgical reconstruction; increase students' self-confidence to perform the procedure.qualitative, with 2 moments of data collection applied to two courses. Questionnaire with open questions, focus group session and filming. Content analysis of the answers to the questions and verbatim of the focus group.a close relationship was observed between simulation and skills development.the students emphasized the importance of the pedagogical activity in the acquisition of suturing skills, improving their self-confidence and reducing the initial anxiety. The use of the qualitative research allowed identifying the impact of the simulated practice on the development of the students' skills and to identify aspects to be improved, contributing to the progress of pedagogical practices.Descreve-se uma atividade pedagógica com estudantes do Mestrado e Pós-Licenciatura em Enfermagem de Saúde Materna e Obstetrícia, aplicando princípios da prática simulada na realização da sutura perineal após o parto. Este procedimento causa muita insegurança e gera grande ansiedade nos estudantes, quando iniciam estágio em bloco de partos. Os objetivos deste artigo são desenvolver competências psicomotoras nos estudantes para a reconstituição cirúrgica perineal; aumentar a autoconfiança dos estudantes para o procedimento. Metodologia qualitativa, com 2 momentos de recolha de dados aplicados a dois cursos. Questionário com perguntas abertas, sessão de “focus group” e filmagem. Análise de conteúdo das respostas às perguntas abertas e verbatim do “focus group”. Como Resultados destaca-se uma estreita relação entre a simulação e o desenvolvimento de competências. Os estudantes salientaram a importância da atividade pedagógica na aquisição de competências de sutura, reforço da autoconfiança e na diminuição da ansiedade inicial. O uso da investigação qualitativa permitiu identificar o impacto da prática simulada no desenvolvimento de competências dos estudantes, identificar aspetos a aperfeiçoar na metodologia, contribuindo para a melhoria das práticas pedagógicas.

Acoustic divergence among populations may result in assortative mating, behavioral isolation, and speciation. In birds, the recogni- tion of suitable mates depends to a large extent on learning, generally resulting in a tendency to discriminate against nonlocal stimuli. However, there may be geographical variation in the discrimination against nonlocal stimuli, and this may allow inferring the mechanisms behind the evolution of vocal recognition. We tested territorial males of 3 west European subspecies of reed bunting (Emberiza schoeniclus schoeniclus, Emberiza schoeniclus lusitanica, and Emberiza schoeniclus witherbyi) using song playback to determine the level of song discrimination. We found that witherbyi and, to some extent lusitanica, males largely ignored schoeniclus songs. However, witherbyi reacted less strongly to the songs of lusitanica than lusitanica did to songs of witherbyi. In contrast, schoenic- lus males did not discriminate the songs of the different subspecies, reacting strongly to all. Differential territorial defense behavior suggest that intruding males with different songs do not represent the same competitive threat, and provide evidence of premating reproductive isolation among these recently evolved subspecies. The high discrimination exhibited by witherbyi and lusitanica seems associated with the high level of local adaptation. Overall, the pattern of premating reproductive isolation appears to agree more with the ecological than with the neutral genetic divergences between subspecies, suggesting that there is an ongoing process of ecological speciation in this study system.

Song divergence between populations of a species can lead to reproductive isolation and speciation. However, birds may have different singing styles used in distinct social contexts, and songs of each style may change at different rates over time and space. Here, we tested whether song divergence between subspecies of reed bunting, Emberiza schoeniclus, differs with singing style, by comparing song traits of its three singing styles among three subspecies breeding in northern and western Europe. We show that the two singing styles under sexual selection (dawn and fast songs, related to obtaining extrapair and social mates, respectively) diverged significantly more than the slow songs (used as an all-clear signal to nest- attending social females). Multiple song traits differed significantly between the subspecies in all singing styles, with E. s. lusitanica generally being intermediate between E. s. schoeniclus and E. s. witherbyi, and the pattern of song complexity opposing the expected latitudinal gradient (of increasing complexity with increasing latitude). Cluster analyses of populations indicate that sexually selected singing styles are better for discriminating subspecies, describing a scenario of a major split in song features between the migratory, northern E. s. schoeniclus and the two resident, southern subspecies, rather than a clinal variation. The greater song divergence in fast and dawn singing styles suggests that sexual selection may be playing an important role in the incipient speciation of reed buntings. (Less)

The European turtle dove is both a highly valued game species and a species of conservation concern, which is declining due probably to a combination of habitat degradation and unsustainable hunting. Although declines seem to be less severe in the Mediterranean region, it remains uncertain the extent to which ongoing land use changes will negatively affect this species. This study examined this issue, by estimating the effects of landscape composition on the broad scale abundance pattern of breeding turtle doves in continental Portugal. Turtle doves were surveyed in the breeding seasons of 2002 and 2003, from 3160 point counts spaced at about 1-km intervals along 158 transects of about 20 km, evenly covering the country. The frequency of occurrence of turtle doves at each transect was used as a proxy of species abundance, and related using GAM modelling to 21 variables describing land cover and woody linear features (e.g., hedgerows and riparian galleries). Turtle doves were most abundant in north- and central-eastern Portugal, with high abundances also recorded in the regions around Lisbon and along the Guadiana valley. Abundances were positively related to forest cover, particularly by broadleaved forests and by pine stands without woody understory, to cover by permanent crops, and to the density of woody linear habitats. Results suggest that conservation of Mediterranean turtle doves requires policies and management strategies reversing the pervasive trends of forest management neglect and agricultural abandonment, while preserving hedgerows and riparian galleries in more intensive agricultural landscapes.

In Iberian cereal-steppes, decoupling of payments from current production levels through the Single Farm Payment raised concerns regarding the potential for land abandonment and replacement of sheep by cattle, with eventual negative consequences for declining grassland birds. This study addressed this issue by analysing the responses of five grassland bird species of conservation concern to spatial land use gradients, which are expected to reflect changes potentially associated with the CAP reform. Our results show that both habitat fragmentation and grazing regimes were major drivers of breeding bird densities, though responses to these factors were species-specific. Thekla larks were most abundant in landscapes with small grassland patches and high edge density, whereas calandra larks were abundant only in large expanses of continuous open farmland habitat. Little bustard and short-toed lark densities declined in highly fragmented landscapes, but they appeared to tolerate or even benefit from low to moderate levels of open habitat fragmentation. Corn buntings were little affected by landscape patterns. At the field scale, little bustard and corn bunting densities were highest in fields grazed by cattle, whereas short-toed larks were mostly associated with sheep pastures. Short-toed larks and Thekla larks were most abundant in old fallow fields where cattle was largely absent, whereas corn buntings showed the inverse pattern. These results confirm the view that the same agricultural policies may be favourable for some species of conservation concern but detrimental to others, and so they cannot be assumed to bring uniform conservation benefits.

The interaction between hunting interests and legally protected predators is often a contentious conservation problem, requiring detailed understanding of predator responses to game management. This issue was addressed in southern Portugal in a treatment-control natural experiment, whereby the abundances of small game, corvids, birds of prey and carnivores were compared in 12 game estates (>500 ha) and 12 matching areas with similar sizes and land uses but no game management. European rabbits (Oryctolagus cuniculus), Iberian hares (Lepus granatensis) and, less so, red-legged partridges (Alectoris rufa) were far more numerous in game estates than elsewhere. Among legally controlled species, there were less Eurasian jays (Garrulus glandarius) but more red foxes (Vulpes vulpes) in game estates, though the latter were primary targets of predator culling. Fox abundance within game estates varied inversely with an index of management intensity (density of small game feeding sites) and increased along with hare abundance. As for protected species, only common kestrels (Falco tinnunculus) and genets (Genetta genetta) were fewer in game estates. The abundance of raptors within game estates varied inversely with gamekeeper density, whereas that of common buzzards (Buteo buteo) increased along with rabbit abundance. Overall, there was little evidence that game management reduced local predator abundances, except in the most intensively managed estates. Game estates provided concentrations of prey that was scarce elsewhere, which may have favoured increased abundances of some predators. Further investigations are needed to find out whether high prey densities may attract predators to game estates with increased mortality risk, which may thus become population sinks for protected species.

This study examined the multi-scale effects of farmland management on the assemblages of grassland wintering birds in Southern Portugal, evaluating the potential influences on bird conservation of ongoing transformations in agricultural landscapes. The bird assemblages of 42 grassland fields were characterised and related to three sets of variables reflecting field management, landscape context and large-scale spatial trends. Birds showed responses to the three sets of variables, with variation partitioning indicating that species richness was primarily influenced by landscape context, whereas abundances were mostly determined by field management. In general, high species richness was associated with small patches of arable land, diverse landscapes, high stream density and forest and shrub cover, which probably acted as sources of non-agricultural species to grassland fields. In contrast, fields located in homogenous arable landscapes tended to be species poor, though they were the most favourable for open farmland species of conservation concern (e.g. skylark, calandra lark and little bustard). Old grazed fallows were generally associated with the highest abundances of both invertebrate and seed-eating birds, particularly that of winter visitors. Seed-eating winter visitors were also associated with stubble fields. The results indicated that conservation of Iberian grasslands for wintering birds requires management at both the landscape and field scales. At the landscape level, large blocks of open farmland habitat need to be maintained. At the field level, conservation management should strive to maintain both stubble fields and old grazed fallows. The application of such prescriptions would require a combination of agri-environmental programs and land planning policies, whereby the financial support to individual farmers should be conditional on the maintenance of adequate landscape contexts at larger spatial scales.

Stroke remains one of the most serious complications of sickle cell disease. Almost 11% of the patients will have a stroke before the age of 20. The etiology is hemorrhagic in a small part of the cases, which is associated with a high mortality. We present the case of a 19 year-old patient, with sickle cell disease and multiple associated complications. The patient was admitted with acute chest syndrome and developed a hemorrhagic stroke while hospitalized.

Hunting and its associated management have significant costs and benefits for biodiversity conservation,which makes this socio-economic activity highly controversial at both international and regional levels. We investigated relationships between management for small game species (mainly Red-legged Partridges Alectoris rufa and rabbits Oryctolagus cuniculus ) and both abundance and richness of farmland and scrubland songbirds, raptors and ground-nesting birds, and on the abundance of three species of conservation concern (Little Bustard Tetrax tetrax , Eurasian Thick-knee Burhinus oedicnemus and Montagu’s Harrier Circus pygargus ) in southern Portugal farmland. We compared 12 game estates and 12 matching areas with similar sizes and land uses but no game management. Richness and abundance were estimated from fixed point counts, and were related to game regime (managed or unmanaged), habitat characteristics and census period. Our results showed that game management was associated, albeit weakly, with higher abundance of raptors and ground-nesting birds, but no relationship (either positive or negative) was found for other guilds and species. Habitat was generally the most important factor explaining bird species richness and abundance. Our results suggest possibilities for promoting management systems that could maximize both hunting sustainability and conservation value of managed areas, particularly when management helps to improve or maintain beneficial habitats or practices for farmland birds., This study was funded by the Portuguese Foundation for Science and Technology (FCT) (PRAXIS/C/AGR/11062/1998) and by the European Commission under the 7th Framework Programme for Research and Technological Development through the project HUNT(212160, FP7- ENV-2007-1), and contributes to the project CGL2009-13029 from the Spanish Ministry of Science.

Summary 1. Mechanical management of forest fuels is increasingly used in the Euro-Mediterranean region in response to the abandonment of traditional agroforestry and the concurrent increase in fire hazard. Although fuel management may have positive side effects for biodiversity, its long-term impacts remain largely unknown. 2. We used a 70-year post-management chronosequence to investigate the influence of time since fuel management and management frequency on bird assemblages in cork oak Quercus suber forests. 3. Fuel management strongly affected bird species richness, abundances and assemblage composition, with rapid changes often occurring during the first 10–20 years, followed in the next decades by a slow convergence to pre-management levels. 4. In winter, overall species richness and abundance, and that of frugivores and shrub foragers, were negatively affected by recent and recurrent management, only recovering in stands unmanaged for >50 years. In spring, insectivore abundance and the richness and abundance of shrub foragers declined immediately following management, increased to a maximum about 20 years later, and declined thereafter. Breeding granivores and ground foragers were the only groups that benefitted from fuel management. There were no overall effects on species of conservation concern, although a few species with unfavourable status benefitted from fuel management. 5. Synthesis and applications. Our study confirmed that mechanical fuel management has positive effects on some early-successional bird species of conservation concern, although its effects were limited. These benefits should be compared with the strong negative impacts on key bird species such as wintering frugivores, which play a pivotal role in ecosystems by promoting seed dispersal. To reconcile the positive and negative aspects, fuel management should be used to create heterogeneous mosaics of forest patches encompassing a range of sizes (10–100 ha) and successional stages of understorey vegetation, including stands undisturbed for >50 years. This management strategy will likely maintain conditions for a wide range of species with contrasting ecological requirements while also reducing fire hazard.

Resumen del trabajo presentado a la International Conference on Hunting for Sustainability: "Ecology, Economics and Society", celebrada en Ciudad Real (España) del 27 al 29 de marzo de 2012., In Europe, hunting and its associated management has been performed for centuries and has potentially had profound effects on landscapes and on the biodiversity they hold. We investigated the effect of hunting management on non-target bird species. For doing so, we explored the relationship between hunting management and different groups of birds of conservation concern. We conducted the study with two different approximations. In a first step, we assessed whether there were a higher abundance or species richness in hunting estates with game management than in those without management. This survey was conducted in 24 game estates in South Portugal in spring and summer 2001-2002. Twelve of the hunting estates performed game management activities for small-game species while the other 12 corresponded to areas open to hunters but where no game management was undertaken. Groups of species considered in the study were passerines, steppe-birds, ground-nesting birds and endangered birds. We modelled the abundance and number of species of each bird group in each estate according to the game management regime (with/without game management) and to habitat variables with GLMMs and selected the models with lowest AICc. Our results show that all groups of species considered (except passerines) were more abundant or more diverse in hunting estates where game management was performed. In a second step, we aimed to know if our previous result was also relevant in another study area, as well as to disentangle which management activities could specifically affect bird diversity. We surveyed 54 small-game hunting estates in Central Spain with varying management intensity in spring and/or summer 2006-2010. Groups of species considered were raptors and steppe-birds. Information about game management was gathered through interviews with game managers. We modelled the abundance and species richness of each bird group in each estate according to habitat and game management variables (type of hunting regime, artificial feeding, predator control, number of keepers and partridge abundance) with GLMMs and selected the models with lowest AICc. Our results showed that management implemented for red-legged partridges (Alectoris rufa) did not seem to have neither positive nor negative effects on the abundance of their predators (raptors), but having good densities of partridges had a positive effect on the number of raptor species. However, some activities leading to improve red-legged partridges (in particular, supplementary feeding and predator control) had a positive effect on steppe-birds, which share habitat requirements with them. Therefore, we conclude that game management activities have positive effects on different groups of bird species in the Iberian Peninsula. All models are affected by habitat variables, so it is very important to maintain the habitat that allows those high densities and that has a positive effect on biodiversity.