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RESUMEN Introducción: La insuficiencia cardiaca (IC) se puede clasificar de diferentes maneras. La más utilizada, según la fracción de eyección ventricular izquierda (FEVI), distingue a grupos con opciones terapéuticas que impactan en la morbimortalidad. Existe información sobre adherencia a las recomendaciones de tratamiento específico al alta de la internación por IC en otros países, pero carecemos de ésta en el nuestro. Objetivos: Evaluar la prescripción de drogas específicas para IC con FEVI reducida (ICFER) al alta de pacientes internados por insuficiencia cardiaca aguda (ICA), así como los parámetros clínicos relacionados con la indicación. Materiales y métodos: Pacientes incorporados al registro prospectivo ARGEN-IC, con diagnóstico de ICA. Se definió FEVI deteriorada a la ≤40%; se analizó la prescripción de drogas recomendadas para ICFER al alta, y su relación con parámetros clínicos. Datos incorporados a la base Survey Monkey y analizados con el programa STATA 14. Se utilizó el test de t o chi cuadrado según la variable utilizada. Resultados: 871 pacientes incluidos, edad 68,1 años y 72,4% varones. FEVI reducida en el 53,3%. La estadía hospitalaria fue 8 días (RIC 5-12) y la mortalidad 7,32%. El 12,6% egresó con tensión arterial sistólica >130 mmHg y el 64,4% con frecuencia cardíaca >70 latidos por minuto. El 22,5% egresó sin betabloqueantes, el 29,1% sin vasodilatadores y el 43,7% sin antialdosterónicos. Entre las probables contraindicaciones, observamos 12,6% de enfermedad pulmonar obstructiva crónica (EPOC), 12,5% de índice de filtrado glomerular menor de 30 ml/min, 8,9% de creatinina mayor de 25 mg/dL y 0,44% hiperkalemia. Conclusiones: Constatamos prescripción subóptima y pobre cumplimiento de las recomendaciones; por ello es de vital importancia implementar estrategias para cambiar la realidad en nuestra región.
ABSTRACT Background: Heart failure (HF) can be classified in different ways. The most used classification is based on left ventricular ejection fraction (LVEF) and involves groups with therapeutic options that impact on morbidity and mortality. The information about adherence to the recommendation of specific treatment at hospital discharge for HF comes from other countries but not ours. Objectives: To evaluate the prescription of specific drugs for HF with reduced LVEF (HFrEF) at discharge in hospitalized patients for acute heart failure (AHF), as well as the clinical parameters related to the indication. Methods: Patients with diagnosis of AHF incorporated to the prospective ARGEN-IC registry were included. Reduced LVEF was defined as that ≤40%. Prescription rate of drugs recommended for HFrEF at discharge and its association with clinical parameters was analyzed. Data was incorporated to the Survey Monkey electronic database and analyzed using STATA® software package. The Student's t test or chi-square test were used, as applicable. Results: A total of 871 patients were included; mean age was 68.1 years and 72.4% were men. LEVF was reduced in 53.3%. Length of hospital stay was 8 days (IQR 5-12) and mortality rate was 7.32%. At discharge, systolic blood pressure was >130 mm Hg in 12.6% of the patients and 64.4% had heart rate >70 beats per minute; 22.5% were discharged without beta-blockers, 29.1% without vasodilators and 43.7% without aldosterone antagonists. Comorbidities included chronic obstructive pulmonary disease (COPD) in 12.6%, glomerular filtration rate <30 mL/min in 12.5 %, serum creatinine >2.5 mg/dL in 8,9% and hyperkalemia in 0.44%. Conclusions: We documented suboptimal prescription rate and poor adherence to the recommendations; thus, it is extremely important to implement strategies to change the reality in our region.
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The Pampas fox (Lycalopex gymnocercus) has suffered from hunting and human persecution for decades, both for fur trade or due to conflicts with livestock. However, studies assessing the effects of hunting pressure on this canid population ecology are lacking. In this work, we assessed the influence of several hunting-related variables on the daily activity patterns and habitat use of the Pampas fox. In private farms of central Argentina, we performed two camera-trapping surveys: one during the non-hunting season and other during the hunting season, distinguishing between sites with or without access by hunters. The habitat use of Pampas foxes did not vary between seasons, but their detectability was lower during the hunting season in habitats that allow humans to see foxes easily (i.e., habitats with high visibility). Pampas foxes selected dusk and night-time, increasing their activity at dusk hours on sites with hunting and showed differences in activity patterns related with the level of visibility of the habitat and to season. Hunting pressure may interact with anthropogenic habitat modifications and create ecological traps for the Pampas fox in agroecosystems.
Subject(s)
Ecosystem , Foxes , Animals , Argentina , HumansABSTRACT
Paciente masculino portador de hipertesión pulmonar severa refractaria a tratamiento médico, sometido a trasplante bipulmonar durante la pandemia por SARS-CoV-2 en la ciudad de Buenos Aires. Para disminuir el riesgo de contagio se realizaron todas las medidas de prevención actualmente recomendadas, con especial énfasis en el uso del equipo de protección personal, contribuyendo de esta forma con el éxito terapéutico alcanzado.
Male patient with severe pulmonary hypertension refractory to medical treatment who underwent a double-lung transplant during the SARS-CoV-2 in the city of Buenos Aires. In order to reduce the risk of contagion all the currently recommended prevention measures were adopted, especially the use of personal protective equipment, thus contributing to the resultant therapeutic success.
Subject(s)
Humans , Lung Transplantation , Coronavirus Infections , Severe Acute Respiratory Syndrome , Pandemics , Hypertension, Pulmonary , LungABSTRACT
RESUMEN Introducción: La especificidad del electrocardiograma como método diagnóstico de causas de muerte súbita cardíaca en deportistas depende de los criterios utilizados para discernir entre alteraciones fisiológicas y patológicas. Objetivos: Evaluar la prevalencia de hallazgos electrocardiográficos anormales en deportistas amateur al comparar los Criterios de Seattle 2013 y 2017. Material y métodos: Fueron evaluados 853 deportistas. Se evaluaron género y edad como variables predictoras independientes. Se realizó un seguimiento mediante métodos complementarios de diagnóstico. Resultados: Presentaron electrocardiogramas anormales según criterios 2013 29 deportistas y 17, según criterios 2017, lo que constituyó el 3,4% y el 2%, respectivamente. No se encontraron diferencias significativas entre géneros ni por edad. Conclusiones: De los electrocardiogramas considerados anormales según los criterios 2013, el 41,4% pasó a considerarse normal al aplicarse los criterios redefinidos en 2017. Ni el género ni la edad constituyen variables predictoras independientes. En ningún evaluado, se pudo demostrar cardiopatía en el seguimiento.
ABSTRACT Introduction: The specificity of the electrocardiogram as a diagnostic method of causes of sudden cardiac death in athletes depends on the criteria used to discern between physiological and pathological alterations. Objectives: To assess the prevalence of abnormal electrocardiographic findings in amateur athletes when comparing the Seattle 2013 and 2017 Criteria. Material and methods: 853 athletes were evaluated. Gender and age were evaluated as independent predictor variables. Follow-up was carried out by means of complementary diagnostic methods. Results: 29 athletes presented abnormal electrocardiograms according to 2013 criteria, and 17 athletes according to 2017 criteria, constituting 3.4% and 2% respectively. No significant differences were found between genders or by age. Conclusions: Of the electrocardiograms considered abnormal according to the 2013 criteria, 41.4% came to be considered normal when applying the criteria redefined in 2017. Neither gender nor age are independent predictor variables. In none of the patients, heart disease could be demonstrated during follow-up.
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[This corrects the article DOI: 10.1371/journal.pone.0206513.].
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Biological invasions are one of the main components of human-caused global change and their negative impact on invaded ecosystems have long been recognized. Invasive mammals, in particular, can threaten native biodiversity and cause economic impacts in the region where they are introduced, often through a wide range of conflicts with humans. Although the wild boar, Sus scrofa, is considered by the IUCN as one of the 100 invasive species most damaging to biodiversity in the world, in Argentina there have only been a few studies focused on its ecology with most of them conducted in protected areas. In this study, we evaluated the effect of several factors related with human disturbance, landscape composition, degree of fragmentation and the presence of a potential competitor and a predator on the habitat use of wild boar using data from camera traps and site-occupancy modeling. Additionally, we described the daily activity pattern of the species and we studied the level of overlap with both a potential competitor and a predator. The sampling effort totaled 7,054 camera trap days. Farm density, proportion of shrubland and proportion of grassland with bushes were the detection variables included in the most supported model whereas proportion of grassland and capture rate of the Pampas fox Lycalopex gymnocercus were the occupancy variables included in the most supported model. However, the proportion of grassland was the only variable that showed statistically significant support in the averaged model, indicating that habitat use of wild boar in this area was significantly negatively affected by the level of grass cover. Wild boars were mostly nocturnal, with more activity between 21:00 and 3:00 and a peak around midnight. Wild boars showed a high level of overlap with the activity pattern of the Pampas fox and a low overlap with the activity pattern of the puma Puma concolor. Despite wild boar being introduced in Argentina a few decades ago, this study is the first landscape-scale research carried out in an agricultural landscape in Argentina and the first one based on camera-trapping data. Our study contributes valuable information that could be used to design strategies to reduce wild boar population or to minimize the damage caused by this invasive species in Argentina.
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La hipertensión pulmonar tromboembólica crónica presenta un tratamiento curativo, siendo la endarterectomía pulmonar (EP) la opción terapéutica establecida. Sin embargo, la angioplastia con balón a arterias pulmonares puede ser considerada una alternativa viable en pacientes inoperables o en aquellos que persisten con hipertensión pulmonar tras una EP. Se reporta a continuación el primer caso de angioplastia con balón a arterias pulmonares realizada en un centro de Argentina.
Chronic thromboembolic pulmonary hypertension presents a curative treatment, with pulmonary endarterectomy being the established therapeutic option. However, balloon angioplasty to pulmonary arteries may be considered an alternative therapeutic option for patients with inoperable or residual disease after surgery. Herewith, we report the first case of chronic thromboembolic pulmonary hypertension treated with balloon pulmonary angioplasty in Argentina.
A hipertensão pulmonar tromboembólica crônica tem um tratamento curativo, a endarterectomia pulmonar (EP), a opção terapêutica estabelecida. No entanto, angioplastia com balão de artérias pulmonares pode ser considerado uma alternativa viável em pacientes inoperáveis ou aqueles que persistem com a hipertensão pulmonar após EP. Relatamos o primeiro caso de angioplastia pulmonar com balão no centro da Argentina.
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Humans , Angioplasty, Balloon , Endarterectomy , Hypertension, PulmonaryABSTRACT
Livestock predation is one of the major causes of conflicts between humans and pumas (Puma concolor). Using data from interviews with ranchers and kill-site inspections, we characterized puma-livestock conflicts in Villarino and Patagones counties of central Argentinean rangelands. Depredation was considered the major cause of livestock losses, and puma attacks were reported in 46.6% and 35.4% of ranches in Villarino and Patagones, respectively. The majority of ranches underwent losses smaller than 1000 USD. The proportion of livestock lost to predation (0.1-10.4%) and financial losses (5.3-1560.4 USD) per ranch/year varied across ranches, and small sheep ranches in Villarino were affected the most. Depredation was recorded only at night and preferentially in grassland with shrubs and cropland habitats. Although nocturnal enclosures appeared to decrease sheep losses, puma hunting was considered the most effective form of reducing depredation and was implemented by most ranchers. Mortality rates were 3.7 and 1.1-1.56 individuals/year × 100 km2 for sheep and pumas, respectively. Nocturnal fencing, shepherding and spatial separation from predators may efficiently reduce sheep losses. However, the poor association between the intensity of puma persecution and puma-related livestock losses suggests that conflict mitigation in central Argentina is not only about reducing damage but also about increasing tolerance.
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The role that mammalian carnivores play in ecosystems can be deeply altered by human-driven habitat disturbance. While most carnivore species are negatively affected, the impact of habitat changes is expected to depend on their ecological flexibility. We aimed to identify key factors affecting the habitat use by four sympatric carnivore species in landscapes of central Argentina. Camera trapping surveys were carried out at 49 sites from 2011 to 2013. Each site was characterized by 12 habitat attributes, including human disturbance and fragmentation. Four landscape gradients were created from Principal Component Analysis and their influence on species-specific habitat use was studied using Generalized Linear Models. We recorded 74 events of Conepatus chinga, 546 of Pseudalopex gymnocercus, 193 of Leopardus geoffroyi and 45 of Puma concolor. We found that the gradient describing sites away from urban settlements and with low levels of disturbance had the strongest influence. L. geoffroyi was the only species responding significantly to the four gradients and showing a positive response to modified habitats, which could be favored by the low level of persecution by humans. P. concolor made stronger use of most preserved sites with low proportion of cropland, even though the species also used sites with an intermediate level of fragmentation. A more flexible use of space was found for C. chinga and P. gymnocercus. Our results demonstrate that the impact of human activities spans across this guild of carnivores and that species-specific responses appear to be mediated by ecological and behavioral attributes.
