Snakebites have a great impact in the Brazilian Amazon, being the lancehead Bothrops atrox the species responsible for most accidents, disabilities, and deaths. This study shows a case report of an indigenous patient from the Yanomami ethnicity, male, 33 years-old, envenomed by a B. atrox snake. Envenoming caused by B. atrox are characterized by local manifestations (e.g., pain and edema) and systemic manifestations, mainly coagulation disorders. The indigenous victim was admitted in the main hospital of Roraima and evolved with an unusual complication, an ischemia and necrosis of the proximal ileum, requiring segmental enterectomy with posterior side-to-side anastomosis. The victim was discharge after 27 days of hospitalization with no complaints. Snakebite envenomations may evolve with life-threatening complications, which can be treated by the antivenom following access to a healthcare unit, often late in indigenous population. This clinical case shows the need of strategies that aim improvement in the access to the healthcare by indigenous people, as well as demonstrates an unusual complication that may result from lancehead snakebites. The article also discusses the decentralization of snakebites clinical management to indigenous community healthcare centers to mitigate complications.

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Influenza A viruses, related to high morbidity and mortality worldwide, are involved in major pandemics since the 20 th century. A new H1N1 epidemic is happening in Brazil where the Olympics will take place late this year. Being a tropical country, the Brazilian climate favours the propagation of the viruses. Therefore, other countries need to be alert to a possible pandemic dissemination of the viruses due to the high flow of people from different countries, and to consider ways of stopping such propagation. Methods of prophylaxis currently available and in circulation, including vaccine, anti-viral drugs and hygiene measures, do not have the desired effectiveness against pandemics. In view of the above scenario, it is essential to increase the surveillance and intervention on the part of health authorities of all the countries in the analysis of potential cases, and to adopt appropriate health measures in order to prevent further pandemic outbreaks.

Objective: to perform a review and descriptive analysis of 24 cases of COVID-19 associated with pulmonary thromboembolism seen in the public service in the State of Roraima in 2021. Methods: retrospective review of 24 selected cases of patients who presented with COVID-19 pneumonia and developed pulmonary thromboembolism (PTE) in the year 2021. All patients selected for this study had a confirmed diagnosis of COVID-19 -either by SWAB-RT-PCR or by clinicalepidemiological diagnosis + imaging testsand a diagnosis of PTE within a period of up to 3 months after the date of hospitalization/ diagnosis. Results: the predominant age range among research participants was patients older than 60 years. There was a predominance of obesity (58.3%) and hypertension (50%) as the main comorbidities among patients in the selected group, followed by diabetes mellitus (41.6%). About 75% of the patients required intensive care and of these, 61.1% were admitted to the intensive care unit for a period of more than 10 days. Most study subjects were on prophylaxis with regular use of enoxaparin at a dose appropriate for their weight (79.2% of participants). Conclusion: there is an association between Covid-19 and the presence of coagulopathies, especially in the most critically ill patients.