Widespread use of anticoagulant rodenticides in agricultural and urban environments. A menace to the viability of the endangered Bonelli's eagle (Aquila fasciata) populations.

Anticoagulant rodenticides (ARs) are one of the most toxic groups of compounds currently used worldwide for rodent pest control. Toxic baits are often, directly or indirectly, ingested by non-target animals, resulting in secondary poisoning and frequently affecting apex predators. Their presence in many species of raptors is quite common, particularly scavenger species, with some of these acting as sentinels for the presence of these substances in the environment. However, there is less data on the presence of ARs in Bonelli's eagle, one of the most endangered eagle species in Spain and which is experiencing a negative population trend in Europe. This medium-sized eagle feeds predominantly on live species, and rarely consumes carrion. In this study, 17 carcasses of Bonelli's eagles from the Eastern Spain were necropsied. Both first and second generation ARs in their livers were analyzed by HPLC-MS-TOF revealing that all the eagles studied had been exposed to at least 5 ARs, out of a total of 10 ARs analyzed, with 7 being the highest number of ARs detected in a sample. Second generation ARs were the most prevalent, particularly bromadiolone and brodifacoum, with the highest concentrations in 94% of the cases. More than a third of the eagles presented a liver concentration of greater than 200 ng/g ARs, suggesting AR poisoning. The elevated presence of these compounds in Bonelli's eagles could be a new cause of mortality for this species or could explain other causes of death, such as the increased mortality in power lines, and should be taken into account for their conservation. At the same time, the presence of these compounds in the environment also represents a risk to public health, as the most frequent species in the diet of Bonelli's eagle (rabbits and partridges) are also hunted and consumed by hunters and their families.

A First Record of Organochlorine Pesticides in Barn Owls (Tyto alba) from Portugal: Assessing Trends from Variation in Feather and Liver Concentrations.

We evaluated feathers as a non-destructive biomonitoring tool documenting organochlorine pesticides (OCP) in liver and checked possible trends in pesticide use in two areas based on OCP concentrations in barn owls (Tyto alba). We measured the concentrations of 16 OCP in 15 primary feathers and 15 livers from barn owl carcasses collected on roadsides in Tagus Valley and Évora regions, south Portugal. Total OCP mean concentration was 8 120 ng g-1 in feathers and 178 ng g-1 in livers. All compounds were detected in feathers while in livers δ-HCH, endosulfan sulphate, p,p'-DDT and p,p'-DDD were not detected. The high ß-HCH and heptachlor concentrations in feathers most likely derived from external endogenous contamination. P,p'-DDE was the OCP with the highest hepatic concentration. Both matrices indicated an exposure to recently released heptachlor. The differing OCP concentrations between Tagus Valley and Évora seem to reflect differences in land-use and pesticide use histories of the two locations, and/or faster degradation of OCP in the Tagus area.

High Levels of Heavy Metals detected in Feathers of an Avian Scavenger Warn of a High Pollution Risk in the Atacama Desert (Chile).

The Atacama Desert represents the highest levels of mining exploitation in Chile, which inexorably results in high levels of pollution. Raptors, and particularly scavengers, have shown their usefulness to evaluate exposure to environmental contaminants in polluted scenarios. In this study, we used primary feathers from a local avian scavenger, turkey vulture Cathartes aura, to evaluate the exposure to cadmium (Cd), lead (Pb), copper (Cu) and zinc (Zn) in two locations from the southern Atacama Desert (coastal and inland) and a third location from the bordering semiarid region, in northern Chile. All metals were detected in all analyzed samples (n = 54). Mean concentrations in Coastal Atacama were 0.68 ± 0.84 ppm for Cd; 1.97 ± 2.01 ppm for Pb; 59.11 ± 80.69 ppm for Cu; and 107.96 ± 51.00 ppm for Zn, while mean concentrations in Inland Atacama were 0.55 ± 0.42 ppm for Cd; 3.37 ± 2.61 ppm for Pb; 91.66 ± 77.74 ppm for Cu; and 214.03 ± 99.08 ppm for Zn. Mean concentrations in Coastal Coquimbo were 0.63 ± 0.69 ppm for Cd; 1.57 ± 0.92 ppm for Pb; 18.09 ± 6.12 ppm for Cu; and 149.37 ± 105.56 ppm for Zn. These differences could be explained by differences on abundance of mining settlements among areas. According to the literature, these values are very high for all metals, exceeding in some cases those values referred as responsible of health disorders in birds. We strongly recommend further research looking at potential adverse effects caused by heavy metal pollution on the health of human and wildlife populations in the southern Atacama Desert.

Seminal vesicles tumor: Rare localization of lymphoma. A case report.

A case affected by a seminal vesicles secondary tumor to diffuse large B-cell lymphoma is reported. Seminal vesicles neoplasms are scarce, and they can be classified into primary or secondary. The most common case is their involvement by extension of adjacent tumors, which are clinically nonspecific. In the case presented herein, the patient complained of oliguria, constipation and perineal pain, where imaging methods revealed the growth of both seminal vesicles. Pathological examination revealed infiltration of seminal vesicles by diffuse large B-cell lymphoma. In view of this clinical event, we briefly reviewed literature related to the involvement of seminal vesicles tumor.

Is it possible to predict the development of diabetes insipidus after pituitary surgery? Study of 241 endoscopic transsphenoidal pituitary surgeries.

PURPOSE: To identify presurgical and surgical factors associated with the development of diabetes insipidus (DI) after pituitary adenoma (PA) resection through an endoscopic endonasal transsphenoidal approach. METHODS: Data from 231 patients with functioning and non-functioning PAs who underwent an endoscopic endonasal transsphenoidal approach in the last ten years. RESULTS: 231 patients with 241 pituitary surgeries were included. Eighty-five percent harbored macroadenomas and 38.1% of them were invasive. After pituitary surgery, 12.5% (n = 30) developed transient DI and 5.0% (n = 12) permanent DI. The global risk of DI was higher in patients younger than 65 years (OR = 2.94, p = 0.029), with total tumoral resection (OR = 2.86, p = 0.007) and with diaphragm opening during pituitary resection (OR = 3.63, p = 0.0003). Once postoperative DI developed, the risk of permanent DI increased in those patients with larger PA (OR = 1.07 for each mm of craniocaudal diameter, p = 0.020), especially in those greater than 30 mm (OR = 8.33, p = 0.004). Moreover, diaphragm opening during pituitary resection (OR = 28.3, p = 0.018) predicted long-term DI independently of pituitary tumor size. The risk of permanent DI increased as PA craniocaudal diameter increased (r = 0.20, p = 0.002). CONCLUSION: In patients with PAs younger than 65 years, in whom diaphragm has been opened during pituitary surgery and/or with a total tumor resection, special hydric balance monitoring should be maintained in the postoperative period due to the increased risk of developing DI. The risk of permanent DI increases as PA craniocaudal diameter increased.

Hg and Se in Organs of Three Cetacean Species from the Murcia Coastline (Mediterranean Sea).

We determinated Hg and Se concentrations in liver, kidney, brain, lung and muscle of five bottlenose dolphin (Tursiops truncatus), four common dolphins (Delphinus delphis) and four Risso's dolphin (Grampus griseus) stranded along the Murcia coast, Southeast Spain, in order to evaluate the risk of Hg toxicity. Hg concentrations showed similar concentrations to other individuals in the Mediterranean Sea with the same length in the same period. We observed a positive correlation of Hg and Se in liver (r = 0.948, p < 0.001) and kidney (r = 0.939; p = 0.001) and ratio the Se/Hg molar was higher than 1 in most cases. Our results suggest that the protective effects of Se against Hg toxicity occur in cetaceans. However, we detected levels of Hg described as responsible liver damage and neurotoxicological effects so other tools, as biochemical markers, should be included. Besides, more studies are needed to evaluate the risk of Hg exposure in dolphins from Murcia coastline.

Trace metals in striped dolphins (Stenella coeruleoalba) stranded along the Murcia coastline, Mediterranean Sea, during the period 2009-2015.

Mercury (Hg), cadmium (Cd), lead (Pb), selenium (Se) and arsenic (As) concentrations in internal tissues of 72 striped dolphins (Stenella coeruleoalba) from Murcia Region (Mediterranean coastline) have been investigated for the first time. Hg showed the highest concentration, followed by Se, Cd, As and Pb. In general, the levels of metal found in this study were similar to those described in similar studies in the Mediterranean Sea. However, in some adult specimens, Hg liver concentrations were related with toxic effects in cetacean. A significant correlation was observed with age, likewise between Se and Hg and Cd in tissues, which agree with detoxify effect attributed to Se through inert complex formation. Molar ratio Hg:Se in liver was close to 1:1 in some specimens, which would indicate overload of the Hg-Se detoxify function and compromised health. These results could contribute to a better knowledge of the distribution of these persistent pollutants in the Mediterranean Sea.

Outcome and toxicity of intensity-modulated radiotherapy with simultaneous integrated boost in patients with pharyngo-laryngeal cancer.

PURPOSE: The present work aims at evaluating intensity-modulated radiation therapy with simultaneous integrated boost (IMRT-SIB) in squamous cell carcinomas (SCC) of the larynx and hypopharynx. METHODS/PATIENTS: We performed a single institutional retrospective analysis on 116 pharyngo (29%)-laryngeal (71%) SCC patients (93% male) treated with IMRT-SIB to 66-69.96 Gy in 33 fractions between 2008 and 2016. Those who underwent surgery (54%) received adjuvant radiation of 66 Gy at 2 Gy/fraction to the surgical bed. 16 patients (14%) were treated for a local recurrence after prior surgery. High-risk lymph node regions received 59.4 Gy at 1.8 Gy/fraction and low risk regions 54.12 Gy at 1.64 Gy/fraction. The median age was 60 years and 95% of patients had an ECOG performance status 0-2. Most had advanced stage disease (III 22%, IV 74%). Chemotherapy was delivered in 74% of cases. RESULTS: Median follow-up was 32 months. Two and three-year overall survival for all patients was 87% and 82%, respectively. There were 28 (24%) locoregional recurrences and 19 (16%) distant failures. Grade 3 mucositis, dermatitis, and xerostomy were observed in 12%, 10%, and 3%, respectively. A longer IMRT-SIB overall treatment time was associated with a higher risk of mortality (HR 1.09, CI 1.01-1.17, P = 0.02). Postoperative IMRT-SIB associated with a significantly lower risk of any recurrence (HR 0.34, CI 0.18-0.64, P = 0.001) and higher local control (HR 0.06, CI 0.01-0.24, P < 0.01). Additionally, it associated with a lower risk of mucositis (P = 0.029) compared with definitive radio (chemo) therapy. CONCLUSIONS: IMRT-SIB is a safe and feasible radiation treatment technique for pharyngo-laryngeal SCC patients with a tolerable acute toxicity profile.

Development of a QuEChERS method for simultaneous analysis of antibiotics in carcasses for supplementary feeding of endangered vultures.

Antibiotics have been beneficial for human and animal health. However, an excessive use in livestock and a deficient management of the carcasses can lead to adverse effects in the scavengers that ingest them, especially in "supplementary feeding sites" (SFS). The aim of this study was to assess the potential risk of exposure to antibiotics for an endangered population of Cinereous vultures (Aegypius monachus) from southeastern Portugal. Hence, a multi-residue method based on QuEChERs was adapted and validated to analyse, in small volumes of tissues, the most frequent antibiotics used in livestock. The method was applied to 87 samples of liver, muscle and kidney from 7 goats and 25 sheep disposed in SFS. According to questionnaires to farmers, the animals had not been treated with antibiotics, but analyses showed residues in 29% of the samples. Antibiotics were more frequent in goats (42.9%) than in sheep (24.2%), and oxytetracycline and trimethoprim were the most common (both 13.8%). Oxytetracycline, the most common antibiotic for livestock in Portugal, showed the highest concentration (1452.68 ng g-1). To our knowledge, this is the first study of presence of antibiotics in carrion from SFS. The concentrations of antibiotics in carrion do not seem to pose a risk of acute intoxication for adult Cinereous vultures. However, subtle and likely chronic exposure with unknown health consequences may occur, which requires more research. Moreover, the results of this first study can be used in future studies to assess the risk for avian scavengers.

Late complications of percutaneous tracheostomy using the balloon dilation technique. / Complicaciones tardías de la traqueotomía percutánea con la modalidad de dilatación con balón.

OBJECTIVE: The purpose of this study was to determine the late complications in critically ill patients requiring percutaneous tracheostomy (PT) using the balloon dilation technique. DESIGN: A prospective, observational cohort study was carried out. SCOPE: Two medical-surgical intensive care units (ICU). PATIENTS: All mechanically ventilated adult patients consecutively admitted to the ICU with an indication of tracheostomy. INTERVENTIONS: All patients underwent PT according to the Ciaglia Blue Dolphin® method, with endoscopic guidance. Survivors were interviewed and evaluated by fiberoptic laryngotracheoscopy and tracheal computed tomography at least 6 months after decannulation. VARIABLES: Intraoperative, postoperative and long-term complications and mortality (in-ICU, in-hospital) were recorded. RESULTS: A total of 114 patients were included. The most frequent perioperative complication was minor bleeding (n=20) and difficult cannula insertion (n=19). Two patients had severe perioperative complications (1.7%) (major bleeding and inability to complete de procedure in one case and false passage and desaturation in the other). All survivors (n=52) were evaluated 211±28 days after decannulation. None of the patients had symptoms. Fiberoptic laryngotracheoscopy and computed tomography showed severe tracheal stenosis (>50%) in 2patients (3.7%), both with a cannulation period of over 100 days. CONCLUSIONS: Percutaneous tracheostomy using the Ciaglia Blue Dolphin® technique with an endoscopic guide is a safe procedure. Severe tracheal stenosis is a late complication which although infrequent, must be taken into account due to its lack of clinical expressiveness. Evaluation should be considered in those tracheostomized critical patients who have been cannulated for a long time.

How does climate change affect regeneration of Mediterranean high-mountain plants? An integration and synthesis of current knowledge.

Mediterranean mountains are extraordinarily diverse and hold a high proportion of endemic plants, but they are particularly vulnerable to climate change, and most species distribution models project drastic changes in community composition. Retrospective studies and long-term monitoring also highlight that Mediterranean high-mountain plants are suffering severe range contractions. The aim of this work is to review the current knowledge of climate change impacts on the process of plant regeneration by seed in Mediterranean high-mountain plants, by combining available information from observational and experimental studies. We also discuss some processes that may provide resilience against changing environmental conditions and suggest some research priorities for the future. With some exceptions, there is still little evidence of the direct effects of climate change on pollination and reproductive success of Mediterranean high-mountain plants, and most works are observational and/or centred only in the post-dispersal stages (germination and establishment). The great majority of studies agree that the characteristic summer drought and the extreme heatwaves, which are projected to be more intense in the future, are the most limiting factors for the regeneration process. However, there is an urgent need for studies combining elevational gradient approaches with experimental manipulations of temperature and drought to confirm the magnitude and variability of species' responses. There is also limited knowledge about the ability of Mediterranean high-mountain plants to cope with climate change through phenotypic plasticity and local adaptation processes. This could be achieved by performing common garden and reciprocal translocation experiments with species differing in life history traits.

A logistic regression model predicting high axillary tumour burden in early breast cancer patients.

PURPOSE: As elective axillary dissection is loosing ground for early breast cancer (BC) patients both in terms of prognostic and therapeutic power, there is a growing interest in predicting patients with (nodal) high tumour burden (HTB), especially after a positive sentinel node biopsy (SNB) because they would really benefit from further axillary intervention either by complete lymph-node dissection or axillary radiation therapy. METHODS/PATIENTS: Based on an analysis of 1254 BC patients in whom complete axillary clearance was performed, we devised a logistic regression (LR) model to predict those with HTB, as defined by the presence of three or more involved nodes with macrometastasis. This was accomplished through prior selection of every variable associated with HTB at univariate analysis. RESULTS: Only those variables shown as significant at the multivariate analysis were finally considered, namely tumour size, lymphovascular invasion and histological grade. A probability table was then built to calculate the chances of HTB from a cross-correlation of those three variables. As a suggestion, if we were to follow the rationale previously used in the micrometastasis trials, a threshold of about 10% risk of HTB could be considered under which no further axillary treatment is warranted. CONCLUSIONS: Our LR model with its probability table can be used to define a subgroup of early BC patients suitable for axillary conservative procedures, either sparing completion lymph-node dissection or even SNB altogether.

Influence of a Former Mining Area in the Heavy Metals Concentrations in Blood of Free-Living Mediterranean Pond Turtles (Mauremys leprosa).

The objective of this study was to assess metal exposure in the Mediterranean Pond Turtle (Mauremys leprosa) inhabiting a watercourse in an ancient mining district polluted by different metals ("Rambla de Las Moreras", southeastern Spain) and included in the Ramsar Convention. For this purpose, mercury (Hg), lead (Pb), copper (Cu), zinc (Zn) and cadmium (Cd) were analysed in blood samples from 42 M. leprosa healthy adults (27 males and 13 females). The highest median concentrations were found for Zn, followed by Cu, Pb, Hg and Cd (366, 33, 9, 0.83 and 0.14 µg/dL, respectively). Although the literature regarding toxic metals in freshwater turtles is relatively scarce, Pb may cause deleterious effects in our population. In general, males presented higher levels than females, which could be due to maternal transfer during egg formation. The significant correlations between Cu-Cd and Cu-Hg suggest the implication of an efficient mechanism of detoxification involving metallothioneins.

Per- and polyfluoroalkyl substances in plasma and feathers of nestling birds of prey from northern Norway.

Plasma samples from nestlings of two top predators, White-tailed eagle (Haliaeetus albicilla) and Northern goshawk (Accipiter gentilis) from northern Norway were analysed for a wide range of per- and polyfluoroalkyl substances (PFASs). Body feathers from the White-tailed eagles were also analysed and significant associations between specific PFASs in blood plasma and body feathers were found (0.36

Validation of a QuECheRS method for analysis of neonicotinoids in small volumes of blood and assessment of exposure in Eurasian eagle owl (Bubo bubo) nestlings.

Neonicotinoid pesticides have gained great interest in the last years both for agricultural and domestic use. Since the information on their environmental distribution or the effects derived from exposure to ecosystems and biota is scarce, new analytical techniques are being developed for monitoring studies. In this sense, two extraction techniques based on QuEChERS (Quick, Easy, Cheap, Effective, Rugged, and Safe) methodology to detect the neonicotinoids authorised in Spain (acetamiprid, clothianidin, dinotefuran, imidacloprid, thiacloprid, nitenpyram and thiamethoxam) were adapted and compared: a) using acetate buffer (AB); and b) using citrate buffer (CB). For detection and quantification, high performance liquid chromatography coupled with time of flight mass spectrometry (HPLC/TOF-MS) was used. The CB method provided a wide range of recoveries (68-134%) and accuracy (4-9%). The AB method provided good recoveries (59-76%, 59% corresponded to clothianidin) precision (4-11%) linearity (0.987-0.998%) and limit of quantification (2-10ng/mL) for all the compounds. To test the effectiveness of the technique, we analysed 30 blood samples of free-ranging nestlings of Eurasian eagle owl (Bubo bubo). The only compound detected, in one nestling from a dry land farming area, was imidacloprid, with a concentration of 3.28ng/mL. To our knowledge, this is the first study of neonicotinoid pesticides in free-ranging birds of prey using non-destructive samples, providing the first insight for biomonitoring studies. Further studies, including toxicokinetics and toxicodynamics, are recommended to assess the risk for these species.

Phase Transition, Dielectric Properties, and Ionic Transport in the [(CH3)2NH2]PbI3 Organic-Inorganic Hybrid with 2H-Hexagonal Perovskite Structure.

In this work, we focus on [(CH3)2NH2]PbI3, a member of the [AmineH]PbI3 series of hybrid organic-inorganic compounds, reporting a very easy mechanosynthesis route for its preparation at room temperature. We report that this [(CH3)2NH2]PbI3 compound with 2H-perovskite structure experiences a first-order transition at ≈250 K from hexagonal symmetry P63/mmc (HT phase) to monoclinic symmetry P21/c (LT phase), which involves two cooperative processes: an off-center shift of the Pb2+ cations and an order-disorder process of the N atoms of the DMA cations. Very interestingly, this compound shows a dielectric anomaly associated with the structural phase transition. Additionally, this compound displays very large values of the dielectric constant at room temperature because of the appearance of a certain conductivity and the activation of extrinsic contributions, as demonstrated by impedance spectroscopy. The large optical band gap displayed by this material (Eg = 2.59 eV) rules out the possibility that the observed conductivity can be electronic and points to ionic conductivity, as confirmed by density functional theory calculations that indicate that the lowest activation energy of 0.68 eV corresponds to the iodine anions, and suggests the most favorable diffusion paths for these anions. The obtained results thus indicate that [(CH3)2NH2]PbI3 is an electronic insulator and an ionic conductor, where the electronic conductivity is disfavored because of the low dimensionality of the [(CH3)2NH2]PbI3 structure.

Combined in situ effects of metals and nutrients on marine biofilms: Shifts in the diatom assemblage structure and biological traits.

The effects of multiple stressors on marine diatom assemblages are still poorly understood. The interactive effects of metals and nutrients were assessed in two coastal biofilms grown at a reference site and a historically contaminated site. The biofilms were exposed in situ to pulse exposures of metals (Zn and Pb) and nutrients (N and P) individually and in combination to mimic patterns of discharge in the study area. The reference community's structure (composition and abundance of taxa) was modified after metals and/or nutrients exposure, but each stressor acted in different way. Irrespective of the stressors or scenario, the abundance of the dominant species Opephora krumbeinii declined, and it is proposed as sensitive species. Nutrient supply favoured the proliferation of certain species with high nutrient tolerances (Fragilaria famelica, Tabularia ktenoeides), whereas metals promoted the colonisation of metal-tolerant species, e.g., Berkeleya fennica, Opephora marina. Simultaneous exposure induced an amplification of levels of accumulated metals, chlorophyll a and EPS contents and triggered the succession of species towards tolerant species with specific growth. Metals seemed to act as a selective factor of metal-tolerant species, and nutrients favoured the proliferation of those species forming zig-zag colonies (Neosynedra provincialis), mucous tubes (Berkeleya spp.) and motile diatoms (Navicula salinicola, Nitzschia incognita), resulting in biofilms with a more complex architecture. The diatom communities from the historically contaminated site were more resistant to pulse exposure, but metals or nutrients loads induced overproduction of mucilage. We propose that growth forms may complement taxonomic approaches and provide a quick and easy way to detect community changes related to metal and nutrient pollution.

Role of axillary ultrasound, magnetic resonance imaging, and ultrasound-guided fine-needle aspiration biopsy in the preoperative triage of breast cancer patients.

PURPOSE: Roughly two-thirds of early breast cancer cases are associated with negative axillary nodes and do not benefit from axillary surgery at all. Accordingly, there is an ongoing search for non-surgical staging procedures to avoid lymph-node dissection or sentinel node biopsy (SNB). Non-invasive imaging techniques with very high sensitivity (Se) and negative predictive value (NPV) could eventually replace SNB. We aimed to establish the role of axillary US and MRI, alone or in combination, associated with ultrasound-guided fine-needle aspiration biopsy (US-FNAB) in the prediction of axillary node involvement. METHODS/PATIENTS: Between January 2003 and September 2015, we included 1505 of the 1538 breast cancer patients attending our centres. All patients had been referred from a single geographical area. Axillary US, magnetic resonance imaging and ultrasound-guided fine-needle aspiration biopsy (US-FNAB) were performed if required. RESULTS: 1533 axillary US examinations and 1351 axillary MRI studies were analyzed. For axillary US, Se, Specificity (Sp), Positive Predictive Value (PPV), and NPV were 47.5, 93.6, 82.5, and 73.8%, respectively. For axillary MRI, corresponding values were 29.8, 96.6, 84.9, and 68.4%. When both tests were combined, Sp and PPV slightly improved over individual tests alone. US-FNAB showed a 100% Sp and PPV, with a Se of 80%. CONCLUSION: We may confidently state that axillary US and US-FNAB have to be included in the preoperative work-up of breast cancer patients.