Mercury bioaccumulation in bats in Madre de Dios, Peru: implications for Hg bioindicators for tropical ecosystems impacted by artisanal and small-scale gold mining.

Mercury (Hg) endangers human and wildlife health globally, primarily due to its release from artisanal small-scale gold mining (ASGM). During gold extraction, Hg is emitted into the environment and converted to highly toxic methylmercury by microorganisms. In Madre de Dios (MDD), Peru, ASGM dominates the economy and has transformed rainforests into expansive deforested areas punctuated by abandoned mining ponds. The aim of this study was to evaluate the use of bats as bioindicators for mercury pollution intensity in tropical terrestrial ecosystems impacted by ASGM. We collected 290 bat fur samples from three post-ASGM sites and one control site in Madre de Dios. Our results showed a wide Hg distribution in bats (0.001 to 117.71 mg/kg) strongly influenced by feeding habits. Insectivorous and piscivorous bats from ASGM sites presented elevated levels of Hg surpassing the mercury small mammal threshold for small mammals (10 mg/kg). We observed the highest reported fur mercury concentrations for insectivorous Neotropical bats reported to date (Rhynchonycteris naso, 117 mg/kg). Our findings further confirm that Hg emissions from ASGM are entering local food webs and exposing wildlife species at several trophic levels to higher levels of Hg than in areas not impacted by mining. We also found that three bat genera consistently showed increased Hg levels in ASGM sites relative to controls indicating potential usefulness as bioindicators of mercury loading in terrestrial ecosystems impacted by artisanal and small-scale gold mining.

Latitude and longitude as drivers of COVID-19 waves' behavior in Europe: A time-space perspective of the pandemic.

BACKGROUND: Social restrictions and vaccination seem to have shaped the pandemic development in Europe, but the influence of geographical position is still debated. This study aims to verify whether the pandemic spread through Europe following a particular direction, during the period between the start of the pandemic and November 2021. The existence of a spatial gradient for epidemic intensity is also hypothesized. METHODS: Daily COVID-19 epidemiological data were extracted from Our World in Data COVID-19 database, which also included vaccination and non-pharmacological interventions data. Latitude and longitude of each country's centroid were used as geographic variables. Epidemic periods were delimited from epidemic surge data. Multivariable linear and Cox's regression models were performed for each epidemic period to test if geographical variables influenced surge dates. Generalized additive models (GAM) were used to test the spatial gradient hypothesis with three epidemic intensity measures. RESULTS: Linear models suggest a possible west-east shift in the first epidemic period and features a significant association of NPIs with epidemic surge delay. Neither latitude nor longitude had significant associations with epidemic surge timing in both second and third periods. Latitude displays strong negative associations with all epidemic intensity measures in GAM models. Vaccination was also negatively associated with intensity. CONCLUSIONS: A longitudinal spread of the pandemic in Europe seems plausible, particularly concerning the first wave. However, a recurrent trend was not observed. Southern Europe countries may have experienced increased transmissibility and incidence, despite climatic conditions apparently unfavourable to the virus.

Acute infectious supraglottitis in adult population: epidemiology, management, outcomes and predictors of airway intervention.

PURPOSE: The purpose is to analyze the incidence of acute infectious supraglottitis in our center between 2010 and 2020, define the characteristics and trends of those patients and identify factors associated with the need of airway intervention. METHODS: A retrospective single-center observational study of a cohort of patients diagnosed with acute infectious supraglottitis between January 2010 and December 2020. Patients were stratified according to airway management. RESULTS: Eighty eight patients were included: 59 men (67%) and 29 women (33%). A significant upward trend of 9% in the annual incidence rate of supraglottitis was seen during 2010-2020, with an important increase in cases during 2019. Muffled voice (41%) and respiratory distress (38%) were the most common presenting symptoms; and the median duration of symptoms before hospital admission was 2 days [IQR 1; 3]. Airway intervention was performed in fifteen patients (17%). Nine patients (10%) were intubated and six required tracheotomy (7%). Comparing the patients who required airway intervention with those who received a conservative treatment, younger patients (p < 0.01) were more likely to need airway intervention. In logistic regression analysis, we found that epiglottic abscess (p = 0.015), hypersalivation (p = 0.027) and smoking (p = 0.036) were independent factors with a significant association with airway intervention. CONCLUSION: There was an important increase in cases and its severity in 2019, but due to COVID-19 pandemic, it was not possible to define if it was an isolate event or an upward trend. Epiglottic abscess, hypersalivation and smoking could be possible risk factors for airway intervention.

Registro de melanismo en Tamandua tetradactyla (Pilosa: Myrmecophagidae) en Perú / Record of melanism in Tamandua tetradactyla (Pilosa: Myrmecophagidae) in Perú

Resumen Se registra un caso de melanismo en Tamandua tetradactyla (Myrmecophagidae), con base en un individuo observado en el departamento de Huánuco, Perú. En la base de datos de iNaturalist se encuentran dos registros anteriores. Con este registro, el número de especies de mamíferos melanísticos en el Perú aumenta a cuatro. Cabe señalar que ya se han reportado casos de melanismo en esta especie en el Neotrópico.

Abstract A case of melanism in Tamandua tetradactyla (Myrmecophagidae) is recorded, based on an individual observed in the Huánuco Department, Peru. Two previous records are found in the iNaturalist database. With this record, the number of melanistic mammal species in Peru increases to four. It should be noted that cases of melanism in this species have already been reported in the Neotropics.

Outcomes and survival of tracheostomised patients during the COVID-19 pandemic in a third level hospital.

PURPOSE: Analyse the evolution and outcomes of COVID-19 tracheostomised patients. Clarify if this cohort presents an increased risk of haemorrhagic complications and verify the correlation between some risk factors with increased mortality. METHODS: A retrospective single-centre observational study of a prospective cohort of all COVID-19 patients admitted to our centre between March and April 2020. A control group was obtained from a historical cohort of patients who required tracheostomy due to prolonged invasive mechanical ventilation (IMV) before 2020. RESULTS: A total of 1768 patients were included: 67 tracheostomised non-COVID-19 patients (historic cohort), 1371 COVID-19 patients that did not require ICU admission, 266 non-tracheostomised COVID-19 patients and 64 tracheostomised COVID-19 patients. Comparing the obesity prevalence, 54.69% of the tracheostomised COVID-19 patients were obese and 10.53% of the non-tracheostomised COVID-19 patients (p < 0.001). The median of ICU admission days was lower (p < 0.001) in the non-tracheostomised cohort (12.5 days) compared with the COVID-19 tracheostomised cohort (34 days). The incidence of haemorrhagic complications was significantly higher in tracheostomised COVID-19 patients (20.31%) compared with tracheostomised non-COVID-19 patients (5.97%) and presented a higher percentage of obesity, hypertension, diabetes and smoking, significantly different from the historic cohort (p < 0.001). A Cox model showed that tracheostomy had no statistically significant effect on mortality in COVID-19 patients. CONCLUSION: Obesity and smoking may be risk factors for tracheostomy in COVID-19 patients, tracheostomised COVID-19 patients present a higher risk of bleeding complications than those admitted for other reasons and an elevated LDH and INR on ICU admission may be associated with increased mortality.

Simultaneous and Bilateral Non-Arteritic Anterior Ischaemic Optic Neuropathy and Acute Angle-Closure.

Non-arteritic anterior ischaemic optic neuropathy (NAION) is the second most common cause of permanent optic nerve-related visual loss in adults after glaucoma. NAION is caused by complex mechanisms that lead to optic nerve head hypoperfusion and is frequently associated with cardiovascular risk factors like type 2 diabetes mellitus (DM2) and hypertension. An attack of acute angle-closure (AAC) occurs when the trabecular meshwork is blocked with peripheral iris that causes an abrupt rise in intraocular pressure, which can trigger a decrease in optic nerve head perfusion. We present a case with simultaneous and bilateral AAC and NAION in association with uncontrolled DM2.

Primer reporte de albinismo en vizcacha Lagidium viscacia (Rodentia: Chinchillidae) en los Andes de Perú

Se documenta el primer registro de albinismo de vizcacha (Lagidium viscacia) con base en dos individuos avistados en el departamento de Apurímac, en Perú. Este registro representa el primer reporte de albinismo en la familia Chinchillidae.

We report the first record of albinism in vizcacha (Lagidium viscacia) based on two adult individuals sighted in department of Apurímac, in Peru. This record represents the first report of albinism in Chinchillidae.

Mercury concentrations in bats (Chiroptera) from a gold mining area in the Peruvian Amazon.

In the southeastern Peruvian Amazon, artisanal and small-scale gold mining (ASGM) is estimated to have released up to 300 tonnes of mercury (Hg) to the environment between 1995 and 2007 alone, and is claimed to be responsible for Hg concentrations above international thresholds for aquatic wildlife species. Here, we examined whether Hg concentrations in bat populations are potentially related to regional ASGM-Hg releases. We determined Hg concentrations in the fur of bats collected at three different distances from the major ASGM areas in Peru. Our findings from 204 individuals of 32 species indicate that Hg concentrations in bat fur mainly resulted from differences in feeding habits, because Hg concentrations were significantly higher in omnivorous bats than in frugivorous bats. At least in two species, populations living in ASGM-affected sites harbored higher Hg concentrations than did populations in unaffected sites. Because Hg concentrations reflect Hg dietary exposure, Hg emissions from amalgam roasting sites appear to deposit locally and enter the terrestrial food web. Although our study demonstrates that ASGM activities (and Hg point sources) increase Hg exposure in wildlife, the overall Hg concentrations reported here are relatively low. The measured Hg concentrations were below the toxicity threshold at which adverse neurological effects have been reported in rodents and mink (>10 µg g-1), and were in the range of Hg concentrations in the fur of bats from nonpoint source affected sites in other latitudes. This study emphasizes the importance of considering feeding habits when evaluating Hg concentrations in bats and other vertebrates.

Morning Glory Disc Anomaly, A Report of a Successfully Treated Case of Functional Amblyopia.

Morning Glory Disc Anomaly (MGDA) is a congenital malformation of the optic nerve characterized by the presence of a funnel-shaped macropapilla with neuroglial remnants in its center surrounded by an elevated and pigmented chorioretinal ring. Its incidence is rare and no gender predisposition has been found. Associated conditions like strabismus lead to an early diagnosis. We report the case of a 3.8-year-old boy with amblyopia of the right eye (count fingers 0.3 meters) due to MGDA. Correction of the refractive error with glasses, along with occlusive therapy resulted in a visual acuity of 20/100 after a five-year follow up. The presence of amblyopia in these cases demands an early management oriented to improve the visual acuity. Every patient with an anatomical malformation diagnosed during the period of sensory maturation should be treated with occlusive therapy and followed on a regular basis to diagnose associated conditions such as retinal detachment. We recommend occlusive therapy in every patient diagnosed with MGDA or in any patient with unilateral or asymmetric structural abnormalities that could lead to amblyopia. This 5-year case follow-up provides additional evidence of the importance of treatment during the period of amblyopia reversibility.

[Ureteral obstruction: an unfrequent complication of Burch colposuspension. Report of two cases]. / Obstrucción ureteral: una complicación no frecuente de la colposuspensión de Burch. Comunicación de dos casos.

The injury of the urinary tract in a pelvic surgery is inherent, its real frequency in which it presents, is difficult to establish, due that not all the lesions are published. In this article, two cases of ureteral obstruction posterior to a Burch-procedure, and the way they were resolved is reported. The ureteral obstruction is a very rare complication, but one that has the worst and severe medico-legal consequences, if they are not resolved opportunely. Its frequency in our service was of 0.41%, in 240 Burch-procedures that were realized during April of 1997 and June of 2000.

Estudio comparativo de diversos métodos de drenaje vesical / Comparative study of several methods of bladder drainage

Se llevó a cabo un estudio comparativo entre diversos métodos de drenaje urinario: uretral abierto y cerrado y suprapúbico, en un grupo de 184 pacientes tratadas quirúrgicamente. En 84% de ellas se practicó cirugía correctiva de incontinencia genuina de esfuerzo. El 73% de esta cirugía fue realizada por vía vaginal. Se valoraron los siguientes parámetros: inicio de micción, incidencia de infección y otras complicaciones. El inicio de micción fue mucho más temprano en el grupo suprapúbico aunque esta diferencia no fue estadísticamente significativa. La infección urinaria fue significativamente diferente entre los grupos en que se utilizó drenaje uretral y aquéllos con derenaje uretral cerrado 39%, drenaje suprapúbico 12%. También hubo diferencia significativas al comparar tiempos de duración de la sonda entre los grupos uretral y suprapúbico. De los métodos suprapúbicos utilizados, se consideró mejor el retrógrado en que se instaló sonda de Foley