Blood lead levels in an endangered vulture decline following changes in hunting activity.

Lead ammunition stands out as one of the most pervasive pollutants affecting wildlife. Its impact on bird populations have spurred efforts for the phase-out of leaded gunshot in several countries, although with varying scopes and applications. Ongoing and future policy changes require data to assess the effectiveness of adopted measures, particularly in the current context of biodiversity loss. Here, we assessed the long-term changes in blood lead (Pb) levels of Egyptian vultures from the Canary Islands, Spain, which have been severely affected by Pb poisoning over the past two decades. During this period, the reduction in hunting pressure and changes in legislation regarding firearms usage for small game hunting likely contributed to a decrease in environmental Pb availability. As anticipated, our results show a reduction in Pb levels, especially after the ban on wild rabbit hunting with shotgun since 2010. This effect was stronger in the preadult fraction of the vulture population. However, we still observed elevated blood Pb levels above the background and clinical thresholds in 5.6% and 1.5% of individuals, respectively. Our results highlight the positive impact of reducing the availability of Pb from ammunition sources on individual health. Nonetheless, the continued use of Pb gunshot remains an important source of poisoning, even lethal, mainly affecting adult individuals. This poses a particular concern for long-lived birds, compounding by potential chronic effects associated with Pb bioaccumulation. Our findings align with recent studies indicating insufficient reductions in Pb levels among European birds of prey, attributed to limited policy changes and their uneven implementation. We anticipated further reductions in Pb levels among Egyptian vultures with expanded restrictions on hunting practices, including a blanket ban on Pb shot usage across all small game species.

Possible zoonotic implications of the discovery of the advanced third stage larva of Gnathostoma turgidum (Spirurida: Gnathostomatidae) in a Mexican fish species.

Gnathostomiasis in humans is acquired by consumption of any infected second intermediate host or paratenic host. This includes amphibians, snakes and poultry as well as fish. In this work we report for the first time in Mexico the presence of an AdvL3 of Gnathostoma turgidum in the musculature of a wild fish (Gobiomorus dormitor, which also acts as intermediate host for the larvae of G. binucleatum and G. lamothei), from the Papaloapan River, Veracruz; previously, larvae of G. turgidum had only been recorded in amphibians in Mexico and in wild swamp eels from Tampa, Florida, USA. The larva found is extremely small (approximately 1,500 by 140 microns in length and width, respectively), and was obtained by artificial digestion with pepsin after examining the musculature against the light between two glass plates, a method by which it went unnoticed. Our finding of an AdvL3 in this fish, together with a previous molecular phylogenetic analysis revealing that the five species involved in human infections do not nest in the same clade, suggest that all species in the genus are potentially zoonotic. In this context, we strongly recommend the identification of larvae extracted from human patients at specific level, in order to know the role played by the 3 species distributed in Mexico in human cases of gnathostomiasis.

Effect of coadministration of Lactiplantibacillus fabifermentans and linear/branched fructans mixtures on the intestinal health of Wistar rats.

A completely randomized experimental design was conducted to evaluate the effect of the coadministration of Lactiplantibacillus fabifermentans (Lpb. fabifermentans) and inulin/agave fructans mixtures on gut microbiota of healthy Wistar rats. Inulin, Agave salmiana fructans or fructan mixtures (1:1) at 12.5 % w/w, and Lpb. fabifermentans at 109 CFU/mL/day were used in the rats' diet for 35 days. Biochemical parameters, short-chain fatty acids (SCFA), structural changes and the bacterial abundance in rats' cecum were evaluated. A significant decrease (p < 0.05) in glucose, cholesterol and triglycerides levels with fructan mixtures combined with Lpb. Fabifermentans was observed. The weight of the small and large intestines, and cecum was higher than the control; no changes were observed in the heart, liver, spleen and kidneys. SCFA concentration mainly, propionate and butyrate was improved (p < 0.05) throughout the gastrointestinal tract in all treatments. Finally, the administration of Lpb. fabifermentans alone or combined with the fructan mixtures promoted an increase in the abundance of cecum intestinal microbiota: Lactobacillus, Bifidobacterium, Prevotella, Blautia, Faecalibacterium, Butyricimonas, Coprococcus, Akkermansia, Methanobrevibacter, Adlercreutzia, Collinsella, Odoribacter, and Roseburia. The inclusion of fructan mixtures in combination with Lpb. fabifermentans could be a good alternative for the development of functional foods that enhance consumer health.

Agave salmiana fructans as gut health promoters: Prebiotic activity and inflammatory response in Wistar healthy rats.

Prebiotic effects of Agave salmiana fructans at five different doses were evaluated by the growth of Bifidobacterium, Lactobacillus, and Clostridium strains and SCFA production in the cecum and proximal colon of healthy Wistar rats. Mucosal integrity, bacterial proliferation, and inflammatory response were also examined. Growth of Bifidobacterium and Lactobacillus strains was improved by 12.5% doses of fructans in both cecum and proximal colon tissues, and a significant decrease of Clostridium (P < 0.05) was observed. Increases in mucosal thickness, proliferation, and cell adhesion were mainly observed in the cecum. High concentration of butyric acid and total SCFA were contained in the 12.5% doses. This study provides direct evidence of the prebiotic effects of Agave salmiana fructans, demonstrating that a diet supplemented with a 12.5% dose of fructans promotes major growth of probiotic bacteria and could be used as a potential prebiotic ingredient under the conditions used in this study. Taken together, these results further indicate the significance of Agave salmiana fructans as a prebiotic ingredient in the regulation and prevention of gastrointestinal diseases, as well as for the design of functional foods.

Physiometabolic effects of Agave salmiana fructans evaluated in Wistar rats.

A prospective completely randomized experimental study was conducted using 48 animals to evaluate the physiometabolic effects of Agave salmiana fructans as a dietary supplement in healthy Wistar rats. Five fructans concentrations from 5 to 20% (w/w) and one control were used in the rats' diet and were divided into six groups (n=8 rats/group). The treatments were carried out for 35days, during which glucose, cholesterol, triglycerides, body-weight gain, food intake, fecal excretion, organ weights, renal and hepatic functions and a histological analysis of the cecum were evaluated. Glucose, cholesterol, triglycerides, renal and hepatic functions were not significantly affected by any treatment. Body-weight gain and food intake were lower in the rat groups fed fructans than in the control group. Increased fecal excretion (p<0.05) was observed only in animals fed 12.5 and 20% fructans. Mice supplemented with fructans exhibited increased weight and length (p<0.05) in the cecum and colon. A histological analysis of the cecum showed cellular proliferation with a dose of 12.5% and membrane lysis at doses of 15 and 20%. In conclusion, the inclusion of 12.5% of Agave salmiana fructans in the animals' diets exerts beneficial physiometabolic effects after the seventh treatment day.

Mycophenolate mofetil-induced neutropenia in liver transplantation.

BACKGROUND: Mycophenolate mofetil (MMF) is a potent, safe immunosuppressive agent for rescue therapy of acute and chronic rejection in orthotopic liver transplant recipients. It helps to reduce the serious toxic side effects of calcineurin inhibitors (CNIs). The side effects of MMF, such as bone marrow toxicity, have been reported. Herein we report four patients who underwent liver transplantation and developed neutropenia while receiving MMF. METHODS: Between April 2002 and October 2003, we performed 24 liver transplants in 25 patients. Eighteen patients were given MMF for the following reasons: renal failure in nine (50%); treatment of acute rejection in three (16.6%); primary prophylaxis of rejection in five (27.7%); and CNI withdrawal in one (5.5%). RESULTS: Of the 18 patients treated with MMF, there were 11 men (61.1%) and seven women (38.8%), with an overall mean age of 55.5 years. This therapy was ceased in four patients due to neutropenia (22%). Discontinuation of MMF was followed by a rapid and spontaneous rise in neutrophils in two patients. Granulocyte colony stimulating factor (GCSF) was administered to one patient and in another a bone marrow biopsy was performed due to persistent anemia, leukopenia, and thrombocytopenia. The mean time from starting MMF to the development of neutropenia was 4 months. Only the third patient showed elevated levels of MMF. CONCLUSIONS: MMF is a potent immunosuppressive agent in liver transplantation. However, because serious hematologic toxicity has been reported, we recommend caution in administration and careful monitoring of blood levels.

Split for two adults: what is the real feasibility?

INTRODUCTION: A split liver for two adults is a good theoretical option but the number of cases is low. We have tried to assess the feasibility of this technique. MATERIALS AND METHODS: From April 2002 to April 2004, we evaluated 81 donors of which only 59 (72.8%) were used for transplantation of which 10 were grafted in other centers (pediatric or emergency code). Among the 49 donors the criteria for splitting were: ages >14 and <50 years, weight >70 and <100 kg, less than 3 days in the intensive care unit (ICU), hemodynamic stability, Na(+) < 160 mg/L, liver enzymes elevated no more than twofold, no macroscopic steatosis, and procurement in our hospital. RESULTS: The mean donor age was 50.7 years (range: 16 to 77) of whom 25 were men (51%). The mean weight was 65.7 kg (range: 50 to 100) and days of ICU stay, 3 (range: 1 to 23). Six grafts (12%) were split. The reasons for not splitting were: age (n = 26 [53%]), weight (n = 17 [34.7%]), UCI >3 days (n = 9 [18.3%]), Na(+) > 160 (n = 1 [2%]), blood liver test elevated (n = 5 [10.2%]), steatosis (n = 6 [12.2%]), and procurement outside our center (n = 20 [40.8%]). The donors not suitable for splitting had: only one criteria (n = 12 [24.4%]; 2 (n = 23 [46.9%], 3 (n = 6 [12.2%]) or 4 (n = 2 [4.1%]). If we had had two suitable recipients, we could performed six more liver transplantations (12.2% increase). CONCLUSIONS: The theoretical feasibility of a split liver for two adults is 12.2%, but the actual probability is lower because of lack of two adequate candidates.

Carbamazepine poisoning in adolescent suicide attempters. Effectiveness of multiple-dose activated charcoal in enhancing carbamazepine elimination.

The aim of the study was to evaluate continuous administration of multiple-dose activated charcoal (MDAC) in enhancing elimination of carbamazepine (CBZ) in eight consecutive adolescent suicide attempters. Diluted charcoal was administered through a nasogastric tube at a dose of 1 g/kg every 4 h, and a saline cathartic at the same dosage was administered every 12 h. Plasma CBZ concentrations were measured at 0.0, 12, 24 and 36 h by means of a modified EMIT technique. As a measure of CBZ disappearance, half life of elimination (t1/2 beta) and exogenous total body clearance (CLB) were calculated. Clinical improvement occurred after 12 to 24 h, except in one patient who was the most severely intoxicated and who required advanced life-support therapy. Pharmacokinetic data reported a mean t1/2 beta of 9.5 h, shorter than the reference value of 18-54 h (p < 0.05), and a mean CLB of 103.13 ml/ min/kg, higher than the reference of 75.01 ml/min/ kg (p < 0.05). Initial mean CBZ levels of 27.9 decreased to 0.82 microgram/ml (97% of elimination, p < 0.05). MDAC was free from adverse side effects. In conclusion, MDAC is an effective procedure in enhancing CBZ elimination in overdosed patients as well as being relatively free from serious side effects, widely available, inexpensive and non-invasive.

Discrepancy between Bioavailability and Hypotensive Effect of Oral and Sublingual Nifedipine.

Nifedipine, 10-mg capsules, were given orally and sublingually to six healthy volunteers according to a randomized crossover design. Nifedipine plasma levels, blood pressure, and heart rate were determined at several times after medication. C(max) was higher (134 plus minus 17 vs. 93 plus minus 2 ng ml(minus sign1), mean plus minus SD, P < 0.01) and occurred earlier (0.5 vs. 1 h) with oral than with sublingual nifedipine. However, there was no significant difference in AUC (268 plus minus 56 vs. 288 plus minus 35 ng h ml(minus sign1)) nor in t(1/2) (1.8 plus minus 0.2 vs. 1.9 plus minus 0.3 h), indicating that sublingual administration decreased the rate but not the extent of nifedipine absorption. Notwithstanding the difference in C(max), both routes yielded a similar reduction in diastolic blood pressure of 13 plus minus 1 mm Hg. Heart rate increase, which reflects the activation of homeostatic mechanisms, was greater with oral than with sublingual nifedipine, that is, 18 plus minus 1 vs. 13 plus minus 1 beats min(minus sign1), P < 0.01. It is concluded that slower absorption after sublingual administration increases nifedipine hypotensive efficiency by producing less counteracting homeostatic responses than the more rapidly absorbed oral nifedipine.

Water transfer analysis in pork meat supported by NMR imaging.

NMR proton density imaging was used to study isothermal and unidirectional drying of pork semi membranosus muscle samples at temperatures of 12, 16 and 20 °C. An independent calibration of the transversal relaxation time T(2) as a function of the moisture content was carried out to convert the signal amplitude into moisture content. Due to spatial heterogeneity in drying, 2D images were needed to assess the evolution of 1D moisture profiles. The relationship between the effective water diffusivity (D) was calculated in function of water content (X) using the Boltzman transformation which needs no a priori on the relationship D=f(X); the effect of lipid content, temperature and fibre direction on this relationship were also studied. In all cases a decrease in water content brought about a decrease in D. A slight increase in lipid content led to a dramatic decrease in D. The fibre direction relative to water movement had a negligible effect. No significative differences in D between the three temperatures were observed, due to variability in the chemical composition of the samples.

[Pseudoxanthoma elasticum. A X-ray microanalytic study]. / Pseudo-xanthome élastique: étude avec microanalyse de rayons X.

We present a very typical case of pseudo-xanthoma elasticum (PXE) with very remarkable cutaneous lesions, a great number of angioid streaks and, at the moment, with no involvement of the peripheral vascular system. From a genetic standpoint, we believe it must be considered as recessive Type I. An X-ray microanalysis was performed showing intense Ca and P deposits in the affected areas as well as complete absence of Si.

[Total intravenous anesthesia with propofol in orthotopic liver transplantation in swine]. / Anestesia intravenosa total con propofol en el trasplante ortotópico de hígado en cerdos.

OBJECTIVE: To study the use of total intravenous anesthesia with propofol as an anesthetic model for orthotopic liver transplantation (OLT) in pigs. ANIMALS AND METHOD: Fifteen OLT were performed in pigs using portacava-jugular veno-venous shunt with an injector pump. Anesthesia was maintained by perfusion of 10 mg/kg/h propofol. Hemodynamic and biochemical measurements were recorded at the following times: AO, baseline; AI, five minutes before removal of the liver; B1, five minutes later but before starting the bypass injector pump; B2, five minutes after starting the injector pump; B3, five minutes before reperfusion; C1, five minutes after starting reperfusion, and C2, after aortic declamping. RESULTS: No cases of malignant hyperthermia appeared. When the liver was removed cardiac output decreased (p < 0.01), as did mean arterial pressure (p < 0.01), mixed venous saturation (p < 0.05), pulmonary capillary pressure and temperature (p < 0.05). Pulmonary vascular resistances increased (p < 0.05). CONCLUSIONS: The use of total intravenous anesthesia with propofol is a satisfactory experimental anesthetic model for OLT in pigs, and it prevents the possible appearance of malignant hyperthermia.

[Poisoning caused by neuroleptics and other related drugs]. / Intoxicaciones causadas por neurolépticos y otros fármacos afines.

Neuroleptics (phenothiazines) and related medicaments such as haloperidol and metoclopramide, are frequent cause of intoxication. The main manifestations are extrapyramidal symptoms. In most cases the intoxications have an acute evolution and the large doses may be complicated with shock, coma and ventricular fibrillation; persistent hyperthermia brings poor prognosis. Their chronic use, even at therapeutic doses, may produce late dyskinesia, difficult to manage. Diphenhydramine is particularly useful to treat the acute intoxication; this could be started with slowly intravenous injected 1 mg/kg until symptoms disappear, and then continue per os for a minimum of these drugs. Its improper use and abuse are due to therapeutic mode.

[Clinical and epidemiological characteristics of severe poisoning in an adult population admitted to an intensive care unit]. / Características clínicas y epidemiológicas de intoxicaciones graves en una población adulta que ingresa a una unidad de cuidados intensivos.

OBJECTIVE: To describe the clinical and epidemiological features of severe acute poisonings in an adult population. DESIGN: Retrospective analysis of clinical cases. PATIENTS AND METHODS: Analysis of the clinical charts, risk factors and main outcomes of 55 acute poisoned patients admitted to an intensive care unit (ICU). RESULTS: Of the 55 clinical charts reviewed, female prevailed over male gender with a relation of 1.5:1, the average age was 32 years (16-83 years), the major etiologic factor for the acute poisonings were drugs in 35 cases (64%), and home or work chemicals in 20 cases (36%). The mechanisms of intoxication/poisoning were: attempted or successful suicide in 51 cases (93%), accidental poisoning in three cases (5%), and iatrogenic in one case (2%). Precipitating factors were major depressive disorder in 29 cases (53%), dysthymic disorder in 12 cases (22%) and adjustment disorder with depressive mood or impulsive act in nine cases (16%). Associated feature comorbid conditions were: homosexuality, schizophrenia, drug addiction, AIDS, other chronic diseases, and previous suicide attempts. Outcomes were 33 (60%) patients discharged from the ICU without sequela, seven (13%) with permanent severe sequela and 15 (27%) deaths. CONCLUSIONS: There was a high rate of suicides related with depressive disorders in a predominantly female population. Drug products were used more frequently than home or work chemicals. Although advanced life support and antidotal treatments were available, mortality was high. Areas where injury prevention efforts might have an influence on adult poisoning morbidity and mortality include management of depression as well suitable control of drugs and chemicals.

[Comparative study of tympanic and mercury thermometry in children]. / Estudio comparativo entre la termometría timpánica y la mercurial en niños.

The aim of the study was to evaluate tympanic thermometry when compared with conventional glass-mercury thermometry, in 186 consecutive pediatric patients. In patients of less than 6 years of age (n = 120), there were no differences between tympanic and rectal measurements, in febrile and afebrile ranges, and significantly different when compared with axillary range. Similar data were reported in children of more than than 6 years of age (n = 65), in whom oral temperatures replace the rectal one. Using the tympanic thermometer as the standard measurement device, the accuracy of rectal, oral and axillary thermometers in determining a febrile state was examined. When tympanic temperature was 38 degrees C, a febrile state was considered, in this condition sensitivity for rectal measurement was of 73%, for oral 64%, and 23 and 29% for the axillary, according to the age group: specificity was of 100% in all the them. According to our data, tympanic measurement was consistent with glass-mercurial, rectal and oral, temperature in a pediatric population. Advantages of tympanic thermometry are its good correlation with central temperature, substantial time reduction of measurement (1 second), easy and non-invasive procedure, improved patient comfort, and lack of mercurial thermometry disadvantages. The conclusion is that tympanic thermometry becomes an acceptable option for pediatric temperature measurement.

[Thallium poisoning which stimulated systemic lupus erythematosus in a child]. / Intoxicación por talio que simuló lupus eritematoso sistémico en un niño.

We report the case of a preschool boy who, without knowledge of his relatives, ingested thallium sulfate in a dose calculated in 30 mg/kg. He presented a systemic lupus erythematosus-like syndrome and only further alopecia oriented the diagnosis of thallium toxicosis; thallium blood levels were; 37.2 micrograms/dl and in urine: 2330 micrograms/L. Treatment with the chelating agent D. penicillamine was effective, the clinical picture disappeared and the decrease of the thallium levels was observed. Thallium intoxication should be considered in the differential diagnosis of connective tissue disease as the above mentioned.

[Mercury poisoning caused by a homeopathic drug]. / Intoxicación mercurial causada por un medicamento homeopático.

We report an infant with diaper dermatitis and mild respiratory and enteral infections, treated with a homeopathic mercurial medicine: Mercurius 6a (cinnabar dilute 1 x 10(6)), who thereafter became seriously ill with exacerbation and dissemination of the dermatitis as well as irritability and albuminuria. Mercury urine levels were 60 micrograms/L (reference less than 10 micrograms/L). The homeopathic medicine was suspended but symptoms persisted. Therefore the chelating agent D-penicillamine was administered per os (50 mg/kg/day during 10 days). The clinical conditions improved and urinary levels of mercury decreased to normal values. We concluded that homeopathic medicaments should be recognised as potentially harmful substances.

[Cardiorespiratory depression in 8 newborn infants whose mothers took "yucuyahui" (Zoapatle-Montanoa tomentosa) during labor]. / Depresión cardiorrespiratoria en ocho recién nacidos cuyas madres ingirieron infusiones de yucuyahui (zoapatle-Montanoa tomentosa) durante el trabajo de parto.

Yucuyahui (zoapatle-Montanoa tomentosa), is a wild herb used as a folk oxytocic-remedy. Eight pregnant women drank infusions of the herb during the labor and their newborns showed cardiorespiratory depression that needs basic or advanced life support to recover. They improved during the first minutes with an average Apgar score at one minute of 4.5, and 7.4 at ten minutes (p < 0.05). A negative correlation was found between the number of ingested infusions and the Apgar score at the one minute (r = -0.65). Simultaneous administration of alcoholic beverages in three of the pregnant woman did not contribute to deep depression in their neonates. The mechanism of M Tomentosa action is still unknown, but it is possible that it is similar to other oxytocic-drugs, as oxytocin or ergot alkaloids, with which Montanoa shares uterine and systemic effects.

[Treatment of acute poisoning caused by carbamazepine, digoxin, and acetylsalicylic acid, with repeated doses of activated charcoal]. / El tratamiento de las intoxicaciones agudas causadas por carbamazepina, digoxina y ácido acetilsalicílico, mediante la administración de dosis repetidas de carbón activado.

Twelve pediatric patients with acute poisonings caused by carbamazepine, digoxin and acetylsalicylic acid were treated with multiple doses of activated charcoal combined with a saline cathartic (adsorption surface of activated charcoal nearly 950 m2/g). This procedure was effective to shorten the plasmatic levels of the drugs, besides the clinical improvement of the poisoned patients. The average initial and final levels of the drugs were: carbamazepine 21.64 and 0.9 micrograms/ml (lowering 95.81%, p < 0.05), digoxin 5.14 and 1.1 ng/ml (lowering 78.6%, P < 0.05) and acetylsalicylic acid 418.5 and 57.5 micrograms/ml, respectively, (lowering 86.3%, p < 0.05). These results suggest the usefulness of activated charcoal in the clearance of the four overdosed drugs.

[Fatal poisoning caused by oil of epazote, Chenopodium graveolens]. / Envenenamiento mortal causado por el aceite de epazote, Chenopodium graveolens.

We present a case of acute lethal poisoning by oil of "epazote" (oil of chenopodium), in a 2 y 9 m female. The volatile oil was administered according to the advice of a "curandera" (female healer), in a total quantity of 40 ml. Clinical features of the poisoning were: vomiting, deep coma, seizures, mydriasis, apnea, metabolic acidosis, neurogenic shock and death. The EEG suggested a diffuse encephalopathy, the CT scan with an image of severe brain edema and ventricular collapse. Relevant postmortem findings were brain edema and neuronal necrosis, pneumonia, enteritis, pericholangitis, mild pancreatitis and tubular necrosis. The phytochemical analysis of volatile oil identified ascaridol, the main active compound of the chenopodium herbs, in a quantity of 39 mg/ml (1,560 mg in the dose administered), and Chenopodium graveolens as the plant employed to prepare it. According to the age of the patient, 60 mg of ascaridol would be the recommended dose formerly used in the treatment of parasitic disease. Thus 1,560 mg was 26 times higher than the recommended dose, and exceeded by 56% the dose of 1,000 mg reported as lethal in humans.