Paralytic and Amnesic Shellfish Toxins Impacts on Seabirds, Analyses and Management

Marine biotoxins have been frequently implicated in morbidity and mortality events in numerous species of birds worldwide. Nevertheless, their effects on seabirds have often been overlooked and the associated ecological impact has not been extensively studied. On top of that, the number of published studies confirming by analyses the presence of marine biotoxins from harmful algal blooms (HABs) in seabirds, although having increased in recent years, is still quite low. This review compiles information on studies evidencing the impact of HAB toxins on marine birds, with a special focus on the effects of paralytic and amnesic shellfish toxins (PSTs and ASTs). It is mainly centered on studies in which the presence of PSTs and/or ASTs in seabird samples was demonstrated through analyses. The analytical techniques commonly employed, the tissues selected and the adjustments done in protocols for processing seabird matrixes are summarized. Other topics covered include the role of different vectors in the seabird intoxications, information on clinical signs in birds affected by PSTs and ASTs, and multifactorial causes which could aggravate the syndromes. Close collaboration between seabird experts and marine biotoxins researchers is needed to identify and report the potential involvement of HABs and their toxins in the mortality events. Future studies on the PSTs and ASTs pharmacodynamics, together with the establishment of lethal doses in various seabird species, are also necessary. These studies would aid in the selection of the target organs for toxins analyses and in the postmortem intoxication diagnosesEn prens

Extension of the Avian Host Range of Collyriclosis in Europe

We describe cases of collyriclosis in apodiform and passeriform birds in Portugal, Switzerland, and Germany. We extend the host range of Collyriculm faba to include apodiform birds (Apus apus, Apus melba, and Apus pallidus) and the passerine Sitta europaea (Eurasian Nuthatch). Infections varied in severity from an incidental finding to severe debilitation and death. The infection route remains unclear with the apparent absence from Germany, Portugal, and Switzerland of the first intermediate host of C. faba, the aquatic gastropod Bythinella austriaca, implying that other organisms might be involved in the parasite’s life cycle. Furthermore, the detection of C. faba cysts in very young passerine birds may indicate an infection during the nestling stage and a rapid development of parasite containing subcutaneous cysts. This series of cases highlights an increased geographic range into Portugal and the potential debilitating nature of a parasite of migratory birds in Europe. However, given the rarity of cases, collyriclosis does not seem to present an important threat to migratory species preservation

Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study

Background Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients’ preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings Between June 16, 2014, and April 29, 2015, data from 22803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj –4·4%, 95% CI –5·5 to –3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj –2·6%, 95% CI –3·9 to –1·4) and the administration of reversal agents (1·23, 1·07–1·41; –1·9%, –3·2 to –0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj –0·3%, 95% CI –2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; –0·4%, –3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications