\u3ci\u3eBOA CONSTRICTOR\u3c/i\u3e (Boa Constrictor)

USA: PUERTO RICO: MUNICIPALITY OF CABO ROJO: Cabo Rojo National Wildlife Refuge (17.978958°N, 67.170910oW; NAD 83). 10 November 2014. O. A. Diaz-Marrero. Verified by S. M. Boback. National Museum of Natural History, Smithsonian Institution (USNM Herp Image 2838a, b; photo vouchers). First municipality record for this exotic species; all previous reports were restricted to the Municipality of Mayaguez, located ca. 25 km north of Cabo Rojo National Wildlife Refuge. Reynolds et al. (2013. BioI. Invasions 15:953-959) concluded that Boa Constrictor introductions into Puerto Rico were likely related to the pet trade and that they genetically matched snakes belonging to the South American clade (B. constrictor), instead of B. imperator, the Mesoamerican species (Hynkova et al. 2009. Zool. Sci. 26:623-631). It also represents the first report of this species from a protected area in Puerto Rico

\u3ci\u3eBOA CONSTRICTOR\u3c/i\u3e (Boa Constrictor)

USA: PUERTO RICO: MUNICIPALITY OF CABO ROJO: Cabo Rojo National Wildlife Refuge (17.978958°N, 67.170910oW; NAD 83). 10 November 2014. O. A. Diaz-Marrero. Verified by S. M. Boback. National Museum of Natural History, Smithsonian Institution (USNM Herp Image 2838a, b; photo vouchers). First municipality record for this exotic species; all previous reports were restricted to the Municipality of Mayaguez, located ca. 25 km north of Cabo Rojo National Wildlife Refuge. Reynolds et al. (2013. BioI. Invasions 15:953-959) concluded that Boa Constrictor introductions into Puerto Rico were likely related to the pet trade and that they genetically matched snakes belonging to the South American clade (B. constrictor), instead of B. imperator, the Mesoamerican species (Hynkova et al. 2009. Zool. Sci. 26:623-631). It also represents the first report of this species from a protected area in Puerto Rico

Comparison of 1-year outcome in patients with severe aorta stenosis treated conservatively or by aortic valve replacement or by percutaneous transcatheter aortic valve implantation (data from a multicenter Spanish registry)

The factors that influence decision making in severe aortic stenosis (AS) are unknown. Our aim was to assess, in patients with severe AS, the determinants of management and prognosis in a multicenter registry that enrolled all consecutive adults with severe AS during a 1-month period. One-year follow-up was obtained in all patients and included vital status and aortic valve intervention (aortic valve replacement [AVR] and transcatheter aortic valve implantation [TAVI]). A total of 726 patients were included, mean age was 77.3 ± 10.6 years, and 377 were women (51.8%). The most common management was conservative therapy in 468 (64.5%) followed by AVR in 199 (27.4%) and TAVI in 59 (8.1%). The strongest association with aortic valve intervention was patient management in a tertiary hospital with cardiac surgery (odds ratio 2.7, 95% confidence interval 1.8 to 4.1, p <0.001). The 2 main reasons to choose conservative management were the absence of significant symptoms (136% to 29.1%) and the presence of co-morbidity (128% to 27.4%). During 1-year follow-up, 132 patients died (18.2%). The main causes of death were heart failure (60% to 45.5%) and noncardiac diseases (46% to 34.9%). One-year survival for patients treated conservatively, with TAVI, and with AVR was 76.3%, 94.9%, and 92.5%, respectively, p <0.001. One-year survival of patients treated conservatively in the absence of significant symptoms was 97.1%. In conclusion, most patients with severe AS are treated conservatively. The outcome in asymptomatic patients managed conservatively was acceptable. Management in tertiary hospitals is associated with valve intervention. One-year survival was similar with both interventional strategies