Improving Cultural Competence in the Nurse to Reduce Adverse Patient Events

Undergraduate Theoretical Proposa

Biologically significant residual persistence of brodifacoum in reptiles following invasive rodent eradication, Galapagos Islands, Ecuador

Rat eradication resulted in prolonged presence of the anticoagulant rodenticide brodifacoum in exposed lizards, likely significantly contributing to the deaths of secondarily exposed raptors up to at least 773 days after bait application

Avian Mycobacteriosis in a Rescued Harpy Eagle from Darien Forest, Panama

Background: The Harpy eagle (Harpia harpyia) is the largest raptor in the Neotropical region, distributed in low densities within primary forest habitats from southern Mexico to east-central Brazil, including Central America and Panama. Although locally extinct due to habitat degradation, human poaching and reduction of tropical forests in recent decades, some remnant populations are known to be small and isolated. Thus, information on its ecology, including infectious diseases, is critical for conservation efforts and management of populations of this emblematic species in the wild. Avian Mycobacteriosis (AM) is a chronic disease affecting a wide range of birds and mammals and clinical cases have been sporadically reported, although in harpy eagles, has not been documented. In addition, scant information exists on pathologies affecting raptors, therefore, this report expands the knowledge on infectious diseases affecting wild birds. This study describes the first case of AM in an immature harpy eagle rescued from Darien gap and presents details of the clinical manifestation of the disease and its histological findings. Case: An immature harpy eagle was presented to a rescue center after being confiscated by Ministry of Environment from a local farm in a remote region of Eastern Panama, in the Darien gap. The raptor had a history of having been kept in captivity for approximately five weeks, cohabiting with backyard poultry and fed corn, raw duck and chicken provided by farm owners. Stagnant water was offered for drinking. The harpy eagle arrived to the facility very lethargic and emaciated. Physical examination revealed damaged plumage, poor body condition and dyspnea. Complete blood count revealed anemia and leukocytosis based on lymphocytosis and eosinophilia. Biochemical profile evidenced an increased level of aspartate aminotransferase (AST), phosphorus and total plasma protein. Most remarkable radiographic findings were splenomegaly, hepatomegaly and increased opacity in kidneys, intestines, and aerial sacs. None of the other diagnostic tests performed were conclusive, like tracheal, esophageal and cloacal cultures for fungal infection and fecal exam. After one week of treatment, it showed a remarkable recovery, but at the end of the second week, declined dramatically, dying in the third week of treatment. Post-mortem examination revealed the presence of diffuse granulomas in multiple organs. Histologic examination with gram and Ziehl Neelsen staining revealed the presence of gram-positive and acid-fast bacteria, compatible with Mycobacterium-like bacilli. PCR-restriction fragment length polymorphism analysis of the hsp65, digested with BstEII and HaEIII restriction enzymes confirmed the presence Mycobacterium avium complex in tissues samples. Discussion: This is the first report of AM in a harpy eagle, presenting an extreme emaciation with dyspnea, abnormalities in spleen, liver and air sacs. Biochemical and hematological parameters revealed alterations consistent with infection and organ malfunctions in liver, but Mycobacteriosis was not suspected initially and it was necessary to support the diagnosis with histopathological studies and DNA amplification for a proper identification of the disease. This allowed us to confirm that ante-mortem clinical diagnosis of Avian Mycobacteriosis can be challenging, especially in birds who usually show non-specific signs of the disease and external lesions are not commonly observed. Further studies are requiring to determine the characteristics and clinical signs of this disease in this and other raptors. Also, to determine the source of infection affecting raptors and other protected species in the Neotropical region, especially for diseases with relevance in the conservation of birds and animal health control.Background: The Harpy eagle (Harpia harpyia) is the largest raptor in the Neotropical region, distributed in low densities within primary forest habitats from southern Mexico to east-central Brazil, including Central America and Panama. Although locally extinct due to habitat degradation, human poaching and reduction of tropical forests in recent decades, some remnant populations are known to be small and isolated. Thus, information on its ecology, including infectious diseases, is critical for conservation efforts and management of populations of this emblematic species in the wild. Avian Mycobacteriosis (AM) is a chronic disease affecting a wide range of birds and mammals and clinical cases have been sporadically reported, although in harpy eagles, has not been documented. In addition, scant information exists on pathologies affecting raptors, therefore, this report expands the knowledge on infectious diseases affecting wild birds. This study describes the first case of AM in an immature harpy eagle rescued from Darien gap and presents details of the clinical manifestation of the disease and its histological findings. Case: An immature harpy eagle was presented to a rescue center after being confiscated by Ministry of Environment from a local farm in a remote region of Eastern Panama, in the Darien gap. The raptor had a history of having been kept in captivity for approximately five weeks, cohabiting with backyard poultry and fed corn, raw duck and chicken provided by farm owners. Stagnant water was offered for drinking. The harpy eagle arrived to the facility very lethargic and emaciated. Physical examination revealed damaged plumage, poor body condition and dyspnea. Complete blood count revealed anemia and leukocytosis based on lymphocytosis and eosinophilia. Biochemical profile evidenced an increased level of aspartate aminotransferase (AST), phosphorus and total plasma protein. Most remarkable radiographic findings were splenomegaly, hepatomegaly and increased opacity in kidneys, intestines, and aerial sacs. None of the other diagnostic tests performed were conclusive, like tracheal, esophageal and cloacal cultures for fungal infection and fecal exam. After one week of treatment, it showed a remarkable recovery, but at the end of the second week, declined dramatically, dying in the third week of treatment. Post-mortem examination revealed the presence of diffuse granulomas in multiple organs. Histologic examination with gram and Ziehl Neelsen staining revealed the presence of gram-positive and acid-fast bacteria, compatible with Mycobacterium-like bacilli. PCR-restriction fragment length polymorphism analysis of the hsp65, digested with BstEII and HaEIII restriction enzymes confirmed the presence Mycobacterium avium complex in tissues samples. Discussion: This is the first report of AM in a harpy eagle, presenting an extreme emaciation with dyspnea, abnormalities in spleen, liver and air sacs. Biochemical and hematological parameters revealed alterations consistent with infection and organ malfunctions in liver, but Mycobacteriosis was not suspected initially and it was necessary to support the diagnosis with histopathological studies and DNA amplification for a proper identification of the disease. This allowed us to confirm that ante-mortem clinical diagnosis of Avian Mycobacteriosis can be challenging, especially in birds who usually show non-specific signs of the disease and external lesions are not commonly observed. Further studies are requiring to determine the characteristics and clinical signs of this disease in this and other raptors. Also, to determine the source of infection affecting raptors and other protected species in the Neotropical region, especially for diseases with relevance in the conservation of birds and animal health control

Avian Mycobacteriosis in a Rescued Harpy Eagle from Darien Forest, Panama

The Harpy eagle (Harpia harpyia) is the largest raptor in the Neotropical region, distributed in low densities within primary forest habitats from southern Mexico to east-central Brazil, including Central America and Panama. Although locally extinct due to habitat degradation, human poaching and reduction of tropical forests in recent decades, some remnant populations are known to be small and isolated. Thus, information on its ecology, including infectious diseases, is critical for conservation efforts and management of populations of this emblematic species in the wild. Avian Mycobacteriosis (AM) is a chronic disease affecting a wide range of birds and mammals and clinical cases have been sporadically reported, although in harpy eagles, has not been documented. In addition, scant information exists on pathologies affecting raptors, therefore, this report expands the knowledge on infectious diseases affecting wild birds. This study describes the first case of AM in an immature harpy eagle rescued from Darien gap and presents details of the clinical manifestation of the disease and its histological findings.The Harpy eagle (Harpia harpyia) is the largest raptor in the Neotropical region, distributed in low densities within primary forest habitats from southern Mexico to east-central Brazil, including Central America and Panama. Although locally extinct due to habitat degradation, human poaching and reduction of tropical forests in recent decades, some remnant populations are known to be small and isolated. Thus, information on its ecology, including infectious diseases, is critical for conservation efforts and management of populations of this emblematic species in the wild. Avian Mycobacteriosis (AM) is a chronic disease affecting a wide range of birds and mammals and clinical cases have been sporadically reported, although in harpy eagles, has not been documented. In addition, scant information exists on pathologies affecting raptors, therefore, this report expands the knowledge on infectious diseases affecting wild birds. This study describes the first case of AM in an immature harpy eagle rescued from Darien gap and presents details of the clinical manifestation of the disease and its histological findings

Understanding the Origins of Bacterial Resistance to Aminoglycosides through Molecular Dynamics Mutational Study of the Ribosomal A-Site

Paromomycin is an aminoglycosidic antibiotic that targets the RNA of the bacterial small ribosomal subunit. It binds in the A-site, which is one of the three tRNA binding sites, and affects translational fidelity by stabilizing two adenines (A1492 and A1493) in the flipped-out state. Experiments have shown that various mutations in the A-site result in bacterial resistance to aminoglycosides. In this study, we performed multiple molecular dynamics simulations of the mutated A-site RNA fragment in explicit solvent to analyze changes in the physicochemical features of the A-site that were introduced by substitutions of specific bases. The simulations were conducted for free RNA and in complex with paromomycin. We found that the specific mutations affect the shape and dynamics of the binding cleft as well as significantly alter its electrostatic properties. The most pronounced changes were observed in the U1406C∶U1495A mutant, where important hydrogen bonds between the RNA and paromomycin were disrupted. The present study aims to clarify the underlying physicochemical mechanisms of bacterial resistance to aminoglycosides due to target mutations

Phloem sap intricacy and interplay with aphid feeding

Aphididae feed upon the plant sieve elements (SE), where they ingest sugars, nitrogen compounds and other nutrients. For ingestion, aphid stylets penetrate SE, and because of the high hydrostatic pressure in SE, phloem sap exudes out into the stylets. Severing stylets to sample phloem exudates (i.e. stylectomy) has been used extensively for the study of phloem contents. Alternative sampling techniques are spontaneous exudation upon wounding that only works in a few plant species, and the popular EDTA-facilitated exudation technique. These approaches have allowed fundamental advances on the understanding of phloem sap composition and sieve tube physiology, which are surveyed in this review. A more complete picture of metabolites, ions, proteins and RNAs present in phloem sap is now available, which has provided large evidence for the phloem role as a signalling network in addition to its primary role in partitioning of photo-assimilates. Thus, phloem sap sampling methods can have remarkable applications to analyse plant nutrition, physiology and defence responses. Since aphid behaviour is suspected to be affected by phloem sap quality, attempts to manipulate phloem sap content were recently undertaken based on deregulation in mutant plants of genes controlling amino acid or sugar content of phloem sap. This opens up new strategies to control aphid settlement on a plant host

SNP-SNP interactions in breast cancer susceptibility

BACKGROUND: Breast cancer predisposition genes identified to date (e.g., BRCA1 and BRCA2) are responsible for less than 5% of all breast cancer cases. Many studies have shown that the cancer risks associated with individual commonly occurring single nucleotide polymorphisms (SNPs) are incremental. However, polygenic models suggest that multiple commonly occurring low to modestly penetrant SNPs of cancer related genes might have a greater effect on a disease when considered in combination. METHODS: In an attempt to identify the breast cancer risk conferred by SNP interactions, we have studied 19 SNPs from genes involved in major cancer related pathways. All SNPs were genotyped by TaqMan 5'nuclease assay. The association between the case-control status and each individual SNP, measured by the odds ratio and its corresponding 95% confidence interval, was estimated using unconditional logistic regression models. At the second stage, two-way interactions were investigated using multivariate logistic models. The robustness of the interactions, which were observed among SNPs with stronger functional evidence, was assessed using a bootstrap approach, and correction for multiple testing based on the false discovery rate (FDR) principle. RESULTS: None of these SNPs contributed to breast cancer risk individually. However, we have demonstrated evidence for gene-gene (SNP-SNP) interaction among these SNPs, which were associated with increased breast cancer risk. Our study suggests cross talk between the SNPs of the DNA repair and immune system (XPD-[Lys751Gln] and IL10-[G(-1082)A]), cell cycle and estrogen metabolism (CCND1-[Pro241Pro] and COMT-[Met108/158Val]), cell cycle and DNA repair (BARD1-[Pro24Ser] and XPD-[Lys751Gln]), and within carcinogen metabolism (GSTP1-[Ile105Val] and COMT-[Met108/158Val]) pathways. CONCLUSION: The importance of these pathways and their communication in breast cancer predisposition has been emphasized previously, but their biological interactions through SNPs have not been described. The strategy used here has the potential to identify complex biological links among breast cancer genes and processes. This will provide novel biological information, which will ultimately improve breast cancer risk management

Diclofenac and other non-steroidal anti-inflammatory drugs: Are vultures in the Iberian peninsula at risk?

Resumen del trabajo presentado a la Raptor Research Foundation Annual Conference, celebrada en Fort Collins, Colorado (USA) del 5 al 10 de noviembre de 2019.Peer reviewe

Optimizing Risk Management Strategies for the Control of Philornis downsi—A Threat to Birds in the Galápagos Islands

One of the most concerning threats to Galápagos bird populations, including some critically endangered species, is the invasive parasitic fly Philornis downsi. While long-term sustained solutions are under study, immediate actions are needed to reduce the impacts of this fly. Application of permethrin to birds's nests has been successfully done, but there might be potential long-term reproductive effects to birds. Cyromazine, an insect growth regulator, has been proposed as an alternative, but its risks and effectiveness are unknown. The goal of this study was to assist managers to determine which combination of chemical (permethrin or cyromazine) and mode of application (injection, spray, and self-fumigation) was likely to be most effective to control P. downsi while minimizing toxicity to small land birds in Galápagos, given data available and high levels of uncertainty in some cases. This study is presented as a semi-quantitative risk assessment employing the use of a multi-criteria decision analysis (MCDA) model. For the six potential alternatives resulting from the combination of chemical and mode of application, the criteria were given a score from 1 to 6 supported by available evidence from the literature and from expert opinion. In addition, three different scenarios with different sets of weights for each criterion were assessed with stakeholder's input. Considering the scenario with higher weight to effectiveness of the method against P. downsi while also weighing heavily to minimize the toxicity to birds, cyromazine spray followed by permethrin injection were the preferred strategies. Self-fumigation was the mode of application with highest uncertainty but with much potential to be further explored for its feasibility. The approach taken here to evaluate mitigation strategies against an important threat for avian species in Galápagos can also be used in other conservation programs when making real time decisions under uncertainty.</p