Latest Articles and News - Jun 26, 2025

Heavy Metal Poisoning and Its Impacts on the Conservation of Amazonian Parrots: An Interdisciplinary Review.

Amazonian parrots (Psittacidae) are essential to ecosystem balance. Already vulnerable to habitat fragmentation and weak environmental regulations, they are now increasingly threatened by heavy metal contamination. This review synthesizes evidence on the sources, transgenerational bioaccumulation, and physiological impacts of metals such as mercury (Hg), lead (Pb), cadmium (Cd), zinc (Zn), and arsenic (As) in these birds. Anthropogenic activities, including illegal gold mining, agricultural intensification, and urban expansion, release metals that biomagnify along food webs. Parrots, as long-lived, high-trophic consumers, accumulate metals in vital tissues, leading to severe neurotoxic effects, immunosuppression, reproductive failure, and reduced survival. Furthermore, maternal transfer of contaminants to eggs exacerbates genetic erosion and threatens population viability. While biomonitoring tools and habitat restoration have been proposed, current strategies are insufficient against the synergistic pressures of pollution and climate change. Addressing heavy metal exposure is critical to conserving Amazonian biodiversity and safe-guarding ecosystem services. Future efforts should prioritize multidisciplinary predictive models, bioremediation actions, and the strengthening of international environmental governance to ensure the survival of these sentinel species.

https://pubmed.ncbi.nlm.nih.gov/40563911/

A Pheochromocytoma Mimicker: Mercury Poisoning.

https://pubmed.ncbi.nlm.nih.gov/40563203/

Successful ECMO rescue for organophosphate poisoning causing refractory acute respiratory distress syndrome: a first pediatric case.

A 20-month-old girl presented with organophosphate poisoning. Her clinical course was complicated by acute respiratory failure despite oxime administration, requiring mechanical ventilation within 24 h. Due to refractory acute respiratory distress syndrome (ARDS), the patient was placed on veno-venous extracorporeal membrane oxygenation (VV-ECMO) therapy on day 3. Successful rescue and complete recovery were achieved with VV-ECMO. Veno-venous ECMO may be an option for organophosphate poisoning in case of respiratory failure.

https://pubmed.ncbi.nlm.nih.gov/40562613/

Comparing Prehospital Time Among Pediatric Poisoning Patients in Rural and Urban Settings.

Barriers to healthcare in rural areas can delay treatment in pediatric patients who have experienced poisoning. We compared emergency medical services (EMS) response times and EMS-reported delays in responding to pediatric poisoning incidents between rural and urban settings using the 2021 National Emergency Medical Services Information System (NEMSIS). The NEMESIS defines rural areas as locations with a population of <50,000, not part of metropolitan areas, while all other locations are classified as urban (metropolitan) areas. In this study we included 11,911 patients (12% rural) <18 years of age who were transported by EMS with a first-responder primary impression of poisoning. We compared study variables using rank-sum tests and chi-square tests. Multivariable analysis of outcomes included quantile regression and logistic regression for continuous data and categorical data, respectively. The median total prehospital time by EMS was 40 minutes (interquartile range 29-57), and the most common type of delay was scene delay (6%). On multivariable quantile regression, patients transported by rural EMS agencies experienced 6.6 minutes (95% confidence interval 5-8, P<0.001) longer prehospital time than those transported by urban agencies. There were no differences between rural and urban EMS agencies in the occurrence of dispatch, response, scene, and transportation delays. These results elucidate the need for equitable allocation of resources and training to enhance rural EMS responders. The additional nearly seven minutes translates into greater risk for the human body to remain physiologically unstable and not be optimally treated. Therefore, by integrating targeted interventions to rural pediatric populations, better care can be achieved across all geographic regions. Further research must be conducted to ascertain the specific factors, aside from delays, that result in the disparity between rural and urban prehospital response time.

https://pubmed.ncbi.nlm.nih.gov/40561991/

"Oh, Another Overdose, for the Love of Pete": First Responder Perspectives on Overdose Response Technology.

Overdose response applications and hotlines are novel overdose response technologies (ORT)/virtual harm reduction strategies that have recently emerged as a strategy to reduce the harms associated with the ongoing opioid epidemic. First responders are often the first point of contact for people who have overdosed and play a significant role in responses enacted by these services. In this study our aim was to explore the attitudes and perceptions of first responders on these novel technologies. We recruited 17 participants using purposive sampling through the province of Alberta between February-April 2023 including 11 paramedics, two firefighters, and five emergency communications operators. To be included in the study, participants were required to be older than 18 years of age, have the ability to communicate effectively in English, provide verbal informed consent, and work in an emergency responder role. Semi-structured interviews were conducted by two evaluators. When reviewing interview transcripts we used thematic analysis to identify key themes and subthemes. Participants discussed their current operating procedures, their current perspectives on overdose response hotlines and apps, how they would best integrate them into their current workloads, and how to raise awareness of these services within first-responder communities. Participants were apprehensive about the integration of these services into their current workloads, including their potential benefits, and raised concerns about their efficacy within communities of people who use drugs. Key strategies were raised for the successful integration of these services into emergency responses including providing information to clients and the feasibility of overdose responses by the general public. This study's results add to the existing literature on the toll of the overdose epidemic seen within first-response communities. Furthermore, we explored the communities' diverse perspectives on these novel technologies, including support and concerns, and propose additional strategies for their integration into emergency responses.

https://pubmed.ncbi.nlm.nih.gov/40561989/

Epidemiology of 911 Calls for Opioid Overdose in Nogales, Arizona.

Drug overdose is the leading cause of unintentional death in the United States, and individuals identifying as BIPOC (Black, indigenous and people of color) and those of low socioeconomic status are over-represented in this statistic. The US-Mexico border faces several unique challenges when it comes to healthcare and the drug overdose crisis, due in large part to health inequities. Although the US Centers for Disease Control and Prevention recommends that overdose prevention programs address health inequities, little is known about opioid overdoses in this rural, primarily Spanish-speaking region. As emergency medical services (EMS) records collect countywide data, they represent a high-quality source for epidemiologic surveillance. We conducted a retrospective chart review based on a local quality assurance program in which two years of EMS records were reviewed with the primary objective of characterizing patients receiving prehospital care for opioid overdoses in a rural, borderland community, and the secondary objective of characterizing EMS's fidelity to a naloxone distribution protocol. We included electronic patient care records for analysis if they included the EMS clinician's impression of overdose, opiate abuse, or opiate-related disorder from November 1, 2020-October 31,2022. The following data points were abstracted: date; patient initials/gender/age; police presence; response location; bystanders on scene; naloxone administration prior to EMS arrival; distribution of naloxone kit (yes/no); substance reported; and disposition. We analyzed descriptive statistics. A total of 74 cases met inclusion criteria over two years with the majority of cases involving men (82%) with a median age of 28. Almost half of overdoses occurred at private residences (46%), and slightly more than half (57%) reported fentanyl use prior to overdose. Family or friends were usually (64%) on scene, and law enforcement was often (77%) the first 911 to arrive. Naloxone was administered on scene in almost all cases (91%), usually by EMS (44%) or law enforcement (43%). The EMS clinicians distributed naloxone kits at 61% of calls. Opioid overdoses along the US-Mexico border occurred primarily among young men using illicit fentanyl in private residences. Although family/friends were often present, they rarely administered naloxone. Law enforcement was often the first 911 responder to arrive. Emergency medical services is a suitable setting for naloxone distribution programs.

https://pubmed.ncbi.nlm.nih.gov/40561962/