Experiencia en nefrectomía: serie de casos de cuatro años

Introducción: Las indicaciones por las cuales un paciente requiere una nefrectomía son múltiples: las neoplasias, la hidronefrosis y la exclusión funcional son las principales. En manos expertas la nefrectomía es un procedimiento seguro, especialmente porque en la actualidad el abordaje por excelencia es realizar una técnica mínimamente invasiva con conservación de nefronas. Se presenta el análisis de la experiencia en Mederi, Hospital Universitario Mayor en esta intervención. Metodología: Se realizó una serie de casos de pacientes llevados a nefrectomía entre mayo de 2008 y mayo de 2012. Se incluyeron la totalidad de los casos. Resultados: Se analizaron 72 registros, 49 mujeres y 25 hombres; 13 de ellas fueron laparoscópicas. La edad promedio fue de 58,6 años. El tiempo medio operatorio fue 169,23 minutos (118-220 minutos). El sangrado operatorio promedio fue de 680,63 ml (IC95%: 2,83-1358 ml). El tiempo de hospitalización promedio fue de 4,88 días IC95%. La mayoría de los pacientes se distribuyeron en estadios medios de la enfermedad tumoral, con poco compromiso ganglionar y metástasis; el diagnóstico histológico y estadio dominante fueron el carcinoma de células renales grado 3 de Fuhrman respectivamente. Se reportan 13 casos de compromiso de la capsula de Gerota y 11 con compromiso del hilio. Discusión: La experiencia en nefrectomía de la institución es muy positiva por el bajo número de mortalidad y complicaciones. En cuanto a la técnica, es importante promover la técnica laparoscópica

La negociación política internacional en derechos humanos: Colombia en la Comisión de Derechos Humanos de las Naciones Unidas

Con la creación y maduración de los organismos internacionales, las relaciones de poder ya no se daban solo entre estados, sino que se incluyen organismos internacionales y organizaciones multinacionales como actores del sistema internacional

Population Assessment of an Endangered Shorebird: the Piping Plover (Charadrius melodus melodus) in Eastern Canada

Small, at-risk populations are those for which accurate demographic information is most crucial to conservation and recovery, but also where data collection is constrained by logistical challenges and small sample sizes. Migratory animals in particular may experience a wide range of threats to survival and reproduction throughout each annual cycle, and identification of life stages most critical to persistence may be especially difficult for these populations. The endangered eastern Canadian breeding population of Piping Plover (Charadrius melodus melodus) was estimated at only 444 adults in 2005, and extensive effort has been invested in conservation activities, reproductive monitoring, and marking of individual birds, providing a comprehensive data set on population dynamics since 1998. We used these data to build a matrix projection model for two Piping Plover population segments that nest in eastern Canada in order to estimate both deterministic and stochastic rates of population growth (λd and λs, respectively). Annual population censuses suggested moderate growth in abundance between 1998–2003, but vital rate estimates indicated that this temporary growth may be replaced by declines in the long term, both in southern Nova Scotia (λd = 1.0043, λs = 0.9263) and in the Gulf of St. Lawrence (λd = 0.9651, λs = 0.8214). Nonetheless, confidence intervals on λ estimates were relatively wide, highlighting remaining uncertainty in future population trajectories. Differences in projected growth between regions appear to be driven by low estimated juvenile post-fledging survival in the Gulf, but threats to juveniles of both population segments following departure from nesting beaches remain unidentified. Similarly, λ in both population segments was particularly sensitive to changes in adult survival as expected for most migratory birds, but very little is understood about the threats to Piping Plover survival during migration and overwintering. Consequently, we suggest that future recovery efforts for these and other vulnerable migrants should quantify and manage the largely unknown sources of both adult and juvenile mortality during non-breeding seasons while maintaining current levels of nesting habitat protection.

Movement of Juvenile Songbirds in Harvested Boreal Forest: Assessing Residency Time and Landscape Connectivity

Little is known about juvenile songbird movement in response to timber harvest, particularly in the boreal forest. If clearcut land cover facilitates movement, the availability of resources may increase. However, if clearcut land cover impedes movement, important post-fledging resources may be rendered inaccessible. Using radio telemetry, we tested the hypothesis that regenerating clearcut land cover would affect the movement of recently independent Yellow-rumped Myrtle Warblers (Dendroica coronata coronata) and Blackpoll Warblers (Dendroica striata) differently than forested land cover owing to intrinsic differences in each land-cover type or in how they are perceived. We found that both species moved extensively before migration. We also found that Blackpoll Warblers were quick to exit local areas composed of clearcut land cover and that both species were quick to exit neighborhoods composed of large proportions of clearcut land cover. However, if individuals encountered clearcut land cover when exiting the neighborhood, movement rate was slowed. Effectively, residency time decreased in clearcut neighborhoods and landscape connectivity was impeded by clearcut land cover. Our results suggest that clearcut land cover may represent low-quality habitat for both species during the post-fledging period. Further research is needed to determine if changes in movement behavior associated with landscape structure affect individual condition and higher-level ecological processes.

Nonbreeding-Season Drivers of Population Dynamics in Seasonal Migrants: Conservation Parallels Across Taxa

For seasonal migrants, logistical constraints have often limited conservation efforts to improving survival and reproduction during the breeding season only. Yet, mounting empirical evidence suggests that events occurring throughout the migratory life cycle can critically alter the demography of many migrant species. Herein, we build upon recent syntheses of avian migration research to review the role of non-breeding seasons in determining the population dynamics and fitness of diverse migratory taxa, including salmonid fishes, marine mammals, ungulates, sea turtles, butterflies, and numerous bird groups. We discuss several similarities across these varied migrants: (i) non-breeding survivorship tends to be a strong driver of population growth; (ii) non-breeding events can affect fitness in subsequent seasons through seasonal interactions at individual- and population-levels; (iii) broad-scale climatic influences often alter non-breeding resources and migration timing, and may amplify population impacts through covariation among seasonal vital rates; and (iv) changes to both stationary and migratory non-breeding habitats can have important consequences for abundance and population trends. Finally, we draw on these patterns to recommend that future conservation research for seasonal migrants will benefit from: (1) more explicit recognition of the important parallels among taxonomically diverse migratory animals; (2) an expanded research perspective focused on quantification of all seasonal vital rates and their interactions; and (3) the development of detailed population projection models that account for complexity and uncertainty in migrant population dynamics.

Declines of Aerial Insectivores in North America Follow a Geographic Gradient

North American birds that feed on aerial insects are experiencing widespread population declines. An analysis of the North American Breeding Bird Survey trend estimates for 1966 to 2006 suggests that declines in this guild are significantly stronger than in passerines in general. The pattern of decline also shows a striking geographical gradient, with aerial insectivore declines becoming more prevalent towards the northeast of North America. Declines are also more acute in species that migrate long distances compared to those that migrate short distances. The declines become manifest, almost without exception, in the mid 1980s. The taxonomic breadth of these downward trends suggests that declines in aerial insectivore populations are linked to changes in populations of flying insects, and these changes might be indicative of underlying ecosystem changes.

Predicting origins of passerines migrating through Canadian migration monitoring stations using stable-hydrogen isotope analyses of feathers: a new tool for bird conservation

The Canadian Migration Monitoring Network (CMMN) consists of standardized observation and migration count stations located largely along Canada’s southern border. A major purpose of CMMN is to detect population trends of migratory passerines that breed primarily in the boreal forest and are otherwise poorly monitored by the North American Breeding Bird Survey (BBS). A primary limitation of this approach to monitoring is that it is currently not clear which geographic regions of the boreal forest are represented by the trends generated for each bird species at each station or group of stations. Such information on “catchment areas” for CMMN will greatly enhance their value in contributing to understanding causes of population trends, as well as facilitating joint trend analysis for stations with similar catchments. It is now well established that naturally occurring concentrations of deuterium in feathers grown in North America can provide information on their approximate geographic origins, especially latitude. We used stable hydrogen isotope analyses of feathers (δ²Hf) from 15 species intercepted at 22 CMMN stations to assign approximate origins to populations moving through stations or groups of stations. We further constrained the potential catchment areas using prior information on potential longitudinal origins based upon bird migration trajectories predicted from band recovery data and known breeding distributions. We detected several cases of differences in catchment area of species passing through sites, and between seasons within species. We discuss the importance of our findings, and future directions for using this approach to assist conservation of migratory birds at continental scales.

Gray-cheeked Thrush (Catharus minimus minimus) distribution and habitat use in a montane forest landscape of western Newfoundland, Canada

Once abundant, the Newfoundland Gray-cheeked Thrush (Catharus minimus minimus) has declined by as much as 95% since 1975. Underlying cause(s) of this population collapse are not known, although hypotheses include loss of winter habitat and the introduction of red squirrels (Tamiasciurus hudsonicus) to Newfoundland. Uncertainties regarding habitat needs are also extensive, and these knowledge gaps are an impediment to conservation. We investigated neighborhood (i.e., within 115 m [4.1 ha]) and landscape scale (i.e., within 1250 m [490.8 ha]) habitat associations of Gray-cheeked Thrush in a 200-km² study area in the Long Range Mountains of western Newfoundland, where elevations range from 300-600 m and landcover was a matrix of old growth fir forest, 6- to 8-year-old clearcuts, coniferous scrub, bogs, and barrens. Thrushes were restricted to elevations above ~375 m, and occurrence was strongly positively related to elevation. Occurrence was also positively related to cover of tall scrub forest at the neighborhood scale, and at the landscape scale showed curvilinear relations with the proportion of both tall scrub and old growth forest that peaked with intermediate amounts of cover. Occurrence of thrushes was also highest when clearcuts made up 60%-70% of neighborhood landcover, but was negatively related to cover of clearcuts in the broader landscape. Finally, occurrence was highest in areas having 50% cover of partially harvested forest (strip cuts or row cuts) at the neighborhood scale, but because this treatment was limited to one small portion of the study area, this finding may be spurious. Taken together, our results suggest selection for mixed habitats and sensitivity to both neighborhood and landscape-scale habitat. More research is needed on responses of thrushes to forestry, including use of older clearcuts, partially harvested stands, and precommercially thinned clearcuts. Finally, restriction of thrushes to higher elevations is consistent with the hypothesis that they have been impacted by squirrels, because squirrels were rare or absent at these elevations.

Pliocene seasonality across the North Atlantic inferred from cheilostome bryozoans

Previous studies have shown an inverse correlation between zooid size in cheilostome bryozoans and ambient water temperature. This relationship underlies the MART technique which uses intracolonial variation in zooid size to predict mean annual range in temperature experienced by bryozoan colonies during their life. Here we apply the MART technique to study Early and Mid Pliocene bryozoans from Central America (Panama, Costa Rica), the USA (Florida, South Carolina, North Carolina, Virginia) and the UK (Suffolk) to reconstruct palaeoseasonality across a range of latitudes for the North Atlantic during the Pliocene Epoch. Compared to the present-day, our analyses suggest greater seasonality (ca 4.5 degrees C) in the southern Caribbean at the time of Cayo Agua Formation deposition (ca 4.25 Ma), in keeping with inferred upwelling prior to the closure of the isthmian barrier at 2.7 Ma. Bryozoans also indicate seasonal upwelling on the Gulf Coast of Florida in a similar manner to the present-day. Because upwelling can be highly localised and prone to spatial and temporal variation in the Gulf of Mexico today, it contributes little to a broad understanding of Pliocene North Atlantic waters. However, MART estimates for the coastal plain region indicate a general reduction in the annual range in temperature relative to the present, suggesting that the colder surface waters that today reach south to Cape Hatteras had less influence in Early to Mid Pliocene times. These results, along with evidence from other proxies, strongly support reduced seasonality and warmer conditions along the eastern seaboard of the USA in the Early to Mid Pliocene. Finally, the MART estimates amongst Coralline Crag localities provide evidence for an increased annual range in temperature in the southern North Sea than at present. Our study shows that bryozoan MART estimates provide a powerful, independent proxy for palaeoseasonality and is the first to demonstrate that the MART technique can be applied to infer palaeoclimates across a wide range of latitudes focusing on a variety of geological formations and geographical regions. Crown Copyright (C) 2009 Published by Elsevier B.V. All rights reserved.

The kinetics of αIIbβ3 activation determines the size and stability of thrombi in mice: implications for antiplatelet therapy.

Two major pathways contribute to Ras-proximate-1-mediated integrin activation in stimulated platelets. Calcium and diacyglycerol-regulated guanine nucleotide exchange factor I (CalDAG-GEFI, RasGRP2) mediates the rapid but reversible activation of integrin αIIbβ3, while the adenosine diphosphate receptor P2Y12, the target for antiplatelet drugs like clopidogrel, facilitates delayed but sustained integrin activation. To establish CalDAG-GEFI as a target for antiplatelet therapy, we compared how each pathway contributes to thrombosis and hemostasis in mice. Ex vivo, thrombus formation at arterial or venous shear rates was markedly reduced in CalDAG-GEFI(-/-) blood, even in the presence of exogenous adenosine diphosphate and thromboxane A(2). In vivo, thrombosis was virtually abolished in arterioles and arteries of CalDAG-GEFI(-/-) mice, while small, hemostatically active thrombi formed in venules. Specific deletion of the C1-like domain of CalDAG-GEFI in circulating platelets also led to protection from thrombus formation at arterial flow conditions, while it only marginally increased blood loss in mice. In comparison, thrombi in the micro- and macrovasculature of clopidogrel-treated wild-type mice grew rapidly and frequently embolized but were hemostatically inactive. Together, these data suggest that inhibition of the catalytic or the C1 regulatory domain in CalDAG-GEFI will provide strong protection from athero-thrombotic complications while maintaining a better safety profile than P2Y12 inhibitors like clopidogrel.

Rap1-Rac1 circuits potentiate platelet activation.

OBJECTIVE: The goal of this study was to investigate the potential crosstalk between Rap1 and Rac1, 2 small GTPases central to platelet activation, particularly downstream of the collagen receptor GPVI. METHODS AND RESULTS: We compared the activation response of platelets with impaired Rap signaling (double knock-out; deficient in both the guanine nucleotide exchange factor, CalDAG-GEFI, and the Gi-coupled receptor for ADP, P2Y12), to that of wild-type platelets treated with a small-molecule Rac inhibitor, EHT 1864 (wild-type /EHT). We found that Rac1 is sequentially activated downstream of Rap1 on stimulation via GPVI. In return, Rac1 provides important feedback for both CalDAG-GEFI- and P2Y12-dependent activation of Rap1. When analyzing platelet responses controlled by Rac1, we observed (1) impaired lamellipodia formation, clot retraction, and granule release in both double knock-out and EHT 1864-treated wild-type platelets; and (2) reduced calcium store release in EHT 1864-treated wild-type but not double knock-out platelets. Consistent with the latter finding, we identified 2 pools of Rac1, one activated immediately downstream of GPVI and 1 activated downstream of Rap1. CONCLUSIONS: We demonstrate important crosstalk between Rap1 and Rac1 downstream of GPVI. Whereas Rap1 signaling directly controls sustained Rac1 activation, Rac1 affects CalDAG-GEFI- and P2Y12-dependent Rap1 activation via its role in calcium mobilization and granule/ADP release, respectively.

Six new loci associated with body mass index highlight a neuronal influence on body weight regulation

Common variants at only two loci, FTO and MC4R, have been reproducibly associated with body mass index (BMI) in humans. To identify additional loci, we conducted meta-analysis of 15 genome-wide association studies for BMI (n > 32,000) and followed up top signals in 14 additional cohorts (n > 59,000). We strongly confirm FTO and MC4R and identify six additional loci (P < 5 x 10(-8)): TMEM18, KCTD15, GNPDA2, SH2B1, MTCH2 and NEGR1 (where a 45-kb deletion polymorphism is a candidate causal variant). Several of the likely causal genes are highly expressed or known to act in the central nervous system (CNS), emphasizing, as in rare monogenic forms of obesity, the role of the CNS in predisposition to obesity.