Estado del conocimiento y nuevos aportes sobre la historia natural del Guacamayo Verde (Ara militares)

Fil: Juárez, Marcos. Facultad de Ciencias Naturales y Museo.Fil: Marateo, Germán. Facultad de Ciencias Naturales y Museo.Fil: Grilli, Pablo Gervasio. Facultad de Ciencias Naturales y Museo.Fil: Pagano, Luis Gerardo. Facultad de Ciencias Naturales y Museo.Fil: Rumi, Mariano. La Plata. Buenos Aires; ArgentinaFil: Silva Croome, Marcelo. Secretaría de Ambiente y Desarrollo Sustentable de la Nación. Buenos Aires; Argentin

Current knowledge and new contributions to the natural history of the Military Macaw (Ara militaris)

El Guacamayo Verde (Ara militaris) se distribuye de manera fragmentada desde México hasta Argentina. Gran parte de su biología básica y ecología no han sido descriptas, en especial para Ara militaris boliviana, que llega a Argentina. La modificación y reemplazo de sus hábitats y la captura de individuos para el comercio de mascotas han determinado la situación preocupante de conservación de la especie (Vulnerable a nivel global y En Peligro Crítico en Argentina). En este trabajo se presenta un resumen actualizado de la información disponible y nuevos aportes sobre diferentes aspectos de la biología y la ecología de la especie. Se proponen diferentes líneas de acción orientadas a reducir los vacíos de información y a conservar las poblaciones de la especie, principalmente en Argentina.The Military Macaw (Ara militaris) has a fragmented distribution from Mexico to Argentina. Much remains unknown about its basic biology and ecology, especially for Ara militaris boliviana, distributed up to Argentina. Habitat modification and replacement, and specimen capture for pet trade has yielded a worrisome conservation status for this species (which is considered Vulnerable at global level and Critically Endangered in Argentina). This work summarizes the information available to date and provides new contributions in relation to different aspects of the biology and ecology of the species. Conservation strategies for Argentinean populations are proposed, as well as guidelines to reduce information gaps regarding this species.Facultad de Ciencias Naturales y Muse

Utilization of livers donated after circulatory death for transplantation - An international comparison.

BACKGROUND AND AIM Liver graft utilization rates are a hot topic due to the worldwide organ shortage and an increasing number of transplant candidates on waiting lists. Liver perfusion techniques have been introduced in several countries, and may help to increase the organ supply, as they potentially allow the assessment of livers before use. METHODS Liver offers were counted from donation after circulatory death (DCD) donors (Maastricht-type-III) arising during the past decade in eight countries, including Belgium, France, Italy, the Netherlands, Spain, Switzerland, UK, and US. Initial DCD-type-III liver offers were correlated with accepted, recovered and implanted livers. RESULTS A total number of 34`269 DCD livers were offered, resulting in 9`780 liver transplants (28.5%). The discard rates were highest in UK and US, ranging between 70 and 80%. In contrast, much lower DCD liver discard rates, e.g., between 30-40%, were found in Belgium, France, Italy, Spain and Switzerland. In addition, large differences were recognized in the use of various machine perfusion techniques, and in terms of risk factors in the cohorts of implanted livers. For example, the median donor age and functional donor warm ischemia were highest in Italy, e.g., >40minutes, followed by Switzerland, France, and the Netherlands. Importantly, such varying risk profiles of accepted DCD livers between countries did not translate into large differences in five-year graft survival rates, which ranged between 60-82% in this analysis. CONCLUSIONS We highlight a significant number of discarded and consequently unused DCD liver offers. Countries with more routine use of in- and ex-situ machine perfusion strategies showed better DCD utilization rates without compromised outcome. IMPACT AND IMPLICATIONS A significant number of Maastricht type III DCD livers are discarded across Europe and North America today. The overall utilization rate among eight Western countries is 28.5%, but varies significantly between 18.9% and 74.2%. For example, the median DCD III liver utilization in five countries, e.g., Belgium, France, Italy, Switzerland, and Spain is 65%, in contrast to 24% in the Netherlands, UK and US. Despite this, and despite different rules and strategies for organ acceptance and preservation, the one and five-year graft survival remains currently relatively comparable among all participating countries. Factors which impact on DCD liver acceptance rates include the national pre-selections of donors, before the offer is made, as well as cutoffs for key risk factors, including donor age and donor warm ischemia time. In addition, a highly varying experience with modern machine perfusion technology is noticed. In situ and ex situ liver perfusion concepts, and assessment tools for type III DCD livers before transplantation may be one key part for the observed differences in better DCD III utilization

Effects of fluoxetine on functional outcomes after acute stroke (FOCUS): a pragmatic, double-blind, randomised, controlled trial

Background Results of small trials indicate that fluoxetine might improve functional outcomes after stroke. The FOCUS trial aimed to provide a precise estimate of these effects. Methods FOCUS was a pragmatic, multicentre, parallel group, double-blind, randomised, placebo-controlled trial done at 103 hospitals in the UK. Patients were eligible if they were aged 18 years or older, had a clinical stroke diagnosis, were enrolled and randomly assigned between 2 days and 15 days after onset, and had focal neurological deficits. Patients were randomly allocated fluoxetine 20 mg or matching placebo orally once daily for 6 months via a web-based system by use of a minimisation algorithm. The primary outcome was functional status, measured with the modified Rankin Scale (mRS), at 6 months. Patients, carers, health-care staff, and the trial team were masked to treatment allocation. Functional status was assessed at 6 months and 12 months after randomisation. Patients were analysed according to their treatment allocation. This trial is registered with the ISRCTN registry, number ISRCTN83290762. Findings Between Sept 10, 2012, and March 31, 2017, 3127 patients were recruited. 1564 patients were allocated fluoxetine and 1563 allocated placebo. mRS data at 6 months were available for 1553 (99·3%) patients in each treatment group. The distribution across mRS categories at 6 months was similar in the fluoxetine and placebo groups (common odds ratio adjusted for minimisation variables 0·951 [95% CI 0·839–1·079]; p=0·439). Patients allocated fluoxetine were less likely than those allocated placebo to develop new depression by 6 months (210 [13·43%] patients vs 269 [17·21%]; difference 3·78% [95% CI 1·26–6·30]; p=0·0033), but they had more bone fractures (45 [2·88%] vs 23 [1·47%]; difference 1·41% [95% CI 0·38–2·43]; p=0·0070). There were no significant differences in any other event at 6 or 12 months. Interpretation Fluoxetine 20 mg given daily for 6 months after acute stroke does not seem to improve functional outcomes. Although the treatment reduced the occurrence of depression, it increased the frequency of bone fractures. These results do not support the routine use of fluoxetine either for the prevention of post-stroke depression or to promote recovery of function. Funding UK Stroke Association and NIHR Health Technology Assessment Programme

Related quality of life questionnaire specific to dysthyroid ophthalmopathy evaluated in a population of patients with Graves’ disease

ABSTRACT Objective The aim of this study was to measure quality of life (QOL) impairment in individuals currently suffering from Graves’ ophthalmopathy (GO) and to determine the correlation of GO-specific QOL scores with disease severity and activity. Subjects and methods Seventy three GO-specific QOL surveys were prospectively analysed and compared with GO status. The GO-specific QOL survey was translated into Spanish and applied to Argentine patients with Graves’ disease (GD). Results were compared with presence or absence of GO, Clinical Activity Score (CAS), severity score, age, gender and thyroid function. Results Fifty-six patients answered the survey and underwent complete ophthalmic evaluation, 15 did not have GO and were considered to be a control group. Appearance QOL score for patients with GO (53 ± 31.4) was lower than the control group (88.3 ± 17) (p < 0,000), no difference was observed in functional QOL score. There was a negative correlation between GO severity and both functional (r = -0.575; p < 0.000) and appearance QOL (r = -0.577; p < 0.000). Functional QOL differed between patients with active GO vs control group (p = 0.043). Patients with active and inactive GO had lower appearance QOL scores than control group (p < 0.000, p < 0.001 respectively). Conclusions GO has significant impact on the life of these Argentine patients. QOL was worse in GO patients than in control group, functional QOL was mostly affected by the activity and appearance QOL was mainly altered by the effects of the disease. Patients with more severe GO had lower scores on both QOL scales

Current knowledge and new contributions to the natural history of the Military Macaw (Ara militaris)

El Guacamayo Verde (Ara militaris) se distribuye de manera fragmentada desde México hasta Argentina. Gran parte de su biología básica y ecología no han sido descriptas, en especial para Ara militaris boliviana, que llega a Argentina. La modificación y reemplazo de sus hábitats y la captura de individuos para el comercio de mascotas han determinado la situación preocupante de conservación de la especie (Vulnerable a nivel global y En Peligro Crítico en Argentina). En este trabajo se presenta un resumen actualizado de la información disponible y nuevos aportes sobre diferentes aspectos de la biología y la ecología de la especie. Se proponen diferentes líneas de acción orientadas a reducir los vacíos de información y a conservar las poblaciones de la especie, principalmente en Argentina.The Military Macaw (Ara militaris) has a fragmented distribution from Mexico to Argentina. Much remains unknown about its basic biology and ecology, especially for Ara militaris boliviana, distributed up to Argentina. Habitat modification and replacement, and specimen capture for pet trade has yielded a worrisome conservation status for this species (which is considered Vulnerable at global level and Critically Endangered in Argentina). This work summarizes the information available to date and provides new contributions in relation to different aspects of the biology and ecology of the species. Conservation strategies for Argentinean populations are proposed, as well as guidelines to reduce information gaps regarding this species.Facultad de Ciencias Naturales y Muse

Negative correlation between bone mineral density and TSH receptor antibodies in long-term euthyroid postmenopausal women with treated Graves’ disease

BACKGROUND: Thyrotoxicosis is a cause of secondary osteoporosis. High concentrations of triiodotironine (T3) in Graves’ disease stimulate bone turnover, but it is unclear if euthyroidism will always normalize bone metabolism. Thyrotropin (TSH) is known to affect directly the bone metabolism through the TSH receptor and TSH receptor antibodies (TRAb) may have an important role in bone turn-over. The aim of our study was to determine, in pre and postmenopausal euthyroidism patients with previous overt hyperthyroidism due to Graves’ disease the bone mineral density (BMD) as well as factors that could affect BMD in each group, including TRAb. METHODS: Cross-sectional, non-interventional study. Fifty-seven patients with previous hyperthyroidism due to Graves’ disease (premenopausal: 30, postmenopausal: 27) that remained euthyroid for at least 6 months prior to study were included and compared with fifty- two matched respective controls. Thyrotoxine (T4), TSH, TRAb and BMD were measured. RESULTS: Only euthyroid postmenopausal patients with a history of hyperthyroidism due to Graves’ disease showed lower whole body BMD than matched controls. The BMD expressed as Z-score was less in whole body and lumbar spine in postmenopausal in relation to premenopausal women with previous overt hyperthyroidism due to Graves’ disease. In the postmenopausal patients, the Z-score of lumbar spine BMD correlated negatively with TRAb (r = −0,53, p < 0.008), positively with the time of evolution of the disease (r = +0.42, p < 0.032) and positively with the time of euthyroidism (r = + 0.50, p < 0.008), but neither with serum T4 nor TSH. In a multiple regression analysis TRAb was the only significant independent variable in relation to lumbar spine BMD (F = 3. 90, p < 0.01). CONCLUSIONS: In euthyroid women with a history of Graves’ hyperthyroidism, BMD was only affected in the postmenopausal group. The negative correlation of Z-score of lumbar spine BMD with TRAb suggests that this antibody may affect the bone metabolism

Thyroid and pregnancy guidelines

En los últimos 4 años se han publicado al menos 3 guías internacionales acerca del manejo de la enfermedad tiroidea en el embarazo: 2 americanas (American Thyroid Association en 2011 y Endocrine Society en 2012) y una europea (European Thyroid Association en 2014).¿Cuál es el objetivo de que la Federación Argentina de Sociedades de Endocrinología (FASEN) convocara a elaborar una guía argentina luego de que el tema fuera tan ampliamente tratado? Por un lado, enfocar la atención en aspectos insuficientemente desarrollados en las guías anteriores o en los que existiera disenso y, por otro, tener la oportunidad de mostrar la experiencia y la postura argentina en varios de los puntos considerados. Se reunió a un comité de expertos de distintos puntos del país (Buenos Aires, Córdoba, Tucumán, San Juan y Jujuy) con experiencia en el manejo de las enfermedades tiroideas en el embarazo.Laboratorio de Investigación en Osteopatías y Metabolismo Minera

Thyroid and pregnancy guidelines

En los últimos 4 años se han publicado al menos 3 guías internacionales acerca del manejo de la enfermedad tiroidea en el embarazo: 2 americanas (American Thyroid Association en 2011 y Endocrine Society en 2012) y una europea (European Thyroid Association en 2014).¿Cuál es el objetivo de que la Federación Argentina de Sociedades de Endocrinología (FASEN) convocara a elaborar una guía argentina luego de que el tema fuera tan ampliamente tratado? Por un lado, enfocar la atención en aspectos insuficientemente desarrollados en las guías anteriores o en los que existiera disenso y, por otro, tener la oportunidad de mostrar la experiencia y la postura argentina en varios de los puntos considerados. Se reunió a un comité de expertos de distintos puntos del país (Buenos Aires, Córdoba, Tucumán, San Juan y Jujuy) con experiencia en el manejo de las enfermedades tiroideas en el embarazo.Laboratorio de Investigación en Osteopatías y Metabolismo Minera