Management of Worsening Aortic Dilation and Insufficiency in a 20-Week Pregnant Woman: A Case Report

Preexisting aortic disease can worsen during pregnancy as physiologic hemodynamic changes evolve. At a large academic institution, a patient with a remote history of vasculitis presented with a second trimester pregnancy with increasing aortic dilatation and aortic insufficiency. Extensive obstetric discussions encompassed maternal cardiac risks from continuing the pregnancy and fetal risks from maternal cardiac intervention. This patient desired termination of pregnancy to avoid further complications and to expedite surgical aortic repair

Profiling patterns of fecal 20-oxopregnane concentrations during ovarian cycles in free-ranging southern white rhinoceros (Ceratotherium simum simum)

Unlike their wild counterparts, many white rhinoceros females in captivity fail to reproduce successfully such that current captive populations are not self-sustaining. The causes of the problem are poorly understood. Variation in cycle length and long periods of acyclicity are characteristics of the majority of these non-reproducing females in captivity but it is unknown whether these characteristics are a feature of reproductively successful free-ranging females. This study therefore aimed to monitor cyclic activity in a wild population of southern white rhinoceros at Lapalala Wilderness, South Africa, by measuring the concentrations of immunoreactive fecal progestagen metabolites (fPM). Five adult females were tracked twice per week for 20 months and if located a fresh fecal sample was collected. Reproductive events and group structural dynamics were also recorded and subsequently correlated with the fPM data. The baseline concentration of fPM was 0.69 ± 0.20 μg/g DW while concentrations during pregnancy were 30- to 400- fold higher. The females exhibited estrous cycle lengths of 30.6 ± 7.7 days and, based on fPM data, gestation length in one female was 502 ± 3 days. Year-round monitoring showed no clear evidence of seasonality in ovarian activity. During cyclic luteal activity females were often seen in the presence of a dominant bull. One female stopped cycling after removal of the local dominant bull and luteal activity only returned after a new bull was introduced. This suggests that white rhinoceros females in the wild might need external stimuli from a male to ovulate. These findings indicate that the irregular cyclicity reported for white rhinoceros housed in zoos and animal parks may result from conditions in captivity and account for reduced fertility.The University of Western Australia, the Mammal Research Institute and Endocrine Research Laboratory, University of Pretoria, the Institute for Breeding Rare and Endangered African Mammals, the AAZK‘s Bowling For Rhinos, and the SAVE African Rhino Foundation.http://www.elsevier.com/locate/anireprosci2016-10-31hb201

From State-Centricism to Where?: The Formation of (Customary) International Law and Non-State Actors

International law-making is no longer a process dominated by states alone. Especially in the formation of customary international law (CIL) the practice of non-state entities - especially of international organizations - has become influential and calls for reconceptualization on the nature of CIL