Achieving landscape-scale deer management for biodiversity conservation: The need to consider sources and sinks

Hyper-herbivory following predator removal is a global issue. Across North America and Europe, increasing deer numbers are affecting biodiversity and human epidemiology, but effectiveness of deer management in heterogeneous landscapes remains poorly understood. In forest habitats in Europe, deer numbers are rarely assessed and management is mainly based on impacts. Even where managed areas achieve stable or improving impact levels, the extent to which they act as sinks or persist as sources exporting deer to the wider landscape remains unknown. We present a framework to quantify effectiveness of deer management at the landscape scale. Applied across 234 km2 of Eastern England, we assessed management of invasive Reeve’s muntjac (Muntiacus reevesi) and native roe (Capreolus capreolus), measuring deer density (using thermal imaging distance transects 780 km/year), fertility, neonatal survival, and culling to quantify source-sink dynamics over 2008–2010. Despite management that removed 23–40% of the annual population, 1,287 (95% CI: 289–2,680) muntjac and 585 (454–1,533) roe deer dispersed annually into the wider landscape, consistent with their ongoing range expansion. For roe deer, culled individuals comprised fewer young deer than predicted by a Leslie matrix model assuming a closed population, consistent with agedependent emigration. In this landscape, for roe and muntjac, an annual cull of at least 60% and 53%, respectively, is required to offset annual production. Failure to quantify deer numbers and productivity has allowed high density populations to persist as regional sources contributing to range expansion, despite deliberative management programs, and without recognition by managers who considered numbers and impacts to be stable. Reversing an unfavorable condition of woodland biodiversity requires appropriate culls across large contiguous areas, supported by knowledge of deer numbers and fertility

Amlodipine and valsartan as components of a rational and effective fixed-dose combination

Pharmacological treatment of hypertension is effective in preventing cardiovascular and renal complications. Calcium antagonists and blockers of the renin-angiotensin system are widely used today to initiate antihypertensive therapy but, when given as monotherapy, do not suffice in most patients to normalize blood pressure. Combining the two types of agents considerably increases the antihypertensive efficacy, but not at the expense of a deterioration of tolerability. This is exemplified by the experience accumulated with the recently developed fixed dose combination containing the AT1-receptor blocker valsartan (160 mg) and the dihydropyridine amlodipine (5 or 10 mg). In a randomized trial, an 8-week treatment normalized blood pressure (<140/90 mmHg) within 8 weeks in a large fraction of hypertensive patients (78.4% and 85.2% using the 5/160 [n = 371] and 10/160 mg [n = 377] dosage, respectively). Like all AT1-receptor blockers valsartan has a placebo-like tolerability. Valsartan prevents to a large extent the occurrence amlodipine-induced peripheral edema. Both amlodipine and valsartan have beneficial effects on cardiovascular morbidity and mortality, as well as protective effects on renal function. The co-administration of these two agents is therefore very attractive, as it enables a rapid and sustained blood pressure control in hypertensive patients. The availability of a fixed-dose combination based on amlodipine and valsartan is expected therefore to facilitate the management of hypertension, to improve long-term adherence with antihypertensive therapy and, ultimately, to have a positive impact on cardiovascular and renal outcomes

Approaching Human Dimensions in Lemur Conservation at Lake Alaotra, Madagascar

‘Human dimensions of wildlife management’ is a concept that emerged some 50 years ago and has gained global application. A majority of cases report on human-wildlife conflicts (HWCs), where wildlife is causing problems to an expanding human population or vice versa. In Madagascar, lemurs represent a flagship for conservation. Many lemur taxa are threatened, and conservation is facing increasing challenges due to habitat loss and degradation. The Alaotran gentle lemur (Hapalemur alaotrensis) is the only marshland living lemur. Its conservation is particularly challenging due to various conflicting interests of different stakeholder groups. The Alaotra region is the bread basket of Madagascar, producing a majority of inland fish and rice. Here we present a new venue taken by conservation, which is based on a transdisciplinary research approach, participatory modeling, and gaming through role-playing games (RPGs). This holds promise to engage stakeholders from the onset of conservation planning and management, and it is hoped that increased participation will spur ownership and thus reduce conflicts among stakeholders to increase conservation effectiveness to safe Hapalemur alaotrensis from extinction

Ace inhibition and cardiovascular mortality and morbidity in essential hypertension: The end of the search or a need for further investigations?

Scientific evidence currently available supports the concept that renin-angiotensin blockade with angiotensin converting enzyme inhibitors as a first-line treatment exhibits in arterial hypertension beneficial effects in the prevention of mortality and morbidity comparable to those achieved with diuretics and β-blockers. In addition, the renin-angiotensin blockade has also proved to be beneficial in the secondary prevention of several complications of hypertensive disease such as after myocardial infarction and congestive heart failure, as well as in the prevention of the incidence of type 2 diabetes, and the progression of diabetic and nondiabetic nephropathy. In this later regard, recent evidence with angiotensin II receptor antagonists in reducing the progression of nephropathy in type 2 diabetes strongly confirms that antagonism of the renin-angiotensin system is an effective approach to cardiovascular and renal disease. Finally, the renin-angiotensin blockade in high-risk patients may reduce cardiovascular mortality independently of the effect on blood pressure (BP). The effect of other antihypertensive drugs on cardiovascular risk in patients with high-normal BP should be investigated to establish whether they exhibit a comparable effect or whether there is a class-related benefit of drugs blocking the renin-angiotensin system. Such a strategy could also be encouraged to design future interventional studies with the newer classes of compounds (angiotensin II AT1-receptor antagonists, vasopeptidase inhibitors, endothelin antagonists), which would have the additional potential advantage of providing information more easily transferable to large-scale clinical practice. Am J Hypertens 2002;15:367-371 © 2002 American Journal of Hypertension, Lt

Syphilis and parvovirus B19 co-infection imitating a lupus nephropathy: A case report.

Syphilis can share clinical features with autoimmune diseases, such as cutaneous Lupus or rheumatoid arthritis. Moreover, secondary syphilis can have visceral involvement, thus affecting the kidney. Syphilitic nephropathy causes nephrotic syndrome with a classic membranous pattern. We present a unique presentation of a co-infection by syphilis and parvovirus B19 sharing all the biological and histological features of proliferative lupus nephritis (LN). We present a case of a 71-year-old Caucasian male returning from a trip to Asia presenting with nephrotic syndrome with antinuclear antibodies (ANA) positivity. Because of nephrotic syndrome a kidney biopsy was performed. It demonstrated a membranous nephropathy with extracapillary proliferation and a full house pattern (presence of IgA, IgG, IgM and C1Q deposits) on immunofluorescence (IF), highly suggestive of LN class III and V. However, several atypical clinical features notably the age, sex of the patient and the history of travel prompt us to search for another cause of nephropathy. A serology was positive for syphilis and a PCR in the renal biopsy was also positive for parvovirus B19. Thus, a co-infection by syphilis and parvovirus B19 was funded to be the cause of the renal lesions. The proteinuria improved; a course of antibiotic was administrated because of neurologic syphilitic involvement (presence of headache with positive syphilis serology in the CSF). A co-infection by syphilis and parvovirus B19 can share all the biological and histological features of proliferative LN and must be recognized as a cause of pseudo-lupus nephritis

Adjuvant therapy after excision and radiation of isolated postmastectomy locoregional breast cancer recurrence: definitive results of a phase III randomized trial (SAKK 23/82) comparing tamoxifen with observation

Background: Adjuvant systemic treatment for patients with isolated locoregional recurrence (ILRR) of breast cancer is based on a single reported randomized trial. The trial, conducted by the Swiss Group for Clinical Cancer Research, compared tamoxifen (TAM) with observation after complete excision of the ILRR and proper radiotherapy. We performed a definitive analysis of treatment outcome at >11 years of follow-up, after the majority of the patients had a subsequent event of interest. Patient and methods One hundred and sixty-seven patients with ‘good-risk' characteristics of disease were randomized. ‘Good-risk' was defined as estrogen receptor expression in the ILRR, or having a disease-free interval of >12 months and a recurrence consisting of three or less tumor nodules, each ≤3 cm in diameter. Seventy-nine percent of the patients were postmenopausal at randomization. Results: The median follow-up time of the surviving patients was 11.6 years. The median post ILRR disease-free survival (DFS) was 6.5 years with TAM and 2.7 years with observation (P = 0.053). The difference was mainly due to reduction of further local relapses (P = 0.011). In postmenopausal patients, TAM led to an increase of DFS from 33% to 61% (P = 0.006). In premenopausal women, 5-year DFS was 60%, independent of TAM medication. For the whole study population, the median post-recurrence overall survival (OS) was 11.2 and 11.5 years in the observation and the TAM group, respectively; premenopausal patients experienced a 5-year OS of 90% for observation compared with 67% for TAM (P = 0.175), while the respective figures for postmenopausal patients were both 75%. Conclusions: These definitive results confirmed that TAM significantly improves the post-recurrence DFS of patients after local treatment for ILRR. This beneficial effect does not translate into a detectable OS advantag