Speciation Associated with Shifts in Migratory Behavior in an Avian Radiation.

Migratory animals move up to thousands of kilometers every year [1]. Losses of migration (i.e., migratory drop-offs) occur when individuals of a migratory species stop migrating and establish founder sedentary populations, a phenomenon documented in birds [2-5] and butterflies [6]. In theory, losses-and also gains-of migration might promote speciation if sedentary and migratory populations become reproductively isolated [7-9]. Because migratory and sedentary strategies involve alternative physiological, behavioral, and morphological traits [10-13], divergence along multiple axes of organismal function is expected to accompany switches in migratory behavior, potentially accelerating speciation. We present evidence of speciation driven by a migratory drop-off in the fork-tailed flycatcher (Tyrannus savana) resulting in reproductive isolation likely driven by changes in breeding schedules (allochronic speciation [13-15]) and geographic isolation of breeding grounds (allopatric speciation [16]). Phylogenetic analyses across New World flycatchers (Tyrannidae) showed that an association between speciation and drop-offs is also observable at a macroevolutionary scale. Loss of migration was significantly more frequent than its gain, and speciation rates of migratory and partially migratory lineages (i.e., species having both migratory and sedentary populations) exceeded those of sedentary lineages. Models of trait evolution indicated that partial migration is an intermediate step between migratory and sedentary states in this family. Given that partial migration is widespread across migratory animals (e.g., of all migratory birds, ca. 51% are partially migratory [5]), speciation via switches in migratory behavior might be an important yet overlooked mechanism of animal diversification.

Efectividad de un programa de rehabilitación respiratoria en pacientes con esclerosis múltiple / Effectiveness of a respiratory rehabilitation program on patients with multiple sclerosis

Las personas con esclerosis múltiple presentan alteraciones de la comunicación oral relacionadas con una insuficiencia respiratoria, lo que obliga a los especialistas en logopedia a trabajar en este problema desde la óptica de su especialidad. Objetivo Evaluar la efectividad de un programa intensivo de rehabilitación respiratoria en personas con esclerosis múltiple, para aumentar su capacidad respiratoria y mejorar la coordinación fonorrespiratoria. Métodos Estudio de intervención cuasi experimental en un grupo de 30 personas adultas de ambos sexos con esclerosis múltiple. Todos recibieron el programa durante cuatro semanas con una hora diaria de ejercitación. Para valorar la efectividad del programa, se realizó una evaluación inicial y otra final de la capacidad vital inspiratoria y espiratoria forzada y de la coordinación fonorrespiratoria, por personal externo. El deterioro neurológico se midió mediante la Escala Expandida de Discapacidad de Kurtzke. Resultados En la muestra hubo predominio de mujeres, una edad promedio de 40,43 ± 11,46 años y 13,40 ± 7,76 años de evolución de la enfermedad. Se encontró esclerosis múltiple progresiva en 22 pacientes y 8 tenían formas de brote-remisión. El deterioro neurológico fue de 5,8 (±1,51) como promedio, lo que habla a favor de una discapacidad moderada en la muestra. Se encontró un aumento de la capacidad vital inspiratoria y espiratoria forzada y un aumento en el tiempo máximo de fonación, en la emisión de series de palabras bisílabas y en la emisión de series de números. Conclusiones El programa intensivo de rehabilitación respiratoria, contribuye al aumento de la capacidad respiratoria de las personas con esclerosis múltiple, por lo que se recomienda su aplicación en el proceso de neurorrehabilitación

People with multiple sclerosis present with altered oral communication related to respiratory failure, which forces the speech therapists to work on this problem within their range of specialty. Objective To evaluate the effectiveness la efectividad) of an intensive respiratory rehabilitation program. Methods Quasi-experimental interventional study carried out in a group of 30 adults of both sexes suffering from multiple sclerosis. All these patients were included in the program for 4 weeks, having one-hour training every day. For assessing the effectiveness of the program, an initial and a final evaluation of the forced vital inspiratory and expiratory capacity and of the phonorespiratory coordination was made by outside experts. The neurological deterioration was measured according the Kurtzkeïs extended disability scale. Results Women predominated in the sample; the average age was 40.43 ± 11.46 years and progression of disease was 13.40 ± 7.76 years. Progressive multiple sclerosis was found in 22 patients and the onset-remission forms in 8 patients. The neurological deterioration amounted to 5.8 (±1.51) as an average, which speaks for the moderate disability rate present in the simple. There was observed increased vital forced inspiratory and expiratory capacities and increase in maximum phonation length and in pronouncing series of two-syllable words and series of numbers. Conclusions The intensive respiratory rehabilitation program helps to increase the respiratory capacity of the patients with multiple sclerosis, hence, its implementation in the neurorehabilitation process is recommended

Minimally invasive venous surgery.

BACKGROUND: Varicose vein surgery of the lower extremities is accomplished by new noninvasive modalities. In this study we evaluated the safety, efficacy, and recuperation time of radiofrequency associated with miniphlebectomies and foam sclerotherapy to treat primary varicose veins of the lower extremities. METHODS: From November 6, 2006 to December 15, 2009, 204 legs in 102 patients with symptomatic primary varicose veins were treated by radiofrequency. There were 74 females and 28 males. Average age was 38 ± 6 years. Preoperatively, each patient had a duplex ultrasound to evaluate permeability, competency of the deep venous system, localization of the reflux areas and diameter of the saphenous veins. Postoperatively, a duplex ultrasound was done at 72 h and at 6 and 12 months. RESULTS: At 12 months, radiofrequency was effective in 98% of the patients. In two cases (1.98%) there were recurrent varicose veins. There were no systemic complications. In one case there was burn damage of the skin requiring surgical treatment, due to perforation of the vein by the catheter tip. The mean recovery time was 1.14 days. CONCLUSIONS: Radiofrequency associated with miniphlebectomies and foam sclerotherapy represents a safe and effective option to treat primary variceal disease in the lower extremities with less postoperative recovery time.

The impact of a monophasic continuous estro-progestogenic treatment on Latin American menopausal women.

OBJECTIVE: The present study was undertaken to assess the impact, effectiveness and safety of a monophasic hormone replacement treatment (HRT) for continuous use with regards to the clinical effects, bleeding patterns and lipid profile of menopausal women in four Latin American countries. DESIGN: Three hundred and six postmenopausal women with natural menopause and uterus present were recruited. This was a multicentre prospective, clinical trial; the participating countries were Brazil (BR), Colombia (CO), Mexico (MX) and Argentina (AR). The study period was 12 months. The HRT regime was formulated in tablets containing 2 mg estradiol E2 and 1mg norethisterone acetate (NETA); one visit every 3 months was solicited. METHODS: HRT was given as one tablet every day without interruption for 1 year. Climacteric complaints, side-effects, reason for discontinuation, bleeding patterns, lipid profile at baseline and 12 months of treatment were documented. RESULTS: There were no significant differences between the four populations on clinical measurements. Thirty-four women discontinued, 13 for bleeding problems. The five most common side-effects were mastalgia, bleeding problems, headache, pelvic pain and nausea. 44.8% of women experienced scanty vaginal bleeding during the first 3 months of therapy. Ninety seven percent of women had amenorrhea at the end of the study in MX, BR and AR, and 100% in CO. Body weight was constant during the study, and no correlation was found between body weight and total days with bleeding. The Kupperman index score was used to evaluate the climacteric complaints, and the score decreased from a mean of 25.4 to 5.1 at 12-months visit. Total cholesterol levels were significantly reduced in BR and CO (P < 0.05) between baseline and the final sample; serum triglycerides remained unchanged, HDL-cholesterol was significantly increased in MX (P < 0.05), and LDL-cholesterol was significantly reduced in CO (P < 0.05). The results of this 1-year study emphasize that a continuous combined HRT regimen with 2 mg E2/1 mg NETA is an attractive alternative for postmenopausal women who are at least 1 year after their menopause and optimally 2 years after their menopause. Although the combination of 2 mg E2 with 1 mg NETA in a continuous combined therapy scheme has been in use in the Nordic countries for over a decade and in Latin America for the last 6 years, there have been no previous published reports on its effectivity in Latin American women. This publication reports the experience in a group of 306 Latin American women, and it is the first Latin American publication with this formulation.

Análisis de los conceptos del modelo de adaptación de Callista Roy / Analysis of the concepts of the Calista Roy's adaptation model

El artículo presenta el análisis sobre los elementos básicos del modelo de adaptación, que viene realizando el grupo de estudio de la Facultad de Enfermería.Partiendo de una revisión histórica, de los principios filosóficos y científicos que sustentan el modelo, se abordan conceptos como sistema adaptativo humano, ambiente, estímulos, mecanismos de enfrentamiento, nivel de adaptación, salud y meta de enfermería, los cuales orientan el cuidado, teniendo en cuenta la autodeterminación de la persona y los mecanismos que emplea para lograr su adaptación.

Pregnancy complicated by acute pulmonary lymphangitic adenomatosis, metastasis and disseminated intravascular coagulation. A case report.

BACKGROUND: The association of pregnancy and cancer is a rare event, occurring in less than 1 case per 5,000 pregnancies, and is a cause of maternal mortality in about 5% of cases. CASE: A 33-year-old, Japanese woman presented at the end of pregnancy with clinical manifestations of pneumonia and developed fatal disseminated intravascular coagulation in the postpartum period. The pathologic findings suggested the existence of a primary cancer in the gastrointestinal tract with pulmonary and placental metastases. CONCLUSION: The biologic course of malignancies in pregnancy is complex. In gastrointestinal cancer, normal pregnancy symptoms can mask and delay the diagnosis. As in this patient, very rare presentations are possible.

Métodos para la hemostasia de pedículos en histerectomía vaginal asistida laparoscópicamente (LAVH). Evaluación de resultados / Methods of pedicles hemostasia in laparoscopically assisted vaginal hysterectomy (LAVH). evaluation of results

El objetivo del estudio fue evaluar si el uso de diferentes métodos de hemostasia de los pedículos tiene efecto sobre la morbilidad relacionada con la histerectomía vaginal asistida laparoscópicamente (LAVH). Fue realizada una revisión de los casos de 53 pacientes sometidas a LAVH evaluándose el método de hemostasia de los pedículos y la frecuencia de complicaciones. Hubo cinco pacientes con hemorragia transoperatoria y dos con lesión vesical que fueron tratadas satisfactoriamente sin complicaciones. No hubo diferencia significativa en la aparición de hemorragia transoperatoria con respecto al método de hemostasia utilizado. No hubo complicaciones quirúrgicas mayores en el grupo total de pacientes estudiadas. Como conclusión, la LAVH ofrece las ventajas de la cirugía laparoscópica con escasa morbilidad postoperatoria. Todos los métodos utilizados en este trabajo para hernostasia de los pedículos en LAVH se consideran seguros y efectivos para pacientes con las indicaciones más frecuentes para realizar histerectomía.

Tumores de vejida y pene en pacientes asistidos en un hospital provincial / Urinary bladder and pinus tumors in patients assisted in a provincial hospital

Incidencia de tumores de vejiga y pene en el Hospital Juan Pablo Pina de San Cristobal, República Dominicana, desde 1988-1991. Se trata de un estudio retrospectivo con la finalidad de verificar la cantidad de tumores de vejiga y pene, así como trazar pautas para prevenir esta patología. En este período encontramos unos 29 casos que asistieron al centro con signos y síntomas sugestivos de la enfermedad. A estos expedientes se les aplicó un cuestionario el cual contenía datos personales, signos y síntomas, además de las pruebas de laboratorio indicada para la misma (citología, urografía excretora y esturio anatomo patológico). Encontramos que la mayor cantidad de casos correspondía al año 1988 (69//). El 48//de los casos fueron mujeres con carcinoma de vejiga y su signo principal fue la hematuria macroscópica. Otra patología frecuente fue el carcinoma de pene y su síntoma principal fue el dolor en el área de la lesión. En estos últimos encontramos que no estaban circuncidados, pertenecían a extracto socio económico bajo y entre ellos prevalecía la mala higiene. Carcioma de vejiga, hematuria, circuncisión

Radioterapia preoperatoria en cáncer de endometrio estadío I: supervivencia a cinco años / Pre-operative radiotheraphy in stage I endometrial cancer: five year survival

Se dan a conocer los resultados del tratamiento aplicado a 25 pacientes con adenocarcinomas de endometrio en estadío ClínicoI, tratadas en el Servicio de Oncología del Hospital 20 de Noviembre de la Ciudad de México, de 1979 a 1984. Se utilizaron tres sucesivos métodos de tratamiento: radioterapia externa, preoperatoria, a la pelvis con telecobalto, dosis de 5000 cGy en 6 a 7 semanas; subsecuentemente, una fuente lineal radiactiva de dos capsulas de radio de 20 o 15 mg colocada dentro de un aplicador intravaginal de plástico flexible, aplicador insertado, a su vez, en un cilindro de acrílico, siendo la dosis recibida por la mucosa vaginal de 5000 cGy; ulteriormente, histerectomía total abdominal extrafacial con salpingo-oforectomía bilateral. Los resultados obtenidos después de cinco años de control fueron: el 92 por ciento de pacientes estaban curadas, y no se presentaron recidivas tumorales intrapélvicas