Cristaluria por sulfadiazina en paciente con nefropatía lúpica Ruiz Álvarez, María J.; Molina-Blas, Sergio; Barrionuevo-González, Marta ...
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio,
06/2022, Letnik:
3, Številka:
2
Journal Article
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Resumen
Objetivos
Se estima que el 29% de los pacientes tratados con sulfadiazina pueden desarrollar un fallo renal agudo. Para su diagnóstico debemos recurrir a un análisis del sedimento urinario.
...Caso clínico
Paciente de 71 años que consulta por pérdida de agudeza visual en el contexto de un brote de Lupus eritematoso sistémico (LES). Se diagnosticó de necrosis retiniana aguda, pendiente de filiación etiológica. Se inició empíricamente tratamiento con sulfadiazina. En los estudios analíticos de seguimiento se solicita sedimento urinario, en el cual se objetivan los siguientes hallazgos: pH 6, 30–50 hematíes/campo, células epiteliales de vías bajas y de transición, cilindros hialinos, gotas de grasa o cuerpos de cruz de Malta y abundantes cristales de sulfadiazina. Se comunica este hallazgo al Servicio de Nefrología y se suspende el tratamiento de forma inmediata.
Conclusiones
La sulfadiazina es un antibiótico de la familia de las sulfamidas. Su cristalización en el interior de los túbulos renales puede causar nefritis instersticial aguda. Estos cristales adoptan una morfología muy diversa en función del metabolito que cristalice: las formas inalteradas precipitan en forma de cristales densos y globulares, o como en el caso de nuestro paciente, los cristales adoptan forma de espigas de trigo en abanico.
Sulfadiazine crystalluria in a patient with lupus nephritis Ruiz Álvarez, Maria Jesús; Molina Blas, Sergio; Barrionuevo González, Marta ...
Advances in Laboratory Medicine / Avances en Medicina de Laboratorio,
06/2022, Letnik:
3, Številka:
2
Journal Article
Recenzirano
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It is estimated that 29% of patients treated with sulfadiazine ultimately develop acute kidney failure. Diagnosis is based on urine sediment analysis.
A 71-year-old woman with loss of visual acuity ...in the context of a flare of systemic erythematosus lupus (SEL). A diagnosis of acute retinal necrosis was established, pending etiological confirmation. Empirical treatment with sulfadiazine was initiated. Follow-up analyses included urine sediment, which revealed pH 6, 30-50 RBCs/field, urothelial cells and lower tract epithelial cells, hyaline casts, fatty casts or Maltese cross, and abundant sulfadiazine crystals. The finding was reported to the Unit of Nephrology, and treatment was immediately suspended.
Sulfadiazine is an antibiotic of the family of sulfamides. Crystalization of sulfadiazine in the renal tubules may cause acute interstitial nephritis. These crystals adopt different shapes according to the metabolite that crystalizes: unaltered forms precipitate into dense, globular crystals, whereas in other cases, as in the case reported in this paper, crystals adopt a fan-shaped, shocks-of-wheat morphology.
Mountain areas often hold special species communities, and they are high on the list of conservation concern. Global warming and changes in human land use, such as grazing pressure and afforestation, ...have been suggested to be major threats for biodiversity in the mountain areas, affecting species abundance and causing distribution shifts towards mountaintops. Population shifts towards poles and mountaintops have been documented in several areas, indicating that climate change is one of the key drivers of species’ distribution changes. Despite the high conservation concern, relatively little is known about the population trends of species in mountain areas due to low accessibility and difficult working conditions. Thanks to the recent improvement of bird monitoring schemes around Europe, we can here report a first account of population trends of 44 bird species from four major European mountain regions: Fennoscandia, UK upland, south‐western (Iberia) and south‐central mountains (Alps), covering 12 countries. Overall, the mountain bird species declined significantly (−7%) during 2002–2014, which is similar to the declining rate in common birds in Europe during the same period. Mountain specialists showed a significant −10% decline in population numbers. The slope for mountain generalists was also negative, but not significantly so. The slopes of specialists and generalists did not differ from each other. Fennoscandian and Iberian populations were on average declining, while in United Kingdom and Alps, trends were nonsignificant. Temperature change or migratory behaviour was not significantly associated with regional population trends of species. Alpine habitats are highly vulnerable to climate change, and this is certainly one of the main drivers of mountain bird population trends. However, observed declines can also be partly linked with local land use practices. More efforts should be undertaken to identify the causes of decline and to increase conservation efforts for these populations.
Overall populations of 44 mountain bird species declined significantly c. −7% in Europe (inc. Fennoscandia, UK upland, Alps and Iberia) during 2002–2014. Mountain specialists species, which occur only in the mountain areas in Europe, showed a significant −10% decline in population numbers.
Although biological conservation is based on international agreements, its effectiveness depends on how countries implement such recommendations as effective conservation tools. The Ramsar Convention ...is the oldest international treaty for wetland and waterbird conservation, establishing the world's largest network of protected areas. However, since it does not constitute any binding measure, its effectiveness in protecting wintering waterbird populations at an international scale has been questioned. Here, we use long-term (1991–2012) count data to assess the effectiveness of the Ramsar Convention in the Mediterranean Basin. We compared abundance and temporal trends of 114 waterbird species between 251 Ramsar wetlands and 3486 non-Ramsar wetlands. We found that the Ramsar network is critical for wintering waterbirds, concentrating nearly half of all waterbirds counted in the Mediterranean Basin in only 7% of monitored wetlands. Waterbird trends followed a northwest-southeast gradient, with a population decrease in the East. A significant and positive Ramsar effect on population trends was only found for the species of higher conservation concern in the Maghreb, particularly when a management plan was implemented. The Ramsar Convention was previously used on very important wetlands for waterbirds in Southern Europe, but is now an underused conservation tool. Our study suggests weaknesses in the use of Ramsar as an effective conservation tool in most of the Mediterranean Basin. However, the Ramsar Convention effectiveness to enhance waterbird populations in the Maghreb should encourage strengthening the Ramsar Convention. It should be done particularly in countries with limited environmental agreements and by systematic implementation of management plans.
Identification of the regional disparities in the Ramsar Convention effectiveness to enhance waterbird populations across the Mediterranean Basin.
Climate change has been associated with both latitudinal and elevational shifts in species' ranges. The extent, however, to which climate change has driven recent range shifts alongside other ...putative drivers remains uncertain. Here, we use the changing distributions of 378 European breeding bird species over 30 years to explore the putative drivers of recent range dynamics, considering the effects of climate, land cover, other environmental variables, and species' traits on the probability of local colonisation and extinction. On average, species shifted their ranges by 2.4 km/year. These shifts, however, were significantly different from expectations due to changing climate and land cover. We found that local colonisation and extinction events were influenced primarily by initial climate conditions and by species' range traits. By contrast, changes in climate suitability over the period were less important. This highlights the limitations of using only climate and land cover when projecting future changes in species' ranges and emphasises the need for integrative, multi-predictor approaches for more robust forecasting.
Unsustainable fossil fuel emissions have prompted a global shift towards renewable energy sources, such as wind. This has led to a strong expansion of wind power generation infrastructures, often ...conflicting with biodiversity conservation. Relatively large flying animals, such as birds and bats, have frequently been reported to collide with wind turbines, resulting in casualties that can depress population size and lead to local extinctions. Migratory species that move across continents through their year-round displacements may be especially at risk. We comprehensively assessed wind turbine exposure for a colonial migratory raptor of European conservation interest, the lesser kestrel Falco naumanni, based on the distribution and size of >1800 colonies and a large GPS-tracking dataset (>350 individuals) for three distinct biogeographical populations (from Iberian, Italian, and Balkan peninsulas). 26 % of the European population has at least one wind turbine within the foraging areas around colony sites, Italian colonies being most at risk. The main European network of protected areas, the Natura 2000 network, failed to mitigate the potential negative impact of wind turbines on breeding populations. GPS-tracking revealed that exposure was negligible in the African non-breeding areas (Sahel region), particularly high during migration, and lower during breeding for Iberian and Balkan individuals but not for Italian ones. Different countries should prioritize different measures to mitigate collision risk with wind power generation infrastructures. This case study can be leveraged by conservationists and renewable energy stakeholders to mitigate conflicts between biodiversity conservation and expected wind energy infrastructure development in the near future.
Climate warming is driving changes in species distributions and community composition. Many species have a so‐called climatic debt, that is, shifts in range lag behind shifts in temperature ...isoclines. Inside protected areas (PAs), community changes in response to climate warming can be facilitated by greater colonization rates by warm‐dwelling species, but also mitigated by lowering extirpation rates of cold‐dwelling species. An evaluation of the relative importance of colonization‐extirpation processes is important to inform conservation strategies that aim for both climate debt reduction and species conservation. We assessed the colonization‐extirpation dynamics involved in community changes in response to climate inside and outside PAs. To do so, we used 25 years of occurrence data of nonbreeding waterbirds in the western Palearctic (97 species, 7071 sites, 39 countries, 1993–2017). We used a community temperature index (CTI) framework based on species thermal affinities to investigate species turnover induced by temperature increase. We determined whether thermal community adjustment was associated with colonization by warm‐dwelling species or extirpation of cold‐dwelling species by modeling change in standard deviation of the CTI (CTISD). Using linear mixed‐effects models, we investigated whether communities in PAs had lower climatic debt and different patterns of community change than communities outside PAs. For CTI and CTISD combined, communities inside PAs had more species, higher colonization, lower extirpation, and lower climatic debt (16%) than communities outside PAs. Thus, our results suggest that PAs facilitate 2 independent processes that shape community dynamics and maintain biodiversity. The community adjustment was, however, not sufficiently fast to keep pace with the large temperature increases in the central and northeastern western Palearctic. Our results underline the potential of combining CTI and CTISD metrics to improve understanding of the colonization‐extirpation patterns driven by climate warming.
Beneficios de las Áreas Protegidas para las Aves Acuáticas No Reproductoras que Están Ajustando su Distribución Debido al Calentamiento Climático
Resumen
El calentamiento climático está generando cambios en la distribución y en la composición comunitaria de las especies. Muchas de ellas tienen una deuda climática, es decir, los cambios en la distribución se atrasan con respecto a los cambios en las isoclinas térmicas. Dentro de las áreas protegidas (APs), los cambios comunitarios como respuesta al calentamiento climático pueden facilitarse mediante tasas mayores de colonización por especies de climas cálidos, pero también pueden mitigarse al reducir las tasas de extirpación de las especies de climas fríos. Se requiere una evaluación de la importancia relativa de los procesos de colonización‐extirpación para orientar las estrategias de conservación que buscan la reducción de la deuda climática y la conservación de las especies. Analizamos las dinámicas de colonización‐extirpación que participan en los cambios comunitarios como respuesta al clima dentro y fuera de las APs. Para realizar lo anterior, usamos datos tomados durante 25 años de la presencia de aves acuáticas no reproductoras en el Paleártico occidental (97 especies, 7,071 sitios, 39 países, 1993–2017). Usamos un marco de trabajo del índice de temperatura comunitaria (ITC) basado en las afinidades térmicas de las especies para así investigar la rotación de especies inducida por el incremento en la temperatura. Determinamos si el ajuste térmico en la comunidad estuvo asociado con la colonización por especies de climas cálidos o con la extirpación de especies de climas fríos al modelar el cambio mediante una desviación estándar del ITC (ITCDS). Con los modelos lineales de efectos mixtos investigamos si las comunidades dentro de las APs tenían una deuda climática más baja y patrones diferentes de cambio comunitario que las comunidades localizadas fuera de las APs. Con la combinación del ITC y deL ITCDS, las comunidades dentro de las APs tuvieron más especies, una mayor colonización, una menor extirpación y una deuda climática más baja (16%) que las comunidades fuera de las APs. Por lo tanto, nuestros resultados sugieren que las APs facilitan dos procesos independientes que moldean las dinámicas comunitarias y mantienen la biodiversidad. Sin embargo, el ajuste comunitario no fue lo suficientemente rápido para mantener el paso de los grandes incrementos en la temperatura de las regiones central y noreste del Paleártico occidental. Nuestros resultados resaltan el potencial que tiene la combinación de las medidas del ITC y del ICTDS para mejorar el entendimiento de los patrones de colonización‐extirpación causados por el calentamiento climático.
【摘要】
气候变暖正在引起物种分布和群落组成的变化。许多物种都背负着所谓的 “气候债务”, 即分布范围的变化滞后于温度的变化。气候变暖背景下, 保护地中适应温暖环境的物种较高的定殖率可以促进群落变化, 适应寒冷环境的物种灭绝率下降也可以减缓影响。评估定殖–灭绝过程的相对重要性, 对于制定旨在减少气候债和促进物种保护的保护战略而言十分重要。本研究利用西古北界非繁殖水鸟 25 年的出现记录 (97 个物种, 7071 个位点, 39 个国家, 1993–2017 年) , 评估了保护地内外鸟类群落响应气候变化过程中的定殖–灭绝动态。我们使用基于物种对温度亲和性的群落温度指数框架探究了温度升高引起的物种更替。通过模拟群落温度指数标准偏差的变化, 我们确定了群落对温度的调整是否与适应温暖环境的物种的定殖或适应寒冷环境的物种的灭绝有关。接下来, 我们利用线性混合效应模型分析了保护地内与保护地外的群落相比是否具有较低的气候债务和不同的群落变化格局。结合群落温度指数与其标准偏差, 我们发现保护地内的群落比保护地外的具有更多的物种、更高的定殖率、更低的灭绝率和更低的气候债务 (16%) 。因此, 我们的结果表明, 保护地促进了群落动态形成和生物多样性维持这两个独立过程。然而, 群落调整的速度不足以跟上古北界中部和东北部地区气温的大幅上升。我们的结果强调了群落温度指数和群落温度指数标准偏差这两个指标相结合, 有潜力提高对气候变暖导致的定殖–灭绝格局的理解。【翻译: 胡怡思; 审校: 聂永刚】
Article impact statement: Protected areas are needed to facilitate waterbird distribution change in response to climate warming in the western Palearctic.
Migratory waterbirds require an effectively conserved cohesive network of wetland areas throughout their range and life-cycle. Under rapid climate change, protected area (PA) networks need to be able ...to accommodate climate-driven range shifts in wildlife if they are to continue to be effective in the future. Thus, we investigated geographical variation in the relationship between local temperature anomaly and the abundance of 61 waterbird species during the wintering season across Europe and North Africa during 1990–2015. We also compared the spatio-temporal effects on abundance of sites designated as PAs, Important Bird and Biodiversity Areas (IBAs), both, or neither designation (Unlisted). Waterbird abundance was positively correlated with temperature anomaly, with this pattern being strongest towards north and east Europe. Waterbird abundance was higher inside IBAs, whether they were legally protected or not. Trends in waterbird abundance were also consistently more positive inside both protected and unprotected IBAs across the whole study region, and were positive in Unlisted wetlands in southwestern Europe and North Africa. These results suggest that IBAs are important sites for wintering waterbirds, but also that populations are shifting to unprotected wetlands (some of which are IBAs). Such IBAs may therefore represent robust candidate sites to expand the network of legally protected wetlands under climate change in north-eastern Europe. These results underscore the need for monitoring to understand how the effectiveness of site networks is changing under climate change.
Aim
Many species are showing distribution shifts in response to environmental change. We explored (a) the effects of inter‐annual variation in winter weather conditions on non‐breeding distributional ...abundance of waterbirds exploiting different habitats (deep‐water, shallow water, farmland) and (b) the long‐term shift in the population centroid of these species and investigate its link to changes in weather conditions.
Location
Europe.
Methods
We fitted generalized additive mixed Models to a large‐scale, 24‐year dataset (1990–2013) describing the winter distributional abundance of 25 waterbird species. We calculated the annual and long‐term (3‐year periods) population centroid of each species and used the winter North Atlantic Oscillation (NAO) index to explain the inter‐annual and long‐term shifts in their location.
Results
(a) Year‐to‐year southwestwards shifts in the population centroids of deep‐ and shallow‐water species were linked to negative NAO values. Shallow‐water species shifted northeastwards associated with positive NAO values and the distance shifted increased with increasing NAO. Deep‐water species shifted northeastwards up to zero NAO indices, but showed no further increase at higher NAO values. (b) Deep‐water species showed long‐term northeastwards shifts in distributional abundance throughout the 1990s and the 2000s. Shallow‐water species, on the other hand, shifted northeastwards during the 1990s and early 2000s, but southwestwards thereafter. There were no significant links between the NAO and year‐to‐year movements or long‐term shifts in farmland species’ population centroid.
Main Conclusions
We provide evidence for a link between both year‐to‐year and long‐term changes in waterbird winter distributional abundances at large geographical scales to short‐ and long‐term changes in winter weather conditions. We also show that species using shallow water, deep‐water and farmland habitats responded differently, especially at high NAO values. As well as important ecological implications, these findings contribute to the development of future conservation measures for these species under current and future climate change.