Application of NHG guidelines in patients referred for stable chest pain syndromes

Purpose. Guidelines of the Dutch Association of General Practitioners (NHG) dictate the evaluation, treatment, and referral process of patients with stable chest pain syndromes (CPS). Adherence to this guideline was assessed in a consecutive group of patients referred to our hospital. Methods. We retrospectively studied the records of 296 subjects referred to our outpatient department in 2007 for evaluation of stable CPS. Referral letters were checked for completeness (past and present history, mentioning of risk factors for cardiovascular disease, physical examination, listing of medication) and used to judge adherence to the guideline. In a subset of patients, additional information regarding the referral process was gathered by telephone interview. Results. The referral letter was complete in only 67 patients (23%); items most often not reported were physical examination (63%) and cardiovascular risk factors (62%). Judging from the referral letter, 23 patients (8%) were evaluated in accordance with the NHG guideline prior to their referral. In patients in whom the final diagnosis of angina pectoris was made by the cardiologist, this was 20%. Seventy-nine patients were contacted by telephone after their work-up by the cardiologist; 36 of them (44%) reported being referred at their first visit to their primary physician, while 14 (18%) were referred at their own request. Conclusion: Prior to referral, only a minority of patients with stable CPS were evaluated and treated in accordance with NHG guidelines. Furthermore, their referral letter was often incomplete. (Neth Heart J 2010;18:178-82.)     

Unique genomic configuration revealed by microsatellite DNA in polyploid dogroses, Rosa sect. Caninae

An allopolyploid complex with high genomic integrity has been studied. Dogroses transmit only seven chromosomes (from seven bivalents) through the pollen, whereas 21, 28 or 35 chromosomes (from seven bivalents and 14, 21 or 28 univalents) come from the egg cells. Seedlings derived from two interspecific crosses were analysed with flow cytometry and molecular markers to determine ploidy level, mode of reproduction and genomic constitution. Evidence was obtained for the formation of unreduced male and female gametes, which can take part in fertilization (producing seedlings with higher ploidy than the parental plants) or in apomictic reproduction. Random amplified polymorphic DNA (RAPD) and microsatellite analyses indicated that three seedlings (5%) were derived through apomixis, whereas the other 49 were hybrids. Bivalent formation appears to involve chromosomes that consistently share the same microsatellite alleles. Allele-sharing between the maternally transmitted and highly conserved univalent-forming chromosomes reflected the taxonomic distance between different genotypes. The frequently recombining bivalent-forming chromosomes were taxonomically less informative.     

Moorland pools as refugia for endangered species characteristic of raised bog gradients

In intact raised bog landscapes transitions from ombrotrophic into minerotrophic conditions occur. These gradients are lost from many bogs due to peat harvesting and drainage, and are difficult to restore. To determine which endangered species are characteristic of pristine raised bog gradients and their current status in degraded bogs, plants and macroinvertebrates were surveyed in Estonian intact raised bogs and Dutch degraded bog remnants. Dutch national distribution data were used to determine whether communities with these species occurred outside bog habitats. Water chemistry data were used to describe associated environmental conditions. Intact bog gradients were the preferred habitat for six plant species and fifteen macroinvertebrate species, all of which are endangered. In degraded bogs these species were scarce or not recorded. In intact bogs these species lived at sites where runoff from the bog massif came into contact with regional ground water resulting in a gradient in pH, alkalinity, Ca, Fe and ionic ratio. Analysis of Dutch national distribution data revealed aggregations of these endangered species in moorland pools. These pools contained water chemistry gradients similar to those found in pristine bogs, which occurred at sites were groundwater seepage and stream water came in contact. In the past, stream water has been used to increase pH and trophic status of moorland pools facilitating fisheries. Today, this practice offers a conservation strategy for the protection of endangered species for which no short-term alternatives are available.     

Do restoration measures rehabilitate fauna diversity in raised bogs? A comparative study on aquatic macroinvertebrates

To assess whether raised bog restorationmeasures contribute to the conservation andrestoration of the fauna diversity,macroinvertebrate species assemblages werecompared between water bodies created byrewetting measures and water bodies whichhave not been subject to restorationmeasures, but are remnants offormer peat cuttings and trenches used forbuckwheat culture in the past.The restoration sites were inhabited bycharacteristic raised bog species and rarespecies, but their numbers were higher atthe remnant sites not affected byrestoration management. A considerablenumber of characteristic and rare faunaspecies were only found at the remnantsites. The remnant sites includedconsiderably more variation inmacroinvertebrate species assemblages andhad a higher cumulative species richness.The number of characteristicmacroinvertebrate species was not clearlyrelated to the presence of a characteristicraised bog vegetation. In restoration sitesnumbers of rare and characteristic speciesper site tended to increase with the timeelapsed after rewetting. However,restoration measures will not automaticallyresult in restoration of a more or lesscomplete macroinvertebrate speciesspectrum, as restoration measures have sofar resulted in habitats for only a limitednumber of the characteristic species.When planning restoration measures, it isrecommended to protect the populations ofrare and characteristic species present inthe area, as these populations may becomethe sources for colonization of rewettedsites. Safeguarding habitat diversityduring the restoration process andrestoration of different elements of thehabitat diversity of complete raised bogsystems will result in the characteristicfauna diversity being conserved andrestored more successfully.     

Vegetation change in a man‐made salt marsh affected by a reduction in both grazing and drainage

Abstract. In order to restore natural salt marsh in a 460‐ha nature reserve established in man‐made salt marsh in the Dollard estuary, The Netherlands, the artificial drainage system was neglected and cattle grazing reduced. Vegetation changes were traced through two vegetation surveys and monitoring of permanent plots over 15 yr after the management had been changed. Exclosure experiments were started to distinguish grazing effects from effects of increased soil waterlogging caused by the neglect of the drainage system. Both vegetation surveys and permanent plots demonstrated a dichotomy in vegetation succession. The incidence of secondary pioneer vegetation dominated by Salicornia spp. and Suaeda maritima increased from 0 to 20%, whereas the late‐successional (Phragmites australis) vegetation from 10 to 15%. Grazing intensity decreased towards the sea. The grazed area contracted landward, which allowed vegetation dominated by tall species to increase seaward. Grazing and increased waterlogging interacted in several ways. The impact of trampling increased, and in the intensively grazed parts soil salinity increased. This can probably be explained by low vegetation cover in spring. Framework Ordination, an indirect‐gradient‐analysis technique, was used to infer the importance of environmental factors in influencing changes in species composition. Many changes were positively or negatively correlated with soil aeration and soil salinity, whereas elevation was of minor importance. Grazing accounted for only a few changes in species frequency. Changes in permanent plots were greater during the first than during the second half of the study period. In exclosures that were installed halfway through the study period, there was a relatively rapid recovery of previously dominant species that had decreased during the first half of the study period. Species richness per unit area in the reserve increased. At the seaward side of the marsh, the altered management allowed succession to proceed leading to establishment of stands of Phragmites australis, whereas on the landward side, the combination of moderate grazing with neglect of the drainage system appeared an effective measure in maintaining habitats for a wider range of halophytic species.     

Partial preferential chromosome pairing is genotype dependent in tetraploid rose

It has long been recognised that polyploid species do not always neatly fall into the categories of auto‐ or allopolyploid, leading to the term ‘segmental allopolyploid’ to describe everything in between. The meiotic behaviour of such intermediate species is not fully understood, nor is there consensus as to how to model their inheritance patterns. In this study we used a tetraploid cut rose (Rosa hybrida) population, genotyped using the 68K WagRhSNP array, to construct an ultra‐high‐density linkage map of all homologous chromosomes using methods previously developed for autotetraploids. Using the predicted bivalent configurations in this population we quantified differences in pairing behaviour among and along homologous chromosomes, leading us to correct our estimates of recombination frequency to account for this behaviour. This resulted in the re‐mapping of 25 695 SNP markers across all homologues of the seven rose chromosomes, tailored to the pairing behaviour of each chromosome in each parent. We confirmed the inferred differences in pairing behaviour among chromosomes by examining repulsion‐phase linkage estimates, which also carry information about preferential pairing and recombination. Currently, the closest sequenced relative to rose is Fragaria vesca. Aligning the integrated ultra‐dense rose map with the strawberry genome sequence provided a detailed picture of the synteny, confirming overall co‐linearity but also revealing new genomic rearrangements. Our results suggest that pairing affinities may vary along chromosome arms, which broadens our current understanding of segmental allopolyploidy.     

Biomonitoring with the BuzzardButeo buteo in the Netherlands: Heavy metals and sources of variation

The feasibility of using Buzzards found dead as indicators of environmental contamination was tested. Liver, kidney, and tibia specimens were examined for the presence of Cd, Cu, Pb, Mn, and Fe, which were used as markers. All buzzards submitted to the Veterinary Institute in 1992 were examined for cause of death and condition. Results showed that more than half had been poisoned or shot. As the condition of the birds worsened, fat reserves were depleted before protein reserves. Concentrations of the heavy metals rose in liver and kidney as nutrient reserves fell. Since the content of heavy metal per organ was not related to body condition, content was considered a better measure for biomonitoring. The concentrations of Cd, Cu, Pb, Mn, or Fe measured in buzzards were not toxic. In several places buzzards had recently ingested relatively large amounts Cd and/or Pb. Buzzards with high contents of Cd, Cu, Pb, and Mn were found in areas having more than average contamination. The North-South gradient in aerosol deposition and soil content of heavy metals (especially Cd & Pb) was reflected in the Buzzard. We concluded that the Buzzard is a suitable and cost-effective biomonitor, to investigate the bioavailability of ecocontaminants in large areas, to signal gross changes in food webs, and to monitor raptor persecution.     

Loss of environmental heterogeneity and aquatic macroinvertebrate diversity following large-scale restoration management

Restoration management frequently focuses on recreating suitable environmental conditions for a ‘target vegetation’. This approach neglects the importance of habitat diversity and spatial configuration for individual species. Here, we investigate the role of environmental heterogeneity in a restoration context and report the response of aquatic macroinvertebrates to re-wetting measures, which were taken to mitigate desiccation in a bog landscape. Because only parts of the study area were affected by re-wetting measures, changes in aquatic macroinvertebrates could be compared between re-wetted and non-re-wetted parts. In addition, species were grouped into life-history strategies to test whether the invertebrate response differed between functional species groups. Total species numbers declined in the re-wetted parts and invertebrate assemblages became more similar both in terms of species and life-history strategies. These results indicate that large-scale re-wetting caused a functional homogenization. Changes in environmental conditions following re-wetting could be consistently related to changes in strategy composition. Retention of rainwater decreased the influence of groundwater. Here species increased that are adapted to physiological stress as well as those employing risk spreading, which indicates that environmental conditions had become harsher and less predictable. In contrast, reduced drainage locally increased groundwater influence, with life-history strategies indicating enhanced predictability of environmental conditions. Importantly, such conditions also characterise lagg zones and transitional mires in pristine raised bog landscapes, which are hotspots for biodiversity. Thus, while large-scale re-wetting decreased environmental heterogeneity, increasing the supply of groundwater seems a more promising restoration strategy for aquatic invertebrates in degraded peatlands.     

Development of microsatellite markers for identifying Brazilian Coffea arabica varieties

Microsatellite markers, also known as SSRs (Simple Sequence Repeats), have proved to be excellent tools for identifying variety and determining genetic relationships. A set of 127 SSR markers was used to analyze genetic similarity in twenty five Coffea arabica varieties. These were composed of nineteen commercially important Brazilians and six interspecific hybrids of Coffea arabica, Coffea canephora and Coffealiberica. The set used comprised 52 newly developed SSR markers derived from microsatellite enriched libraries, 56 designed on the basis of coffee SSR sequences available from public databases, 6 already published, and 13 universal chloroplast microsatellite markers. Only 22 were polymorphic, these detecting 2-7 alleles per marker, an average of 2.5. Based on the banding patterns generated by polymorphic SSR loci, the set of twenty-five coffee varieties were clustered into two main groups, one composed of only Brazilian varieties, and the other of interspecific hybrids, with a few Brazilians. Color mutants could not be separated. Clustering was in accordance with material genealogy thereby revealing high similarity.