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During the cross-sectional studies (February 1981 to July 1984) performed by the Group for Epidemiology and Prevention of Cholelithiasis (GREPCO) in Rome, Italy, 161 subjects were identified as having gallstones. Ten subjects did not participate in the prospective follow-up. At entry, 33 of the 151 remaining subjects were symptomatic, and 118 were asymptomatic. Data on incidence of biliary colics, complications, cholecystectomy, and death were collected at least every 2 years. In the initially asymptomatic group, the cumulative probability (% +/- SE) of developing biliary colic was 11.9 +/- 3.0 at 2 years, 16.5 +/- 3.5 at 4 years, and 25.8 +/- 4.6 at 10 years. None of the variables considered as possible modifiers of the natural history were found to be associated with an increased risk of developing biliary colic. The cumulative probability (% +/- SE) of developing complications after 10 years was 3.0 +/- 1.8 in the initially asymptomatic group and 6.5 +/- 4.4 in the symptomatic group (P = NS). Incidence of cholecystectomy was higher in the initially symptomatic than in the asymptomatic group (log-rank test = 2.27; P = .02). Fifteen (53.6%) of the 28 operated in the initially asymptomatic group were submitted to cholecystectomy, although specific symptoms did not occur. Twelve (10.2%) and 2 (6.1%) of the initially asymptomatic and symptomatic subjects died during the follow-up. One patient in the former group died at age 64 of a histologically proven adenocarcinoma of the gallbladder. In conclusion, this study demonstrates that the natural history of gallstones is less benign than is generally considered.

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Molecular genetics research can benefit efforts to conserve the genetic diversity of tropical plant species. Clear and efficient procedures are needed to access DNA samples, while respecting tropical countries' and local communities' rights on genetic resource usage. The Nagoya Protocol on Access and Benefit-Sharing, which took effect in 2014, provides an opportunity to establish such procedures. However, scientists are concerned that its emphasis on monetary gains restricts research focused on scientific, societal, and environmental benefits. Despite much political and scientific debate, few concrete cases have demonstrated the practical functioning of the Nagoya Protocol. This paper describes the first application of the Protocol in Guatemala, where it was used to grant permission to a non-commercial study on gene flow in mahogany (Swietenia macrophylla King) populations in the Maya Biosphere Reserve of Pet en. On the basis of this study, we discuss five strategies to enhance the application of molecular genetics to conservation biology under the Nagoya Protocol: (1) generate short and standardized procedures; (2) enable science communication;(3) cultivate a common understanding between users, providers, and potential beneficiaries; (4) involve local research and practitioner organizations; and (5) integrate participatory research. Positive societal views on the application of molecular genetics to conservation biology generate further support for work in this discipline and promote adoption of research results for the conservation of genetic diversity of tropical plant species.Abstract in Spanish is available with online material.

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