De novo transcriptome sequencing, assembly, and gene expression profiling of a salt-stressed halophyte (Salsola drummondii) from a saline habitat.

Salsola drummondii is a perennial habitat-indifferent halophyte growing in saline and nonsaline habitats of the Arabian hyperarid deserts. It offers an invaluable opportunity to examine the molecular mechanisms of salt tolerance. The present study was conducted to elucidate these mechanisms through transcriptome profiling of seedlings grown from seeds collected in a saline habitat. The Illumina Hiseq 2500 platform was employed to sequence cDNA libraries prepared from shoots and roots of nonsaline-treated plants (controls) and plants treated with 1200 mM NaCl. Transcriptomic comparison between salt-treated and control samples resulted in 17,363 differentially expressed genes (DEGs), including 12,000 upregulated genes (7870 in roots, 4130 in shoots) and 5363 downregulated genes (4258 in roots and 1105 in shoots). The majority of identified DEGs are known to be involved in transcription regulation (79), signal transduction (82), defense metabolism (101), transportation (410), cell wall metabolism (27), regulatory processes (392), respiration (85), chaperoning (9), and ubiquitination (98) during salt tolerance. This study identified potential genes associated with the salt tolerance of S. drummondii and demonstrated that this tolerance may depend on the induction of certain genes in shoot and root tissues. These gene expressions were validated using reverse-transcription quantitative PCR, the results of which were consistent with transcriptomics results. To the best of our knowledge, this is the first study providing genetic information on salt tolerance mechanisms in S. drummondii.

Correction to: Effect of maturation time on dormancy and germination of Citrullus colocynthis (Cucurbitaceae) seeds from the Arabian hyper-arid deserts.

Following publication of the original article [1] author Hatem Shabana wrote to say that one of her affiliations was missing. The affiliation is as follows: Departmento de Biología Vegetal, Universidad de Málaga, P. O. Box 59, 29080 Málaga, Spain.

Influence of dose and route of administration on the outcome of infection with the virulent Neospora caninum isolate Nc-Spain7 in pregnant sheep at mid-gestation.

Experimental infections in pregnant sheep have been focused on studying the effect of the time of challenge on the outcome of N. caninum infection, whereas the impact of the dose and route of challenge has not been studied in depth. Therefore, clinical outcome, immune responses, parasite detection and burden, and lesion severity in placental tissues and foetal brains were investigated in 90-day-pregnant sheep inoculated intravenously with 105 (G1), 104 (G2), 103 (G3), or 102 (G4) tachyzoites or subcutaneously with 104 (G5) tachyzoites of the virulent Nc-Spain7 isolate and an uninfected group (G6). Comparing challenge doses, G1 was the only group that had 100% abortion. Likewise, IFNγ levels in G1 increased earlier than those in other intravenously infected groups, and IgG levels on day 21 post-infection (pi) were higher in G1 than those in other intravenously infected groups. Concerning vertical transmission, G1 shows a higher parasite burden in the foetal brain than did G2 and G3. Comparing routes of administration, no differences in foetal survival rate or parasite load in the foetal brain were found. Although G2 had higher IFNγ levels than G5 on day 10 pi, no differences were found in humoral immune responses. Because the outcome after intravenous infection with 105 tachyzoites was similar to that observed after intravenous infection with 106 tachyzoites used in a previous work (100% abortion and vertical transmission), we conclude that it may be reasonable to use 105 tachyzoites administered by the intravenous route in further experiments when assessing drugs or vaccine candidates.

Effect of maturation time on dormancy and germination of Citrullus colocynthis (Cucurbitaceae) seeds from the Arabian hyper-arid deserts.

BACKGROUND: Light and temperatures of germination greatly affect germination of several Cucurbitaceae species. Environmental conditions prevailing at seed maturation time can affect dormancy and germination requirements. Citrullus colocynthis seeds have a deep dormancy. This perennial prostrate shrub grows all over the year in the arid Arabian deserts. We explored if seed dormancy and germination requirements of C. colocynthis depend on time of fruit collection. Matured seeds were collected at five different times during 2014/2015 year from a population around Dubai city. Fresh seeds were germinated at three temperature regimes in both continuous darkness and alternating 12 h light/12 h darkness. Impacts of seed storage and other treatments on germination were applied on seeds collected in March and exhibited deep dormancy. RESULTS: March collected seeds almost did not germinate in both light and dark at the three temperatures, but those of the other collections responded differently to both light and temperatures. At the lowest temperatures, seeds of all collections did not germinate in light, but those of June, October and December collections germinated in dark. There were negative correlations between final germination and seed length, width, mass and coat thickness. Physical scarification, water soaking and seed storage did not break dormancy of March collection. CONCLUSIONS: Germination of C. colocynthis is very sensitive to light and incubation temperature as well as to the environmental conditions associated with the time of seed maturation. It is important to investigate the effects of environmental factors prevailing during seed maturation under controlled conditions to understand exact reasons for unusual seed dormancy and germination requirements of C. colocynthis, which seems to be very sensitive to maternal environment.

Scarlet fever: A not so typical exanthematous pharyngotonsillitis (based on 171 cases).

AIM: To describe the age, signs and clinical symptoms of children with scarlet fever at the present time, and to check whether they are equivalent to those with traditional streptococcal pharyngotonsillitis. STUDY DESIGN: An observational, retrospective study was conducted on the clinical records of 5500 children aged from 0 to 15 years attending a primary health care center. A record was made of the percentage of the cases in which signs and symptoms appear and the Centor score was calculated. Microbiological diagnosis of the disease was made using the rapid antigen-detection test or traditional culture. RESULTS: A total of 171 out of 252 scarlet fever diagnoses were microbiologically verified in 158 patients. The median age was 3.8 years (interquartile range: 2.91-4.78), with the majority (57%) under the age of 4 years. There was fever in 89% of the processes (95% CI: 84-94%), with a temperature of >38°C in 73% (95% CI: 65-80%), enlarged lymph nodes in 70% (95% CI: 58-82%), absence of cough in 73% (95% CI: 65-80%), and tonsillar exudate in only 24% (95% CI: 17-31%). The Centor score (n=105) was ≤2 points in 86% (95% CI: 79-92%). The only difference regarding age is that episodes in patients under the age of 4 years old have significantly higher fever (>38°C) than the older ones (80% versus 63%. OR 3.13; 95% CI: 1.46-6.71). CONCLUSION: Scarlet fever pharyngotonsillitis differs from the traditional streptococcal pharyngotonsillitis, and its evaluation using clinical prediction rules such as Centor or McIsaac is questionable. The main diagnostic key must certainly be rash, regardless of patient age.

Excessive polypharmacy and survival in polypathological patients.

PURPOSE: The purpose of this study was to determine whether excessive polypharmacy is associated with a higher survival rate in polypathological patients. PATIENTS AND METHODS: An observational, prospective, and multicenter study was carried out on those polypathological patients admitted to the internal medicine and acute geriatrics departments between March 1 and June 30, 2011. For each patient, data concerning age, sex, comorbidity, Barthel and Lawton-Brody indexes, Pfeiffer's questionnaire, socio-familial Gijon scale, delirium, number of drugs, and number of admissions during the previous year were gathered, and the PROFUND index was calculated. Polypharmacy was defined as the use of ≥ 5 drugs and excessive polypharmacy as the use of ≥ 10. A 1-year long follow-up was carried out. A logistic regression model was performed to analyze the association of variables with excessive polypharmacy and a Cox proportional hazard model to determine the association between polypharmacy and survival. RESULTS: We included 457 polypathological patients. Mean age was 81.0 (8.8) years and 54.5% were women. The mean number of drugs used was 8.2 (3.4). Excessive polypharmacy was directly associated with heart disease [hazard ratio (HR) 2.33 95% CI 1.40-3.87; p =0.001], respiratory disease [HR 1.87 95% CI 1.13-3.09; p = 0.01], peripheral artery disease/diabetes with retinopathy and/or neuropathy [HR 2.02 95% CI 1.17-3.50; p = 0.01], and the number of admissions during the previous year [HR 1.21 96%CI 1.01-1.44; p = 0.04]. It was inversely associated with delirium [HR 0.48 95% CI 0.25-0.91; p = 0.02]. There were no statistical differences regarding the probability of 1-year survival between patients with no polypharmacy, with simple polypharmacy, and with excessive polypharmacy (0.66, 0.60, and 0.57, respectively, p = 0.12). CONCLUSIONS: A greater use of drugs may not be harmful but is also not associated with a higher probability of survival in polypathological patients.

Ulcerative and pyogranulomatous pododermatitis due to Pseudomonas luteola infection in a domestic ferret (Mustela putorius furo): a case report with literature review of this emerging zoonotic disease in ferrets.

Pseudomonas luteola (P.luteola), formerly called Chryseomonas luteola, is a strict aerobic gram-negative bacillus, 0.8 to 1.0 µm wide and 1.5 to 2.5 µm long, considered an opportunistic pathogen found ubiquitously in humid environments, both in soil and water. It sporadically causes disease in animals and immunosuppressed humans or those subjected to invasive procedures such us peritoneal dialysis or catheterization. In ferrets, this infection was first described in Spain in 2012 and since then, cases have appeared occasionally in Finland, Austria, Australia, France, the United States and also in Spain. This pathogen is considered an emerging zoonotic disease in ferrets, causing respiratory disease, panniculitis, and abscesses due to pyogranulomatous or suppurative inflammation predominantly of the pleura, lung, mediastinum, panniculus or salivary glands, frequently with lethal consequences. The clinical case of a ferret, infected by Pseudomona luteola, presenting with ulcerative suppurative pododermatitis and ipsilateral popliteal purulent lymphadenitis, is described. Together with a complete resolution of the clinical case by means of a non-invasive medical management likely due to the rapid detection, identification, and treatment of the infection.

Use of a local anaesthetic and antiseptic wound formulation for the treatment of lambs naturally infected with Orf virus.

Contagious ecthyma (CE) is a worldwide highly contagious zoonotic viral skin disease of sheep and goats. Treatment for Orf virus (ORFV) infection usually involves topical and oral antibiotics. An anaesthetic and antiseptic topical gel (Multisolfen® or Tri-Solfen®; MS®, Medical Ethics, Australia) has been documented as an efficacious therapy for lesions from mucosal and epithelial viral infections in ruminants. The present study tested a new treatment protocol of MS® for CE therapy on-farm in 150 lambs naturally infected with ORFV. Lambs were divided into three cohorts of 50 lambs each (C, D and E). Cohort C was treated with MS® 3 times with an interval of 3 days between treatments, cohort D was treated daily with hypochlorous acid, whilst cohort E served as untreated controls. The lambs were examined clinically every two days, weight measured weekly, with whole blood and sterile swabs from ORFV lesions collected for haematological analysis and specific ORFV PCR. Cohort C presented fewer lambs displaying ORFV-associated lesions than other cohorts at different times of the experiment. Further, lesions treated with MS® were milder compared with other cohorts. However, following cessation of therapy, most of the lambs again developed ORFV-associated lesions. No differences between cohorts were observed in weight, haematological and PCR results. These findings suggest that topical treatment with MS® is effective for CE in field conditions, especially in the first stages of the clinical course, although treatment with MS® may need to be extended a minimum of 4 weeks.

First Evidence of Leishmania infantum Antibodies in Sheep (Ovis aries) from Southern Germany.

In Europe, Leishmania infantum is the most prevalent Leishmania species, and this protozoan is transmitted by phlebotomine sandflies. A recent publication has shown that sheep harbor L. infantum antibodies. This raises questions about the epidemiological role of small ruminants. Therefore, sera from small ruminants located in two southern German federal states, Baden-Wuerttemberg (BW) and Bavaria (BAV), were analyzed with an ELISA to determine the presence of L. infantum antibodies. The species, sex and age (gimmer vs. ewe) were recorded, and a univariate analysis was conducted to determine possible associations. In total, seven sheep flocks (274 sheep/10 goats) from BW and seven sheep flocks (277 sheep/78 goats) from BAV were examined. In BW, four sheep from three flocks tested positive for L. infantum antibodies. In BAV, the same number of positive sheep were detected but in four flocks. The total seropositivity rate in sheep was 1.45%. All goats tested negative. No significant association (p > 0.05) was detected between Leishmania seropositivity and the variables evaluated. Our study reveals the exposure of sheep to L. infantum in a non-endemic area. Further investigation is needed to determine whether sheep can be used as sentinels to identify new phlebotomine habitats and Leishmania risk areas.

Analysing disease trajectories in a cohort of 71,849 Patients: A visual analytics and statistical approach.

BACKGROUND: Disease trajectories have become increasingly relevant within the context of an aging population and the rising prevalence of chronic illnesses. Understanding the temporal progression of diseases is crucial for enhancing patient care, preventive measures, and effective management. OBJECTIVE: The objective of this study is to propose and validate a novel methodology for trajectory impact analysis and interactive visualization of disease trajectories over a cohort of 71,849 patients. METHODS: This article introduces an innovative comprehensive approach for analysis and interactive visualization of disease trajectories. First, Risk Increase (RI) index is defined that assesses the impact of the initial disease diagnosis on the development of subsequent illnesses. Secondly, visual graphics methods are used to represent cohort trajectories, ensuring a clear and semantically rich presentation that facilitates easy data interpretation. RESULTS: The proposed approach is demonstrated over the disease trajectories of a cohort comprising 71,849 patients from Tolosaldea, Spain. The study finds several clinically relevant trajectories in this cohort, such as that after suffering a cerebral ischemic stroke, the probability of suffering dementia increases 10.77 times. The clinical relevance of the study outcomes have been assessed by an in-depth analysis conducted by expert clinicians. The identified disease trajectories are in agreement with the latest advancements in the field. CONCLUSION: The proposed approach for trajectory impact analysis and interactive visualization offers valuable graphs for the comprehensive study of disease trajectories for improved clinical decision-making. The simplicity and interpretability of our methods make them valuable approach for healthcare professionals.

Sonographic diagnosis of symptomatic ureteral calculi: usefulness of the twinkling artifact.

PURPOSE: Our aim was to analyze the value of ultrasound using the twinkling sign in the diagnosis of ureteral stones in patients with renal colic in the emergency setting. MATERIALS AND METHODS: Prospective study of 100 patients with suspected renal colic who underwent an US examination, including color Doppler mode. We analyzed sensitivity, specificity, predictive values, and accuracy. We evaluated whether the stone was observed before or after the twinkling artifact, and whether the use of the Doppler color increased the examination time. RESULTS: US including color Doppler detected 76 of the 84 confirmed lithiasis. The sensitivity and specificity were 90 % and 100 %, respectively. The positive predictive value was 100 % and the negative 67 %. The accuracy was 92 %. A total of 59 calculi (78 %) examined by color Doppler sonography showed the twinkling artifact. Seventy percent of the twinkling-positive calculi showed the artifact before the stone itself was detected. Considering the location of the stones the twinkling sign was seen before the stone in 92 % of lithiasis located in the mid lumbar ureter (p = 0.02). The use of the twinkling artifact showed a trend to facilitate the detection of smaller calculi (<10 mm) (p = 0.08). The average examination time was 5.8 min [± 4.3] (without differences between the stones detected before or after the twinkling artifact, p = 0.75). CONCLUSION: Doppler US examination shows good sensitivity and specificity for the diagnosis of symptomatic ureteral stones. The twinkling artifact is useful for the early detection of the calculi, especially in the middle tract of the ureter, usually the most difficult place in sonographic diagnosis. It also seems helpful for the detection of smaller stones. The use of color Doppler does not increase the exploration time.

Paratesticular rhabdomyosarcoma: a case report.

OBJECTIVE: To report a case of paratesticular rhadomyosarcoma and to perform a bibliographic review. METHODS: We report the case of a 16-year-old male referred to our Department because of a left paratesticular hard tumor with progressive growth. Ultrasound examination showed a paratesticular heterogeneous mass with Internal flow on Doppler. RESULTS: The patient underwent left inguinal orchiectomy, with pathological diagnosis of rhabdomyosarcoma. He refused adjuvant chemotherapy. After being disease-free for 13 months, he presented with left colic pain. Ultrasound and CT examinations showed a left paraaortic retroperitoneal mass causing grade III ureterohydronephrosis, and lung metastases. Despite rescue chemotherapy treatment, there was no response and the abdominal mass progressed. A surgical approach was not possible since patient showed a rapid clinical worsening leading to his death a few weeks later. CONCLUSIONS: Paratesticular sarcomas are very uncommon tumors with poor prognosis.

Large-cell neuroendocrine carcinoma of prostate. Case report.

OBJECTIVE: To report a case of a neuroendocrine differentiation in a prostate cancer patient, a rare subtype. METHODS: We describe the case of a patient diagnosed with adenocarcinoma of the prostate initially, who presented hematuria due to disease progression with neuroendocrine differentiation despite androgen-deprivation therapy (ADT ). DISCUSSION: Prostate cancer is the most common tumor in men. Histologically they are diagnosed as adenocarcinomas, which followed by ADT for a long time, develop neuroendocrine differentiation (NED ). CONCLUSIONS: The prognostic significance of NED remains controversial. We must think in neuroendocrine differentiation in ADT-treated patient with disease progression and low PSA.

The high climate vulnerability of western Mediterranean forests.

Understanding the effects of climate change is one of the most challenging goals for biodiversity conservation. The forests of Andalusia, in Southern Spain, are part of an important Mediterranean Basin biodiversity hotspot. However, great changes in climate are expected to occur in this region, and there is an increasing need to assess the vulnerability of its vegetation. We assess the vulnerability of twelve forest types in the region that are included in the European Directive 92/43/EEC as Habitats of Community Interest (HCI). HCI are natural habitat types which are in danger, have a small natural range, or present an outstanding example of a biogeographical regions in the European Union. We assessed vulnerability by analyzing the climate exposure level of each forest type under two global climate models (MRI-CGCM3, which predicts warmer and wetter conditions, and MIROC-ESM which predicts hotter and drier conditions), two emission scenarios (RCP4.5, a representative concentration pathway that predicts stable emissions of CO2, and RCP8.5, that predicts the highest CO2 emissions) by the mid- and end-century time periods. The vulnerability analysis also includes the sensitivity and adaptive capacity of the dominant tree species which compose each forest type. An overall vulnerability score was calculated for each forest type, model, scenario and time period. High-elevation forest types and those with high moisture requirements were more vulnerable to climate change, while forest types dominated by more thermophilic species were less vulnerable and more resilient. The worst climate impacts were predicted in the MIROC-ESM model and RCP8.5 scenario by the end of the century (2070-2100), while the least climatic stress was obtained in the MRI-CGCM3 model and RCP4.5 scenario by the mid-century (2040-2070), which still shows high potential stress for most forest types. By the end of the century, the climate exposure of the entire forest domain will range between 32 % in the least stressful situation (MRI-CGCM3 and RCP4.5), and 98 % in the most climatically stressful situation (MIROC-ESM and RCP8.5). However, the effects of climate change will be perceptible by the mid-century, with most of the HCI forest types suffering climate stress. The "Andalusian oak forest" and the "Corylus wet forest" types were the most vulnerable to climate change, while the "Mediterranean pine forest", the "Olea and Ceratonia forests" and the "oak forests" were the least vulnerable. This assessment identifies the vulnerable forest types to climate change in the south of the Iberian Peninsula, and provides context for natural resource managers in making decisions about how to adapt forests to the impacts of climate change.

Use of a Local Anaesthetic/Antiseptic Formulation for the Treatment of Lambs Experimentally Infected with Orf Virus.

Contagious ecthyma is a highly transmissible eruptive viral disease of the skin and mucosa of sheep and goats distributed worldwide. The treatment of orf lesions is usually based on the use of antiseptics and antibiotics for the management of presumptive secondary infections, increasing risks of antimicrobial resistance. The wound dressing formulation Tri-Solfen® (TS) containing two local anaesthetics (lignocaine and bupivacaine), adrenaline and an antiseptic (cetrimide) in a gel formulation has been demonstrated to reduce suffering and enhance recovery in cattle and buffalo with oral and skin lesions due to foot-and-mouth disease virus infection and reduced the orf viral load in lambs. In the present study, experimental infection with the orf virus was conducted in 50 newborn lambs and 25 animals were treated after the presence of the first lesions with TS and repeated three days later. Daily clinical examination, haematological, serological, biomolecular and post-mortem analyses were conducted during 34 days after treatment. Results indicated that treatment had no effect on weight gain and clinical progression of the lesions. It was determined that seroconversion after experimental infection occurs 34 days after infection and suggested that the deep basal epithelial location of the orf lesions may have prevented the therapy from having altered the clinical course.

DigiHEALTH: Suite of Digital Solutions for Long-Term Healthy and Active Aging.

The population in the world is aging dramatically, and therefore, the economic and social effort required to maintain the quality of life is being increased. Assistive technologies are progressively expanding and present great opportunities; however, given the sensitivity of health issues and the vulnerability of older adults, some considerations need to be considered. This paper presents DigiHEALTH, a suite of digital solutions for long-term healthy and active aging. It is the result of a fruitful trajectory of research in healthy aging where we have understood stakeholders' needs, defined the main suite properties (that would allow scalability and interoperability with health services), and codesigned a set of digital solutions by applying a continuous reflexive cycle. At the current stage of development, the digital suite presents eight digital solutions to carry out the following: (a) minimize digital barriers for older adults (authentication system based on face recognition and digital voice assistant), (b) facilitate active and healthy living (well-being assessment module, recommendation system, and personalized nutritional system), and (c) mitigate specific impairments (heart failure decompensation, mobility assessment and correction, and orofacial gesture trainer). The suite is available online and it includes specific details in terms of technology readiness level and specific conditions for usage and acquisition. This live website will be continually updated and enriched with more digital solutions and further experiences of collaboration.

Right hypochondrium pain and giant mass.

OBJECTIVE: To report a case of a right hypochondrium giant mass in a 40-year-old patient. METHODS: We report the case of a 40 year-old male referred to our Department because of right hypochondrium pain and increased abdominal perimeter. Radiological examination showed a 30 × 24 × 20 cm retroperitoneal mass, dependent on the upper pole of the right kidney. RESULTS: We performed radical nephrectomy through a mid line laparotomy. The pathological analysis described it as a clear cell renal carcinoma pT2bN0M0. CONCLUSION: There are few reported cases of renal carcinomas with intraparenchymal bleeding exceeding 20 cm, the largest one exceeding 10 kg, and they usually show a good prognosis.

Visualization System for the Impact of Context Open Data in Clinical Settings.

The usage of context open data, such as environmental data, socio-economic resources, etc., in clinical settings has been limited till now. But in recent years the number of studies that consider these factors is increasing. However, for clinicians, researchers or other stakeholders to be able to use this information in clinical practice, appropriate visualizations tools must be developed. At the same time, the data are generally displayed in formats that are difficult to interpret. The use of geolocalized visualizing tools through maps provides a better understanding in most cases. The proposed tool aims to contribute to the development of systems that can help to the exploitation of clinical and context open data, making them more easily interpretable.

Retrospective study on the effectiveness and safety of the shortened 5- to 7-day antibiotic regimen for acute streptococcal pharyngotonsillitis compared to the classic 10-day regimen.

INTRODUCTION: Antibiotherapy regimens for management of acute streptococcal pharyngitis traditionally last 10 days, but the development of resistance to different antimicrobials has motivated the exploration of shorter courses. MATERIAL AND METHODS: We selected patients given a diagnosis of streptococcal pharyngitis in 2 paediatric caseloads of 1 primary care centre between June 2016 and April 2020. We compared outcomes in patients treated with 8- to 10-day courses versus 5- to 7-day courses. RESULTS: The analysis included 350 care episodes (252 patients). Sixty-four percent were managed with 8- to 10-day courses of antibiotherapy (group 1) and 36% with 5- to 7-day courses (group 2). There were no significant differences in the incidence of streptococcal pharyngitis or scarlet fever in the 3 months that followed (OR, 0.98; 95% confidence interval [CI], 0.46-2.03), with similar percentages in both groups (9.8% vs 9.5%). Overall, without differentiating based on the type of infection (streptococcal pharyngitis, scarlet fever or other streptococcal infections), we found similar outcomes (OR, 0.81; 95% CI, 0.41-1.59): 13.4% in group 1 and 11.1% in group 2. We also found no differences in the frequency of adverse events documented in the health records (OR, 0.29; 95% CI, 0.04-2.44): 2.7% in group 1 and 0.8% in group 2. CONCLUSIONS: In our experience, a shorter antibiotic course (5-7 days) is not less effective or more unsafe for management of acute streptococcal pharyngitis than the traditional 10-day course.

Copper Poisoning, a Deadly Hazard for Sheep.

Copper (Cu) is an essential microelement for animals. However, sheep are particularly susceptible to Cu intoxication, a deadly disease reported worldwide. The risk of developing this poisoning is higher in vulnerable breeds and in intensively managed lambs or milk sheep. Two types of Cu intoxication can occur depending on the chronic or acute exposure to Cu. In chronic Cu poisoning (CCP), the most common form, Cu is accumulated in the liver during a subclinical period. A low intake of Cu antagonists (molybdenum, sulphur, iron, or zinc) favours Cu accumulation. The sudden release of Cu into the blood causes acute haemolysis with anaemia, haemoglobinuria, jaundice and death within 1-2 days. Acute Cu poisoning is related to the accidental administration or ingestion of toxic amounts of Cu. Acute oral exposure to Cu causes severe gastroenteritis, shock and death. Collapse and death occur shortly after parenteral administration. The diagnosis is based on history, clinical, gross pathological, histological and toxicological findings. Treatment of sheep with severe clinical signs often has poor success but is very effective during the Cu accumulation phase. Different therapies, based on either chelating agents or Cu antagonists, have been used to treat and prevent CCP.