Upper thermal limits are 'hard-wired' across body mass but not populations of an estuarine fish.

Climate warming is seeing temperatures breach exceptional thresholds as the frequency and intensity of heat waves increase. Efforts to forecast species vulnerability to climate warming often focus on upper thermal limits threatening survival, overlooking the role of intraspecific variation in determining vulnerability. Using an estuarine fish (black bream, Acanthopagrus butcheri) as a model, we explore how intraspecific variation in body mass and among populations affects upper thermal tolerance. Upper thermal limits were quantified using critical thermal maxima (CTmax) of wild fish. We used a ∼500 g (mean = 52.4 g, range = 0.57-541 g) mass range to test the relationship between body mass and thermal tolerance. Four distinct black bream populations were chosen along a 5° latitudinal cline to explore population differences in thermal limits. Contrary to expectations, there was no effect of body mass on upper thermal limits. However, significant population differences in thermal tolerance were observed that correlate with mean habitat temperatures. Specifically, the southern population had a significantly lower CTmax (35.57 ± 0.43 °C) compared to northern (36.32 ± 0.70 °C) and mid-latitude (36.36 ± 1.15 °C) populations. These data underscore the importance of observing intraspecific variation in thermal limits to reveal the capabilities of individuals within a species to cope with climate warming and improve the management of at-risk life stages and populations.

The mechanistic basis and adaptive significance of cross-tolerance: a 'pre-adaptation' to a changing world?

Protective responses are pivotal in aiding organismal persistence in complex, multi-stressor environments. Multiple-stressor research has traditionally focused on the deleterious effects of exposure to concurrent stressors. However, encountering one stressor can sometimes confer heightened tolerance to a second stressor, a phenomenon termed 'cross-protection'. Cross-protection has been documented in a wide diversity of taxa (spanning the bacteria, fungi, plant and animal kingdoms) and habitats (intertidal, freshwater, rainforests and polar zones) in response to many stressors (e.g. hypoxia, predation, desiccation, pathogens, crowding, salinity, food limitation). Remarkably, cross-protection benefits have also been shown among emerging, anthropogenic stressors, such as heatwaves and microplastics. In this Commentary, we discuss the mechanistic basis and adaptive significance of cross-protection, and put forth the idea that cross-protection will act as a 'pre-adaptation' to a changing world. We highlight the critical role that experimental biology has played in disentangling stressor interactions and provide advice for enhancing the ecological realism of laboratory studies. Moving forward, research will benefit from a greater focus on quantifying the longevity of cross-protection responses and the costs associated with this protective response. This approach will enable us to make robust predictions of species' responses to complex environments, without making the erroneous assumption that all stress is deleterious.

Risk of complications after a non-ST segment elevation acute myocardial infarction in a Latin-American cohort: An application of the ACTION ICU score.

BACKGROUND: European Society of Cardiology (ESC) guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation (NSTEMI) recommend Intensive Care Unit (ICU) surveillance during the first 24-48 h. Interestingly, the in-hospital mortality of NSTEMI patients has consistently decreased, giving some patients the option to be managed in general hospital wards. The ACTION ICU score has been proposed to identify high-risk patients with NSTEMI and guide the selective risk-based need for ICU care. OBJECTIVE: To evaluate the usefulness of the ACTION ICU score to predict patients' risk of developing complications requiring ICU care in a Latin-American cohort with NSTEMI. METHODS: We applied the ACTION ICU score in a retrospective cohort. A composite primary outcome included: cardiorespiratory arrest, shock, high-grade atrio-ventricular block, respiratory failure, stroke, or death. The predictive performance of this model was estimated with a conditional multivariable logistic regression analysis. RESULTS: Of 1,062 patients with NSTEMI, the primary outcome was present in 75 patients (7.1%), and 1,019 (96%) were admitted to ICU. The most common event was respiratory failure (4.0%), followed by cardiogenic shock (3.7%), and cardiac arrest (1.7%). The presence of heart failure signs or symptoms had the highest association with the primary outcome (OR:2.16; 95%CI:1.61-2.92). The best cut-off point for this population was 3 (complications risk: 4.0%, SEN:96%, SP:15.4%, NPV:98.1%, PPV:7.9%). CONCLUSION: The ACTION ICU score may be a promising tool to identify the need for ICU care in Latin-American patients with NSTEMI. Furthermore, additional research is needed to evaluate the cost-effectiveness of this strategy.

Type III Kounis Syndrome Secondary to Ciprofloxacin-Induced Hypersensitivity.

Kounis syndrome (KS) is a rare syndrome characterized by the co-occurrence of acute coronary syndromes in the setting of mast cell and platelet activation in response to hypersensitivity reactions. It can be manifested as coronary vasospasms, acute myocardial infarction, or stent thrombosis triggered by drugs, vaccines, foods, coronary stents, and insect bites. It is a life-threatening condition that needs to be adequately recognized for early diagnosis and appropriate treatment. In this case report, we present a 71-year-old patient with a history of arterial hypertension and non-ST elevation myocardial infarction six months earlier that was treated percutaneously with angioplasty plus stent implantation in the circumflex artery, who subsequently presented to the emergency department due to generalized itching associated with tongue swelling, dyspnea, and chest pain after ingestion of ciprofloxacin for the treatment of a urogenital infection. An electrocardiogram showed ST elevation in II, III, and aVF leads, and positive troponin; thus, a coronary arteriography was performed that showed complete thrombotic stent occlusion in the circumflex artery. Consequently, diagnosis of type 4b inferolateral acute myocardial infarction secondary to ciprofloxacin-triggered type III Kounis syndrome was made. The aim of this report is to understand the relationship between the allergic reaction to ciprofloxacin and the acute coronary syndrome, and to create awareness of the importance of early diagnosis and treatment of this potentially fatal syndrome.

Stress history affects heat tolerance in an aquatic ectotherm (Chinook salmon, Oncorhynchus tshawytscha).

The stress history of an ectotherm may be a pivotal predictor of how they cope with rapid spikes in environmental temperature. An understanding of how stressors in habitats and commercial operations affect ectotherm heat tolerance is urgently required so that management actions can be informed by thermal physiology. We hypothesised that brief exposure to mild stress would heighten tolerance to subsequent heat stress, indicative of a cross-tolerance interaction, whereas exposure to severe stress would reduce heat tolerance, reflecting a cross-susceptibility interaction. To test this hypothesis, we assessed how three acute stressors (salinity shock [10 or 33 ppt for 2 h]), air exposure (1 or 5 min) and crowding [95.6 kg m-3 for 2 h]), commonly experienced by fish, affected the heat tolerance (measured as critical thermal maximum, CTMAX) in juvenile Chinook salmon (Oncorhynchus tshawytscha). Fish were exposed to one of the three stressors and left for 24 h of recovery prior to measuring CTMAX. Heat tolerance was improved by ∼0.6 °C in fish exposed to salinity shock (10 ppt) and air exposure (5 min) compared to unstressed controls, demonstrating cross-tolerance. However, the development of cross-tolerance was non-linear with stressor severity, and crowding stress had no effect on CTMAX. Together these results show that some forms of stress can heighten acute heat tolerance in ectotherms, but the development of cross-tolerance is highly specific to both stressor type and stressor severity.

Exercise training does not affect heat tolerance in Chinook salmon (Oncorhynchus tshawytscha).

The progression of climate warming will expose ectotherms to transient heatwave events and temperatures above their tolerance range at increased frequencies. It is therefore pivotal that we understand species' physiological limits and the capacity for various controls to plastically alter these thresholds. Exercise training could have beneficial impacts on organismal heat tolerance through improvements in cardio-respiratory capacity, but this remains unexplored. Using juvenile Chinook salmon (Oncorhynchus tshawytscha), we tested the hypothesis that exercise training improves heat tolerance through enhancements in oxygen-carrying capacity. Fish were trained once daily at 60% of their maximum sustainable swim speed, UCRIT, for 60 min. Tolerance to acute warming was assessed following three weeks of exercise training, measured as the critical thermal maximum (CTMAX). CTMAX measurements were coupled with examinations of the oxygen carrying capacity (haematocrit, haemoglobin concentration, relative ventricle size, and relative splenic mass) as critical components of the oxygen transport cascade in fish. Contrary to our hypothesis, we found that exercise training did not raise the CTMAX of juvenile Chinook salmon with a mean CTMAX increase of just 0.35 °C compared to unexercised control fish. Training also failed to improve the oxygen carrying capacity of fish. Exercise training remains a novel strategy against acute warming that requires substantial fine-tuning before it can be applied to the management of commercial and wild fishes.

Fire and rain: A systematic review of the impacts of wildfire and associated runoff on aquatic fauna.

Climate and land-use changes are expected to increase the future occurrence of wildfires, with potentially devastating consequences for freshwater species and ecosystems. Wildfires that burn in close proximity to freshwater systems can significantly alter the physicochemical properties of water. Following wildfires and heavy rain, freshwater species must contend with complex combinations of wildfire ash components (nutrients, polycyclic aromatic hydrocarbons, and metals), altered light and thermal regimes, and periods of low oxygen that together can lead to mass mortality events. However, the responses of aquatic fauna to wildfire disturbances are poorly understood. Here we provide a systematic review of available evidence on how aquatic animals respond to and recover from wildfire disturbance. Two databases (Web of Science and Scopus) were used to identify key literature. A total of 83 studies from across 11 countries were identified to have assessed the risk of wildfires on aquatic animals. We provide a summary of the main ecosystem-level changes associated with wildfires and the main responses of aquatic fauna to such disturbances. We pay special focus to physiological tools and biomarkers used to assess how wildfires impact aquatic animals. We conclude by providing an overview of how physiological biomarkers can further our understanding of wildfire-related impacts on aquatic fauna, and how different physiological tools can be incorporated into management and conservation plans and serve as early warning signs of wildfire disturbances.

Se espera que el cambio climático y el cambio en el uso de suelo aumentaran la ocurrencia de incendios forestales, con consecuencias potencialmente devastadoras para las especies de agua dulce y los ecosistemas. Los incendios forestales que arden cerca de los sistemas de agua dulce pueden alterar significativamente las propiedades fisicoquímicas del agua. Después de los incendios forestales y llueves fuertes, las especies de agua dulce lidian con combinaciones complejas de componentes de cenizas de incendios forestales (nutrientes, sedimentos, hidrocarburos aromáticos policíclicos y metales), regímenes de luz y térmicos alterados y períodos de bajo oxígeno que, en conjunto, pueden conducir a eventos de mortalidad masiva. Sin embargo, las respuestas de la fauna acuática a las perturbaciones de los incendios forestales son poco conocidas. Aquí proporcionamos una revisión sistemática de la evidencia disponible sobre cómo los animales acuáticos responden y se recuperan de la perturbación de los incendios forestales. Se utilizaron dos bases de datos (Web of Science y Scopus) para identificar la literatura clave. Se identificaron un total de 83 estudios de 11 países que habían evaluado el riesgo de incendios forestales en animales acuáticos. Proporcionamos un resumen de los principales cambios a nivel de ecosistema asociados con los incendios forestales y las principales respuestas de la fauna acuática a tales perturbaciones. Prestamos especial atención a las herramientas fisiológicas y los biomarcadores que se utilizan para evaluar cómo los incendios forestales afectan a los animales acuáticos. Concluimos proporcionando una descripción general de cómo los biomarcadores fisiológicos pueden mejorar nuestra comprensión de los impactos relacionados con los incendios forestales en la fauna acuática, y cómo se pueden incorporar diferentes herramientas fisiológicas en los planes de gestión y conservación y servir como señales de alerta temprana de las perturbaciones de los incendios forestales.

Long-Term Results of Slipped Capital Femoral Epiphysis Treated with the Modified Dunn Procedure in a Colombian Cohort.

BACKGROUD: Slipped capital femoral epiphysis (SCFE) is a severe and catastrophic disorder that affects the hips of adolescents. Many reports about surgical procedures to treat this condition have been published, but to our knowledge, there are no published results of treatment in Latin American patients. This study describes the clinical and radiological results of the modified Dunn procedure with the surgical approach described by Ganz to treat mild to severe SCFE in a cohort of Colombian pediatric patients. METHODS: We retrospectively analyzed 21 patients (22 hips) with SCFE treated with surgical dislocation of the hip from 2005 to 2017. The same pediatric orthopedic surgeon performed all operations. Clinical outcome was assessed using the range of movement and Merle d'Aubigné score, while radiological measurements and assessment included the slip angle and Tönnis score. RESULTS: The average duration of follow-up was 29 months (range, 12-72 months). Of all cases, 17 presented with acute-on-chronic symptoms. Preoperatively, all 22 hips were classified as poor according to the Merle d'Aubigné score. Preoperative radiological classification showed compromise grade II or III in 20 hips. Last follow-up Merle d'Aubigné score rated 17 cases as good or excellent (p < 0.05). The postoperative radiological classification was grade I or II in all 22 cases, and the Tönnis score was stage II in 3 cases and stage III in 4 cases. CONCLUSIONS: Our results suggest that the modified Dunn osteotomy performed through the Ganz technique could be safely and effectively used to treat patients with mild to severe SCFE.

Syncope due to non-sustained episodes of Torsade de Pointes associated to androgen-deprivation therapy use: a case presentation.

BACKGROUND: Abiraterone is a medication frequently used for metastatic castrate-resistant prostate cancer. We report a case of non-sustained episodes of TdP associated with severe hypokalemia due to androgen-deprivation therapy. Few case presentations describe this association; the novelty lies in the potentially lethal cardiovascular events among cancer patients receiving hormonal therapy. CASE PRESENTATION: A 70-year-old male presented with recurrent syncope without prodrome. ECG revealed frequent ventricular ectopy, non-sustained episodes of TdP, and severe hypomagnesemia and hypokalemia. During potassium and magnesium infusion for repletion, the patient underwent temporary transvenous atrial pacing. As part of the work-up, coronary angiography revealed a mild coronary artery disease, and transthoracic echocardiogram showed a moderately depressed ejection fraction. After electrolyte disturbances were corrected, the QT interval normalized, and transvenous pacing was no longer necessary. Abiraterone was discontinued during the admission, and the patient returned to baseline. CONCLUSIONS: Cancer treatment is complex and requires a multidisciplinary approach. We presented a case of non-sustained TdP associated with androgen-deprivation therapy in an elderly patient with mild coronary artery disease and moderately reduced ejection fraction. Close follow-up and increased awareness are required in patients with hormonal treatment, especially in the setting of other cardiovascular risk factors.

Exposure to Nitrate Increases Susceptibility to Hypoxia in Fish.

AbstractAquatic hypoxic events are increasing in frequency and intensity as concentrations of nutrients, such as nitrate, continue to rise from human activities. Many fish species can alter their behavior and physiology to cope with drops in oxygen, but these compensatory strategies may be compromised under high levels of nitrate pollution. Hence, we investigated whether exposure to elevated nitrate concentrations affects key behavioral (avoidance and aquatic surface respiration [ASR]) and physiological (hemoglobin and hematocrit levels, ventilation frequency, and burst and prolonged swimming performance) responses of fish to mitigate the impacts of acute hypoxia. Juvenile silver perch (Bidyanus bidyanus) were exposed to one of three nitrate concentrations (0, 50, or 100 mg NO3- L-1) for 3 wk, after which behavioral and physiological responses of fish to progressive hypoxia were assessed. Fish exposed to nitrate utilized ASR at a higher threshold of partial pressure of oxygen during progressive hypoxia compared with control animals but did not alter behavioral avoidance of low oxygen levels. In these nitrate-exposed fish, the early onset of ASR behaviors is likely a behavioral, compensatory strategy to cope with nitrate-induced physiological disruptions, namely, increases in ventilation frequency and lower levels of hemoglobin and hematocrit. The physiological constraints placed by nitrate and acute hypoxia exposures manifested to lower the swimming performance of silver perch. Collectively, these data suggest that exposure to elevated nitrate is likely to disrupt key behavioral and physiological strategies used by fish to cope with short-term hypoxia.

Harnessing the potential of cross-protection stressor interactions for conservation: a review.

Conservation becomes increasingly complex as climate change exacerbates the multitude of stressors that organisms face. To meet this challenge, multiple stressor research is rapidly expanding, and the majority of this work has highlighted the deleterious effects of stressor interactions. However, there is a growing body of research documenting cross-protection between stressors, whereby exposure to a priming stressor heightens resilience to a second stressor of a different nature. Understanding cross-protection interactions is key to avoiding unrealistic 'blanket' conservation approaches, which aim to eliminate all forms of stress. But, a lack of synthesis of cross-protection interactions presents a barrier to integrating these protective benefits into conservation actions. To remedy this, we performed a review of cross-protection interactions among biotic and abiotic stressors within a conservation framework. A total of 66 publications were identified, spanning a diverse array of stressor combinations and taxonomic groups. We found that cross-protection occurs in response to naturally co-occurring stressors, as well as novel, anthropogenic stressors, suggesting that cross-protection may act as a 'pre-adaptation' to a changing world. Cross-protection interactions occurred in response to both biotic and abiotic stressors, but abiotic stressors have received far more investigation. Similarly, cross-protection interactions were present in a diverse array of taxa, but several taxonomic groups (e.g. mammals, birds and amphibians) were underrepresented. We conclude by providing an overview of how cross-protection interactions can be integrated into conservation and management actions and discuss how future research in this field may be directed to improve our understanding of how cross-protection may shield animals from global change.

Double whammy: Nitrate pollution heightens susceptibility to both hypoxia and heat in a freshwater salmonid.

Species persistence in a changing world will depend on how they cope with co-occurring stressors. Stressors can interact in unanticipated ways, where exposure to one stressor may heighten or reduce resilience to another stressor. We examined how a leading threat to aquatic species, nitrate pollution, affects susceptibility to hypoxia and heat stress in a salmonid, the European grayling (Thymallus thymallus). Fish were exposed to nitrate pollution (0, 50 or 200 mg NO3- L-1) at two acclimation temperatures (18 °C or 22 °C) for eight weeks. Hypoxia- and heat-tolerance were subsequently assessed, and the gills of a subset of fish were sampled for histological analyses. Nitrate-exposed fish were significantly more susceptible to acute hypoxia at both acclimation temperatures. Similarly, in 18 °C- acclimated fish, exposure to 200 mg NO3- L- 1 caused a 1 °C decrease in heat tolerance (critical thermal maxima, CTMax). However, the opposite effect was observed in 22 °C-acclimated fish, where nitrate exposure increased heat tolerance by ~1 °C. Further, nitrate exposure induced some histopathological changes to the gills, which limit oxygen uptake. Our findings show that nitrate pollution can heighten the susceptibility of fish to additional threats in their habitat, but interactions are temperature dependent.

Thermal plasticity of the cardiorespiratory system provides cross-tolerance protection to fish exposed to elevated nitrate.

Exposure to nitrate is toxic to aquatic animals due to the formation of methaemoglobin and a subsequent loss of blood-oxygen carrying capacity. Yet, nitrate toxicity can be modulated by other stressors in the environment, such as elevated temperatures. Acclimation to elevated temperatures has been shown to offset the negative effects of nitrate on whole animal performance in fish, but the mechanisms underlying this cross-tolerance interaction remain unclear. In this study, juvenile silver perch (Bidyanus bidyanus) were exposed to a factorial combination of temperature (28 °C or 32 °C) and nitrate concentrations (0, 50 or 100 mg NO3- L-1) treatments to test the hypothesis that thermal acclimation offsets the effects of nitrate via compensatory changes to the cardiorespiratory system (gills, ventricle and blood oxygen carrying capacity). Following 21 weeks of thermal acclimation, we found that fish acclimated to 32 °C experienced an expansion of gill surface area and an increase in ventricular thickness regardless of nitrate exposure concentration. Exposure to nitrate (both 50 and 100 mg NO3- L-1) reduced the blood oxygen carrying capacity of silver perch due to increases in methaemoglobin concentration and a right shift in oxygen-haemoglobin binding curves in fish from both thermal acclimation treatments. These results indicate that plasticity of the gills and ventricle of warm acclimated fish are potential mechanisms which may provide cross-tolerance protection to elevated nitrate concentrations despite nitrate induced reductions to oxygen transport.

Thermal acclimation offsets the negative effects of nitrate on aerobic scope and performance.

Rising temperatures are set to imperil freshwater fishes as climate change ensues unless compensatory strategies are employed. However, the presence of additional stressors, such as elevated nitrate concentrations, may affect the efficacy of compensatory responses. Here, juvenile silver perch (Bidyanus bidyanus) were exposed to current-day summer temperatures (28°C) or a future climate-warming scenario (32°C) and simultaneously exposed to one of three ecologically relevant nitrate concentrations (0, 50 or 100 mg l-1). We measured indicators of fish performance (growth, swimming), aerobic scope (AS) and upper thermal tolerance (CTmax) to test the hypothesis that nitrate exposure would increase susceptibility to elevated temperatures and limit thermal compensatory responses. After 8 weeks of acclimation, the thermal sensitivity and plasticity of AS and swimming performance were tested at three test temperatures (28, 32, 36°C). The AS of 28°C-acclimated fish declined with increasing temperature, and the effect was more pronounced in nitrate-exposed individuals. In these fish, declines in AS corresponded with poorer swimming performance and a 0.8°C decrease in CTmax compared with unexposed fish. In contrast, acclimation to 32°C masked the effects of nitrate; fish acclimated to 32°C displayed a thermally insensitive phenotype whereby locomotor performance remained unchanged, AS was maintained and CTmax was increased by ∼1°C irrespective of nitrate treatment compared with fish acclimated to 28°C. However, growth was markedly reduced in 32°C-acclimated compared with 28°C-acclimated fish. Our results indicate that nitrate exposure increases the susceptibility of fish to acute high temperatures, but thermal compensation can override some of these potentially detrimental effects.