RESUMEN
Western Iberia has recently shown increasing frequency of drought conditions coupled with heatwave events, leading to exacerbated limiting climatic conditions for plant growth. It is not clear to what extent wood growth and density of agroforestry species have suffered from such changes or recent extreme climate events. To address this question, tree-ring width and density chronologies were built for a Pinus pinaster stand in southern Portugal and correlated with climate variables, including the minimum, mean and maximum temperatures and the number of cold days. Monthly and maximum daily precipitations were also analyzed as well as dry spells. The drought effect was assessed using the standardized precipitation-evapotranspiration (SPEI) multi-scalar drought index, between 1 to 24-months. The climate-growth/density relationships were evaluated for the period 1958-2011. We show that both wood radial growth and density highly benefit from the strong decay of cold days and the increase of minimum temperature. Yet the benefits are hindered by long-term water deficit, which results in different levels of impact on wood radial growth and density. Despite of the intensification of long-term water deficit, tree-ring width appears to benefit from the minimum temperature increase, whereas the effects of long-term droughts significantly prevail on tree-ring density. Our results further highlight the dependency of the species on deep water sources after the juvenile stage. The impact of climate changes on long-term droughts and their repercussion on the shallow groundwater table and P. pinaster's vulnerability are also discussed. This work provides relevant information for forest management in the semi-arid area of the Alentejo region of Portugal. It should ease the elaboration of mitigation strategies to assure P. pinaster's production capacity and quality in response to more arid conditions in the near future in the region.
RESUMEN
OBJECTIVES: To analyze whether C-reactive protein (CRP) predicts the need for urgent urinary diversion in patients with renal colic and urolithiasis. CRP may help in the differential diagnosis of complicated hydronephrosis. METHODS: Prospective study done on 110 consecutive patients with renal colic secondary to upper urinary tract calculi admitted in the emergency room. Clinical and analytical data were collected. Criteria for emergency drainage had been established in advance, based on the risk of sepsis, renal failure, persistence of pain, and findings on computed tomography scan. CRP was blindly determined using immunoturbidimetric assay on the Integra 700 analyzer. Statistical analysis included Mann-Whitney test, Cox multivariate analysis, and receiver operating characteristic curves, to determine optimum cut-off points to decide drainage based on laboratory data. RESULTS: Mean CRP value was 47.6 mg/L (CI, 31.4-63.8), 139.6 mg/L (CI, 13-183.1) in 29 patients treated with diversion and 14.67 mg/L (CI, 6.7-22.5) in the control group (P <.001). Age, sex, rate of patients with hypertension, history of cardiovascular disease, leukocyte total count, and serum creatinine differed between groups (P <.05). Regression analysis revealed CRP (P <.0001) and age (P = .0001) were predictive of urinary diversion. Receiver operating characteristic analysis revealed 68.4% area under the curve for creatinine, 68.8% for leukocytosis, and 86.8% for CRP. A cut-off point for CRP of 28 mg/L achieved optimum sensitivity (75.8%) and specificity (88.9%) for determining the decision for drainage. CONCLUSIONS: Determination of CRP in patients with renal colic due to urolithiasis provides an objective and useful parameter for deciding placement of urinary stent, which is even more valuable than leukocytosis or seric creatinine level.