Adaptation of sea turtles to climate warming: Will phenological responses be sufficient to counteract changes in reproductive output?

Sea turtles are vulnerable to climate change since their reproductive output is influenced by incubating temperatures, with warmer temperatures causing lower hatching success and increased feminization of embryos. Their ability to cope with projected increases in ambient temperatures will depend on their capacity to adapt to shifts in climatic regimes. Here, we assessed the extent to which phenological shifts could mitigate impacts from increases in ambient temperatures (from 1.5 to 3°C in air temperatures and from 1.4 to 2.3°C in sea surface temperatures by 2100 at our sites) on four species of sea turtles, under a "middle of the road" scenario (SSP2-4.5). Sand temperatures at sea turtle nesting sites are projected to increase from 0.58 to 4.17°C by 2100 and expected shifts in nesting of 26-43 days earlier will not be sufficient to maintain current incubation temperatures at 7 (29%) of our sites, hatching success rates at 10 (42%) of our sites, with current trends in hatchling sex ratio being able to be maintained at half of the sites. We also calculated the phenological shifts that would be required (both backward for an earlier shift in nesting and forward for a later shift) to keep up with present-day incubation temperatures, hatching success rates, and sex ratios. The required shifts backward in nesting for incubation temperatures ranged from -20 to -191 days, whereas the required shifts forward ranged from +54 to +180 days. However, for half of the sites, no matter the shift the median incubation temperature will always be warmer than the 75th percentile of current ranges. Given that phenological shifts will not be able to ameliorate predicted changes in temperature, hatching success and sex ratio at most sites, turtles may need to use other adaptive responses and/or there is the need to enhance sea turtle resilience to climate warming.

Tratamiento de infecciones graves por Acinetobacter baumannii / Treatment of Acinetobacter baumannii severe infections

El Acinetobacter baumannii es un patógeno gramnegativo, multirresistente (MR) que causa infecciones nosocomiales, especialmente en las unidades de cuidados intensivos (UCI) y en los pacientes inmunocomprometidos. El A. baumannii ha desarrollado una resistencia antibiótica de amplio espectro, asociada con alta tasa de mortalidad entre los pacientes infectados comparada con las otras especies de Acinetobacter no baumannii. En relación con el impacto clínico, las cepas resistentes están asociadas con incremento de la estadía hospitalaria y de la mortalidad. El A. baumannii puede causar diferentes infecciones, especialmente neumonía asociada a la ventilación mecánica, bacteriemia, e infección de piel y partes blandas, entre otras. Los factores de riesgo más frecuentes para la adquisición de A. baumannii MR son el uso previo de antibióticos, la asistencia respiratoria mecánica, la estadía en la UCI y en el hospital, la severidad de la enfermedad y el uso de dispositivos médicos. Los esfuerzos actuales están focalizados en determinar todos los mecanismos de resistencia descritos en el A. baumannii, con el objetivo de identificar esquemas terapéuticos más efectivos (AU)

Acinetobacter baumannii is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients. A. baumannii has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non-baumannii species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. A. baumannii can cause a variety of infections, especially ventilator-associated pneumonia, bacteremia, and skin wound infections, among others. The most common risk factors for the acquisition of MDR A. baumannii are previous antibiotic use, mechanical ventilation, length of ICU and hospital stay, severity of illness, and use of medical devices. Current efforts are focused on addressing all the antimicrobial resistance mechanisms described in A. baumannii, with the objective of identifying the most promising therapeutic scheme (AU)

Treatment of Acinetobacter baumannii severe infections.

Acinetobacter baumannii is a Gram-negative, multidrug-resistant (MDR) pathogen that causes nosocomial infections, especially in intensive care units (ICUs) and immunocompromised patients. A. baumannii has developed a broad spectrum of antimicrobial resistance, associated with a higher mortality rate among infected patients compared with other non-baumannii species. In terms of clinical impact, resistant strains are associated with increases in both in-hospital length of stay and mortality. A. baumannii can cause a variety of infections, especially ventilator-associated pneumonia, bacteremia, and skin wound infections, among others. The most common risk factors for the acquisition of MDR A. baumannii are previous antibiotic use, mechanical ventilation, length of ICU and hospital stay, severity of illness, and use of medical devices. Current efforts are focused on addressing all the antimicrobial resistance mechanisms described in A. baumannii, with the objective of identifying the most promising therapeutic scheme.

Influence of the ripening chamber's geographical location on dry-cured Iberian ham's key odorants.

Olfactometric and sensory analyses have been applied to study the possible influence of the ripening chamber's geographical location on the aroma sensory profiles and key odorants of Iberian ham. Dry-cured Iberian ham was obtained from 3 acorn-fed pigs and, for the first time, both of the participating production facilities, located in two different Andalusian municipalities with different altitudes above mean sea level, processed one of the two hind legs from each pig. The descriptive sensory profile of orthonasal and retronasal odours was determined by trained panellists, while odour-active compounds were determined by gas chromatography/mass spectrometry-olfactometry (GC/MS-O). The results obtained showed that, separately, both techniques enable Iberian ham samples to be differentiated by their ripening chamber's geographical location. For sensory analysis, retronasal sensory analysis appeared to be the most suitable for this goal, highlighting the "meat broth odour" and "roasted nuts odour" descriptors which presented significant differences between geographical locations for samples from all pigs. Moreover, ripening chamber's geographical location characteristics and the initial composition of the raw material seemed to influence the content of some odour-active compounds. The odour-active compound identified as octane/acetone and isobutanol were conditioned by the ripening chamber's geographical location, while decanal/2-ethyl-1-hexanol, 1-undecanol, 2-furanmethanol and cis-2-nonenal were also influenced by the individual pig itself. This study showed that slight climatological differences due to the location of the ripening chamber seem to have somewhat of an influence on the aromatic profile.

A non-destructive sampling method for food authentication using gas chromatography coupled to mass spectrometry or ion mobility spectrometry.

The study of volatile compounds obtained by gas chromatography (GC) coupled to mass spectrometry (MS) or ion mobility spectrometry (IMS) may be very useful to protect food quality, especially when using a non-destructive sampling method. In this work, the authentication of the highly appreciated dry-cured Iberian ham by those techniques was studied and compared. The results obtained show the suitability of a non-destructive sampling method coupled to headspace sampling (HS)-GC-IMS or HS-GC-MS to determine volatile markers in the feeding Iberian pig regime. Although both methods were suitable to differentiate the ham categories, HS-GC-IMS was more sensitive detecting a higher number of compounds than HS-GC-MS, which provided accurate qualitative results. The results of principal component analysis showed that ethanol, 2-propanol and 3-methylbutanol, identified by HS-GC-IMS, and 3-methylbutanal and heptane, identified by HS-GC-MS, could be considered potential markers to identify ham from different feeding regimes.

Anaesthesia of hatchling green sea turtles (Chelonia mydas) with intramuscular ketamine-medetomidine-tramadol.

OBJECTIVE: To characterise intramuscular ketamine-medetomidine-tramadol anaesthesia in hatchling green sea turtles (Chelonia mydas). STUDY DESIGN: Prospective clinical trial. ANIMALS: Ten hatchling green sea turtles. MATERIALS AND METHODS: Prior to anaesthesia, cardiopulmonary parameters, cloacal temperature, and venous blood gas and biochemistry were obtained from hatchling green sea turtles while they were being gently restrained. Animals were then anaesthetised with ketamine (5 mg kg-1 ), medetomidine (0.05 mg kg-1 ) and tramadol (5 mg kg-1 ) via intramuscular injection. Turtles were checked for the depth of anaesthesia at five-min intervals by recording reflexes (righting, palpebral, pinch, cloacal) and measuring heart rate, respiratory rate and cloacal temperature. After 20 min, a second venous blood sample was obtained for further blood gas and biochemical analysis and the medetomidine was antagonised using atipamezole (5:1 medetomidine, 0.25 mg kg-1 ). RESULTS: All turtles were successfully anaesthetised with a mean time to induction of 3.4 min (±1). In all animals, a loss of reflexes (except for palpebral reflex) and voluntary movement was observed for the entire 20 min. Anaesthesia resulted in marked apnoea for the duration of the procedure. Venous blood gas and biochemistry analysis indicated that a 20 min period of apnoea had no measurable effects on venous blood gas results. All turtles recovered uneventfully after atipamazole antagonisation, with a mean time to first breath 4.5 min (±3.7), and mean recovery time 15.5 min (±15.4). CONCLUSIONS AND CLINICAL RELEVANCE: Intramuscular ketamine-medetomidine-tramadol, antagonised with atipamazole appears to be an effective anaesthetic protocol in hatchling green sea turtles for short procedures with no deleterious effects on venous blood gases or biochemistry.

Assessment of UV-visible spectroscopy as a useful tool for determining grape-must caramel in high-quality wine and balsamic vinegars.

The addition of E-150d caramel, known as grape-must caramel in vinegars, is a legal but without limitation practice in Spanish wine vinegars, as those with a protected designation of origin (PDO), for unifying the final colour of different batches and barrels. It is also used in the production of 'Balsamic vinegar of Modena' vinegars, with a maximum addition fixed at 2% v/v by law. Although its quantification in vinegars was studied by other techniques, there is still not any official method for it. Therefore, UV-vis spectroscopy was assessed as a quick analytical method able to quantify grape-must caramel in Balsamic vinegars of Modena and Spanish PDO wine vinegars. Univariate and multivariate calibrations were assessed for this quantification. Results demonstrated the ability of UV-vis spectroscopy coupled with multivariate calibration in the quantification of grape-must caramel, predicting caramel amounts under 2% v/v in both Balsamic and PDO wine vinegars.

Sensory and spectroscopic characterization of Argentinean wine and balsamic vinegars: A comparative study with European vinegars.

In Argentina, vinegars are cheap agro-food products without exhaustive regulation and the production of high-quality vinegars has not been exploited yet. In fact, Argentinean vinegars have not been studied. In this context, a first study of Argentinean balsamic and wine vinegars was carried out by a sensory and spectroscopic characterization and by a comparison with well-recognized European vinegars. For that, ultraviolet-visible and fluorescence spectroscopies were applied together with principal component analysis (PCA) and parallel factor analysis (PARAFAC) performed on each data set, respectively. Results showed differences between acetification processes, origin countries and a wide variability within Argentinean production. The sensory characterization on Argentinean wine vinegars was performed by triangular and ordering preference tests showing statistically significant preferences toward the traditional and the rapid vinegars. This work highlights the effect of production on quality in order to provide added value to the Argentinean vinegars.

Guías de práctica clínica basadas en la evidencia para el manejo de la sedoanalgesia y delirium en el paciente adulto críticamente enfermo / Evidence-based clinical practice guidelines for the management of sedoanalgesia and delirium in critically ill adult patients

Dada la importancia del manejo de la sedación, analgesia y delirium en las unidades de cuidados intensivos, y con el fin de actualizar las guías publicadas anteriormente, se decidió elaborar una nueva guía de práctica clínica con los soportes, manejos e intervenciones más relevantes acordes con las publicaciones recientes. Para elaborar esta guía, se reunió un grupo de 24 intensivistas procedentes de 9 países de la Federación Panamericana e Ibérica de Sociedades de Medicina Crítica y Terapia Intensiva. Se acogió la propuesta del Grading of Recommendations Assessment, Development and Evaluation Working Group para emitir el grado de recomendación y evaluar la calidad de la evidencia. Se realizó una búsqueda sistemática de la literatura utilizándose: MEDLINE, las siguientes bases de datos de la biblioteca Cochrane: Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials (CENTRAL), Database of Abstracts of Reviews of Effects, National Health Service Economic Evaluation Database, y la base de datos de Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). Finalmente, se seleccionaron 438 referencias, permitiendo realizar 47 recomendaciones fuertes con evidencia alta y moderada, 14 recomendaciones condicionales con evidencia moderada y 65 recomendaciones condicionales con evidencia baja. Se confirma la importancia del manejo inicial y multimodal del dolor, se hace énfasis en la disminución de los niveles de sedación y la utilización de sedación profunda solo en casos específicos. Aumenta la evidencia y recomendaciones para el uso de medicamentos como dexmedetomidina, remifentanil, ketamina, entre otros

Given the importance of the management of sedation, analgesia and delirium in Intensive Care Units, and in order to update the previously published guidelines, a new clinical practice guide is presented, addressing the most relevant management and intervention aspects based on the recent literature. A group of 24 intensivists from 9 countries of the Pan-American and Iberian Federation of Societies of Critical Medicine and Intensive Therapy met to develop the guidelines. Assessment of evidence quality and recommendations was made according to the Grading of Recommendations Assessment, Development and Evaluation Working Group. A systematic search of the literature was carried out using MEDLINE, Cochrane Library databases such as the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects, the National Health Service Economic Evaluation Database and the database of Latin American and Caribbean Literature in Health Sciences (LILACS). A total of 438 references were selected. After consensus, 47 strong recommendations with high and moderate quality evidence, 14 conditional recommendations with moderate quality evidence, and 65 conditional recommendations with low quality evidence were established. Finally, the importance of initial and multimodal pain management was underscored. Emphasis was placed on decreasing sedation levels and the use of deep sedation only in specific cases. The evidence and recommendations for the use of drugs such as dexmedetomidine, remifentanil, ketamine and others were incremented

Evidence-based clinical practice guidelines for the management of sedoanalgesia and delirium in critically ill adult patients. / Guías de práctica clínica basadas en la evidencia para el manejo de la sedoanalgesia y delirium en el paciente adulto críticamente enfermo.

Given the importance of the management of sedation, analgesia and delirium in Intensive Care Units, and in order to update the previously published guidelines, a new clinical practice guide is presented, addressing the most relevant management and intervention aspects based on the recent literature. A group of 24 intensivists from 9 countries of the Pan-American and Iberian Federation of Societies of Critical Medicine and Intensive Therapy met to develop the guidelines. Assessment of evidence quality and recommendations was made according to the Grading of Recommendations Assessment, Development and Evaluation Working Group. A systematic search of the literature was carried out using MEDLINE, Cochrane Library databases such as the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects, the National Health Service Economic Evaluation Database and the database of Latin American and Caribbean Literature in Health Sciences (LILACS). A total of 438 references were selected. After consensus, 47 strong recommendations with high and moderate quality evidence, 14 conditional recommendations with moderate quality evidence, and 65 conditional recommendations with low quality evidence were established. Finally, the importance of initial and multimodal pain management was underscored. Emphasis was placed on decreasing sedation levels and the use of deep sedation only in specific cases. The evidence and recommendations for the use of drugs such as dexmedetomidine, remifentanil, ketamine and others were incremented.

Influence of Saccharomyces cerevisiae and Lachancea thermotolerans co-inoculation on volatile profile in fermentations of a must with a high sugar content.

The aim of this work was to evaluate how the use of mixed cultures of Saccharomyces cerevisiae and Lachancea thermotolerans indigenous yeast strains influences the volatile composition of wine. Multivariate curve resolution (MCR) method has been applied to data analysis. Five fermentation trials were carried out: three co-inoculated with L. thermotolerans:S. cerevisiae, at the ratio of 50:1, 20:1 and 5:1 respectively, and two with a pure culture of each strain. A must from sun-dried Pedro Ximénez grapes was employed. Volatile composition was determined by dual sequential stir bar sorptive extraction, followed by GC-MS analysis. MCR provided 171 peaks. Results in co-inoculation fermentations revealed that the majority compounds obtained in each case followed the same trend as that observed for the pure culture of the strain that was present in a higher proportion. Finally, 50:1 and 20:1 seemed to be the best proportions to obtain a wine with a quality volatile profile.

Viral load, tissue distribution and histopathological lesions in goats naturally and experimentally infected with the Small Ruminant Lentivirus Genotype E (subtype E1 Roccaverano strain).

Small Ruminant Lentivirus (SRLV) subtype E1, also known as Roccaverano strain, is considered a low pathogenic virus on the basis of natural genetic deletions, in vitro properties and on-farm observations. In order to gain more knowledge on this atypical lentivirus we investigated the in vivo tropism of Roccaverano strain in both, experimentally and naturally infected goats. Antibody responses were monitored as well as tissue distribution and viral load, evaluated by real time PCR on single spliced (gag/env) and multiple spliced (rev) RNA targets respectively, that were compared to histopathological lesions. Lymph nodes, spleen, alveolar macrophages and mammary gland turned out to be the main tissue reservoirs of genotype E1-provirus. Moreover, mammary gland and/or mammary lymph nodes acted as active replication sites in dairy goats, supporting the lactogenic transmission of this virus. Notably, a direct association between viral load and concomitant infection or inflammatory processes was evident within organs such as spleen, lung and testis. Our results validate the low pathogenicity designation of SRLV genotype E1 in vivo, and confirm the monocyte-macrophage cell lineage as the main virus reservoir of this genotype. Accordingly, SRLV genotype E displays a tropism towards all tissues characterized by an abundant presence of these cells, either for their own anatomical structure or for an occasional infectious/inflammatory status.

Evaluación de las actitudes hacia la discapacidad en Educación Física: Efecto diferencial del sexo, contacto previo y la percepción de habilidad y competencia / Avaliação das atitudes em relação à deficiência na Educação Física: efeito diferencial do sexo, contato anterior e percepção de habilidade e competência / Evaluation of attitudes towards disability in Physical Education: Differential effect of sex, previous contact and skill and competence perception

El objetivo del estudio es examinar las actitudes hacia la discapacidad de alumnos de Educación Secundaria Obligatoria en Educación Física, comparando las diferencias en función del sexo, de la edad, del contacto previo con personas con discapacidad y de la habilidad deportiva y competitividad percibida. Doscientos noventa y cuatro estudiantes de Educación Secundaria Obligatoria de tres centros de Castilla - La Mancha (14.54 ± 1.31 años) formaron parte de este estudio. Para el análisis de las actitudes hacia la discapacidad se utilizaron dos instrumentos: "The Attitudes towards Inclusion of Students with Disabilities in Physical Education" (AISDPE) (Reina, Hutzler, Íñiguez Santiago, y Moreno-Murcia, 2016), y la "Escala de Actitud hacia el Alumnado con Discapacidad en Educación Física" (EAADEF) (Íñiguez-Santiago, Férriz, Martínez-Galindo, Cebrián-Sánchez, y Reina, 2017). Los resultados muestran que contactos más íntimos o frecuentes relacionados con la inclusión (como tener un amigo/a o familiar con discapacidad o realizar deporte inclusivo) se relacionarían con una actitud más positiva hacia la discapacidad, en contraposición a los contactos más superficiales o puntuales (compartir aula o clases de EF). Además, la habilidad y competitividad percibida se presentan como posibles variables mediadoras en el proceso de una potencial inclusión efectiva (AU)

The aim of the study is to examine the attitudes towards the disability of students of Compulsory Secondary Education in Physical Education, comparing the differences according to sex, age, previous contact with people with impairments and the skill and competence perception. Two hundred ninety - four students from three centers of Castilla - La Mancha (14.54 ± 1.31 years) took part of this study. In order to analyze the attitudes towards disability, two instruments were used: "The Attitudes toward Inclusion of Students with Disabilities in Physical Education" (AISDPE) (Reina, Hutzler, Íñiguez-Santiago, and Moreno-Murcia, 2016); Attitude's towards Students with Disabilities in Physical Education "(EAADEF) (Íñiguez-Santiago, Férriz, Martínez-Galindo, Cebrián-Sánchez, and Reina, 2017). The results show that more intimate or frequent contacts related to inclusion (such as having a friend or family member with disability or engaging in inclusive sport) would be related to a more positive attitude towards disability, as opposed to more superficial or specific contacts Classroom or EF classes). In addition, the perceived ability and competitiveness are presented as possible mediating variables in the process of a potential effective inclusion (AU)

O objetivo do estudo é analisar as atitudes em relação à deficiência dos alunos do Ensino Secundário em Educação Física, comparando as diferenças com base no sexo, idade, contato prévio com pessoas com deficiência e capacidade atlética percebida e competitividade. Duzentos e noventa e quatro alunos do ensino secundário três centros de Castilla - La Mancha (14,54 ± 1,31 anos) fizeram parte deste estudo. Para a análise das atitudes em relação à deficiência foram utilizados dois instrumentos: "As atitudes para a inclusão de alunos com deficiência em Educação Física" (AISDPE) (Reina, Hutzler, Íñiguez-Santiago, e Moreno-Murcia, 2016), e "Scale atitude para Estudantes com Deficiência em Educação Física (EAADEF)" (Íñiguez-Santiago, Férriz, Martínez-Galindo, Cebrián-Sánchez, e Reina, 2017). Os resultados mostram que a maioria dos contatos íntimos ou frequentes relacionadas com a inclusão (como ter um amigo / ou membro da família com deficiência ou fazer desporto inclusive) se relacionam com uma atitude mais positiva em relação à deficiência, por oposição aos contatos mais superficiais ou ponto (partilha sala de aula ou aulas de educação física). Além disso, habilidade e competitividade percebida são apresentados como possível processo de variáveis mediadoras incluindo potencial efetivo (AU)

Prenatal stress from trawl capture affects mothers and neonates: a case study using the southern fiddler ray (Trygonorrhina dumerilii).

Assessing fishing effects on chondrichthyan populations has predominantly focused on quantifying mortality rates. Consequently, sub-lethal effects of capture stress on the reproductive capacity of chondrichthyans are largely unknown. We investigated the reproductive consequences of capture on pregnant southern fiddler rays (Trygonorrhina dumerilii) collected from Swan Bay, Australia, in response to laboratory-simulated trawl capture (8 h) followed immediately by air exposure (30 min). Immediately prior to, and for up to 28 days post trawling, all females were measured for body mass (BM), sex steroid concentrations (17-ß estradiol, progesterone, testosterone) and granulocyte to lymphocyte (G:L) ratio. At parturition, neonates were measured for total length (TL), BM and G:L ratio. Trawling reduced maternal BM and elevated the G:L ratio for up to 28 days. Trawling did not significantly affect any sex steroid concentrations relative to controls. Neonates from trawled mothers were significantly lower in BM and TL than control animals, and had an elevated G:L ratio. Our results show that capture of pregnant T. dumerilii can influence their reproductive potential and affect the fitness of neonates. We suggest other viviparous species are likely to be similarly affected. Sub-lethal effects of capture, particularly on reproduction, require further study to improve fisheries management and conservation of chondrichthyans.

Small Ruminant Lentiviruses in Sheep: Pathology and Tropism of 2 Strains Using the Bone Marrow Route.

The objective of this work was to comparatively study the tissue tropism and the associated pathology of 2 autochthonous small ruminant lentivirus (SRLV) field strains using an experimental infection in sheep through the bone marrow. Fifteen male, SRLV-free lambs of the Rasa Aragonesa breed were inoculated with strain 697 (nervous tissue origin, animals A1-A6), with strain 496 (articular origin, animals B1-B6), or with uninfected culture medium (C1-C3). Clinical, serologic, and polymerase chain reaction (PCR) evaluations were performed periodically. Two lambs from each infected group and a control animal were euthanized at 134, 273, and 319 days postinfection. Tissues were analyzed by gross and histopathologic evaluation; immunohistochemistry for CD3, CD4, CD8, CD68, and FoxP3 cell markers; lung morphometric evaluation; and tissue proviral quantification by PCR. All infected animals became positive either by enzyme-linked immunosorbent assay and/or PCR, with group B lambs showing the highest serologic values and more consistently positive PCR reactions. Group A lambs showed representative lung lesions but only mild histopathologic changes in the central nervous system (CNS) or in carpal joints. Contrarily, group B lambs demonstrated intense carpal arthritis and interstitial pneumonia but an absence of lesions in the CNS. Proviral copies in tissues were detected only in group B lambs. Experimental infection with these SRLV strains indicates that strain 496 is more virulent than strain 697 and more prone to induce arthritis, whereas strain 697 is more likely to reproduce encephalitis in Rasa Aragonesa lambs. Host factors as well as viral factors are responsible for the final clinicopathologic picture during SRLV infections.

Manejo del síndrome de abstinencia alcohólica en los pacientes críticos / Management of the syndrome of alcohol withdrawal in critical patients

El manejo del síndrome de abstinencia alcohólica es un desafío en los pacientes críticos. Con frecuencia, se desconocen los antecedentes de consumo de alcohol o este dato es incompleto, lo que limita la identificación de quienes pueden desarrollar este síndrome. El cese abrupto del consumo de alcohol coloca a estos pacientes en alto riesgo de sufrir síndrome de abstinencia alcohólica grave. Típicamente, las benzodiacepinas son consideradas las drogas de primera línea para el manejo de estos casos. Sin embargo, si el paciente progresa a un estado más grave con convulsiones o delirium tremens, puede ser necesario administrar medicación adyuvante a las benzodiacepinas, como el propofol o la dexmedetomidina, o emplear estas últimas drogas como terapias alternativas en aquellos que no responden a las benzodiacepinas. La aparición de convulsiones representa un fuerte factor de riesgo para la progresión a un síndrome de abstinencia alcohólica grave, con el desarrollo posterior de delirium tremens hasta en el 30% de los casos. El delirium tremens es el cuadro más grave y ocurre en el 5-20% de los pacientes con este síndrome, con una mortalidad hasta del 25% sin tratamiento y que se reduce al 0-1% con tratamiento. Es importante conocer el antecedente del consumo de alcohol para evitar el síndrome de abstinencia alcohólica o tratar rápidamente sus síntomas más graves, y mejorar la supervivencia de estos pacientes.(AU)

Alcohol withdrawal syndrome (AWS) is a well-known and a challenging condition occurring in critically ill patients. Frequently, history of alcohol abuse is unknown when the patient is admitted to the intensive care unit, limiting the identification of those who could develop AWS. The abrupt cessation of a heavy or constant drinking put these patients in high risk of suffering from this syndrome in its severe form. Typically, benzodiazepines are considered the first line of treatment. However, if clinical conditions progress to epileptic seizures or delirium tremens or are refractory to benzodiazepines, adjuvant drugs like propofol or dexmedetomidine might be an option to control the severe symptoms. Delirium tremens can occur in up to 30% of patients; it is the most severe picture with a mortality of 25% without treatment and that can be reduced to almost 0-1% with treatment. It is important to appropriately identify alcohol abuse in order to avoid the early clinical manifestations of AWS or rapidly treat its most severe symptoms and improve survival.(AU)

Recent developments in the analysis of musty odour compounds in water and wine: A review.

One of the most common taints in foods is a musty or earthy odour, which is commonly associated with the activity of microorganisms. Liquid foods, particularly wine and water, can be affected by this defect due to the presence of certain aromatic organic compounds at very low concentrations (ng/L) consistent with human threshold perception levels. The volatile compounds responsible for a mouldy off-aroma include approximately 20 compounds, namely, haloanisoles, geosmin, 2-methylisoborneol, several alkyl-methoxypyrazines, 1-octen-3-ol, 1-octen-3-one, trans-octenol, 3-octanone, fenchol and fenchone. Methods for determining these very low concentrations of odour compounds must be extremely sensitive and selective with efficient preconcentration treatments. A number of extraction techniques based on LLME (liquid-liquid microextraction), SPME (solid-phase microextraction) or SBSE (stir-bar sorptive extraction) can be applied and should be selected on a case-by-case basis. Moreover, recent developments in GC instrumentation coupled to different detection systems can effectively increase the selectivity and sensitivity of the analysis of target compounds.

Small ruminant lentivirus infections and diseases.

Small ruminant lentiviruses include viruses with diverse genotypes that frequently cross the species barrier between sheep and goats and that display a great genetic variability. These characteristics stress the need to consider the whole host range and to perform local surveillance of the viruses to opt for optimum diagnostic tests, in order to establish control programmes. In the absence of effective vaccines, a comprehensive knowledge of the epidemiology of these infections is of major importance to limit their spread. This article intends to cover these aspects and to summarise information related to characteristics of the viruses, pathogenesis of the infection and description of the various syndromes produced, as well as the diagnostic tools available, the mechanisms involved in transmission of the pathogens and, finally, the control strategies that have been designed until now, with remarks on the drawbacks and the advantages of each one. We conclude that there are many variables influencing the expected cost and benefits of control programs that must be evaluated, in order to put into practice measures that might lead to control of these infections.

Standing out and moving up: performance appraisal of cultural minority physicians.

Despite a growing diversity within society and health care, there seems to be a discrepancy between the number of cultural minority physicians graduating and those in training for specialization (residents) or working as a specialist in Dutch academic hospitals. The purpose of this article is to explore how performance appraisal in daily medical practice is experienced and might affect the influx of cultural minority physicians into specialty training. A critical diversity study was completed in one academic hospital using interviews (N = 27) and focus groups (15 participants) with cultural minority physicians and residents, instructing specialists and executives of medical wards. Data were digitally recorded and transcribed verbatim. A thematic and integral content analysis was performed. In addition to explicit norms on high motivation and excellent performance, implicit norms on professionalism are considered crucial in qualifying for specialty training. Stereotyped imaging on the culture and identity of cultural minority physicians and categorical thinking on diversity seem to underlie daily processes of evaluation and performance appraisal. These are experienced as inhibiting the possibilities to successfully profile for selection into residency and specialist positions. Implicit criteria appear to affect selection processes on medical wards and possibly hinder the influx of cultural minority physicians into residency and making academic hospitals more diverse. Minority and majority physicians, together with the hospital management and medical education should target inclusive norms and practices within clinical practice.

Small ruminant lentivirus-induced arthritis: clinicopathologic findings in sheep infected by a highly replicative SRLV B2 genotype.

We describe the clinicopathologic features of an arthritis outbreak in sheep induced by small ruminant lentivirus (SRLV), linked to the presence of a new SRLV isolate phylogenetically assigned to caprine arthritis encephalitis virus-like subgroup B2. Thirteen SRLV seropositive Rasa Aragonesa adult ewes were selected from 5 SRLV highly infected flocks (mean seroprevalence, 90.7%) for presenting uni- or bilateral chronic arthritis in the carpal joint. A complete study was performed, including symptomatology, histopathology, immunocytochemistry, immunohistochemistry, in situ hybridization, and microbiology. The carpus was the joint almost exclusively affected, with 10 sheep (76%) showing a moderate increase in carpal joint size (diameter range, 18-20 cm; normal range, 15-16 cm) without signs of locomotion problems and with 3 ewes (23%) showing severe inflammation with marked increase in diameter (21-24 cm), pain at palpation, and abnormal standing position. Grossly, chronic proliferative arthritis was observed in affected joints characterized by an increased thickness of the synovial capsule and synovial membrane proliferation. Microscopically, synovial membrane inflammation and proliferation and hyperplasia of synoviocytes were observed. More positive cases of SLRV infection were detected by immunocytochemistry of articular fluid than of bronchoalveolar lavage fluid. Immunohistochemistry and in situ hybridization also detected positive cells in the subsynovial connective tissue, lung, mediastinal lymph node, mammary gland, and mammary lymph node. All animals were negative for the presence of Mycoplasma or other bacteria in the articular space. The present outbreak likely represents an adaptation of a caprine virus to sheep. Our results underline the importance of the arthritis induced by SRLV in sheep, a clinical form that might be underestimated.