Characterization of Anthocyanins From Intraspecific Crosses of Monastrell With Other Premium Varieties.

One way in which the wine sector is reacting to the challenge of climate change is to develop plant material that is adapted to the new conditions. Such a strategy will allow the continuation of quality viticulture in traditional winemaking areas that will otherwise be abandoned. The objective of this study was to characterize the anthocyanin composition and content of selected intraspecific hybrids of Monastrell with two other varieties (Syrah and Cabernet Sauvignon). The experiment was carried out over three successive seasons, and the polyphenolic quality of the grapes and wines was assessed along with the adaptation of the hybrids to the high temperatures which will inevitably affect our area (south-eastern Spain). The results showed that, compared with grapes of the Monastrell variety and the wines made from them, most of the hybrids (MS10, MS34, and MC111) had a higher total anthocyanin concentration and overall content of acylated anthocyanins, depending on the year studied.

Influence of methyl jasmonate and benzothiadiazole on the composition of grape skin cell walls and wines.

Phenolic compounds are very important in crop plants, particularly in grapes. The different strategies to increase their levels include the use of elicitors such as methyl jasmonate (MeJ) and benzothiadiazole (BTH). In an attempt to improve the quality of wines, our aim was to evaluate the effect of preharvest application of these elicitors on the composition and structure of the skin cell walls of Monastrell, Merlot and Cabernet Sauvignon grapes, and to ascertain any relationship with the extractability of phenolic compounds during winemaking. The results indicated that the exogenous application of MeJ and BTH during veraison caused significant changes in several components of the skin cell walls, such as phenolic compounds, proteins and structural sugars. However these changes manifested themselves in different proportions in each variety and year, pointing to the varietal and meteorological dependence of the response to the application of these elicitors. The treatments delayed the maturation process in all varieties when rainfall was low. This observation, together with the observed increase in proteins and phenols in the skin cell wall of Monastrell and Cabernet Sauvignon, could contribute to the strength necessary to maintain the integrity of berries and to increasing resistance to fungal pathogens as the phenolic compounds evolve, thus improving the phenolic profile. However, the structural integrity of Merlot variety tended to decrease in the same conditions.

Cardiac and Pulmonary Ultrasound for Diagnosing TRALI.

Unexpected acute respiratory failure after anesthesia is a diagnostic challenge: residual neuromuscular blockade, bronchial hyperresponsiveness, laryngospasm, atelectasis, aspiration pneumonitis, and other more uncommon causes should be taken into account at diagnosis. Lung ultrasound and echocardiography are diagnostic tools that would provide the differential diagnosis. We report a suspected case of a transfusion related acute lung injury (TRALI) following administration of platelets. The usefulness of lung and cardiac ultrasound is discussed to facilitate the challenging diagnosis of the acute early postoperative respiratory failure.

Identification of Grapholita molesta (Busk) (Lepidoptera: Tortricidae) Biotypes Using Infrared Spectroscopy.

The aim of this study was to determine the differences between two Grapholita molesta (Busk) populations by applying infrared spectroscopy. Grapholita molesta populations were collected from different regions within Porto Amazonas, Brazil, and Emilia Romagna, Italy. Eggs, fifth instars, pupae, and adults were examined. Pupae and adults were sexed. A spectrophotometer that was set between 400 and 4000 cm(-1) range was used to perform 32 scans. The spectra obtained were analyzed using partial least squares (PLS), and external validation of the model was conducted with Unscrambler(TM) software, Version 9.1 (CAMO Software AS, Oslo, Norway). The results showed the differences between the populations in all of the analyzed stages of maturation. The pupal stage was the most viable stage for reading the beam spectrum, and it was concluded that IR can separate G. molesta biotypes.

Ritmo circadiano y variaciones temporales en el paro cardiaco súbito extrahospitalario / Circadian rhythm and time variations in out-hospital sudden cardiac arrest

Objetivos: Analizar las características cronobiológicas y las variaciones temporales del paro cardiaco extrahospitalario (PCEH). Diseño: Estudio descriptivo retrospectivo. Pacientes: Todos los casos de PCEH de origen cardíaco registrados en la base de datos del servicio de emergencias médicas (SEM) de la Comunidad Autónoma de Castilla y León (España) durante 18 meses. Variables de interés principales: Edad, sexo, recuperación de la circulación espontánea, primer ritmo monitorizado (desfibrilable /no desfibrilable), lugar de alerta [(hogar, lugar público, centro atención primaria (AP)], testigo (familiar, transeúnte, fuerzas de seguridad, personal AP), hora de alerta (0-8; 8-16; 16-24), hora de activación del equipo de emergencias, hora de atención y día de la semana. Análisis univariante mediante Chi2, varianza y tests no paramétricos. Análisis cronobiológico mediante transformada rápida de Fourier y test Cosinor. Resultados: Se estudiaron 1.286 casos registrados entre enero 2007 y junio 2008. Se observaron diferencias estadísticas significativas en menor edad (p<0,05), mayor incidencia en el hogar (p<0,001) y mayor frecuencia de familiares-convivientes como testigos (p<0,001) en el periodo de 0-8h. El análisis cronobiológico mostró ritmo diario (circadiano) con acrofase a las 11:16h (p<0,001) y ritmo semanal (circaseptano) con acrofase en miércoles (p<0,05). Las medianas de intervalos alerta-atención y activación-atención fueron respectivamente 11,7min y 8,0min, sin diferencias entre periodos horarios. Conclusiones: Se demuestra la presencia de un ritmo diario de aparición del PCEH con pico matinal y un ritmo semanal con pico en miércoles. Estos resultados orientan al ajuste preventivo y a la planificación de recursos y mejoras en la respuesta, en determinados periodos horarios (AU)

Objectives: To analyze the chronobiological and time variations of out- hospital cardiac arrest (OHCA). Design: A retrospective descriptive study was made. Patients: All cases of OHCA of cardiac origin registered over 18 months in the database of the emergency medical service (EMS) of the Autonomous Community of Castilla y León (Spain) were evaluated. Variables analyzed: Age, sex, recovery of spontaneous circulation (ROSC), first monitored rhythm (amenable / not amenable to defibrillation), alert site [(home, public place, primary care (PC) center], alerting person (family, witness, law enforcement member, PC center staff), alert time (0-8; 8-16; 16-24), emergency team activation time, care time and day of the week. Univariate analysis (chi-squared), variance, and nonparametric tests comparing the variables in three periods of 8hours. Chronobiological analysis by fast Fourier transform and Cosinor testing. Results: We studied 1286 cases reported between January 2007 and June 2008. Statistically significant differences were observed in terms of younger age, higher incidence in the victim's home, and greater frequency of family-cohabiting persons as witnesses in the period between 0 and 8hours. Chronobiological analysis found daily rhythm (circadian) with acrophase at 11.16h (p<0.001) and weekly rhythm (circaseptan) with acrophase on Wednesday (p<0.05). The median alert time-care time interval and emergency team activation time-care time were 11.7min and 8.0min, respectively, without differences between periods. Conclusions: We have demonstrated the presence of a daily rhythm of emergence of OHCA with a morning peak and a weekly rhythm with a peak on Wednesdays. These results can guide the planning of resources and improvements in response in certain time periods (AU)

Características generales de la parada cardiaca extrahospitalaria registrada por un servicio de emergencias médicas / General characteristics out of hospital cardiac arrest of cardiac origin recorded by an emergency medical service

Objetivo: Analizar las características generales de la parada cardiaca extrahospitalaria(PCEH) en una comunidad autónoma y los factores asociados a la recuperación de la circulación espontánea (RCE).Método: Estudio descriptivo retrospectivo de las PCEH de origen cardiaco incluidas en la base de datos del servicio de emergencias (SEM) de Castilla y León en un periodo de18 meses. El objetivo primario fue la RCE. Las variables analizadas fueron la edad, sexo, ritmo desfibrilable (DF), lugar del paro, testigo, intervalo alerta-atención inicial e intervalo despacho SEM-atención inicial. Resultados: Se estudiaron 1.286 PCEH, que representan 0,34 casos/1.000 habitantes/año. La mediana de edad fue de 73,0 años (rango intercuartílico 21,0), y el66,5% fueron hombres. Se consiguió RCE en el 22,2%. Las características de la PCEH fueron: ritmo DF 15,3%; en el hogar 72,2%, en un lugar público 21,3%, en un centro atención primaria (AP) 6,5%; presenciada por un familiar 49,1%, por un transeúnte 31,6%, por fuerzas seguridad 2,6% y por personal AP 15,7%. Fueron variables independientes asociadas a la RCE: edad inferior a 50 años [OR 1,6 (IC 95%: 1,03; 2,4)],ritmo DF [OR 3,8 (IC 95%: 2,7; 5,3)], lugar del paro en centro AP [OR 2,7 (IC 95%:1,4; 4,9)] y en lugar público [OR 1,8 (IC 95%: 1,2; 2,7)].Conclusiones: La incidencia de PCEH fue similar a otras series europeas. Destaca el bajo porcentaje de ritmos DF. Se confirma el hogar como lugar de más frecuente presentación, y una menor edad, la presencia de ritmos DF y la presentación en lugares públicos o centros sanitarios, como factores independientes asociados a RCE (AU)

Objective: To analyze the general characteristics out of hospital cardiac arrest (OHCA) including the frecuency of return of spontaneous circulation and related factors. Methods: Retrospective descriptive analysis of cases of OHCA in the records of the emergency medical service of Castile-Leon covering a period of 18 months. The main independent outcome analyzed was return of spontaneous circulation. Independent variables analyzed were age, sex, presence of shockable rhythm, location of cardiac arrest, witness, time between emergency call and initiation of care, and time between ambulance dispatch and initiation of care. Results: The EMS attended a total of 1286 cases of OHCA, representing an annual incidence of 0.34 cases per 1000 population. The median age (interquartile range) was 73.0 (21.0) years; 66.5% of the patients were men, spontaneous circulation returned in 22.2%, and a shockable rhythm was present in 15.3%. Cardiac arrest occurred in the home in72.2% of the cases, in a public place in 21.3%, and at a primary health care clinic in 6.5%. Witnesses were a familymember (49.1%), a passer-by (31.6%), a member of a security force (2.6%), and a primary care staff member (15.7%).Independent variables related to return of spontaneous circulation were age under 50 years (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.03-2.4), presence of a shockable rhythm (OR, 3.8; 95% CI, 2.7-5.3); cardiac arrest at a primary health care clinic (OR, 2.7; 95% CI, 1.4-4.9) or in a public place (OR, 1.8; 95% CI, 1.2-2.7).Conclusions: The incidence of OHCA was similar to that reported for other European series. The low percentage of shockable rhythm was noteworthy. The home was confirmed as the most common setting for cardiac arrest; lower age, presence of shockable rhythm, occurrence of cardiac arrest in a public place or at a primary care clinic were confirmed as variables independently associated with return of spontaneous circulation (AU)

[Circadian rhythm and time variations in out-hospital sudden cardiac arrest]. / Ritmo circadiano y variaciones temporales en el paro cardiaco súbito extrahospitalario.

OBJECTIVES: To analyze the chronobiological and time variations of out- hospital cardiac arrest (OHCA). DESIGN: A retrospective descriptive study was made. PATIENTS: All cases of OHCA of cardiac origin registered over 18 months in the database of the emergency medical service (EMS) of the Autonomous Community of Castilla y León (Spain) were evaluated. VARIABLES ANALYZED: Age, sex, recovery of spontaneous circulation (ROSC), first monitored rhythm (amenable / not amenable to defibrillation), alert site [(home, public place, primary care (PC) center], alerting person (family, witness, law enforcement member, PC center staff), alert time (0-8; 8-16; 16-24), emergency team activation time, care time and day of the week. Univariate analysis (chi-squared), variance, and nonparametric tests comparing the variables in three periods of 8 hours. Chronobiological analysis by fast Fourier transform and Cosinor testing. RESULTS: We studied 1286 cases reported between January 2007 and June 2008. Statistically significant differences were observed in terms of younger age, higher incidence in the victim's home, and greater frequency of family-cohabiting persons as witnesses in the period between 0 and 8 hours. Chronobiological analysis found daily rhythm (circadian) with acrophase at 11.16 h (p<0.001) and weekly rhythm (circaseptan) with acrophase on Wednesday (p<0.05). The median alert time-care time interval and emergency team activation time-care time were 11.7 min and 8.0 min, respectively, without differences between periods. CONCLUSIONS: We have demonstrated the presence of a daily rhythm of emergence of OHCA with a morning peak and a weekly rhythm with a peak on Wednesdays. These results can guide the planning of resources and improvements in response in certain time periods.

[69 years old male patient, with impairment of physical condition, hyperpigmentation, cutaneous lesion and a deficient response to treatment]. / Varón de 69 años con afectación del estado general, hiperpigmentación, lesión cutánea y respuesta deficiente al tratamiento.

We submit the case of a male patient, suffering from a tuberculous ethiology adrenal primary insufficiency, showing a dermal lesion, in which necrotizing granulomas were found, and from which bacterial culture growth yielded mycobacterium bovis. Given the clinical findings, and awaiting for the bacterial culture result, a triple treatment with tuberculostatics was started, but had to be discontinued because of hepatic toxicity. After culture of cutaneous biopsy yielded micobaterium tuberculosis, treatment with streptomycin, rifampicin and etambutol was restarted. Three weeks later, in spite of increasing hydrocortisone dose to 40 mg, adrenal insufficiency reappeared. Under the circumstances, we chose to continue rifampicin and double hydrocortisone dose. The case is of concern because of the concurrency of three nowadays infrequent disorders: tuberculous ethiology adrenal insufficiency, cutaneous tuberculosis due to mycobacterium bovis and primary adrenal insufficiency due to rifampicin treatment, the latter resolved after increasing hydrocortisone dose.

Epidemiología del cáncer de origen desconocido en Asturias (1992-1996) / Epidemiology of cancer of unknown primary sitye in Asturias (1992-1996)

Propósito: La toma de decisiones diagnósticas en el Cáncer de Origen Desconocido (COD) es un arduo problema médico sujeto a gran variabilidad. La protocolización basada en la evidencia científica, podría evitar gestos sanitarios innecesarios y reducir el sufrimiento del enfermo, sin disminución de la supervivencia. Se describen las características clínico-patológicas y epidemiológicas del COD en Asturias, el nivel de adecuación de las decisiones diagnósticas a un protocolo teórico, su repercusión económica y la supervivencia. Método: Estudio descriptivo longitudinal retrospectivo (1992-96) de los casos de COD diagnosticados en los hospitales de Asturias. Resultados: Se incluyeron 568 casos: edad media 66,9 años; 59,7 por ciento varones; 39,3 por ciento estudiado en Servicios de Medicina Interna; 27,1 por ciento con hallazgo del tumor primario (más frecuente, pulmonar); mediana de la supervivencia 13 semanas. El número de técnicas diagnósticas fue variable y la media de estancia hospitalaria, 24,7 días. Un buen ajuste al protocolo se asoció con un número mayor de primarios conocidos. Conclusiones: Existe variabilidad diagnóstica del COD en Asturias. La protocolización podría evitarla en parte y resultaría beneficiosa para el paciente y el sistema sanitario (AU)

Spontaneous acute abdominal aortic dissection.

A case of spontaneous acute infrarenal aortic dissection, with extension to the right common iliac artery and proximally to just below the origin of the renal arteries is presented. This dissection did not involve the visceral vessels nor the iliac system. The diagnosis was made with ultrasonography and computed tomography, without the need for angiography, and confirmed during surgical intervention, in which, prosthetic replacement of the affected segment was carried out.

Post-natal changes in biliary lipids in suckling goat kids.

The post-natal composition of biliary lipids in the bile of suckling goat kids has been studied during the first month of life. Samples of hepatic and vesicular bile were obtained from animals fed with milk. Bile flow increased with age and the concentration of bile acids also rose up to 14 days of age. Cholesterol reached maximum values immediately after birth and then decreased. Bile acids conjugated with taurine predominated and this pattern of preferential tauroconjugation persisted at all ages, as has also been found in carnivores and sheep. Comparison of vesicular and hepatic bile composition revealed a poor concentration capacity of the gallbladder in pre-ruminant kids.

Outcome of silent lupus nephritis.

To analyze the long-term outcome in patients with silent lupus nephritis, we retrospectively studied 20 patients with systemic lupus erythematosus without clinical renal involvement who had renal biopsies in our unit between 1978 and 1986 and reviewed 193 cases reported between 1957 and 1995. Two patients of the current series were lost to follow-up. Mean follow-up in the other 18 was 13 +/- 3 years (range, 2 to 17). On kidney biopsy, nine had class I, six class II, one class IV, and two class V disease (WHO classification). Three patients with prior normal renal function died of nonrenal causes. During the study, the remaining 15 patients had normal renal function and urinalysis. Most patients from the literature had "mild" histologic lesions, but 30 had diffuse proliferative glomerulonephritis. Over an average of 46 months of follow-up from biopsy, renal survival rate and patient survival rate were 98% and 91%, respectively. Three patients died of end-stage renal failure. In conclusion, end-stage renal failure in patients with silent lupus nephritis is rare regardless of the histopathological renal lesions. Patients survival depends on nonrenal causes.

Taurine- and glycine-conjugated bile acids in the preruminant goat: identification by high performance liquid chromatography.

A reversed-phase high performance liquid chromatography technique has been developed for the identification of taurine- and glycine-conjugated bile acids in the bile of preruminant goats. The mobile phase consisted of two solvents: acetonitrile (A) and 5 mM potassium phosphate buffer (pH 4.5) (B). Samples (10 microliters) were eluted with a linear gradient in which acetonitrile was increased from 25 to 35%, and from 35 to 45%, at 10 min intervals. Flow rate was 1.0 ml min-1, and bile acids were detected at 200 nm. This sample high resolution technique was highly reproducible, involved a minimum of straightforward sample treatment, and required a short chromatographic development time. The technique will be of use in the systematic identifications of bile acids in preruminants.

Conjugated bile acids and intestinal flora during the preruminant stage in goat. Influence of a lamb milk replacer.

A total of 45 preruminant goats were fed either goat milk or a milk substitute to compare the evolution of taurine and glycine conjugated bile acids and the evolution of the intestinal flora during the first month of life. Samples of hepatic bile were obtained from kids of 1, 7, 14, 21, and 28 days old and conjugated bile acids were measured by high performance liquid chromatography. Bacterial flora were determined in 14 and 28 day old animals. Ours results show that under our experimental conditions tauroconjugated bile acids clearly predominated over the conjugated with glycine. This pattern of preferential tauroconjugation persisted at all ages tested and in both groups studied. On the other hand, it seems that the quality of the protein and fat used in the elaboration of the milk replacer affects the intestinal flora and the postnatal evolution of conjugated bile acids.

Light, immunofluorescence and electron microscopy renal biopsy findings as predictors of mortality in eighty-five Spanish patients with systemic lupus erythematosus.

This study aimed to define prognostic indicators of death in renal biopsies from Spanish patients with SLE. Renal biopsies of eighty-five lupus patients with and without clinical nephritis, taken between 1974 and 1987, were reviewed. Samples previously processed for light (LM), immunofluorescence (IM) and electron (EM) microscopy were analysed blind. Kaplan-Maier curves, log-rank test, and multivariate Cox's regression statistical methods were used for comparison of biopsy data in relation to patient survival. Univariate analysis showed that vascular hyalinosis, glomerular sclerosis, fibrous crescent and chronicity index higher than 3 by LM, and intramembranous dense-deposits by EM are predictors of poor survival. A multivariate approach confirmed the independent influence of vascular hyalinosis, chronicity index higher than 3 and intramembranous deposits. A predictive model can be constructed with three LM (hyalinosis, tubular atrophy and glomerular sclerosis) and three EM variables (subepithelial, mesangial and intramembranous deposits). Selected renal biopsy changes detected by LM and EM are therefore predictors of death in patients with lupus. Chronicity markers, more than those of activity or severity, are the best prognostic indicators.

The amputation level: noninvasive methods and clinical criteria.

Before undergoing amputation of a lower limb, one hundred and forty-six patients suffering from arteriosclerosis were studied with the purpose of finding prognostic indicators of success at the most distal level. The best results were obtained when skin perfusion pressure was above 60 mmHg in diabetics and above 40 mmHg in non-diabetics. Lower limb systolic blood pressure and skin thermometry also proved to be useful. The method proposed might be helpful to the surgeon in choosing the best treatment for the patient. It is a nonivasive procedure which can be easily performed and does not require sophisticated or expensive equipment.