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The changes produced during the aging of wines in oak barrels are strongly dependent on the oak’s geographical origin and aging time. This paper analyzes the effect of Quercus alba oak from four different geographical locations in four states in the USA, namely Missouri (Mo), Ohio (Oh), Kentucky (Kt), and Pennsylvania (Py), during 24 months of aging. Oak origin had a higher effect on the wine’s aromatic composition than the polyphenolic one. Mo and Oh barrels enhanced coconut, spicy, and sweet notes for 12 months of aging, while Kt barrels achieved higher extraction of wood-related compounds at longer aging (24 months). Py wines showed the lowest contents of most volatile compounds at both aging times, as well as hydroxycinnamic acids, flavanols, anthocyanins, flavonols, stilbenes, and ellagitannins, attributed to their higher porosity. At 12 months of aging, Kt wines showed the highest content of ellagitannins, and Mo wines had the highest content of anthocyanins, but Oh wines had the highest concentrations at 24 months. In the sensory analysis, Kt wines were preferred at both aging times. Kt and Mo wines achieved the highest punctuations for the olfactory phase at 12 months of aging and Kt wines kept it after 24 months. These findings are essential for producers to achieve the sensory characteristics of their wines through strategic barrel aging.

Polysaccharides are the main group of macromolecules in wines. Climate change is a major problem for viticulturists as it leads to the production of unbalanced grapes. This is attributed to a mismatch between the technological maturity and phenolic maturity of grapes, which can negatively impact the production of high quality wines. To mitigate this effect, biostimulants can be applied to grapevines. For the first time in the literature, this work studied the foliar application of methyl jasmonate plus urea (MeJ + Ur) on the vineyard and its effect on the monosaccharide and polysaccharide composition of Tempranillo grapes and wines over two consecutive seasons. To achieve this, the extraction and precipitation of polysaccharides was conducted, and the identification and quantitation of monosaccharides was performed via GC–MS. The effect of MeJ + Ur foliar treatment in both the grapes and wines was season-dependent. The MeJ + Ur treatment had a slight impact on the monosaccharide composition of the grapes and also demonstrated a small effect on the wines. Multifactor and discriminant analysis revealed that the season had a greater influence on the monosaccharide and polysaccharide composition of grapes and wines compared to the influence of MeJ + Ur treatment. Interestingly, the MeJ + Ur-treated wines exhibited a higher sensory evaluation than the control wines in the second vintage. To gain further insights into the effect of MeJ + Ur foliar application on the monosaccharide and polysaccharide composition of grapes and wines, further investigations should be conducted.

Febrile neutropenia is one of the main infectious complications experienced by paediatric patients with blood or solid tumours, which, despite the advances in diagnosis and treatment, are still associated with a significant morbidity and mortality. These patients have several risk factors for infection, chief of which are chemotherapy-induced neutropenia, the disruption of cutaneous and mucosal barriers and the use of intravascular devices. Early diagnosis and treatment of febrile neutropenia episodes based on the patient’s characteristics is essential in patients with blood and solid tumours to improve their outcomes. Therefore, it is important to develop protocols in order to optimise and standardise its management. In addition, the rational use of antibiotics, with careful adjustment of the duration of treatment and antimicrobial spectrum, is crucial to address the increase in antimicrobial drug resistance.The aim of this document, developed jointly by the Spanish Society of Pediatric Infectious Diseases and the Spanish Society of Pediatric Hematology and Oncology, is to provide consensus recommendations for the management of febrile neutropenia in paediatric oncology and haematology patients, including the initial evaluation, the stepwise approach to its treatment, supportive care and invasive fungal infection, which each facility then needs to adapt to the characteristics of its patients and local epidemiological trends. Resumen: La neutropenia febril es una de las principales complicaciones infecciosas que sufren los pacientes pediátricos oncohematológicos, y a pesar los avances en diagnóstico y tratamiento, siguen condicionando una mortalidad y morbilidad significativa. Estos pacientes agrupan una serie de factores de riesgo de infección, donde destaca la neutropenia asociada a quimioterapia, la disrupción de barreras cutáneo-mucosas y el uso de dispositivos intravasculares. El abordaje diagnóstico y terapéutico precoz de los episodios de neutropenia febril en los pacientes oncohematológicos, ajustado a las características individuales de cada paciente, es fundamental para mejorar su pronóstico. Por ello, diseñar protocolos de abordaje, que sistematicen su atención, permite optimizar y homogeneizar su abordaje. Además, racionalizar el uso de los antimicrobianos, ajustando la duración y el espectro de los mismos, es crucial para hacer frente al incremento de resistencias a antimicrobianos.El objetivo de este documento, elaborado entre la Sociedad Española de Infectología Pediátrica y la Sociedad Española de Hematología y Oncología Pediátrica, es dar recomendaciones de consenso sobre el manejo de la neutropenia febril en el paciente oncohematológico, respecto al abordaje inicial, terapia secuencial y de soporte e infección fúngica invasiva, que cada centro debe adaptar a las características de sus pacientes y epidemiología local.

Update of the consensus on acute otitis media (AOM) (2012) and sinusitis (2013) following the introduction of pneumococcal vaccines in the immunization schedule, and related changes, such as epidemiological variation, colonization by of nonvaccine serotypes and emerging antimicrobial resistances. A majority of studies show that the introduction of the pneumococcal 13-valent conjugate vaccine has been followed by a reduction in the nasopharyngeal carriage of pneumococcus, with an increase in the proportion of drug-resistant nonvaccine serotypes. The diagnosis of AOM is still clinical, although more stringent criteria are proposed, which are based on the visualization of abnormalities in the tympanic membrane and the findings of pneumatic otoscopy performed by trained clinicians. The routine diagnosis of sinusitis is also clinical, and the use of imaging is restricted to the assessment of complications. Analgesia with acetaminophen or ibuprofen is the cornerstone of AOM management; watchful waiting or delayed antibiotic prescription may be suitable strategies in select patients. The first-line antibiotic drug in children with AOM and sinusitis and moderate to severe disease is still high-dose amoxicillin, or amoxicillin-clavulanic acid in select cases. Short-course regimens lasting 5–7 days are recommended for patients with uncomplicated disease, no risk factors and a mild presentation. In allergic patients, the selection of the antibiotic agent must be individualized based on severity and whether or not the allergy is IgE-mediated. In recurrent AOM, the choice between watchful waiting, antibiotic prophylaxis or surgery must be individualized based on the clinical characteristics of the patient. Resumen: Actualización de los documentos de consenso de OMA (2012) y sinusitis (2013) tras la introducción de vacunas antineumocócicas en calendario vacunal, tras los cambios derivados de las variaciones epidemiológicas, colonización por serotipos no vacunales y la aparición de resistencias. Según la mayoría de los estudios, la introducción de la vacuna antineumocócica conjugada tridecavalente (VNC-13) se ha traducido en un descenso de la colonización nasofaríngea por neumococo, con un aumento porcentual de serotipos resistentes no cubiertos. El diagnóstico de OMA continúa siendo clínico, aunque se proponen criterios más rigurosos, apoyados en la visualización de alteraciones en la membrana timpánica y la otoscopia neumática realizada por personal entrenado. El diagnóstico rutinario de la sinusitis es clínico y la realización de pruebas de imagen está limitada al diagnóstico de complicaciones asociadas. La analgesia con paracetamol o ibuprofeno es la base del tratamiento en la OMA; la conducta expectante o la prescripción antibiótica diferida podrían ser estrategias adecuadas en pacientes seleccionados. El tratamiento antibiótico de elección en niños con OMA y sinusitis aguda con síntomas moderados-graves continúa siendo amoxicilina a dosis altas, o amoxicilina-clavulánico en casos seleccionados. En cuadros no complicados, sin factores de riesgo y con buena evolución se proponen pautas cortas de 5–7 días. En pacientes alérgicos se debe individualizar especialmente la indicación de tratamiento antibiótico, que dependerá del estado clínico y si existe o no alergia IgE-mediada. En OMA recurrente, la elección entre un manejo expectante, profilaxis antibiótica o cirugía se debe individualizar según las características del paciente.

The disruptive effect exerted by high-power ultrasound on grape cell walls enhances phenolic extraction, improving chromatic characteristics during red wine maceration. However, short maceration times may, sometimes, hinder this enhancement, and this effect could be attributed to the suspended cell wall material formation facilitated by sonication. This suspended material, having a strong affinity for phenolic compounds, can lead to their precipitation and elimination during subsequent vinification stages and, consequently, a significant portion of extracted phenolic compounds may not contribute to the final phenolic composition of the wine, impacting its chromatic features. To demonstrate this effect, sonicated grapes of two different varieties were vinified with No modified process that eliminated part of this suspended material. Results confirm our hypothesis; that is, the lack of positive outcomes in some cases is due to phenolic compound adsorption on suspended material.

In the post-restrictions COVID-19 period, the incidence of bronchiolitis in infants has increased considerably. Several scores determine the degree of severity of the bronchiolitis episode, but few are clinician-friendly. The main aim of this research was to find the easy-to-use score that most accurately estimated the severity of patients’ infections according to their clinical situations and most accurately predicted the need for hospital admission. An observational cross-sectional study was performed in a reference pediatric hospital during the post-restrictions period of the COVID-19 pandemic (2021 and 2022). A comparison was made between the severity estimate provided by five international acute bronchiolitis scales and the clinical severity of the acute bronchiolitis episode. Three hundred and seventy-seven patients participated in the investigation, with a mean age of 5.68 months; 68.7% of the participants had a mild episode of bronchiolitis, 24.5% had a moderate episode, and 6.9% had a severe episode. The severity estimated by the Tal scale modified by McCallum showed a statistically significant correlation with the clinical severity established by clinical criteria (0.836; p < 0.001). It showed a high correlation with other international scores, such as the Wang score (0.820; p < 0.05) and the Wood–Downes–Ferrés score (0.936; p < 0.001). In the multivariate analysis, the constituent variables of the modified Tal score appeared in the final model that predicts the need for hospital admission. In the context of increased incidence after COVID-19, the Tal score modified by McCallum is an easy-to-use measuring instrument that presents an excellent concordance with the clinical severity estimated at first care contact. It also offers a more significant prediction of the need for hospital admission.

Objective: This study aims to identify the possible factors that delay the time-to-diagnosis of Huntington’s disease (HD). Methods: A cross-sectional study in HD patients was carried out. Variables registered were CAG repeats, age of onset, primary symptom at onset, age of molecular diagnosis, and time-to-diagnosis, among others. Results: 107 patients (50.5% female) with a mean age of 49 ± 12.8 years (y) were included in the study. Median CAG size was 45 (38-73). Mean age of onset, mean age of molecular diagnosis, and mean time-to-diagnosis were 39 ± 12.9, 45.1 ± 12.1, and 6.4 ± 6.4 years, respectively. In the comparative analysis, the neuropsychiatric- and the young-onset groups had a longer time-to-diagnosis than the motor- and typical-onset groups (p = 0.02 and p < 0.01, respectively). In the linear regression analysis, neuropsychiatric- and young-onset were independent risk factors. Conclusions: Delayed diagnosis showed relation to neuropsychiatric- and early-onset in HD.

Most vineyards in Mediterranean areas are cultivated using a training system and drip irrigation. However, the increasing risk of water deficit stress due to global warming will mean that viticulture need to adapt to a tougher water-saving policy. Thus, we investigated the effects of total suppression of irrigation on a grapevine (Vitis vinifera cv. Callet) and the phenolic composition and sensory quality of this native red variety wine from the Balearic Islands over three seasons. Significant yield reductions of up to 15.6 %, 17.2 % and 22.2 % were observed in non-irrigated (NI) plants in 2016, 2017 and 2018 respectively, compared to irrigated plants (I); however, wine quality parameters improved. In the years with the highest rainfall (715 mm in 2016 and 799 mm in 2017), NI favoured the enrichment of sugars, anthocyanins and phenolic compounds in the wine and enhanced the development of aromatic components. However, with lower rainfall (524 mm in 2018), the NI treatment appeared to diminish the quality of the wine, particularly affecting the global sensory quality of the wines. Thus, development of specific water strategies tailored to the vineyard, year, vintage and grape variety may regulate the phenolic composition of red wines to meet production goals and reduce total water consumption.

Polysaccharides in wine play important roles in the stabilization and in the sensory properties of wines. Elicitor application constitutes an interesting field of research since it is indirectly involved in the accumulation in grape cell walls of molecules like callose, lignin, phenolic compounds and glycoproteins. Currently, biomimetic calcium phosphate (ACP) nanoparticles are successfully used in viticulture for the controlled delivery of bioactive molecules, such as elicitors. The aim of this study was to compare the effect of the application of two different elicitors on both grape and wine of Tempranillo polysaccharide composition. Methyl jasmonate (MeJ) and nanoparticles doped with MeJ were applied to the canopy at veraison and one week later in two vintages. In the grape extracts, the foliar treatments did not increase the content of monosaccharides or that of the main pectin families; therefore, the elicitors did not reinforce the cell walls of the Tempranillo grape. The extractability and solubility of the pectic families of the grape cell walls into the wine depended on the type of family and the climate of the vintages.

Many authors have investigated the role of mannoproteins on wine quality, but very few have analyzed the use of grape-derived polysaccharides as they are not commercially available. In this study, purified grape-derived polysaccharides from red wine (WPP) and winemaking by-products (DWRP: Distilled Washing Residues Polysaccharides) were used as potential fining agents to modulate white wine flavor. Phenolics and volatile compounds were analyzed in the control and wines treated with WPP, DWRP, and commercial mannoproteins (CMs) after one and twelve months of bottling, and a sensory analysis was conducted. WPP and DWRP, rich in rhamnogalacturonans-II, showed themselves to be good modulators of wine aroma and astringency. Improvement in wine aroma was related to an increase in all volatile families expect higher alcohols and volatile acids. The modulation of astringency and bitterness was related to a reduction in the proanthocyanidin content and its mean degree of polymerization. Extracts with polysaccharides with higher protein contents presented a higher retention of volatile compounds, and DWRP extract had more positive effects on the overall aroma. Our novel results present the possibility of obtaining valuable polysaccharides from distilled washing residues of wine pomaces, which could promote its valorization as a by-product. This is the first time the potential use of this by-product has been described.

Ensuring the effective management of every rhinoceros population is crucial for securing a future for the species, especially considering the escalating global threat of poaching and the challenges faced in captive breeding programs for this endangered species. Steroid hormones play pivotal roles in regulating diverse biological processes, making fecal hormonal determinations a valuable non-invasive tool for monitoring adrenal and gonadal endocrinologies and assessing reproductive status, particularly in endangered species. The purpose of this study was to develop a statistical model for predicting the sex of white rhinoceroses using hormonal determinations obtained from a single fecal sample. To achieve this, 562 fecal samples from 15 individuals of the Ceratotherium simum species were collected, and enzyme immunoassays were conducted to determine the concentrations of fecal cortisol, progesterone, estrone, and testosterone metabolites. The biological validation of the method provided an impressive accuracy rate of nearly 80% in predicting the sex of hypothetically unknown white rhinoceroses. Implementing this statistical model for sex identification in white rhinoceroses would yield significant benefits, including a better understanding of the structure and dynamics of wild populations. Additionally, it would enhance conservation management efforts aimed at protecting this endangered species. By utilizing this innovative approach, we can contribute to the preservation and long-term survival of white rhinoceros populations.

The disruptive effect exerted by high-power ultrasound (US) on grape cell walls is established as the reason behind the chromatic, aromatic and mouthfeel improvement that this treatment causes in red wines. Given the biochemical differences that exist between the cell walls of different grape varieties, this paper investigates whether the effect of the application of US in a winery may vary according to the grape variety treated. Wines were elaborated with Monastrell, Syrah and Cabernet Sauvignon grapes, applying a sonication treatment to the crushed grapes using industrial-scale equipment. The results showed a clear varietal effect. The wines made with sonicated Syrah and Cabernet Sauvignon grapes showed an important increase in the values of color intensity and concentration of phenolic compounds, and these increases were higher than those observed when sonication was applied to Monastrell crushed grapes, whereas Monastrell wines presented the highest concentration in different families of polysaccharides. These findings correlate with the differences in the composition and structure of their cell walls since those of Monastrell grapes presented biochemical characteristics associated with a greater rigidity and firmness of the structures.

Resumen: Introducción: En 2014 se publicó el Documento de Consenso desarrollado por SEIP-SERPE-SEOP para el diagnóstico y el tratamiento de las infecciones osteoarticulares (IOA). En 2015 se constituyó RIOPed como red nacional multidisciplinar para la investigación en IOA. El objetivo del estudio ha sido valorar el grado de adecuación a las recomendaciones establecidas en el consenso durante un año de seguimiento. Material y métodos: Estudio prospectivo multicéntrico nacional realizado entre septiembre de 2015 y septiembre de 2016 en 37 hospitales con inclusión de pacientes menores de 16 años diagnosticados de IOA, confirmada mediante aislamiento microbiológico, o probable: artritis séptica (AS) con > 40.000 leucocitos en líquido sinovial u osteomielitis (OM)/osteoartritis (OA)/espondilodiscitis (ED) con prueba de imagen compatible. Los resultados se compararon con los obtenidos en el estudio retrospectivo realizado entre 2008 y 2012. Resultados: Se incluyeron 255 casos: 131 OM, 79 AS, 30 OA y 15 ED. Respecto a las pruebas complementarias que el consenso consideró de obligada realización, la radiografía se llevó a cabo en el 87,8% de los casos, el hemocultivo en el 91,6% y el cultivo de líquido sinovial en el 99% de AS. Se realizó RM en el 71% de las OM. La elección del tratamiento antibiótico intravenoso empírico se adecuó a las recomendaciones en el 65,1% de los casos, y en el 62,3% para el tratamiento oral. Se llevó a cabo cirugía en el 36,8% de las AS (85,7% artrotomía), con un descenso significativo respecto al estudio retrospectivo (p = 0,014). Solo el 58,5% de casos se ajustaron a las recomendaciones de duración del tratamiento; sin embargo, se comprobó una menor duración del tratamiento intravenoso. Conclusiones: En general, el grado de adecuación a las recomendaciones que marcaron el grupo de expertos es bueno para las pruebas complementarias y aceptable respecto a la elección del tratamiento antibiótico, aun detectándose casi un 40% de inadecuación. Se ha conseguido un descenso de la estancia hospitalaria. Abstract: Introduction: In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up. Material and methods: A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients > 16 years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with > 40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012. Results: A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P = .014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed. Conclusions: In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved.

Introduction: In 2014 the Consensus Document produced by the Spanish Paediatric Societies (SEIP-SERPE-SEOP) was published to help in the diagnosis and treatment of osteoarticular infections (OAI). In 2015 the RIOPed was considered as a multidisciplinary national network for the investigation into OAI. The aim of this study was to assess the level of adaption to the recommendations established in the Consensus during one year of follow-up. Material and methods: A prospective, national multicentre study was carried out in 37 hospitals between September 2015 and September 2016. The study included patients >16 years-old with a diagnosis of OAI, confirmed by microbiological isolation, or probable: septic arthritis (SA) with >40,000 white cells in synovial fluid, or osteomyelitis (OM)/spondylodiscitis (SD) with a compatible imaging test. The results were compared with those obtained in a retrospective study conducted between 2008 and 2012. Results: A total of 235 cases were included, of which 131 were OM, 79 SA, 30 OA, and 15 SD. As regards the complementary tests that the Consensus considered mandatory to perform, radiography was carried out on 87.8% of the cases, a blood culture on 91.6%, and culture of the synovial fluid in 99% of SA. A magnetic resonance (MR) was performed on 71% of the OM cases. The choice of intravenous empirical antibiotic treatment was adapted to the recommendations in 65.1% of cases, and in 62.3% for the oral treatment. Surgery was performed in 36.8% of SA cases (85.7% arthrotomy), with a significant decrease compared to the retrospective study (P = .014). Only 58.5% of cases followed the recommendations on the duration of the treatment; however, a lower duration of intravenous treatment was observed. Conclusions: In general, the level of adaptation to the recommendations that were set by the Expert Group, is good for the complementary tests, and acceptable as regards the choice of antibiotic treatment, although inadequate in almost 40% of cases. A decrease in hospital stay was achieved. Resumen: Introducción: En 2014 se publicó el Documento de Consenso desarrollado por SEIP-SERPE-SEOP para el diagnóstico y el tratamiento de las infecciones osteoarticulares (IOA). En 2015 se constituyó RIOPed como red nacional multidisciplinar para la investigación en IOA. El objetivo del estudio ha sido valorar el grado de adecuación a las recomendaciones establecidas en el consenso durante un año de seguimiento. Material y métodos: Estudio prospectivo multicéntrico nacional realizado entre septiembre de 2015 y septiembre de 2016 en 37 hospitales con inclusión de pacientes menores de 16 años diagnosticados de IOA, confirmada mediante aislamiento microbiológico, o probable: artritis séptica (AS) con >40.000 leucocitos en líquido sinovial u osteomielitis (OM)/osteoartritis (OA)/espondilodiscitis (ED) con prueba de imagen compatible. Los resultados se compararon con los obtenidos en el estudio retrospectivo realizado entre 2008 y 2012. Resultados: Se incluyeron 255 casos: 131 OM, 79 AS, 30 OA y 15 ED. Respecto a las pruebas complementarias que el consenso consideró de obligada realización, la radiografía se llevó a cabo en el 87,8% de los casos, el hemocultivo en el 91,6% y el cultivo de líquido sinovial en el 99% de AS. Se realizó RM en el 71% de las OM. La elección del tratamiento antibiótico intravenoso empírico se adecuó a las recomendaciones en el 65,1% de los casos, y en el 62,3% para el tratamiento oral. Se llevó a cabo cirugía en el 36,8% de las AS (85,7% artrotomía), con un descenso significativo respecto al estudio retrospectivo (P = ,014). Solo el 58,5% de casos se ajustaron a las recomendaciones de duración del tratamiento; sin embargo, se comprobó una menor duración del tratamiento intravenoso. Conclusiones: En general, el grado de adecuación a las recomendaciones que marcaron el grupo de expertos es bueno para las pruebas complementarias y aceptable respecto a la elección del tratamiento antibiótico, aun detectándose casi un 40% de inadecuación. Se ha conseguido un descenso de la estancia hospitalaria.

The objective of this study was to evaluate the effect of microwave treatment of crushed grapes on the yeast population of the must and on the development of alcoholic fermentation, as well as on the extraction of different compounds from the grapes such as polysaccharides and amino acids that can affect the organoleptic quality and stability of the wine. This study demonstrated for the first time the effect of the microwave treatment of grapes on native yeast species and their diversity, producing an increase in fermentation kinetics and a decrease in the lag phase. The microwave treatment produced a positive effect on the extraction of amino acids and polysaccharides from the grapes, resulting in significantly higher amounts of the main amino acids of the must and some major volatile compounds in the treated samples. The polysaccharides most affected by the microwave treatment were the PRAGs, the main polysaccharides liberated from grapes during the maceration.

Resumen: Se presenta una actualización del documento de consenso sobre el diagnóstico y tratamiento de la faringoamigdalitis aguda, publicado en 2011. Las escalas de predicción clínica no deben ser utilizadas para iniciar antibioterapia, salvo que las pruebas microbiológicas no estén disponibles o exista riesgo de fiebre reumática. No existe ninguna escala que sea mejor que las expuestas en el consenso previo. Se proponen casos en los que se recomienda realizar pruebas microbiológicas, con independencia de los resultados de las escalas. El tratamiento de elección de la faringoamigdalitis estreptocócica es penicilina en dos dosis diarias y durante 10 días. Amoxicilina, en una o dos dosis diarias y durante el mismo tiempo, es la primera alternativa terapéutica. Las cefalosporinas de primera generación son el tratamiento de elección en niños con reacción retardada no grave a penicilina o amoxicilina. En reacciones alérgicas inmediatas deben utilizarse antibióticos no betalactámicos, siendo josamicina y diacetil-midecamicina las mejores opciones. En el fracaso terapéutico bacteriológico, y en el estado de portador, los tratamientos planteados en el consenso previo siguen siendo válidos. Abstract: An update of the Spanish consensus document on the diagnosis and treatment of acute tonsillopharyngitis is presented. Clinical scores should not be used to prescribe antibiotics, unless microbiological tests are not available or there is a child at risk of rheumatic fever. There is no score better than those set out in the previous consensus. Microbiological tests are recommended in proposed cases, regardless of the result of the scores. Penicillin is the treatment of choice, prescribed twice a day for 10 days. Amoxicillin is the first alternative, prescribed once or twice a day for the same time. First-generation cephalosporins are the treatment of choice in children with non-immediate reaction to penicillin or amoxicillin. Josamycin and midecamycin are the best options for children with immediate penicillin allergic reactions, when non-beta-lactam antibiotics should be used. In microbiological treatment failure, and in streptococcal carriers, the treatments proposed in the previous consensus are still applicable.

An update of the Spanish consensus document on the diagnosis and treatment of acute tonsillopharyngitis in 2011 is presented. Clinical scores should not be used to prescribe antibiotics, unless microbiological tests are not available or there is a child at risk of rheumatic fever. There is no score better than those set out in the previous consensus. Microbiological tests are recommended in proposed cases, regardless of the result of the scores. Penicillin is the treatment of choice, prescribed twice a day for 10 days. Amoxicillin is the first alternative, prescribed once or twice a day for the same time. First-generation cephalosporins are the treatment of choice in children with non-immediate reaction to penicillin or amoxicillin. Josamycin and midecamycin are the best options for children with immediate penicillin allergic reactions, when non-beta-lactam antibiotics should be used. In microbiological treatment failure, and in streptococcal carriers, the treatments proposed in the previous consensus are still applicable. Resumen: Se presenta una actualización del documento de consenso sobre el diagnóstico y tratamiento de la faringoamigdalitis aguda, publicado en 2011. Las escalas de predicción clínica no deben ser utilizadas para iniciar antibioterapia, salvo que las pruebas microbiológicas no estén disponibles o exista riesgo de fiebre reumática. No existe ninguna escala que sea mejor que las expuestas en el consenso previo. Se proponen casos en los que se recomienda realizar pruebas microbiológicas, con independencia de los resultados de las escalas. El tratamiento de elección de la faringoamigdalitis estreptocócica es penicilina en dos dosis diarias y durante diez días. Amoxicilina, en una o dos dosis diarias y durante el mismo tiempo, es la primera alternativa terapéutica. Las cefalosporinas de primera generación son el tratamiento de elección en niños con reacción retardada no grave a penicilina o amoxicilina. En reacciones alérgicas inmediatas deben utilizarse antibióticos no betalactámicos, siendo josamicina y diacetil-midecamicina las mejores opciones. En el fracaso terapéutico bacteriológico, y en el estado de portador, los tratamientos planteados en el consenso previo siguen siendo válidos.

White rhinoceroses (Ceratotherium simum) are the most social and gregarious species of all rhinoceroses known worldwide. One of the most critical effects of elevated glucocorticoid concentrations, especially in threatened species, is its relation to chronic stress, which could potentially lead to immunosuppression and reduced reproductive activity. Our aim is to determine how different social environments and management systems might be influencing the secretion of fecal glucocorticoids in white rhinoceroses. We have analyzed the concentration of fecal glucocorticoid metabolites in 658 fecal samples from 14 white rhinoceroses, seven free-ranging rhinos, and seven rhinos from two different managed captive populations. HPLC techniques were used to determine the main glucocorticoid metabolite found in this species, and a competitive EIA was used to establish fecal 5α-pregnan-3 3β, 11β, 21-triol-20-oneglucocorticoid metabolite (fGCM) levels. Our results reveal that management systems and social interactions had an influence on fGCM levels, suggesting that the more restrictive the management and social conditions are, the higher the glucocorticoid concentrations that are found. Additionally, sex was also found to influence fGCM levels, as in females, fGCM concentrations were higher than in males. We conclude that the analysis of glucocorticoids in relation to other factors is a powerful tool to assess adrenocortical response in white rhinoceros in order to broaden the knowledge of their reproductive biology and improve the management of the species.

Resumen: La infección del tracto urinario se define como el crecimiento de microorganismos en orina recogida de forma estéril, en un paciente con síntomas clínicos compatibles. En ausencia de sintomatología el aislamiento de bacterias en urocultivo se denomina bacteriuria asintomática y no precisa tratamiento. En neonatos y lactantes el signo guía para sospechar una infección del tracto urinario es la fiebre. En niños continentes los síntomas urinarios clásicos cobran mayor importancia. El diagnóstico requiere siempre la recogida de urocultivo previo al inicio de tratamiento antibiótico. En niños continentes la muestra de orina para urocultivo se debe recoger por micción espontánea. En niños no continentes mediante sondaje vesical, pudiendo optar por punción suprapúbica en neonatos y lactantes pequeños. No se debe enviar para urocultivo una muestra recogida mediante bolsa adhesiva. No se han demostrado diferencias significativas en la evolución clínica y desarrollo de secuelas entre la administración antibiótica oral exclusiva frente a la intravenosa de corta duración seguida de administración oral. La selección de la antibioterapia empírica inicial se basará en el patrón local de susceptibilidad. En la cistitis este consenso recomienda el uso empírico de cefalosporinas de segunda generación en menores de 6 años y fosfomicina trometamol en mayores. La antibioterapia empírica recomendada en pielonefritis que no precisan ingreso son las cefalosporinas de tercera generación. En caso de precisar ingreso se recomiendan los aminoglucósidos. En menores de 3 meses se debe añadir ampicilina. Una vez conocido el resultado del cultivo se debe dirigir el tratamiento de continuación, tanto intravenoso como oral. Abstract: Urinary tract infection (UTI) is defined as the growth of microorganisms in a sterile urine culture in a patient with compatible clinical symptoms. The presence of bacteria without any symptoms is known as asymptomatic bacteriuria, and does not require any treatment. In neonates and infants, fever is the guiding sign to suspecting a UTI. Classic urinary tract symptoms become more important in older children. Urine cultures collected before starting antibiotics is always required for diagnosis. Clean-catch (midstream) specimens should be collected for urine culture. In the case of non-toilet-trained children, specimens must be obtained by urinary catheterisation, or suprapubic puncture in neonates and infants. Specimens collected by urine bag should not be used for urine culture. There are no significant differences in the clinical evolution and prognosis between oral versus short intravenous followed by oral antibiotic. Empirical antibiotic therapy should be guided by local susceptibility patterns. Second-generation cephalosporin (children under 6 years) and fosfomycin trometamol (over 6 years), are the empiric therapy recommended in this consensus. In the case of pyelonephritis, recommended antibiotic treatment are third-generation cephalosporins (outpatient care) or, if admission is required, aminoglycosides. Ampicillin should be added in infants less than 3 months old. Antibiotic de-escalation should be always practiced once the result of the urine culture is known.

Urinary tract infection (UTI) is defined as the growth of microorganisms in a sterile urine culture in a patient with compatible clinical symptoms. The presence of bacteria without any symptoms is known as asymptomatic bacteriuria, and does not require any treatment. In neonates and infants, fever is the guiding sign to suspecting a UTI. Classic urinary tract symptoms become more important in older children. Urine cultures collected before starting antibiotics is always required for diagnosis. Clean-catch (midstream) specimens should be collected for urine culture. In the case of non-toilet-trained children, specimens must be obtained by urinary catheterisation, or suprapubic puncture in neonates and infants. Specimens collected by urine bag should not be used for urine culture. There are no significant differences in the clinical evolution and prognosis between oral versus short intravenous followed by oral antibiotic. Empirical antibiotic therapy should be guided by local susceptibility patterns. Second-generation cephalosporin (children under 6 years) and fosfomycin trometamol (over 6 years), are the empiric therapy recommended in this consensus. In the case of pyelonephritis, recommended antibiotic treatment are third-generation cephalosporins (outpatient care) or, if admission is required, aminoglycosides. Ampicillin should be added in infants less than 3 months old. Antibiotic de-escalation should be always practiced once the result of the urine culture is known. Resumen: La infección del tracto urinario se define como el crecimiento de microorganismos en orina recogida de forma estéril, en un paciente con síntomas clínicos compatibles. En ausencia de sintomatología el aislamiento de bacterias en urocultivo se denomina bacteriuria asintomática y no precisa tratamiento. En neonatos y lactantes el signo guía para sospechar una infección del tracto urinario es la fiebre. En niños continentes los síntomas urinarios clásicos cobran mayor importancia. El diagnóstico requiere siempre la recogida de urocultivo previo al inicio de tratamiento antibiótico. En niños continentes la muestra de orina para urocultivo se debe recoger por micción espontánea. En niños no continentes mediante sondaje vesical, pudiendo optar por punción suprapúbica en neonatos y lactantes pequeños. No se debe enviar para urocultivo una muestra recogida mediante bolsa adhesiva. No se han demostrado diferencias significativas en la evolución clínica y desarrollo de secuelas entre la administración antibiótica oral exclusiva frente a la intravenosa de corta duración seguida de administración oral. La selección de la antibioterapia empírica inicial se basará en el patrón local de susceptibilidad. En la cistitis este consenso recomienda el uso empírico de cefalosporinas de segunda generación en menores de 6 años y fosfomicina trometamol en mayores. La antibioterapia empírica recomendada en pielonefritis que no precisan ingreso son las cefalosporinas de tercera generación. En caso de precisar ingreso se recomiendan los aminoglucósidos. En menores de 3 meses se debe añadir ampicilina. Una vez conocido el resultado del cultivo se debe dirigir el tratamiento de continuación, tanto intravenoso como oral.

The application of high-power ultrasounds (US) at 28 kHz to the crushed grapes and the use of different pomace contact times caused changes in the content and composition of monosaccharides and polysaccharides in the musts and wines. These differences were maintained from the moment of pressing (end of maceration) until the end of the alcoholic fermentation. The US increased the content of monosaccharides and polysaccharides in the musts by facilitating their extraction from the solid parts during maceration. The application of medium maceration time (3 days) to sonicated grapes led to an extraction of polysaccharides rich in arabinose and galactose, rhamnogalacturonan type II (RG-II) and mannoproteins (MP), similar to that observed in the control wines made with an extended maceration of 7 days (968.21 vs. 1029.45; 895.04 vs. 1700.50; 356.81 vs. 343.95, respectively). This fact was attributed to a higher extraction in the must during the sonication process and to an important release of pectic polysaccharides during the pressing of the sonicated pomace, which is reported here for the first time. Therefore, the US technology could be useful for increasing the polysaccharide content in the wines or for reducing the maceration time needed to achieve certain levels of wine polysaccharides.

Vitis vinífera L. cv. Maturana Blanca is an autochthonous minor variety recently recovered in the Rioja Qualified Denomination of Origin (D.O.Ca Rioja, Spain) for the production of monovarietal white wines with singular and differentiated characteristics. In this paper, Maturana Blanca wines made with different technologies were analyzed by sensory analysis and aromatic profile by gas chromatography-mass detector. Maturana Blanca wines were characterized by low pH, high acidity, and yellowish tonalities. The compounds that most influenced the aroma of Maturana Blanca wines were those related to fruity (acetates and ethyl esters), floral aromas (2-phenylethanol), and spicy notes (γ-decalactone). These wines were mainly characterized by volatile compounds of fruity aromas of banana and apple. The use of pre-fermentative maceration increased the concentration of ethyl esters and acetates and produced wines with higher odor activity values, indicating a greater aromatic intensity. The aromatic profile of Maturana Blanca wines fermented in oak barrels showed a greater complexity as they were also characterized by the presence of important amounts of furfural, whiskey lactone, and eugenol. The sensory analysis confirmed the results obtained in the aromatic analysis, and described the wines as fresh and balanced in mouth, with notes of acidity and medium to high persistence. These results will contribute to a better knowledge of this white variety.

La creciente evidencia científica de mindfulness permite su expansión en distintos contextos, entre ellos el contexto educativo. Sin embargo, unida a esta rápida expansión, existe la preocupación de que los profesionales que enseñen mindfulness no tengan la suficiente formación personal y no posean las competencias y las habilidades necesarias para desempeñar esta tarea. Este artículo se basa en la información obtenida a partir de una búsqueda realizada en diferentes bases de datos, y referida a los principales artículos y trabajos publicados sobre mindfulness dirigidos al profesorado. Se exponen aspectos relativos a la formación en mindfulness y a las competencias, las habilidades y los principios necesarios para que los profesores apliquen mindfulness en las aulas; también se exponen las principales dificultades encontradas, los factores que contribuyen al éxito y las sugerencias de mejora respecto a la puesta en práctica de estos programas.

El empleo de Prunus avium (L.) como hábitat para el longicornio legalmente protegido Rosalia alpina (Linnaeus, 1758) se registra por primera vez. Las observaciones tuvieron lugar en un cerezo moribundo localizado en un jardín en un entorno rural perteneciente al término municipal de Asteasu (Gipuzkoa). La presencia de adultos apareándose y buscando lugares para ovopositar, de orificios de salida y de una larva dentro de una rama muerta, sugieren que la especie es capaz de completar su ciclo biológico en el cerezo. Dentro de las ramas muertas se encontraron otras dos especies de saproxílicos: Cerambyx scopolii Fuessly, 1775 and Ampedus pomonae (Stephens, 1820). En la región del área de estudio, R. alpina sólo había sido previamente citada en ejemplares de Fagus sylvatica L. Por tanto, se recomiendan futuras investigaciones para determinar la importancia de otras especies de árboles como hábitat alternativo y su papel para la conservación de R. alpina.

The objective of this article is to analyze the progress made in the Americas in the implementation of the World Health Organization Framework Convention on Tobacco Control (FCTC) after its tenth anniversary of entry into force. At the time of the analysis, 30 of the 35 countries of the Americas are Parties to the FCTC. While progress has been made in implementing the measures contained in the FCTC, the level of implementation has not been homogeneous either across mandates or across countries. Forty percent of Parties to the Convention in the Americas are yet to implement any of the measures at their highest level of implementation according to the WHO classification. It is crucial that the countries of the Americas continue to progress towards the full imple­mentation of the FCTC progressively. In these efforts, it is important to take into account that FCTC measures such as those related to smoke-free environments and adoption of effective health warnings are basic public health measures, which are almost entirely within the competence of health authorities and therefore susceptible to be implemented in a prompt fashion in all countries of the region.

CF2 and Mef2 influence a variety of developmental muscle processes at distinct stages of development. Nevertheless, the exact nature of the CF2-Mef2 relationship and its effects on muscle building remain yet to be resolved. Here, we explored the regulatory role of CF2 in the Drosophila embryo muscle formation. To address this question and not having proper null CF2 mutants we exploited loss or gain of function strategies to study the contribution of CF2 to Mef2 transcription regulation and to muscle formation. Our data point to CF2 as a factor involved in the regulation of muscle final size and/or the number of nuclei present in each muscle. This function is independent of its role as a Mef2 collaborative factor in the transcriptional regulation of muscle-structural genes. Although Mef2 expression patterns do not change, reductions or increases in parallel in CF2 and Mef2 transcript abundance were observed in interfered and overexpressed CF2 embryos. Since CF2 expression variations yield altered Mef2 expression levels but with correct spatio-temporal Mef2 expression patterns, it can be concluded that only the mechanism controlling expression levels is de-regulated. Here, it is proposed that CF2 regulates Mef2 expression through a Feedforward Loop circuit.

Psoriasis is a chronic autoimmune systemic disease with an approximate incidence of 2% worldwide; it is commonly characterized by squamous lesions on the skin that present the typical pain, stinging, and bleeding associated with an inflammatory response. In this work, poly(methyl vinyl ether-alt-maleic ethyl monoester) (PMVEMA-ES) nanofibers have been designed as a delivery vehicle for three therapeutic agents with palliative properties for the symptoms of this disease (salicylic acid, methyl salicylate, and capsaicin). For such a task, the production of these nanofibers by means of the electrospinning technique has been optimized. Their morphology and size have been characterized by optical microscopy and scanning electron microscopy (SEM). By selecting the optimal conditions to achieve the smallest and most uniform nanofibers, approximate diameters of up to 800–900 nm were obtained. It was also determined that the therapeutic agents that were used were encapsulated with high efficiency. The analysis of their stability over time by GC-MS showed no significant losses of the encapsulated compounds 15 days after their preparation, except in the case of methyl salicylate. Likewise, it was demonstrated that the therapeutic compounds that were encapsulated conserved, and even improved, their capacity to activate the transient receptor potential cation channel 1 (TRPV1) channel, which has been associated with the formation of psoriatic lesions.

En este trabajo se exploran las condiciones de relativa desventaja en relación con el ingreso que prevalecen en los hogares que tienen migración a Estados Unidos, comparándolos con el total de los hogares de México. La información proviene de la muestra censal del XII Censo General de Población y Vivienda 2000. En primer término se aborda el análisis de la distribución porcentual de los ingresos totales mensuales, después se analizan las distribuciones de los ingresos mensuales por trabajo y posteriormente se estudian los ingresos por remesas. En cada una de estas partes se toma una distribución de ingresos con base en siete estratos, utilizando el salario mínimo vigente en febrero de 2000. Finalmente, se establecen una serie de ideas que podrían explicar el fenómeno migratorio a Estados Unidos desde la visión del ingreso en los hogares mexicanos.

De la dicotomía seriedad-risa, Beltrán Almería emprende el análisis de la literatura occidental que sustentará en cinco conceptos: tradición, patetismo, didactismo, humorismo y realismo. Así, los parámetros para enfocar los géneros son derivados de una visión tanto antropológica como ontológica, ya que estos cambios repercuten en la visión del mundo, y por ende, en la forma de representar esa visión mediante el discurso. Los seis apartados del libro se estructuran como un tinglado en el que el culmen serán los capítulos dedicados al Humorismo y al Realismo.

Introducción: Los trastornos de la conducta alimentaria (TCA) son especialmente frecuentes en los jóvenes. Objetivo: Determinar la prevalencia de TCA en jóvenes universitarios y sus factores asociados. Metodología: Estudio de prevalencia en jóvenes universitarios españoles del proyecto uniHcos. Mediante regresión logística no condicional se determinó la magnitud de la asociación entre los factores de riesgo asociados al estilo de vida y padecer un TCA medido mediante el cuestionario Sick. Control, One, Fat, Food (SCOFF). Resultados: La prevalencia de TCA fue del 19.5%, siendo mayor en mujeres (ORa=1.59; p=0.006). En los chicos, tener criterios de padecer TCA se asoció con vivir en colegios mayores. con realizar "binge drinking", y uso problemático de internet. En las mujeres el estudiar titulaciones diferentes a las ciencias de la salud (ORa=1.50) y el uso problemático de internet (ORa=2.33). Aquellas mujeres con riesgo de TCA presentaban con mayor frecuencia depresión (ORa=2.02), dolores menstruales (ORa=1.81) y mala salud percibida (ORa=1.70). En los hombres, aquellos con riesgo de TCA presentaban con mayor frecuencia una mala salud percibida (ORa=2.42). Conclusiones: El riesgo de obtener resultados positivos en el SCOFF en nuestro estudio es similar a lo publicado para otras poblaciones de estudiantes, así como su asociación con determinadas adicciones y problemas de salud. Se observaron diferencias en función del sexo que precisan atención en el diseño de estrategias de prevención y control.