Efficiency and sensitivity optimization of a protocol to quantify indoor airborne SARS-CoV-2 levels.

BACKGROUND: Development of methodologies to quantify airborne micro-organisms is needed for the prevention and control of infections. It is difficult to conclude which is the most efficient and sensitive strategy to assess airborne SARS-CoV-2 RNA levels due to the disparity of results reported in clinical settings. AIM: To improve our previously reported protocol of measuring SARS-CoV-2 RNA levels, which was based on bioaerosol collection with a liquid impinger and RNA quantification with droplet digital polymerase chain reaction (ddPCR). METHODS: Air samples were collected in COVID-19 patient rooms to assess efficiency and/or sensitivity of different air samplers, liquid collection media, and reverse transcriptases (RT). FINDINGS: Mineral oil retains airborne RNA better than does hydrophilic media without impairing integrity. SARS-CoV-2 ORF1ab target was detected in 80% of the air samples using BioSampler with mineral oil. No significant differences in effectiveness were obtained with MD8 sampler equipped with gelatine membrane filters, but the SARS-CoV-2 copies/m3 air obtained with the latter were lower (28.4 ± 6.1 vs 9 ± 1.7). SuperScript II RT allows the detection of a single SARS-CoV-2 genome RNA molecule by ddPCR with high efficiency. This was the only RT that allowed the detection of SARS-CoV-2 N1 target in air samples. CONCLUSION: The collection efficiency and detection sensivity of a protocol to quantify SARS-CoV-2 RNA levels in indoor air has been improved in the present study. Such optimization is important to improve our understanding of the microbiological safety of indoor air.

[Moyamoya disease: revision and description of a number of pedriatic cases]. / Enfermedad de moyamoya: descripción de una serie de casos pediátricos.

INTRODUCTION: Moyamoya disease is caused because of progressive occlusion of the arterial circle of Willis, leading to a compensatory net-like abnormal vessels development. The objective is to describe the number of cases in our center (tertiary hospital). PATIENTS AND METHODS: Retrospective study. Revision of pediatric medical histories diagnosed of moyamoya disease or moyamoya syndrome (in case of predisposing disease) between 2005 and 2018. Demographic variables were collected, related to diagnosis, risk factors, treatment, and follow-up. RESULTS: Seven cases were collected with a median age of 6 years and an equitable distribution by sex. Five associated predisposing pathologies (Down syndrome, neurofibromatosis, sickle cell disease, Behcet). The main clinical diagnosis was neurological focus (five cases), followed by epileptic seizures (four), and headache (two). One was asymptomatic at diagnosis. Six strokes were documented, five of them were isquemic. The arteriography (goldstardard) was made in five patients. Five presented bilateral involvement of the vessels, the internal carotid arteries and the middle cerebral arteries were the most affected. Six received acetylsalicylic acid treatment and five of them required antiepileptic drugs. Revascularization surgery (encephaloduroarteriomyosinangiosis) was performed in four patients, and in one, strokes persisted. The most prevalent sequelae were hemiparesis and psychomotor retardation. CONCLUSIONS: The risk factors presented in our patients match to those described in the literature. The symptoms at the onset can be diverse and ischemic strokes predominate in our series. Revascularization surgery was effective in more than half of the cases. Subsequent follow-up is necessary to assess complications and sequelae.

TITLE: Enfermedad de moyamoya: descripción de una serie de casos pediátricos.Introducción. La enfermedad de moyamoya se produce por la oclusión de las arterias alrededor del polígono de Willis y genera una amplia red de vasos colaterales. El objetivo es describir la serie histórica de nuestro centro (hospital terciario). Pacientes y métodos. Es un estudio retrospectivo. Se hizo una revisión de historias clínicas de pacientes pediátricos diagnosticados de enfermedad o síndrome de moyamoya (si patología predisponente) entre 2005 y 2018. Se recogieron variables demográficas, relacionadas con el diagnóstico, factores de riesgo, tratamiento y seguimiento. Resultados. Se obtuvieron siete casos, con una mediana de edad de seis años y distribución por sexos equitativa. Cinco asociaban patologías predisponentes (síndrome de Down, neurofibromatosis, drepanocitosis y Behçet). La clínica predominante en el diagnóstico fue focalidad neurológica (cinco casos), seguida de crisis epilépticas (cuatro) y cefalea (dos). Un paciente era asintomático en el momento del diagnóstico. Se documentaron seis ictus, cinco de los cuales fueron isquémicos. La arteriografía (técnica de referencia) constaba en cinco pacientes. Cinco presentaban afectación bilateral y estaban mayormente afectadas las arterias carótidas internas y las cerebrales medias. Seis recibieron tratamiento con ácido acetilsalicílico y cinco necesitaron fármacos antiepilépticos. La cirugía de revascularización (encefaloduroarteriomiosinangiosis) se realizó en cuatro pacientes y en uno persistieron los ictus. Las secuelas más prevalentes fueron hemiparesia y retraso psicomotor. Conclusiones. Los factores de riesgo presentados en nuestros pacientes se ajustan a los descritos en la bibliografía. La clínica en el inicio puede ser diversa y predominan los ictus isquémicos en nuestra serie. La cirugía de revascularización fue efectiva en más de la mitad de los casos. Es necesario un seguimiento posterior para evaluar complicaciones y secuelas.

Enfermedad de moyamoya: descripción de una serie de casos pediátricos / Moyamoya disease: revision and description of a number of pedriatic cases

Introducción: La enfermedad de moyamoya se produce por la oclusión de las arterias alrededor del polígono de Willis y genera una amplia red de vasos colaterales. El objetivo es describir la serie histórica de nuestro centro (hospital terciario). Pacientes y métodos: Es un estudio retrospectivo. Se hizo una revisión de historias clínicas de pacientes pediátricos diagnosticados de enfermedad o síndrome de moyamoya (si patología predisponente) entre 2005 y 2018. Se recogieron variables demográficas, relacionadas con el diagnóstico, factores de riesgo, tratamiento y seguimiento. Resultados: Se obtuvieron siete casos, con una mediana de edad de seis años y distribución por sexos equitativa. Cinco asociaban patologías predisponentes (síndrome de Down, neurofibromatosis, drepanocitosis y Behçet). La clínica predominante en el diagnóstico fue focalidad neurológica (cinco casos), seguida de crisis epilépticas (cuatro) y cefalea (dos). Un paciente era asintomático en el momento del diagnóstico. Se documentaron seis ictus, cinco de los cuales fueron isquémicos. La arteriografía (técnica de referencia) constaba en cinco pacientes. Cinco presentaban afectación bilateral y estaban mayormente afectadas las arterias carótidas internas y las cerebrales medias. Seis recibieron tratamiento con ácido acetilsalicílico y cinco necesitaron fármacos antiepilépticos. La cirugía de revascularización (encefaloduroarteriomiosinangiosis) se realizó en cuatro pacientes y en uno persistieron los ictus. Las secuelas más prevalentes fueron hemiparesia y retraso psicomotor. Conclusiones: Los factores de riesgo presentados en nuestros pacientes se ajustan a los descritos en la bibliografía. La clínica en el inicio puede ser diversa y predominan los ictus isquémicos en nuestra serie. La cirugía de revascularización fue efectiva en más de la mitad de los casos. Es necesario un seguimiento posterior para evaluar complicaciones y secuelas.(AU)

Introduction: Moyamoya disease is caused because of progressive occlusion of the arterial circle of Willis, leading to a compensatory net-like abnormal vessels development. The objective is to describe the number of cases in our center (tertiary hospital). Patients and methods: Retrospective study. Revision of pediatric medical histories diagnosed of moyamoya disease or moyamoya syndrome (in case of predisposing disease) between 2005 and 2018. Demographic variables were collected, related to diagnosis, risk factors, treatment, and follow-up. Results: Seven cases were collected with a median age of 6 years and an equitable distribution by sex. Five associated predisposing pathologies (Down syndrome, neurofibromatosis, sickle cell disease, Behçet). The main clinical diagnosis was neurological focus (five cases), followed by epileptic seizures (four), and headache (two). One was asymptomatic at diagnosis. Six strokes were documented, five of them were isquemic. The arteriography (goldstardard) was made in five patients. Five presented bilateral involvement of the vessels, the internal carotid arteries and the middle cerebral arteries were the most affected. Six received acetylsalicylic acid treatment and five of them required antiepileptic drugs. Revascularization surgery (encephaloduroarteriomyosinangiosis) was performed in four patients, and in one, strokes persisted. The most prevalent sequelae were hemiparesis and psychomotor retardation. Conclusions: The risk factors presented in our patients match to those described in the literature. The symptoms at the onset can be diverse and ischemic strokes predominate in our series. Revascularization surgery was effective in more than half of the cases. Subsequent follow-up is necessary to assess complications and sequelae.(AU)

Synthesis of aminopyrazoles from sydnones and ynamides.

Aminopyrazoles are prepared from readily accessible sydnones and sulfonyl ynamides using either a copper-mediated sydnone alkyne cycloaddition (CuSAC) or in situ generated strained cyclic ynamides.

Endogenous jasmonic and salicylic acids levels in the Cd-hyperaccumulator Noccaea (Thlaspi) praecox exposed to fungal infection and/or mechanical stress.

KEY MESSAGE: Sensitivity to Erysiphe in Noccaea praecox with low metal supply is related to the failure in enhancing SA. Cadmium protects against fungal-infection by direct toxicity and/or enhanced fungal-induced JA signaling. Metal-based defense against biotic stress is an attractive hypothesis on evolutionary advantages of plant metal hyperaccumulation. Metals may compensate for a defect in biotic stress signaling in hyperaccumulators (metal-therapy) by either or both direct toxicity to pathogens and by metal-induced alternative signaling pathways. Jasmonic acid (JA) and salicylic acid (SA) are well-established components of stress signaling pathways. However, few studies evaluate the influence of metals on endogenous concentrations of these defense-related hormones. Even less data are available for metal hyperaccumulators. To further test the metal-therapy hypothesis we analyzed endogenous SA and JA concentrations in Noccaea praecox, a cadmium (Cd) hyperaccumulator. Plants treated or not with Cd, were exposed to mechanical wounding, expected to enhance JA signaling, and/or to infection by biotrophic fungus Erysiphe cruciferarum for triggering SA. JA and SA were analyzed in leaf extracts using LC-ESI(-)-MS/MS. Plants without Cd were more susceptible to fungal attack than plants receiving Cd. Cadmium alone tended to increase leaf SA but not JA. Either or both fungal attack and mechanical wounding decreased SA levels and enhanced JA in the Cd-rich leaves of plants exposed to Cd. High leaf Cd in N. praecox seems to hamper biotic-stress-induced SA, while triggering JA signaling in response to fungal attack and wounding. To the best of our knowledge, this is the first report on the endogenous JA and SA levels in a Cd-hyperaccumulator exposed to different biotic and abiotic stresses. Our results support the view of a defect in SA stress signaling in Cd hyperaccumulating N. praecox.

Aplicaciones de la técnica de difusión por resonancia magnética en el manejo de la patología tumoral osteomuscular / Applications of diffusion techniques in magnetic resonance imaging of musculoskeletal tumors

La resonancia magnética (RM) es la técnica de elección en el diagnóstico, estadificación y seguimiento de la patología tumoral osteomuscular. La imagen de difusión (RM-D) en RM es una nueva técnica de imagen funcional, que aporta información complementaria a las secuencias convencionales de RM. La difusión por RM ha demostrado ser una técnica útil en distintas situaciones clínicas como la caracterización de la patología que afecta a la médula ósea (metástasis óseas, fracturas benignas o enfermedad hematológica), valoración de tumores óseos y de partes blandas o la monitorización de la respuesta al tratamiento de lesiones tumorales. El objetivo de este artículo es mostrar una revisión de la técnica de difusión en RM y aplicaciones clínicas actuales en el manejo de la patología tumoral osteomuscular (AU)

Magnetic resonance imaging (MRI) is the technique of choice in the diagnosis, staging, and follow-up of musculoskeletal tumors. Diffusion imaging is a new functional MRI technique that provides information that is complementary to that obtained in conventional MRI sequences. Diffusion imaging has proven useful in different clinical situations like the characterization of disease involving the bone marrow (bone metastases, benign fractures, or hematological disease), the evaluation of tumors of the bones and soft tissues, and the monitoring of the response to treatment in patients with tumors. The aim of this article is to review the diffusion technique in MRI and its current clinical applications in the management of musculoskeletal tumors (AU)

[Applications of diffusion techniques in magnetic resonance imaging of musculoskeletal tumors]. / Aplicaciones de la técnica de difusión por resonancia magnética en el manejo de la patología tumoral osteomuscular.

Magnetic resonance imaging (MRI) is the technique of choice in the diagnosis, staging, and follow-up of musculoskeletal tumors. Diffusion imaging is a new functional MRI technique that provides information that is complementary to that obtained in conventional MRI sequences. Diffusion imaging has proven useful in different clinical situations like the characterization of disease involving the bone marrow (bone metastases, benign fractures, or hematological disease), the evaluation of tumors of the bones and soft tissues, and the monitoring of the response to treatment in patients with tumors. The aim of this article is to review the diffusion technique in MRI and its current clinical applications in the management of musculoskeletal tumors.

Docetaxel combined with irinotecan or 5-fluorouracil in patients with advanced oesophago-gastric cancer: a randomised phase II study.

BACKGROUND: Docetaxel and irinotecan chemotherapy have shown good efficacy in the treatment of advanced oesophago-gastric cancer. This randomised phase II study evaluated the efficacy and toxicity profile of two non-platinum docetaxel-based doublet regimens in advanced oesophago-gastric cancer. METHODS: Chemotherapy-naïve patients with advanced oesophago-gastric cancer were randomised to receive either 3-weekly DI (docetaxel 60 mg m(-2) plus irinotecan 250 mg m(-2) (Day 1)) or 3-weekly DF (docetaxel 85 mg m(-2) (Day 1) followed by 5-fluorouracil 750 mg m(-2) per day as a continuous infusion (Days 1-5)). RESULTS: A total of 85 patients received DI (n=42) or DF (n=43). The primary endpoint was overall response rate (ORR). The ORR and time to progression (TTP) in the evaluable population (n=65) were 37.5% (DI) vs 33.3% (DF), and 4.2 months vs 4.4 months, respectively. In the intent-to-treat population, the observed ORR, TTP and median overall survival were similar between the two groups. Grade 3-4 neutropenia, febrile neutropenia and diarrhoea were more frequent in the DI arm as compared with the DF arm (83.3% vs 69.8%, 40.5% vs 18.6%, and 42.9% vs 16.3%, respectively). CONCLUSION: Both docetaxel-based doublet regimens show comparable efficacy; however, the DF regimen was associated with a better toxicity profile and is an alternative treatment option for patients in whom platinum-based regimens are unsuitable.

Utilidad de la resonancia magnética en el cáncer de próstata / Usefulness of magnetic resonance imaging in prostate cancer

Los avances técnicos de la resonancia magnética (RM) en la última década hacen que se considere la técnica de elección en el manejo global del paciente con sospecha o diagnóstico de cáncer de próstata. La RM permite combinar información morfológica y funcional al mismo tiempo mediante la aplicación de secuencias como la espectroscopia, difusión y secuencias dinámicas con contraste endovenoso en el mismo estudio. La RM permite no solo focalizar el estudio en la glándula sino valorar también la extensión regional a toda la pelvis o a todo el cuerpo dependiendo de la indicación clínica, en menos de 1 hora de exploración. Las principales indicaciones clínicas de la RM de próstata son: a) estadificación local, regional o a distancia; b) detección o guía para biopsia diagnóstica ante la sospecha clínica o resultado negativo en biopsias previas; y c) monitorización terapéutica. Es preciso conocer los distintos protocolos con secuencias específicas en RM de próstata, dependiendo de las diferentes indicaciones clínicas, para su correcta realización e interpretación. Este artículo pretende ser una actualización en la utilización de la RM de próstata en el manejo del cáncer de próstata, describiendo un enfoque útil que permita aplicar la información morfológica y funcional en la práctica clínica (AU)

In the last decade, technical advances in magnetic resonance imaging (MRI) have made it the technique of choice in the overall management of patients with suspected or confirmed prostate cancer. MR makes it possible to acquire information about morphology and function in the same examination by using techniques like spectroscopy, diffusion, and dynamic sequences with intravenous contrast material administration. Moreover, MRI enables both focused study of the prostate gland and of regional and/or whole-body involvement, depending on the clinical indications, in less than an hour. The main clinical indications for MRI of the prostate are a) staging local, regional, and/or remote disease; b) detecting prostate cancer or guiding prostate biopsy in cases of clinical suspicion or negative findings in previous biopsy specimens; and c) monitoring the response to treatment. It is important to know the different protocols with specific MRI sequences for the prostate, depending on the different clinical indications, to ensure that they are performed and interpreted correctly. This article provides up-to-date information about the use of MRI for the study of the prostate to show how the morphological and functional information can be used in clinical practice (AU)

[Usefulness of magnetic resonance imaging in prostate cancer]. / Utilidad de la resonancia magnética en el cáncer de próstata.

In the last decade, technical advances in magnetic resonance imaging (MRI) have made it the technique of choice in the overall management of patients with suspected or confirmed prostate cancer. MR makes it possible to acquire information about morphology and function in the same examination by using techniques like spectroscopy, diffusion, and dynamic sequences with intravenous contrast material administration. Moreover, MRI enables both focused study of the prostate gland and of regional and/or whole-body involvement, depending on the clinical indications, in less than an hour. The main clinical indications for MRI of the prostate are a) staging local, regional, and/or remote disease; b) detecting prostate cancer or guiding prostate biopsy in cases of clinical suspicion or negative findings in previous biopsy specimens; and c) monitoring the response to treatment. It is important to know the different protocols with specific MRI sequences for the prostate, depending on the different clinical indications, to ensure that they are performed and interpreted correctly. This article provides up-to-date information about the use of MRI for the study of the prostate to show how the morphological and functional information can be used in clinical practice.

Mutational characterization of steroid 21-hydroxylase gene in Portuguese patients with congenital adrenal hyperplasia.

Congenital adrenal hyperplasia (CAH) due to steroid 21-hydroxylase deficiency is a common inherited disorder of adrenal hormone biosynthesis due to mutations in the 21-hydroxylase gene, CYP21A2. Genotyping for ten of the most frequent mutations was performed in 84 Portuguese CAH patients: 10 salt-wasters, 6 simple-virilizers and 68 non-classical patients. The patients were diagnosed by a level of 17-hydroxyprogesterone above 10 ng/ml either in basal conditions or after an ACTH 0,25 mg IV Test. A variety of genotyping techniques were used to detect these ten mutations. CYP21A2 mutations were detected in 91.7% (77/84) of the patients. The frequency of alleles carrying two or more CYP21A2 mutations (9.5% - 16/168) is higher than in other populations. The most frequent mutations identified in our population were V281L (41.7%) and deletions/conversions involving the promoter region of the CYP21A2 gene (28.3%). A decreased frequency of IVS2-12C/A>G mutation (5.6%) was the most characteristic feature of our population. This study allow the characterization of the mutational spectrum of CAH patients, mainly non-classical CAH, with 21-hydroxylase deficiency from Portugal showing specific genetic features of this population which reveals differences with worldwide countries.

Resonancia magnética de mama: utilidad de la difusión para diferenciar entre lesiones benignas y malignas / Breast MRI: the usefulness of diffusion-weighted sequences for differentiating between benign and malignant lesions

Objetivo: Valorar la utilidad en la resonancia magnética (RM) de mama de la difusión y el coeficiente de difusión aparente (CDA) para diferenciar entre lesiones benignas y malignas. Material y métodos: Se estudian prospectivamente 88 pacientes, de 31 a 79 años, con 94 lesiones (80 malignas y 14 benignas), que fueron remitidas para un estudio prequirúrgico de extensión local, y a las que se realizó una RM de mama con estudio dinámico tras administrar contraste intravenoso y secuencia de difusión, valorando su correspondiente CDA. Se correlacionan los resultados obtenidos en difusión con la anatomía patológica. Resultados: El valor medio del CDA de las lesiones malignas (1,12±0,25×10−3mm2/s) fue significativamente inferior (p<0,001) al de las benignas (1,61±0,52×10−3mm2/s). No se obtuvieron diferencias significativas entre los diferentes subtipos de carcinomas invasivos y tampoco entre el carcinoma intraductal y el invasivo (p>0,05). Con un valor CDA<0,95×10−3mm2/s como indicador de malignidad, la sensibilidad es del 52% y la especifidad es del 100%.ConclusiónEn la RM de mama la difusión aporta información adicional en la caracterización de la benignidad y malignidad de las lesiones mejorando la especifidad de la técnica (AU)

Objective: To evaluate the usefulness of diffusion-weighted MRI sequences and of the apparent diffusion coefficient (ADC) to differentiate between benign and malignant breast lesions. Material and methods: We prospectively studied 88 patients (aged 31 to 79 years) with 94 lesions (80 malignant and 14 benign) who were referred for preoperative local staging. All patients underwent dynamic MRI examination after intravenous contrast administration and a diffusion-weighted sequence with ADC calculation. The results obtained at diffusion-weighted imaging were correlated with those obtained at histological examination. Results: The mean value of the ADC for malignant lesions (1.12±0.25×10−3mm2/s) was significantly lower (p<0.001) than for benign lesions (1.61±0.52×10−3mm2/s). No significant differences in ADC values were found between the different subtypes of invasive carcinomas or between intraductal carcinoma and invasive carcinoma (p>0.05). Using an ADC lower than 0.95×10−3mm2/s as a threshold for malignancy, the sensitivity is 52% and the specificity is 100%.ConclusionDiffusion-weighted sequences provide additional information in breast MRI that is useful for differentiating between benign and malignant lesions, thus improving the specificity of the technique (AU)

[Breast MRI: the usefulness of diffusion-weighted sequences for differentiating between benign and malignant lesions]. / Resonancia magnética de mama: utilidad de la difusión para diferenciar entre lesiones benignas y malignas.

OBJECTIVE: To evaluate the usefulness of diffusion-weighted MRI sequences and of the apparent diffusion coefficient (ADC) to differentiate between benign and malignant breast lesions. MATERIAL AND METHODS: We prospectively studied 88 patients (aged 31 to 79 years) with 94 lesions (80 malignant and 14 benign) who were referred for preoperative local staging. All patients underwent dynamic MRI examination after intravenous contrast administration and a diffusion-weighted sequence with ADC calculation. The results obtained at diffusion-weighted imaging were correlated with those obtained at histological examination. RESULTS: The mean value of the ADC for malignant lesions (1.12+/-0.25x10(-3)mm(2)/s) was significantly lower (p<0.001) than for benign lesions (1.61+/-0.52x10(-3)mm(2)/s). No significant differences in ADC values were found between the different subtypes of invasive carcinomas or between intraductal carcinoma and invasive carcinoma (p>0.05). Using an ADC lower than 0.95x10(-3)mm(2)/s as a threshold for malignancy, the sensitivity is 52% and the specificity is 100%. CONCLUSION: Diffusion-weighted sequences provide additional information in breast MRI that is useful for differentiating between benign and malignant lesions, thus improving the specificity of the technique.

[Glucose metabolism alterations and follow-up study of a non-diabetic adult population]. / Alteraciones del metabolismo de la glucosa y estudio de seguimiento de una población adulta no diabética.

OBJECTIVE: To determine the appearance of type 2 diabetes mellitus (DM2) and impaired fasting glucose (IFG) at five years of follow-up in a known non-diabetic population. DESIGN: nested case control studies (case s-control into a cohort) developed in two stages: 1) identification and characterization of the cohort and 2) follow-up. STUDY POPULATION: representative sample of a non-diabetic population between 40 and 75 years old attended in a Primary Health Center. IDENTIFICATION: 326 persons, 2.1% of whom were diagnosed of previously unknown DM2 and 7.3% of IFG. Insulin resistance (IR) was higher in patients with IFG and pancreatic function of beta cells (PFBC) was higher in the population without glucose metabolism alteration. FOLLOW-UP: 121 persons, 9.7 % of whom evolved to DM2 (all with IFG). IFG proportion at the end of the follow-up was 23.96%. CONCLUSIONS: At 5 years of follow-up, more than 1/3 of the population studied developed DM2 or IFG. These diagnoses were related with IR and PFBC.

Transfer of selected mineral nutrients and trace elements in the host-hemiparasite association, Cistus-Odontites lutea, growing on and off metal-polluted sites.

The role of a hemiparasitic life-style in plant resistance to toxic trace elements in polluted soils is unclear. Restriction of metal uptake by the host, restriction of metal transfer from host to parasite, or transformation of metals into a less toxic form may play a role. This study analysed the transfer of selected mineral elements from soil to host (Cistus spp.) and from host to hemiparasite (Odontites lutea) at locations with different metal burdens: a Cu-rich serpentine site, Pb-Ba mine spoil and an unpolluted soil. Highest soil-to-host transfer factors for K, Mg, Ca, Zn, Cu and Pb were observed on the unpolluted soil. Statistically significant differences among locations of host-to-parasite transfer factors were only found for Ca and Pb. Restriction of transfer of unfavourable Ca/Mg ratios, characteristic at the serpentine site, and of high Pb and Zn concentrations at the Pb-Ba mine occurred mainly at the soil-host, and not at the host-parasite, level. Odontites lutea was able to withstand enhanced Zn and Pb concentrations and low Fe/Cu ratios in shoot tissue without developing toxicity symptoms. This could be caused by specific metal resistance mechanisms in this hemiparasite and/or the transformation and transfer of these metals into a less toxic form by the metal-tolerant host.

Alteraciones del metabolismo de la glucosa y estudio de seguimiento de una población adulta no diabética / Glucose metabolism alterations and follow-up study of a non-diabetic adult population

Objetivo. Determinar la aparición de diabetes mellitus (DM) y glucemia basal alterada (GBA) a los cinco años de seguimiento de una población no diabética conocida. Material y métodos. Diseño: estudio casos-control anidado (casos-control dentro de una cohorte) desarrollado en dos fases, la de identificación y caracterización de la cohorte a estudio y la de seguimiento. Población a estudio: muestra representativa de población no diabética de 40 a 75 años atendida en un Centro de Atención Primaria. Resultados. Fase de identificación: 326 personas de las que un 2,1% fueron diagnosticadas de DM2 no conocida previamente y un 7,3% de GBA. La resistencia a la insulina (RI) fue superior en los pacientes con GBA y la función de la célula beta pancreática (FBP) fue superior en la población sin alteraciones del metabolismo de la glucosa. Fase de seguimiento: 121 personas. Un 9,7% evolucionaron a DM2 (todos con GBA previa) siendo la proporción de GBA al final del seguimiento de 23,96%. Conclusiones. A los cinco años de seguimiento, más de un tercio de la población estudiada evolucionó a DM o a GBA, estando la aparición de estas alteraciones relacionada con la RI y con la FBP (AU)

Objective. To determine the appearance of type 2 diabetes mellitus (DM2) and impaired fasting glucose (IFG) at five years of follow-up in a known non-diabetic population. Patients and methods. Design: nested case control studies (case s-control into a cohort) developed in two stages: 1) identification and characterization of the cohort and 2) follow-up. Study population: representative sample of a non-diabetic population between 40 and 75 years old attended in a Primary Health Center. Results. Identification: 326 persons, 2.1% of whom were diagnosed of previously unknown DM2 and 7.3% of IFG. Insulin resistance (IR) was higher in patients with IFG and pancreatic function of beta cells (PFBC) was higher in the population without glucose metabolism alteration. Follow-up: 121 persons, 9.7 % of whom evolved to DM2 (all with IFG). IFG proportion at the end of the follow-up was 23.96%. Conclusions. At 5 years of follow-up, more than 1/3 of the population studied developed DM2 or IFG. These diagnoses were related with IR and PFBC (AU)

Diagnostic value of apparent diffusion coefficients to differentiate benign from malignant vertebral bone marrow lesions.

AIM: The aim of this study is to evaluate the value of the apparent diffusion coefficient (ADC) obtained in diffusion-weighted (DW) MR sequences for the differentiation between malignant and benign bone marrow lesions. METHOD: Forty-five patients with altered signal intensity vertebral bodies on conventional MR sequences were included. The cause of altered signal intensity was benign osteoporotic collapse in 16, acute neoplastic infiltration in 15, and infectious processes in 14; based on plain-film, CT, bone scintigraphy, conventional MR studies, biopsy or follow-up. All patients underwent isotropic DW MR images (multi-shot EPI, b values of 0 and 500 s/mm(2)). Signal intensity at DW MR images was evaluated and ADC values were calculated and compared between malignancy, benign edema and infectious spondylitis. RESULTS: Acute malignant fractures were hyperintense compared to normal vertebral bodies on the diffusion-weighted sequence, except in one patient with sclerotic metastases. Mean ADC value from benign edema (1.9+/-0.39 x 10(-3) mm(2)/s) was significantly (p<0.0001) higher than untreated metastasic lesions (0.9+/-1.3 x 10(-3)mm (2)/s). Mean ADC value of infectious spondilytis (0.96+/-0.49 x 10(-3) mm(2)/s) was not statistically (p>0.05) different from untreated metastasic lesions. ADC value was low (0.75 x 10(-3) mm(2)/s) in one case of subacute benign fracture. CONCLUSIONS: ADC values are a useful complementary tool to characterize bone marrow lesions, in order to distinguish acute benign fractures from malignant or infectious bone lesions. However, ADC values are not valuable in order to differentiate malignancy from infection.

Valoración de un método automático de diagnóstico asistido por ordenador en la RM de pacientes con cáncer de mama / No disponible

Objetivo: Valorar y comparar entre el programa manualestándar y un nuevo programa de diagnóstico asistido por ordenador(CAD) en el estudio del cáncer de mama por RM.Material y métodos: Durante 24 meses se han estudiadode forma prospectiva 51 pacientes con 66 lesiones mamarias,57 malignas y 9 benignas, remitidas para la estadificación localprequirúrgica por RM de mama.Tras realizar el estudio dinámico tridimensional con contrasteendovenoso, se analiza el postprocesado de cada lesiónmediante el programa de análisis manual y el automático dediagnóstico asistido por ordenador (CADstream®), comparandolos resultados obtenidos y su correlación definitiva con anatomíapatológica.Resultados: El método automático de diagnóstico asistidopor ordenador en la valoración del cáncer de mama muestrauna sensibilidad (95%) ligeramente superior al método manual(89%) y con una especificidad igual con ambos métodos(66%). La fiabilidad es del 91 y 86% respectivamente, siendoestos resultados superiores debido a que el programa automáticovalora con más precisión la curva de captación en toda lalesión, pero sin variación en los hallazgos morfológicos.Ambos métodos modificaron la actitud terapéutica en un18% de los casos.El método automático consigue un elevado índice de correlaciónhistológica respecto al tamaño real del tumor (ligeramentesuperior al manual), reduce de forma significativa artefactosmejorando la calidad de imágenes y disminuyenotablemente el tiempo de análisis del radiólogo.Conclusiones: El método de diagnóstico asistido por ordenadoraplicado en RM mama es un método fiable y una herramientade trabajo muy útil en el análisis del postprocesado(AU)

Objective: To assess a new program for computer-aided diagnosisin breast MRI and to compare it with standard manualsoftware.Material and methods: We studied 66 breast lesions (57malignant and 9 benign) in 51 women referred for breast MRIfor preoperative local staging.After dynamic breast MRI with intravenous contrast andthree-dimensional reconstruction, we processed each lesionwith both standard manual software and the computer-aideddiagnosis program (CADstream®). We compared the twomethods on diagnostic accuracy and their correlations with thehistological findings.Results: The sensitivity of the computer-aided diagnosisprogram for staging breast was slightly higher than that of themanual method (95 vs. 89%); the specificity of the two techniqueswas similar (66%). The overall diagnostic accuracy was91% for the computer-aided method and 86% for the manualmethod. The automatic method is more accurate because itassesses the curve for the entire lesion better, without changesin the assessment of the morphological features.MRI examination modified the therapeutic approach in18 cases, regardless of the method used.The correlation of the automatic method with the histologicalfindings for tumor size was slightly higher than that of themanual method. The automatic method also yielded better imagequality with fewer artifacts and significantly reduced thetime radiologists needed to analyze the images.Conclusions: The computer-aided diagnosis program is reliableand useful for analyzing postprocessing breast MRI(AU)