Impacto de los sistemas de nefrometría renal en la valoración de las complicaciones en el tratamiento percutáneo guiado por imagen de las masas renales de pequeño tamaño / Usefulness of renal nephrometry scoring systems in the prediction of complications associated to percutaneous image-guided treatment for small renal masses

Introducción Los tumores renales son un desafío para los profesionales de la salud debido a su creciente prevalencia y complejidad de manejo. El estudio investiga la utilidad de los sistemas de nefrometría renal R.E.N.A.L. score y Padua en la predicción de complicaciones de la crioablación percutánea (CA). Material y métodos El estudio analiza de forma prospectiva a 90 pacientes con carcinoma de células renales (CCR) estadio T1a tratados con crioablación, totalizando 101 tumores. Resultados Se estudiaron 90 pacientes con 101 tumores renales de pequeño tamaño que recibieron terapia crioablativa. Los pacientes tenían una edad media de 68 años y mayoría eran hombres (74,4%). La mayoría de los tumores eran menores a 4 cm (89,1%) y la puntuación media del Padua y R.E.N.A.L. scores fue de 8,65 y 7,35, respectivamente. Se observaron complicaciones en 12 casos. El PADUA y R.E.N.A.L. scores demostraron un poder predictivo moderado (área bajo la curva [AUC] = 0,58 y AUC = 0,63, respectivamente) para las complicaciones poscrioablación. Conclusiones La CA es un tratamiento seguro y efectivo para los tumores renales de pequeño tamaño. Los sistemas de nefrometría renal R.E.N.A.L. y Padua scores tienen un poder predictivo moderado para las complicaciones asociadas a la CA de tumores renales. (AU)

Introduction Due to their increasing prevalence and complex management, renal tumors are challenging for health professionals. The study aims to evaluate the usefulness of R.E.N.A.L. and PADUA nephrometry scores in the prediction of complications after percutaneous cryoablation. Material and methods The study prospectively analyzed 90 patients with 101 stage T1a renal cell carcinoma (RCC) tumors treated with cryoablation. Results Ninety patients with 101 small renal tumors who received cryoablative therapy were investigated. The mean age of the patients was 68 years and 74.4% were male. Most tumors were smaller than 4 cm (89.1%) and the mean PADUA and R.E.N.A.L. scores were 8.65 and 7.35, respectively. Complications were observed in 12 cases. PADUA and R.E.N.A.L. scores demonstrated moderate predictive power (AUC = 0.58 and AUC = 0.63, respectively) for post-cryoablation complications. Conclusions Percutaneous cryoablation is a safe and effective treatment for small renal tumors. The R.E.N.A.L. and PADUA renal nephrometry scores have moderate predictive power for complications associated with percutaneous cryoablation of renal tumors. (AU)

Usefulness of renal nephrometry scoring systems in the prediction of complications associated to percutaneous image-guided treatment for small renal masses.

INTRODUCTION: Due to their increasing prevalence and complex management, renal tumors are challenging for health professionals. The study aims to evaluate the usefulness of R.E.N.A.L. and PADUA nephrometry scores in the prediction of complications after percutaneous cryoablation. MATERIAL AND METHODS: The study prospectively analyzed 90 patients with 101 stage T1a renal cell carcinoma (RCC) tumors treated with cryoablation. RESULTS: Ninety patients with 101 small renal tumors who received cryoablative therapy were investigated. The mean age of the patients was 68 years and 74.4% were male. Most tumors were smaller than 4 cm (89.1%) and the mean PADUA and R.E.N.A.L. scores were 8.65 and 7.35, respectively. Complications were observed in 12 cases. PADUA and R.E.N.A.L. scores demonstrated moderate predictive power (AUC = 0.58 and AUC = 0.63, respectively) for post-cryoablation complications. CONCLUSIONS: Percutaneous cryoablation is a safe and effective treatment for small renal tumors. The R.E.N.A.L. and PADUA renal nephrometry scores have moderate predictive power for complications associated with percutaneous cryoablation of renal tumors.

Present and future of Spanish Military Telemedicine / Presente y futuro de la Telemedicina Militar Española. 25 años de la Unidad de Telemedicina en el Hospital Central de la Defensa «Gómez Ulla»

Telemedicine consists of the exchange of health information between healthcare professionals, and between healthcare professionals and patients, through the use of information and communications technologies (ICT). It is already considered an emerging technology in what is commonly called the «Productivity Plateau». It is also probably an exponential growth technology, in which the «trigger» for such growth will be a mixture of new technologies such as portable sensors/ wearables that detect multiple patient data (Blood Pressure, Heart Rate, Respiratory Rate, Glycaemia, Temperature, etc.), better communications (5G), augmented and mixed reality (augmented and virtual), artificial intelligence systems to improve diagnosis, etc. In Spain, Military Telemedicine is a pioneer in the field. The main mission is to provide remote health support to health professionals or military personnel deployed in Operations and remote or difficult-to-access locations. In 2021 the Spanish Telemedicine Unit at Central Defense Hospital «Gómez Ulla» will celebrate its 25Th anniversary. This article discusses the aforementioned aspects of telemedicine as an emerging technology and describes the current mission, organization and capabilities of Spanish military telemedicine, as well as its future

La Telemedicina consiste en el intercambio de información sanitaria entre profesionales sanitarios, o entre profesional sanitario y paciente, mediante el uso de las tecnologías de la información y comunicaciones (TIC). Se considera ya una tecnología emergente en el denominado «Plateau de productividad». Probablemente se trate de una tecnología de crecimiento exponencial, en la cual el «gatillo» para dicho crecimiento será una mezcla de diferentes tecnologías, como nuevos sensores portátiles que detecten múltiples datos de los pacientes (Tensión Arterial, Frecuencia cardiaca, Frecuencia respiratoria, Glucemia, Temperatura, etc), mejores comunicaciones (5G), realidad aumentada y mixta (aumentada y virtual), sistemas de inteligencia artificial para ayuda al diagnóstico, etc. En España, la Telemedicina Militar es pionera en este campo. Su misión fundamental es el apoyo y asesoramiento sanitario a distancia a personal sanitario y también no sanitario, tanto en Zona de Operaciones (ZO) como en situación de aislamiento y/o localización remota. En 2021 el Servicio de Telemedicina del Hospital Central de la Defensa «Gomez Ulla» celebrará su 25 aniversario. En el artículo se tratan los mencionados aspectos acerca de la Telemedicina como tecnología emergente y se describe la misión, organización y capacidades actuales de la Telemedicina Militar Española, así como sus perspectivas de futuro

Carboxylate metabolism in sugar beet plants grown with excess Zn.

The effects of Zn excess on carboxylate metabolism were investigated in sugar beet (Beta vulgaris L.) plants grown hydroponically in a growth chamber. Root extracts of plants grown with 50 or 100µM Zn in the nutrient solution showed increases in several enzymatic activities related to organic acid metabolism, including citrate synthase and phosphoenolpyruvate carboxylase, when compared to activities in control root extracts. Root citric and malic acid concentrations increased in plants grown with 100µM Zn, but not in plants grown with 50µM Zn. In the xylem sap, plants grown with 50 and 100µM Zn showed increases in the concentrations of citrate and malate compared to the controls. Leaves of plants grown with 50 or 100µM Zn showed increases in the concentrations of citric and malic acid and in the activities of citrate synthase and fumarase. Leaf isocitrate dehydrogenase increased only in plants grown with 50µM Zn when compared to the controls. In plants grown with 300µM Zn, the only enzyme showing activity increases in root extracts was citrate synthase, whereas the activities of other enzymes decreased compared to the controls, and root citrate concentrations increased. In the 300µM Zn-grown plants, the xylem concentrations of citric and malic acids were higher than those of controls, whereas in leaf extracts the activity of fumarase increased markedly, and the leaf citric acid concentration was higher than in the controls. Based on our data, a metabolic model of the carboxylate metabolism in sugar beet plants grown under Zn excess is proposed.

Effects of zinc toxicity on sugar beet (Beta vulgaris L.) plants grown in hydroponics.

The effects of high Zn concentration were investigated in sugar beet (Beta vulgaris L.) plants grown in a controlled environment in hydroponics. High concentrations of Zn sulphate in the nutrient solution (50, 100 and 300 microm) decreased root and shoot fresh and dry mass, and increased root/shoot ratios, when compared to control conditions (1.2 microm Zn). Plants grown with excess Zn had inward-rolled leaf edges and a damaged and brownish root system, with short lateral roots. High Zn decreased N, Mg, K and Mn concentrations in all plant parts, whereas P and Ca concentrations increased, but only in shoots. Leaves of plants treated with 50 and 100 microm Zn developed symptoms of Fe deficiency, including decreases in Fe, chlorophyll and carotenoid concentrations, increases in carotenoid/chlorophyll and chlorophyll a/b ratios and de-epoxidation of violaxanthin cycle pigments. Plants grown with 300 microm Zn had decreased photosystem II efficiency and further growth decreases but did not have leaf Fe deficiency symptoms. Leaf Zn concentrations of plants grown with excess Zn were high but fairly constant (230-260 microg.g(-1) dry weight), whereas total Zn uptake per plant decreased markedly with high Zn supply. These data indicate that sugar beet could be a good model to investigate Zn homeostasis mechanisms in plants, but is not an efficient species for Zn phytoremediation.

[Helicobacter pylori infection in the child population in Spain: prevalence, related factors and influence on growth]. / Infección por Helicobacter pylori en población infantil: prevalencia, factores asociados e influencia sobre el crecimiento.

INTRODUCTION: A causal relationship between Helicobacter pylori infection and the occurrence of digestive diseases in adults and children has been proven. Worldwide, the prevalence of H. pylori varies and it is possibly influenced by differences in the level of development. The goals of this study were a) to ascertain the prevalence of H. pylori infection in the child population in Spain, b) to study several factors related to this infection, and c) to establish its possible influence on growth. PATIENTS AND METHODS: We performed a descriptive, cross-sectional survey of a representative sample of children aged 1 to 14 years old. The sample consisted of 284 children (prevalence 5 15 %; accuracy 5 4 %; CI > 95 %), selected at random and stratified by age and sex. A pre-coded questionnaire was used for data collection. Diagnosis of H. pylori was established by detection of H. pylori antigen in stools with enzyme immunoassay. RESULTS: The sample consisted of 144 boys and 140 girls, with a mean age of 6.89 6 4.25 years. The prevalence of H. pylori infection was 15.8 % and progressively increased with age: 1- to 3-year-olds (8.4 %), 4- to 9-year-olds (13.9 %), 10- to 14-year-olds (24 %) (p < 0.05). The prevalence was significantly higher in boys (p < 0.01). Analysis of socio-environmental variables showed a higher H. pylori infection rate in children from families with a low socioeconomic level (p < 0.01), a high rate of overcrowding (p < 0.05), and in immigrants (p < 0.001). The H. pylori infection rate was higher in children with recurrent abdominal pain (p < 0.001) and in those whose parents had suffered from gastroduodenal disease (p < 0.001). H. pylori infection was more frequent in children aged 10 to 14 years old with weight and height percentiles below the 25th percentile (p < 0.05). Comparison of means revealed no significant differences. CONCLUSIONS: The prevalence of H. pylori infection found in our study was slightly lower than that found in other studies carried out in Spain; our data were more similar to those of industrialized countries. H. pylori infection was linked to age, sex and deprived socioeconomic environments, and was more frequent in children with recurrent abdominal pain and in those whose parents suffered from gastroduodenal disease. H. pylori infection did not seem to negatively affect growth in our child population.

Infección por Helicobacter pylori en población infantil: prevalencia, factores asociados e influencia sobre el crecimiento / Helicobacter pylori infection in the child population in Spain: Prevalence, related factors and influence on growth

Introducción: Está demostrado que hay relación de causalidad entre la infección por Helicobacter pylori y la aparición de patología digestiva en adultos y niños. La prevalencia mundial es variable y posiblemente está influida por el grado de desarrollo. Los objetivos de este estudio son conocer la prevalencia de infección por H. pylori en nuestra población infantil, analizar diversos factores asociados a esta infección y estudiar su posible influencia sobre el crecimiento. Pacientes y métodos: Estudio descriptivo transversal realizado en una muestra representativa de la población de niños con edades entre 1 y 14 años. El tamaño muestral es de 284 niños (prevalencia 5 15 %; precisión 5 4 %; IC > 95 %). La muestra fue elegida de manera aleatoria y estratificada por edades y sexo. Se recogen datos en un cuestionario precodificado. El diagnóstico de infección por H. pylori se realiza por detección de antígeno de H. pylori en heces mediante enzimoinmunoanálisis. Resultados: La muestra estaba formada por 144 niños y 140 niñas con una media de edad de 6,89 6 4,25 años. La prevalencia de infección por H. pylori fue del 15,8 %. Esta aumenta progresivamente con la edad: 1-3 años (8,4 %); 4-9 años (13,9 %), y 10-14 años (24 %) (p < 0,05) y es más frecuente en varones (p < 0,01). El análisis de las variables socioambientales demuestran elevada frecuencia de infección por H. pylori en niños de familias con bajo nivel socioeconómico (p < 0,01), alto índice de hacinamiento (p < 0,05) e inmigrantes (p < 0,001). Se observa mayor frecuencia de H. pylori en niños que presentan dolor abdominal recurrente (DAR) (p < 0,001) y cuyos padres presentan patología gastroduodenal (p < 0,001). Con más frecuencia de la esperada aparece H. pylori en niños de 10 a 14 años con percentiles de peso y talla < P25 (p < 0,05). En el contraste de medias no se observan diferencias significativas. Conclusiones: La prevalencia de infección por H. pylori en nuestro estudio es algo menor de lo encontrado en otros estudios realizados en nuestro país, ya que se acerca al patrón de países industrializados. Está asociado a la edad, sexo y ambientes socioeconómicos poco favorecidos. Es más frecuente esta infección en niños con DAR y cuando los padres sufren patología gastroduodenal. Esta infección parece no influir negativamente en el crecimiento de los niños de nuestra población infantil

Introduction: A causal relationship between Helicobacter pylori infection and the occurrence of digestive diseases in adults and children has been proven. Worldwide, the prevalence of H. pylori varies and it is possibly influenced by differences in the level of development. The goals of this study were a) to ascertain the prevalence of H. pylori infection in the child population in Spain, b) to study several factors related to this infection, and c) to establish its possible influence on growth. Patients and methods: We performed a descriptive, cross-sectional survey of a representative sample of children aged 1 to 14 years old. The sample consisted of 284 children (prevalence 5 15 %; accuracy 5 4 %; CI > 95 %), selected at random and stratified by age and sex. A pre-coded questionnaire was used for data collection. Diagnosis of H. pylori was established by detection of H. pylori antigen in stools with enzyme immunoassay. Results: The sample consisted of 144 boys and 140 girls, with a mean age of 6.89 6 4.25 years. The prevalence of H. pylori infection was 15.8 % and progressively increased with age: 1- to 3-year-olds (8.4 %), 4- to 9-year-olds (13.9 %), 10- to 14-year-olds (24 %) (p < 0.05). The prevalence was significantly higher in boys (p < 0.01). Analysis of socio-environmental variables showed a higher H. pylori infection rate in children from families with a low socioeconomic level (p < 0.01), a high rate of overcrowding (p < 0.05), and in immigrants (p < 0.001). The H. pylori infection rate was higher in children with recurrent abdominal pain (p < 0.001) and in those whose parents had suffered from gastroduodenal disease (p < 0.001). H. pylori infection was more frequent in children aged 10 to 14 years old with weight and height percentiles below the 25th percentile (p < 0.05). Comparison of means revealed no significant differences. Conclusions: The prevalence of H. pylori infection found in our study was slightly lower than that found in other studies carried out in Spain; our data were more similar to those of industrialized countries. H. pylori infection was linked to age, sex and deprived socioeconomic environments, and was more frequent in children with recurrent abdominal pain and in those whose parents suffered from gastroduodenal disease. H. pylori infection did not seem to negatively affect growth in our child population

Magnetic characterisation of rat muscle tissues after subcutaneous iron dextran injection.

Ex vivo freeze-dried rat muscle tissues, collected at different times t after a single dose of subcutaneously injected iron dextran, have been magnetically characterised. The AC susceptibility of the tissues shows an overall superparamagnetic behaviour and the dependence on t of, especially, the out-of-phase component is remarkably systematic despite the fact that each tissue originates in a different rat individual. The experiments show that the akaganéite (beta-FeOOH) nanoparticles contained in the injected drug are progressively degraded in the living tissue and, at times of the order of 1 month and for all the analysed rat individuals, converge to a magnetically well-defined species with much narrower magnetic activation energy distribution than iron dextran. Thorough transmission electron microscopy experiments of the same tissues indicate the presence of oxyhydroxide particles, whose size decreases for increasing t in agreement with the interpretation of the magnetic susceptibility. The conclusions drawn from the magnetic study do well correspond to the properties of the whole tissue since no biochemical extraction work has been done. The AC susceptibility appears to be a valuable and complementary tool in pharmacological studies of iron-containing drugs.

Seasonal changes in photosynthesis and photoprotection in a Quercus ilex subsp. ballota woodland located in its upper altitudinal extreme in the Iberian Peninsula.

Quercus ilex L. subsp. ballota (Desf.) Samp., a Mediterranean evergreen species growing in a continental Mediterranean climate, did not experience water stress and showed greater sensitivity to winter stress than to summer stress over a 12-month period. Net CO2 assimilation rates and photosystem II (PSII) efficiency decreased markedly during the cold months and recovered completely in spring. Lutein, neoxanthin and beta-carotene to chlorophyll (Chl) molar ratios all showed the same trend throughout the year, increasing from September to March. This increase was a result of increases in carotenoid concentrations, because Chl concentration per unit leaf area remained stable, and was higher at the end than at the beginning of the first growing season. Lutein-epoxide was a minor component of the total lutein pool. Thermal energy dissipation and non-photochemical quenching (NPQ) were associated with the de-epoxidated forms of the xanthophyll cycle pigments in the warm months. Photosynthetic rates decreased slightly at midday in summer. These changes were accompanied by decreases in maximum potential PSII efficiency (which recovered during the night), actual and intrinsic PSII efficiencies, photochemical quenching and increases in NPQ. Overall, our data indicate down-regulation of photosynthesis during the summer. The diurnal de-epoxidation of violaxanthin to antheraxanthin and zeaxanthin occurred throughout the year, except in January. Antioxidant enzymatic activity increased in the winter months, especially during the coldest months, highlighting its key role in photoprotection against photo-oxidation. Structural and functional modifications protected PSII from permanent damage and allowed 1-year-old leaves to photosynthesize at high rates when temperatures increased in spring.

Tratamiento conservador de la fimosis en niños: nuestra experiencia con esteroides tópicos / Conservative treatment of phimosis in children: our experience with topical steroids

Objetivo. Evaluar los resultados del uso de esteroides tópicos a largo plazo en el tratamiento de la fimosis en la infancia. Pacientes y métodos. Estudio prospectivo realizado durante los años 2001 y 2002. Niños de 3 a 14 años con fimosis recibieron administración tópica de betametasona en crema dos veces al día durante 5 semanas, además de la retracción del prepucio después del quinto día de tratamiento. Los resultados fueron evaluados al finalizar el tratamiento, a los seis meses y un año más tarde. Resultados. Completaron el tratamiento y se realizó seguimiento en 45 niños. La edad media fue de 5,3 años. Al inicio del estudio, 13 niños tenían fimosis puntiforme, 13 presentaban anillo flmótico no retraible y 19 fimosis anular retraible. A las 5 semanas, 38 niños (84,4 por ciento) tenían la fimosis corregida totalmente; a los 6 meses y al año, esta cifra disminuyó a 32 (71,1 por ciento) y 30 (66,7 por ciento), respectivamente. No se apreciaron diferencias significativas en cuanto al porcentaje de respuesta entre los pacientes con diferentes tipos de fimosis y grupos de edad. En todos los pacientes con fimosis recurrente se pudo comprobar que el cumplimiento en las recomendaciones de manejo del prepucio fue deficiente. En todos los casos, el tratamiento fue bien tolerado, sin presencia de efectos secundarios locales ni sistémicos. Conclusiones. Con el tratamiento tópico de la fimosis mediante esteroides se obtienen muy buenos resultados; es seguro, sencillo y económico, y constituye una alternativa a la cirugía. Asimismo, es bien aceptado por los padres y los niños. Es fundamental el cambio de hábitos en la higiene y manejo del prepucio para el éxito a largo plazo (AU)

[Isolated non-compaction of the ventricular myocardium]. / Miocardio ventricular no compacto aislado.

Isolated non-compaction of the ventricular myocardium is a rare disorder of endomyocardial morphogenesis characterized by numerous, excessively prominent ventricular trabeculations, probably due to arrest of normal endomyocardial embryogenesis. We report two cases of isolated non-compaction of the ventricular myocardium.The first patient had a brother who died in the first year of life after heart transplantation due to refractory heart failure caused by restrictive biventricular cardiomyopathy associated with a right ventricular diverticulum. This could have been a case of isolated non-compaction of the ventricular myocardium that was not diagnosed. The patient, who is 8 years old, is asymptomatic and echocardiogram (ECG) showed multiple prominent ventricular trabeculations in the apical portion of the left ventricle, slightly depressed systolic and diastolic function and restrictive ventricular filling pattern.The second patient is a 7-year-old boy who presents recurrent syncopes. ECG showed multiple prominent ventricular trabeculations, restrictive ventricular filling pattern and normal systolic function. The Holter ECG recording showed multiple premature ventricular complexes and nonsustained ventricular tachycardia. An implantable subcutaneous Holter recorder was inserted, which was associated with an episode of aborted sudden death and polymorphic ventricular tachycardia followed by asystole. The patient was then treated with an implantable defibrillator.

Photosynthetic responses to water deficit in six Mediterranean sclerophyll species: possible factors explaining the declining distribution of Rhamnus ludovici-salvatoris, an endemic Balearic species.

We sought to explain the declining distribution in the Balearic Islands of the endemic shrub Rhamnus ludovici-salvatoris R. Chodat, by comparing its photosynthetic response to drought with that of several widely distributed, competing Mediterranean species (R. alaternus L., Quercus ilex L., Pistacia lentiscus L., Q. humilis Mill. and P. terebinthus L.). All of the study species, except for the two Rhamnus species, avoided desiccation by rapidly adjusting their stomatal conductance at the onset of drought, and maintaining constant leaf relative water content. The two Rhamnus species showed desiccation-tolerant behavior; i.e., as drought progressed, their predawn leaf relative water content decreased simultaneously with stomatal closure. All four desiccation-avoiding species showed a significant positive correlation between leaf thermal dissipation (estimated by the fluorescence parameter NPQ (non-photochemical quenching)) and the de-epoxidation state of the xanthophyll cycle (DPS). The two Rhamnus species exhibited maximum DPS regardless of treatment, but only R. alaternus increased NPQ in response to drought. Rhamnus ludovici-salvatoris had a high ratio of photorespiration to photosynthesis and a low intrinsic water-use efficiency; traits that are likely to be unfavorable for plant productivity under arid conditions. It also had the lowest DPS and thermal dissipation among the six species. We conclude that the photosynthetic traits of R. ludovici-salvatoris account for its limited ability to compete with other species in the Mediterranean region.

Characterization of the responses of cork oak (Quercus suber) to iron deficiency.

We studied responses of cork oak (Quercus suber L.) to iron (Fe) deficiency by comparing seedlings grown hydroponically in nutrient solution with and without Fe. Seedlings grown without Fe developed some responses typical of the Strategy I group of Fe-efficient plants, including two- and fourfold increases in plasma membrane ferric chelate reductase activity of root tips after 2 and 4 weeks of culture in the absence of Fe, respectively. Moreover, seedlings grown hydroponically for 2 weeks without Fe caused marked decreases in the pH of the nutrient solution, indicating that root plasma membrane ATPase activity was induced by Fe deficiency. Iron deficiency also caused marked decreases in leaf chlorophyll and carotenoid concentrations, and chlorophyll concentrations were decreased more than carotenoid concentrations. Iron deficiency resulted in an 8% decrease in the dark-adapted efficiency of photosystem II and a 43% decrease in efficiency of photosystem II at steady-state photosynthesis. No major root morphological changes were observed in seedlings grown without Fe, although seedlings grown in Fe-deficient nutrient solution had light-colored roots in contrast to the dark brown color of control roots.

Iron deficiency-associated changes in the composition of the leaf apoplastic fluid from field-grown pear (Pyrus communis L.) trees.

Experiments have been carried out with field-grown pear trees to investigate the effect of iron chlorosis on the composition of the leaf apoplast. Iron deficiency was associated with an increase in the leaf apoplastic pH from the control values of 5.5-5.9 to 6.5-6.6, as judged from direct pH measurements in apoplastic fluid obtained by centrifugation and fluorescence of leaves incubated with 5-CF. The major organic acids found in leaf apoplastic fluid of iron-deficient and iron-sufficient pear leaves were malate, citrate and ascorbate. The total concentration of organic acids was 2.9 mM in the controls and increased to 5.5 mM in Fe-deficient leaves. The total apoplastic concentration of inorganic cations (Ca, K and Mg) increased with Fe deficiency from 15 to 20 mM. The total apoplastic concentration of inorganic anions (Cl-, NO3-, SO4(2-) and HPO4(2-)) did not change with Fe deficiency. Iron concentrations decreased from 4 to 1.6 microM with Fe deficiency. The major Fe species predicted to exist in the apoplast was [FeCitOH](-1) in both Fe-sufficient and deficient leaves. Organic acids in whole leaf homogenates increased from 20 to 40 nmol x m(-2) with Fe deficiency. The accumulation of organic anions in the Fe-deficient leaves does not appear to be associated to an increased C fixation in leaves, but rather it seems to be a consequence of C transport via xylem.

[Gastritis caused by Helicobacter heilmannii (Gastrospirillum hominis). Report of 3 cases]. / Gastritis por Helicobacter heilmannii (Gastrospirillum hominis). Descripción de tres casos.

Helicobacter heilmannii infection is rare. Its clinical picture is rather different from that caused by Helicobacter pylori: alterations in the gastric mucosa are milder and mainly located in the gastric antrum, and the frequency of erosions and ulcers is lower. It has been described in association with conditions similar to those related to H. pylori: peptic ulcer, chronic gastritis, gastric adenocarcinoma, intestinal metaplasia and MALT (mucose associated lymphoid tissue) lymphoma, although the incidence is lower. We describe three cases of gastritis caused by H. heilmannii, which we consider to be of interest because of the absence of cases published in Spain. One of the cases is especially unusual because of its association with a duodenal ulcer. We also describe the main features of H.r heilmannii. Its clinical treatment is similar to that used in H. pylori, with demonstrated morphological improvement of the lesions after eradication of the infectious agent.

Technical advance: reduction of Fe(III)-chelates by mesophyll leaf disks of sugar beet. Multi-component origin and effects of Fe deficiency.

The characteristics of the Fe(III)-chelate reductase activity have been investigated in mesophyll disks of Fe-sufficient and Fe-deficient sugar beet leaves. The Fe(III)-chelate reductase activity of mesophyll disks was light dependent and increased markedly when the epidermis was removed. Iron(III)-citrate was photo-reduced directly by light in the absence of plant tissue. Total reductase activity was the sum of enzymatic mesophyll reduction, enzymatic reduction carried out by organelles exposed at the disk edge and reduction caused by the release of substances both by exposed mesophyll cells and at the disk edge. Compounds excreted were shown by HPLC to include organic anions, mainly oxalate, citrate and malate. When expressed on a leaf surface basis, Fe deficiency decreased the total mesophyll Fe(III)-chelate reductase activity. However, Fe-sufficient disks reduced less Fe than the Fe-deficient ones when expressed on a chlorophyll basis. The optimal pH values for Fe(III) reduction were always in the range 6.0-6.7. In control leaves Fe(III)-citrate and Fe(III)-malate were the substrates that led to the highest Fe reduction rates. In Fe-deficient leaves Fe(III)-malate led to the highest Fe reduction rates, followed by Fe(III)-EDTA and then Fe(III)-citrate. K:(m) values for the total reductase activity, enzymatic mesophyll reduction and enzymatic reduction carried out by organelles at the disk edge were obtained.

Iron deficiency interrupts energy transfer from a disconnected part of the antenna to the rest of Photosystem II.

Iron deficiency changed markedly the shape of the leaf chlorophyll fluorescence induction kinetics during a dark-light transition, the so-called Kautsky effect. Changes in chlorophyll fluorescence lifetime and yield were observed, increasing largely the minimal and the intermediate chlorophyll fluorescence levels, with a marked dip between the intermediate and the maximum levels and loss of the secondary peak after the maximum. During the slow changes, the lifetime-yield relationship was found to be linear and curvilinear (towards positive lifetime values) in control and Fe-deficient leaves, respectively. These results suggested that part of the Photosystem II antenna in Fe-deficient leaves emits fluorescence with a long lifetime. In dark-adapted Fe-deficient leaves, measurements in the picosecond-nanosecond time domain confirmed the presence of a 3.3-ns component, contributing to 15% of the total fluorescence. Computer simulations revealed that upon illumination such contribution is also present and remains constant, indicating that energy transfer is partially interrupted in Fe-deficient leaves. Photosystem II-enriched membrane fractions containing different pigment-protein complexes were isolated from control and Fe-deficient leaves and characterized spectrophotometrically. The photosynthetic pigment composition of the fractions was also determined. Data revealed the presence of a novel pigment-protein complex induced by Fe deficiency and an enrichment of internal relative to peripheral antenna complexes. The data suggest a partial disconnection between internal Photosystem II antenna complexes and the reaction center, which could lead to an underestimation of the Photosystem II efficiency in dark-adapted, low chlorophyll Fe-deficient leaves, using chlorophyll fluorescence.

Effects of iron deficiency on the composition of the leaf apoplastic fluid and xylem sap in sugar beet. Implications for iron and carbon transport.

The effects of iron deficiency on the composition of the xylem sap and leaf apoplastic fluid have been characterized in sugar beet (Beta vulgaris Monohil hybrid). pH was estimated from direct measurements in apoplastic fluid and xylem sap obtained by centrifugation and by fluorescence of leaves incubated with 5-carboxyfluorescein and fluorescein isothiocyanate-dextran. Iron deficiency caused a slight decrease in the pH of the leaf apoplast (from 6.3 down to 5.9) and xylem sap (from 6.0 down to 5.7) of sugar beet. Major organic acids found in leaf apoplastic fluid and xylem sap were malate and citrate. Total organic acid concentration in control plants was 4.3 mM in apoplastic fluid and 9.4 mM in xylem sap and increased to 12.2 and 50.4 mM, respectively, in iron-deficient plants. Inorganic cation and anion concentrations also changed with iron deficiency both in apoplastic fluid and xylem sap. Iron decreased with iron deficiency from 5.5 to 2.5 microM in apoplastic fluid and xylem sap. Major predicted iron species in both compartments were [FeCitOH](-1) in the controls and [FeCit(2)](-3) in the iron-deficient plants. Data suggest the existence of an influx of organic acids from the roots to the leaves via xylem, probably associated to an anaplerotic carbon dioxide fixation by roots.

Responses of sugar beet roots to iron deficiency. Changes in carbon assimilation and oxygen use.

Different root parts with or without increased iron-reducing activities have been studied in iron-deficient and iron-sufficient control sugar beet (Beta vulgaris L. Monohil hybrid). The distal root parts of iron-deficient plants, 0 to 5 mm from the root apex, were capable to reduce Fe(III)-chelates and contained concentrations of flavins near 700 microM, two characteristics absent in the 5 to 10 mm sections of iron-deficient plants and the whole root of iron-sufficient plants. Flavin-containing root tips had large pools of carboxylic acids and high activities of enzymes involved in organic acid metabolism. In iron-deficient yellow root tips there was a large increase in carbon fixation associated to an increase in phosphoenolpyruvate carboxylase activity. Part of this carbon was used, through an increase in mitochondrial activity, to increase the capacity to produce reducing power, whereas another part was exported via xylem. Root respiration was increased by iron deficiency. In sugar beet iron-deficient roots flavins would provide a suitable link between the increased capacity to produce reduced nucleotides and the plasma membrane associated ferric chelate reductase enzyme(s). Iron-deficient roots had a large oxygen consumption rate in the presence of cyanide and hydroxisalycilic acid, suggesting that the ferric chelate reductase enzyme is able to reduce oxygen in the absence of Fe(III)-chelates.

Valoración de un ventilador volumétrico en condiciones hipobáricas. Metodología de un modelo experimental / Evaluation of a volumetric ventilator in hypobaric conditions. Methodology and experimental model

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