Stoneflies left over from a mining disaster: new species and records of Perlidae (Plecoptera) from the Doce River basin, southeastern Brazil.

Seven years after a mudflow reached an important area of the Doce River basin, southeastern Brazil, and with the objective of reporting the current Plecoptera fauna, specimens of Anacroneuria Klaplek, 1909 (Plecoptera: Perlidae) were studied. Three new records from this basin are included: A. mineira Novaes & Bispo, 2014; A. atrifrons Klaplek, 1922; and Anacroneuria itatiaiensis Baldin, Bispo & Novaes, 2013. A new species is described: A. piranga sp. nov. Castillo-Velsquez, Gonalves & Salles. The new species is morphologically similar to A. annulicauda Stark & Kondratieff, 2004 and A. atrifrons, but can be distinguished by the keel of the penial armature, which is flat and pointed at the apex. In addition to its description, photographs of all species are included, as well as a detailed description of the habitat of the new species.

New species of Rivudiva Lugo-Ortiz amp; McCafferty (Ephemeroptera: Baetidae) with comments on R. minantenna Lugo-Ortiz amp; McCafferty and R. trichobasis Lugo-Ortiz amp; McCafferty.

Based on nymphs collected in Espírito Santo and Amazonas, Southeastern and Northern Brazil, two new species of the genus Rivudiva Lugo-Ortiz McCafferty, 1998 (Ephemeroptera: Baetidae) are described. Rivudiva inma sp. nov. shares several characteristics with R. minantenna Lugo-Ortiz McCafferty, 1998, but can be distinguished by details of leg setation, such as length and shape of robust setae and presence of setae on trochanter. Rivudiva oonirikoperi sp. nov. is more similar to R. trichobasis Lugo-Ortiz McCafferty, 1998, but can be separated by the absence of setae on scape and pedicel, shape of distal margin of labrum, and length of maxillary palp. New diagnoses and illustrations are provided for R. minantenna and R. trichobasis, as well as a key to the known nymphs of Rivudiva species.

Two new species of Atopophlebia Flowers, 1980 (Ephemeroptera, Leptophlebiidae) from Colombia.

Atopophlebia pacis sp. nov. and Atopophlebia caldasi sp. nov. are newly described based on material from Colombia, Putumayo and Caldas, respectively. Both species are known from nymphs and alate stages, male imago for A. pacis, male subimago, female imago and eggs for A. caldasi. This is the first description of eggs of the genus. The following characteristics are useful for distinguishing the males of the new species: A. pacis sp. nov., 1) eyes meeting on meson of head; 2) fore wings hyaline, veins yellow (Fig. 2); 3) fore tibia completely tinged with black; 4) abdominal segments yellowish, terga VIII with conspicuous triangular anterolateral black mark (Fig. 1); 5) apical projection of penis lobe short; A. caldasi sp. nov., 1) eyes meeting on meson of head; 2) fore tibia completely tinged with black; 3) abdominal segments orange, posterior margin of all terga tinged with black, black bands broader on terga V to VIII. Egg of A. caldasi is characterized by presenting a prismatic shape with longitudinal chorionic depressions at the sides and concave polar regions. An updated key for male adults of Atopophlebia is presented.

Biocompatible porous metal-organic framework nanoparticles based on Fe or Zr for gentamicin vectorization.

Due to their high porosity and versatile composition and structure, nanoscaled Metal-Organic Frameworks (nanoMOFs) have been recently proposed as novel drug delivery systems, and have been demonstrated to have important capacities and potential for controlled release of different active ingredients. Gentamicin (GM; a broad spectrum aminoglycoside antibiotic indicated in bacterial septicemia therapy) has great therapeutic interest, but the associated bioavailability and toxicity drawbacks accompanying high doses and repeated administration of this free drug make its encapsulation inside new nanocarriers necessary. GM encapsulation within two different porous biofriendly Fe and Zr-carboxylates nanoMOFs was performed by a simple impregnation method, with full characterization of the resulting GM-containing solid using a large panel of techniques (X ray powder diffraction-XRPD, Fourier transform infrared spectroscopy-FTIR, thermogravimetric analysis-TGA, N2 sorption, scanning electron microscopy-SEM, dynamic light scattering-DLS, ζ-potential, fluorescence spectroscopy and molecular simulations). High reproducible encapsulation rates, reaching 600 µg of GM per·mg of formulation, were obtained using the biocompatible mesoporous iron(III) trimesate nanoparticles (NPs) MIL-100(Fe) (MIL: Materials from Institut Lavoisier). In vitro GM delivery studies were also carried out using different oral and intravenous simulated physiological conditions, with complete antibiotic release within 8 h when using protein free media, but lower release rates in the presence of proteins. Furthermore, in vitro toxicity of GM-containing MIL-100(Fe) NPs was investigated on two different cell lines: a monocyte from leukemia (THP-1) and adherent fibroblastoid cells (NIH/3T3). These nanoMOFs had a low cytotoxic profile with IC50 values up to 1 mg·mL-1, ensuring adequate cell proliferation after 24 h. Finally, antibacterial activity studies were carried out on two Gram-positive bacteria and one Gram-negative bacterium: S. aureus, S. epidermidis and P. aeruginosa, respectively. GM-loaded MIL-100(Fe) NPs exhibited the same activity as free GM, confirming that the antibiotic activity of the released GM was conserved.

Corinnella lourii, a rare new species of Baetidae (Ephemeroptera) from central Brazil.

A new species of the rare genus Corinnella is described based on nymphs from the Rio Pindaíba, a river located close to the Cerrado - Amazonian border. The new species is more related to C. eximia than to C. thomasi, but can be distinguished from them by the following combination of characters: 1) distomedial emargination of labrum broad and with very small process; 2) maxillary palp 2.0× length of galea-lacinia; 3) posterior margin of terga I-IX with pointed spaced spines; 4) claws with four denticles.

Chitosan-coated mesoporous MIL-100(Fe) nanoparticles as improved bio-compatible oral nanocarriers.

Nanometric biocompatible Metal-Organic Frameworks (nanoMOFs) are promising candidates for drug delivery. Up to now, most studies have targeted the intravenous route, related to pain and severe complications; whereas nanoMOFs for oral administration, a commonly used non-invasive and simpler route, remains however unexplored. We propose here the biofriendly preparation of a suitable oral nanocarrier based on the benchmarked biocompatible mesoporous iron(III) trimesate nanoparticles coated with the bioadhesive polysaccharide chitosan (CS). This method does not hamper the textural/structural properties and the sorption/release abilities of the nanoMOFs upon surface engineering. The interaction between the CS and the nanoparticles has been characterized through a combination of high resolution soft X-ray absorption and computing simulation, while the positive impact of the coating on the colloidal and chemical stability under oral simulated conditions is here demonstrated. Finally, the intestinal barrier bypass capability and biocompatibility of CS-coated nanoMOF have been assessed in vitro, leading to an increased intestinal permeability with respect to the non-coated material, maintaining an optimal biocompatibility. In conclusion, the preservation of the interesting physicochemical features of the CS-coated nanoMOF and their adapted colloidal stability and progressive biodegradation, together with their improved intestinal barrier bypass, make these nanoparticles a promising oral nanocarrier.

Skull reconstruction after resection of bone tumors in a single surgical time by the association of the techniques of rapid prototyping and surgical navigation.

PURPOSE: Presentation of a new cranioplasty technique employing a combination of two technologies: rapid prototyping and surgical navigation. This technique allows the reconstruction of the skull cap after the resection of a bone tumor in a single surgical time. METHODS: The neurosurgeon plans the craniotomy previously on the EximiusMed software, compatible with the Eximius Surgical Navigator, both from the company Artis Tecnologia (Brazil). The navigator imports the planning and guides the surgeon during the craniotomy. The simulation of the bone fault allows the virtual reconstruction of the skull cap and the production of a personalized modelling mold using the Magics-Materialise (Belgium)-software. The mold and a replica of the bone fault are made by rapid prototyping by the company Artis Tecnologia (Brazil) and shipped under sterile conditions to the surgical center. The PMMA prosthesis is produced during the surgical act with the help of a hand press. RESULTS: The total time necessary for the planning and production of the modelling mold is four days. The precision of the mold is submillimetric and accurately reproduces the virtual reconstruction of the prosthesis. The production of the prosthesis during surgery takes until twenty minutes depending on the type of PMMA used. The modelling mold avoids contraction and dissipates the heat generated by the material's exothermic reaction in the polymerization phase. The craniectomy is performed with precision over the drawing made with the help of the Eximius Surgical Navigator, according to the planned measurements. The replica of the bone fault serves to evaluate the adaptation of the prosthesis as a support for the perforations and the placement of screws and fixation plates, as per the surgeon's discretion. CONCLUSIONS: This technique allows the adequate oncologic treatment associated with a satisfactory aesthetic result, with precision, in a single surgical time, reducing time and costs.

Revealing the diversity of Cloeodes Traver, 1938 (Ephemeroptera: Baetidae) in the Neotropics: description of eleven new species from Brazilian mountain ranges.

In the present work, based on material from distinct mountain ranges in Brazil, 11 new species of Cloeodes with hind wings or hind wing pads are described, illustrated and discussed. Among the new species, in C. aiuruoca, C. amantykyra, C. atlanticus, C. boldrinii and C. ioachimi, the apex of the fore femora in the nymphs is extremely projected (a characteristic previously found only in two species of the genus). Cloeodes guara and C. tracheatus share the presence of unusual large and dark gills. Cloeodes melanotarsus is readily distinguished by conspicuous blackish tarsi, C. lucifer by the bright yellow coloration of tergum I, and C. xyrognathos by blade-like incisors. Cloeodes magnus, besides being the largest species of the genus, with a body size reaching 12 mm, possess short maxillary palp. Comments on the presence of C. irvingi and C. opacus in Brazil are also provided. An interactive online key is provided for the nymphs of all the species of Cloeodes in which hind wing pads are present.

Revision of Campsurus violaceus species group (Ephemeroptera: Polymitarcyidae) with new synonymies and nomina dubia in Campsurus Eaton, 1868.

The violaceus species group (formerly notatus species group) of Campsurus Eaton is revised. All the species in the violaceus group are diagnosed. A new species, C. molinai sp. nov. is described based on male imagos from Bolivia, characterized by their large and sclerotized penes. The violaceus group is proposed to include the following species: C. assimilis Traver, C. truncatus Ulmer (=C. mahunkai Puthz = C. melanocephalus Pereira & da Silva, new synonyms), C. violaceus Needham & Murphy (= C. meyeri Navás = C. notatus Needham & Murphy = C. paranensis Navás, new synonyms), C. emersoni Traver, C. decoloratus (Hagen), and C. molinai sp.nov. Additionally we consider the following species as nomina dubia: C. longicauda Navás, C. pfeifferi Navás, C. zikani Navás, C. albicans (orig. Ephemera albicans Percheron in Guerin & Percheron), C. burmeisteri Ulmer, C. dallasi Navás, C. quadridentatus Eaton, C. claudus Needham & Murphy, C. corumbanus Needham & Murphy, C. dorsalis (Burmeister), C. mutilus Needham & Murphy, and C. striatus Needham & Murphy. Given the results presented herein (five species synonymized and 12 proposed as nomina dubia), only 28 valid species remain in the genus Campsurus. Additionally, the nymphal stages of C. violaceus and C. truncatus are described and illustrated. Female adult genitalia (sockets) and eggs of C. decoloratus are described for the first time. Diagnoses, new country records, and redescriptions of selected characters of the imagos for the species of the violaceus group are given.

[Recovery of maxillary tooth sensibility after Le Fort I osteotomy]. / Récupération de la sensibilité dentaire maxillaire après ostéotomie de Le Fort I.

INTRODUCTION: Upper alveolar nerves, when injured during Le Fort I osteotomies, alter maxillary tooth sensitivity. We had for aim to analyze post-operative maxillary tooth sensitivity recovery. MATERIAL AND METHODS: We conducted a prospective study in a series of patients having undergone Le Fort I osteotomy, with, or without mandibular osteotomy or intermaxillary disjunction (IMD). The direction and range of displacement of the maxillary bone were recorded. One tooth in each alveolar sector (incisivocanine, premolar, molar) was tested with an electric stimulator for each patient. The tests were performed before (D-1), and after surgery (D2 or day+2, D+15, M2 (or month +2), M3, and M6). RESULTS: Twenty-two patients were included. Among the tested teeth, 91.9 % were sensitive at D-1. At D2, only 12.7 % of teeth were sensitive. At D15, M2, M3, and M6, the sensitivity was respectively 33.3 %, 43.1 %, 50 %, and 61.8 %. The recovery of sensitivity was faster in young patients (under 35 years of age) and for upper middle and superior alveolar nerves. There was no difference regarding the direction of maxillary movement. DISCUSSION: Among the teeth that were sensitive before surgery, 87.3 % had not regained sensitivity at D2. The recovery of sensitivity increased at D15. A great displacement of the maxillary bone was an aggravating factor for loss of tooth sensitivity.

Lithotripsy for salivary stones with prospective US assessment on our first 25 consecutive patients.

OBJECTIVES: To evaluate the predictive value of sonographic fragmentation in the successful treatment of sialolithiasis. The main objective was to streamline the management by treating the patients with three sessions of ultrasonic lithotripsy, and to compare the success rate and complications with data from the literature. A second objective was to analyse the predictive value of data from the post procedure and follow-up sonography related to therapeutic success with regard to size, site and location of stones. MATERIAL AND METHODS: Prospective follow-up of 25 patients (mean age of 43 ± 17.2 years old 11-68; 13 women, 10 men) over a period of 31 months (October 2009-April 2012) with one or more salivary calculi (19 parotid, submandibular 6) treated with extracorporeal lithotripsy (electromagnetic MINILITH SL 1, Storz Medical, Switzerland). No anaesthesia or analgesia was used. Each session of lithotripsy lasted on average 30 min. Minor complications were collected on an anonymised sheet. RESULTS: Complete success (absence of clinical symptoms 3 months after the end of treatment (or the last session) and residual stones <2 mm) was observed in 36% of patients, partial success (persistence of symptoms least 3 months (lower intensity and lower frequency) or size of residual stones>2 mm) in 48% and failure (persistence of same or increased symptoms at 3 months or no change in size of the calculi) in 17% of patients. Sonographic fragmentation of the stone (p = 0.004), total energy delivered (p = 0.008) and the total number of shock waves (n = 0.045) are predictive factors of complete success. Size, salivary topography, ductal topography, mobilization of the stones, occurrence of minor side effects and total duration of treatment had no predictive value of complete success (p > 0.05). There was no significant difference between the first 5 and the last 20 patients (p = 0.367). In agreement with the literature data, the efficacy of treatment was greater for parotid than submandibular calculi. CONCLUSION: Extracorporeal lithotripsy is an alternative to conventional surgery with no major complications. Sonographic fragmentation of calculi, total energy and total number of shock waves are predictive factors of successful treatment.

Cyclin D1-induced proliferation is independent of beta-catenin in head and neck cancer.

OBJECTIVE: Head and neck squamous cell carcinoma (HNSCC) progression and metastasis have previously been associated with the activation of phosphatidylinositol 3-kinase-protein kinase B (PI3K-Akt) and Wnt signalling pathways, which lead to the activation of pro-proliferative genes, such as cyclin D1. The current study aims to investigate whether there is a crosstalk between these pathways in HNSCC and which pathway is more likely to regulate cyclin D1. MATERIAL AND METHODS: Two HNSCC and a control keratinocyte cell lines were treated with EGF and wortmannin to respectively activate and block the PI3K-Akt and Wnt pathways. Partial and total levels of cyclin D1, beta-catenin and Akt were evaluated by Western blotting and immunofluorescence. Twenty-four paraffin-embedded samples of human HNSCC, as well as normal oral mucosa biopsies, were also immunohistochemically evaluated for beta-catenin and cyclin D1 expression. RESULTS: Following both treatments, change in cyclin D1 protein was correlated with Akt levels only. Cytoplasmic staining for beta-catenin and loss of its membranous expression in the HNSCC invasive areas were found in 92% of the HNSCC biopsies. CONCLUSION: Taken together, we show that the change in cyclin D1 levels is more likely to be due to the EGFR-Akt pathway activation than due to beta-catenin nuclear translocation.

Características de carcaça de cabritos criados em dois sistemas de terminação / Carcass characteristics of goat kids in two finishing systems

Avaliaram-se as características da carcaça de cabritos Saanen confinados, Saanen e 7/8 Boer - 1/8 Saanen semiconfinados, bem como a influência de grupo genético e sistema de terminação sobre o rendimento comercial, índice de compacidade, não constituintes, área de olho de lombo, força de cisalhamento, gordura, teor de umidade e teor de extrato etéreo. Utilizaram-se 31 machos inteiros, com aproximadamente 128 dias de idade e 22,9±2,4kg de peso vivo. Destes, 22 eram da raça Saanen e nove animais eram mestiços 7/8 Boer - 1/8 Saanen. Os animais da raça Saanen foram divididos em dois grupos de 11 animais, sendo um grupo mantido em confinamento e outro em semiconfinamento, enquanto os mestiços foram mantidos em semiconfinamento. Compararam-se os sistemas de terminação na raça Saanen, e os grupos genéticos no sistema semiconfinado. Os animais confinados receberam 3,5% do PV em ração completa peletizada; os semiconfinados tiveram acesso à pastagem e suplementação de 1,5% do PV em ração concentrada peletizada. Aos 47 dias de terminação, os animais foram abatidos e as características de carcaça determinadas por meio de uma amostra de lombo dissecado. Foram observadas diferenças entre sistemas de terminação para rendimento comercial de carcaça, índice de compacidade da carcaça, não constituintes de carcaça, área de olho de lombo, força de cisalhamento, gordura, teor de umidade e de extrato etéreo. Entre os grupos genéticos, foram observadas diferenças para área de olho de lombo, espessura de gordura e matéria mineral. O sistema de terminação exerceu influência sobre as características de carcaça avaliadas. A raça Saanen pode ser utilizada para a produção de carne quando submetida ao confinamento.

Was evaluated carcass characteristics of feedlot goats Saanen, Saanen and 7/8 Boer - 1/8 Saanen semi-confined, as well as the influence of the genetic groups and finishing systems on the commercial performance, compactness index, not constituents, area ribeye, shear force, fat, moisture and ether extract content. Were used 31 bulls, with approximately 128 days of age and 22.9±2.4kg live weight (LW). Of these, 22 were Saanen, and nine animals were crossbred 7/8 Boer - 1/8 Saanen. The Saanen animals were divided into two groups of 11 animals each, one group and another kept in a feedlot in semiconfinement, while crossbreds were kept in semiconfinement. Was compared the finishing systems in Saanen, and genetic groups in semi-confined system. The confined animals received 3.5% of LW in complete pelleted ration, the semiconfinados had access to pasture and supplementation of 1.5% of LW in pelleted concentrate ration. At 47 days of terminating the animals were slaughtered and the carcass characteristics determined using a sample loin dissected. Differences were observed between finishing systems for commercial carcass yield, carcass compactness index, not constituents carcass, loin eye area, shear force, fat, moisture and ether extract. Between genetic groups, differences were observed for ribeye area, fat thickness and mineral matter. The finishing system exerted influence on carcass traits evaluated. The Saanen can be used for the production of meat when subjected to confinement.

[Total nasal reconstruction with a titanium miniplate as structural support]. / Rhinopoïèse totale avec armature par miniplaque en titane.

INTRODUCTION: Total nasal reconstructions using bone graft, as structural support is the gold standard. We retrospectively studied an alternative technique relying on a titanium miniplate as a structural support. PATIENTS AND METHODS: Five patients underwent total nasal reconstruction, using a 1mm titanium miniplate fixed to the frontal bone and to the anterior maxilla. The miniplate was covered by a fascia lata graft in three cases. The functional and aesthetic results were evaluated on a scale from 0 (disappointing results) to 3 (excellent results) by the patient and by the surgeon, at 1 month and at 3 years after the total nasal reconstruction. RESULTS: The functional results were assessed on average at 2.2/3 at 1 month, and 2.4/3 at 3 years postoperatively. The aesthetic results are estimated at 2 (patient) and 1.8 (medical team) at 1 month and at 2.6 (patient) and 2.2 (medical team) at 3 years. There were no major complications. The minor complications were exposure of the two miniplates, which had not been covered with fascia lata. These complications were resolved by local surgery. DISCUSSION: The functional and aesthetic results of total nasal reconstruction relying on a titanium miniplate were similar to those obtained with a bone graft. This technique is simple, there is no need for an osseous donor site, it is stable at long-term, and its cost is moderate.

Minimal iliac bone harvesting in sinus lift surgery.

For sinus grafting, the authors propose a minimal posterior iliac bone harvesting, with local anesthesia. Autogenous bone grafting continues to be considered the gold standard for sinus grafting. The classic harvesting sites are calvarial, anterior iliac, and tibial, and harvesting is usually practiced under general anesthesia. We performed this technique in 7 patients under local anesthesia. In the posterior iliac crest, with a specific trocar for bone puncture biopsy, bone was harvested. We performed 1 cm longer for 5-mm diameter of bone. Three bone biopsies were harvested on each side. The harvested cancellous bone (5 cm(3)) was mixed with triphosphocalcic (TCP) material (2 cm(3)), and blood (1 cm(3)). A classic sinus lift was realized. After 6 months, the success rate of bone grafting was 100%. Each of the 7 patients could be implanted by an average of 4 dental implants by superior maxillary. For sinus lift, this simple posterior iliac-bone biopsy harvesting under local anesthesia is very comfortable for the patient and also safe. It provides enough marrow bone to be mixed with TCP for a sinus lift.

The adults of Camelobaetidiusjanae Dominique & Thomas, 2001 and C. yacutinga Nieto, 2003, with a new synonym for C. leentvaari Demoulin, 1966 (Ephemeroptera: Baetidae).

The genus Camelobaetidius Demoulin, 1966 has 39 species distributed throughout the Nearctic and Neotropical Regions, being one of the most studied genera of the family Baetidae. Based on material from Brazil, the aim of the present paper is to describe adults of C. janae Dominique & Thomas, 2001 and C. yacutinga Nieto, 2003, and to recognize a new synonym for Camelobaetidius leentvaari Demoulin, 1966 (= C. mantis Traver & Edmunds, 1968 nov. syn.) based on the examination of type material.

A new species of Corinnella Thomas & Dominique, 2006 (Ephemeroptera: Baetidae).

The monotypic genus Corinnella Thomas & Dominique, 2006, was described based on nymphs from French Guyana, and since the original description nothing has been added to knowledge of its systematics. The aim of the present paper is to describe a new species of the genus from Northern Brazil, to improve its diagnoses, and to report the genus for the first time from Brazil. The new species can be recognized by: labrum with discernible anteromedial emargination and process; posterior margin of terga IV with rounded spines; and tarsal claw with seven to nine denticles, with the outer and inner denticles distinctly longer than the others.

Morphology of male reproductive systems in Ephemeroptera: intrinsic musculature.

Although the Ephemeroptera have been studied over a long period of time, there are still few studies on the morphology of male reproductive system. The spermatic ducts are considered conserved among different Ephemeroptera groups. However, previous studies distinguished different organizational patterns of the spermatic duct intrinsic musculature. This study describes the morphology of the spermatic ducts, especially their musculature, in six species of Ephemeroptera, representing five families. We have observed variations in the organizational pattern of the spermatic ducts, even between species from the same family. Moreover, all species studied had intrinsic musculature in the spermatic ducts although with different organizational patterns. Thus, we believe that this musculature is important to move the spermatozoa along the ducts of all Ephemeroptera and not only of those with aflagellated spermatozoa (Leptophlebiidae). The variations in musculature organization must be related to differences in reproductive physiology (i.e., copula duration) and not only with spermatozoa characteristics.

[Cone beam 3D sialography: preliminary study]. / Sialographie 3D en cone beam: étude préliminaire.

INTRODUCTION: Stones, stenosis and inflammatory lesions are the main causes of mealtime syndrome. The aim of paraclinical exam is to find the cause of these obstructive symptoms. Ultrasound is often sufficient to confirm the lithiasic origin of salivary gland swelling. Non-lithiasic salivary obstructions are more difficult to diagnose. We studied the feasibility and quality of a new medical imaging device: three-dimensional (3D) sialography using the technique of cone beam with flat panel (CPCT). PATIENTS AND METHODS: Five patients were included, referred for diagnostic management of non-lithiasic salivary gland parotid colic. It was performed for each patient in the angiography room, conventional sialography and 3D CPCT. Images were compared to conventional sialography. RESULTS: None of catheterization failure or side effects were observed in five patients. 3D CPCT sialography enabled to view gland ducts until their fifth or sixth division. Compared to conventional sialography, 3D CPCT improves signal and contrast to noise ratio. DISCUSSION: This technique allows an anatomic resolution and signal/noise ratio unmatched. It also allows to reduce metallics artefacts. Its main drawback is those associated with ductal catheterization, exposure to ionizing radiation and potential allergy to iodinated contrast agents.