Surgical Outcomes in a Lung Cancer-Screening Program Using Low Dose Computed Tomography.

OBJECTIVE: Lung cancer (LC) is the leading cause of death from cancer worldwide. More than 27,000 LCs are diagnosed annually in Spain, and most are unresectable. Early detection and treatment reduce LC mortality. This study describes surgical outcomes in a longstanding LC screening cohort in Spain. METHODS: We conducted a retrospective study of surgical outcomes in a LC screening (LCS) program using low dose computed tomography (LDCT) since the year 2000. A descriptive analysis of clinical and radiological parameters, presence or absence of a preoperative diagnosis, pathological staging, morbidity, mortality, and survival was performed. RESULTS: Ninety-seven (2.5%) LC were diagnosed in 3825 screened. Twenty individuals with LC had no surgery due to advanced stage or small cell histology. Eighty-seven surgical procedures were carried out for suspected or biopsy proven LC, detected by LDCT. Most operated patients were male (57[85%]) aged 64±9.1 years. Nine patients underwent a second operation for a metachronous primary lung cancer. Mean tumor size was 15.2±7.6mm. Eight nodules were benign (9.2%). Lobectomy was performed in 56 cases (83.6%). Adenocarcinoma (n=39; 58.2%) was the most frequent histological type followed by squamous cell carcinoma (n=17; 25.4%). Fifty-nine (88%) tumors were in Stage I. Thirteen patients (15.4%) had 16 complications. The estimated survival rates at 5 and 10 years for stage I were 93% (95% CI: 79%-98%) and 83% (95% CI: 65%-92%), respectively. CONCLUSION: Lung cancer screening was associated with excellent surgical outcomes with 5 and 10-year survival rates exceeding 90 and 80%, respectively.

The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population / Dimensiones del arco posterior de C2 para el guiado de tornillos translaminares. Estudio radiológico en población española

BACKGROUND: To describe the feasibility of the posterior arch of C2 accepting two crossing screws in the Spanish population. METHODS: One hundred and fifty patients who underwent a routine neck CT scan for non-cervical pathology were enrolled. Submillimeter slices (thickness 0.7 mm) every 0.4 mm were performed with a 64 multi-detector CT scan, which allows isometric measurements. We measured the length and height of the cortical and cancellous (endomedullar) region of the lamina and the spinous process, inclination, maximal screw length and spinolaminar angle. RESULTS: The average (standard deviation) measurements of the lamina were: width of the left cortical 7.2 (1.5) mm, right cortical 6.9 (1.3) mm, width of the cancellous part of the left lamina 4.8 (1.5) mm, right side 4.6 (1.4) mm. The mean left cortical height was 13.0 (1.5) mm and 13.1 (1.6) mm for the right. The mean height of the cancellous part was 9.0 mm for both sides. The average measurements of the spinous process were: cortical length 15.7 (3.5) mm, endomedullar length 12.5 (3.9) mm; cortical height 11.9 (2.2) mm, endomedullar height 8.4 (2.1) mm; spinolaminar angle 49º (4); the maximum screw length 3.18 cm, and the inclination angle 143º. CONCLUSION: A CT scan with submillimeter slices is necessary in order to avoid malpositioning of the screws. The outer cortical measurements are 2 to 4 mm bigger than the endomedullar ones. Taking into account the dimensions of the spinous process, 24% of the population would not be candidates for this crossing screw technique

FUNDAMENTO: Describir la capacidad del arco posterior de C2 en población española para colocar dos tornillos cruzados translaminares. MÉTODO: Se reclutaron 150 pacientes a los que se les realizó un escáner del cuello por patología no cervical. Para el estudio se utilizó un 64 multi-detector TAC realizando cortes submilimétricos (0,7 mm de grosor) cada 0,4 mm, permitiendo obtener medidas isométricas. Se midieron anchura y altura cortical y endomedular de la lámina y de la espinosa, inclinación de la lámina, máxima longitud de tornillo y ángulo espinolaminar. RESULTADOS: Las media (desviación estándar) de las medidas de la lámina fueron: anchura cortical izquierda 7.2 (1,5) mm, cortical derecho 6,9 (1,3) mm, anchura endomedular izquierda 4,8 (1,5) mm, derecha 4,6 (1,4) mm La altura media cortical izquierda fue 13,0 (1,5) mm y de 13,1 (1,6) mm para la derecha. La altura media endomedular fue de 9,0 mm en ambos lados. Las medidas medias de la espinosa fueron: longitud media cortical 15,7 (3,5) mm, longitud endomedular 12,5 (3,9) mm; altura cortical 11,9 (2,2) mm, altura endomedular de 8,4 (2,1) mm; ángulo espinolaminar 49º (4); la longitud máxima de tornillo 3,18 cm; y el ángulo de inclinación 143º. CONCLUSIONES: Para evitar la colocación errónea de los tornillos es necesario un estudio de TAC con cortes submilimétricos. La diferencia entre las medidas corticales y endomedulares oscila entre 2 y 4 mm. Teniendo en cuenta las dimensiones de la espinosa, un 24% de la población no sería candidato a esta técnica de tornillos cruzados translaminares

The dimensions of the posterior arch of C2 for instrumented screw fixation. A radiological study in the Spanish population.

BACKGROUND: To describe the feasibility of the posterior arch of C2 accepting two crossing screws in the Spanish population. METHODS: One hundred and fifty patients who underwent a routine neck CT scan for non-cervical pathology were enrolled. Submillimeter slices (thickness 0.7 mm) every 0.4 mm were performed with a 64 multi-detector CT scan, which allows isometric measurements. We measured the length and height of the cortical and cancellous (endomedullar) region of the lamina and the spinous process, inclination, maximal screw length and spinolaminar angle. RESULTS: The average (standard deviation) measurements of the lamina were: width of the left cortical 7.2 (1.5) mm, right cortical 6.9 (1.3) mm, width of the cancellous part of the left lamina 4.8 (1.5) mm, right side 4.6 (1.4) mm. The mean left cortical height was 13.0 (1.5) mm and 13.1 (1.6) mm for the right. The mean height of the cancellous part was 9.0 mm for both sides. The average measurements of the spinous process were: cortical length 15.7 (3.5) mm, endomedullar length 12.5 (3.9) mm; cortical height 11.9 (2.2) mm, endomedullar height 8.4 (2.1) mm; spinolaminar angle 49º (4); the maximum screw length 3.18 cm, and the inclination angle 143º. CONCLUSION: A CT scan with submillimeter slices is necessary in order to avoid malpositioning of the screws. The outer cortical measurements are 2 to 4 mm bigger than the endomedullar ones. Taking into account the dimensions of the spinous process, 24% of the population would not be candidates for this crossing screw technique.

Safety of regadenoson for vasodilation in cardiac MRI stress tests. / Seguridad del empleo de regadenosón como fármaco vasodilatador en resonancia magnética cardíaca de estrés.

OBJECTIVE: To determine the safety of regadenoson for vasodilation in cardiac MRI stress tests to detect myocardial ischemia. MATERIAL AND METHODS: We retrospectively analyzed cardiac MRI studies done in 120 patients (mean age, 67±11.6 years; 88 men) with suspected ischemic heart disease or known coronary disease who had clinical indications for cardiac MRI stress tests. All studies were done on a 1.5 T scanner (MAGNETOM Aera, Siemens Healthineers) using regadenoson (5ml, 0.4mg) for vasodilation. We recorded cardiovascular risk factors, medications, and indications for the test as well as vital signs at rest and under stress and the symptoms and adverse effects induced by the drug. RESULTS: No symptoms developed in 52.6% of patients. The most common symptoms were central chest pain (25%) and dyspnea (12%). At peak stress, the mean increase in heart rate was 23.9±11.4 beats per minute and the mean decreases in systolic and diastolic blood pressure were 7.1±18.8mmHg and 5.3±9.2mmHg, respectively (p <0.001). The response to regadenoson was less pronounced in obese and diabetic patients. The increase in heart rate was greater in symptomatic patients (27.4±11.2 bpm vs. 20.6±10.7 bpm in asymptomatic patients, p=0.001). No severe adverse effects were observed. CONCLUSION: Regadenoson is well tolerated and can be safely used for cardiac MRI stress tests.

Correction to: A thiotrophic microbial community in an acidic brine lake in Northern Chile.

In Table 1 of the original article, the unit mg/L was incorrectly published as ng/L in the aluminum, chloride, sulphate and OM columns.

A thiotrophic microbial community in an acidic brine lake in Northern Chile.

The endorheic basins of the Northern Chilean Altiplano contain saline lakes and salt flats. Two of the salt flats, Gorbea and Ignorado, have high acidic brines. The causes of the local acidity have been attributed to the occurrence of volcanic native sulfur, the release of sulfuric acid by oxidation, and the low buffering capacity of the rocks in the area. Understanding the microbial community composition and available energy in this pristine ecosystem is relevant in determining the origin of the acidity and in supporting the rationale of conservation policies. Besides, a comparison between similar systems in Australia highlights key microbial components and specific ones associated with geological settings and environmental conditions. Sediment and water samples from the Salar de Gorbea were collected, physicochemical parameters measured and geochemical and molecular biological analyses performed. A low diversity microbial community was observed in brines and sediments dominated by Actinobacteria, Algae, Firmicutes and Proteobacteria. Most of the constituent genera have been reported to be either sulfur oxidizing microorganisms or ones having the potential for sulfur oxidation given available genomic data and information drawn from the literature on cultured relatives. In addition, a link between sulfur oxidation and carbon fixation was observed. In contrast, to acid mine drainage communities, Gorbea microbial diversity is mainly supported by chemolithoheterotrophic, facultative chemolithoautotrophic and oligotrophic sulfur oxidizing populations indicating that microbial activity should also be considered as a causative agent of local acidity.

Adaptación y validación de la Frontotemporal Dementia Rating Scale (FTD-FRS) al castellano / Adaptation and validation of a Spanish-language version of the Frontotemporal Dementia Rating Scale (FTD-FRS)

Introducción: La Frontotemporal Dementia Rating Scale (FTD-FRS) es una escala diseñada para facilitar la estadificación clínica y la evaluación de la progresión de pacientes con demencia frontotemporal (DFT). Objetivo: Realizar un estudio multicéntrico de adaptación y validación al castellano de la FTD-FRS. Metodología: La adaptación se realizó mediante 2 procesos de traducción y retrotraducción inglés-español español-inglés y se verificó con los autores originales. El proceso de validación se llevó a cabo en una muestra consecutiva de pacientes diagnosticados de DFT. Se evaluó la consistencia interna, se determinó la unidimensionalidad con el método Rasch, se analizaron la validez de constructo y la validez discriminante, y se calculó el grado de acuerdo entre la Clinical Dementia Rating scale y la FTD-FRS para los casos con DFT. Resultados: Se incluyeron 60 pacientes con DFT. La puntuación media de la FTD-FRS fue de 12,1 puntos (DE = 6,5; rango = 2-25) mostrando diferencias intergrupos (F = 120,3; gl = 3; p < 0,001). El α de Cronbach = 0,897, el análisis de componentes principales de los residuos produjo un aceptable autovalor para 5 contrastes (1,6-2,7) y una varianza respecto al origen del 36,1%. La FTD-FRS correlacionó con el Mini-mental test (r = 0,572; p < 0,001) y capacidad funcional (DAD; r = 0,790; p < 0,001). La FTD-FRS correlacionó significativamente con la Clinical Dementia Rating scale (r = −0,641; p < 0,001) pero se observó variabilidad entre la distribución de la gravedad, siendo valorados como más leves según la Clinical Dementia Rating scale que con la FTD-FRS (kappa = 0,055). Conclusiones: El estudio de traducción y validación al español mostró resultados de validez y unidimensionalidad (gravedad) satisfactorios para el uso de la FTD-FRS en el estudio de la gravedad en pacientes con DFT (AU)

Introduction: The Frontotemporal Dementia Rating Scale (FTD-FRS) is a tool designed to aid with clinical staging and assessment of the progression of frontotemporal dementia (FTD-FRS). Objective: Present a multicentre adaptation and validation study of a Spanish version of the FRS. Methodology: The adapted version was created using 2 translation-back translation processes (English to Spanish, Spanish to English) and verified by the scale's original authors. We validated the adapted version in a sample of consecutive patients diagnosed with FTD. The procedure included evaluating internal consistency, testing unidimensionality with the Rasch model, analysing construct validity and discriminant validity, and calculating the degree of agreement between the Clinical Dementia Rating scale (CDR) and FTD-FRS for FTD cases. Results: The study included 60 patients with DFT. The mean score on the FRS was 12.1 points (SD = 6.5; range, 2-25) with inter-group differences (F = 120.3; df = 3; P < .001). Cronbach's alpha was 0.897 and principal component analysis of residuals delivered an acceptable eigenvalue for 5 contrasts (1.6-2.7) and 36.1% raw variance. FRS was correlated with the Mini-mental State Examination (r = 0.572; P < .001) and functional capacity (DAD; r = 0.790; P < .001). FTD-FRS also showed a significant correlation with CDR (r = −0.641; P < .001), but we did observe variability in the severity levels; cases appeared to be less severe according to the CDR than when measured with the FTD-FRS (kappa = 0.055). Conclusions: This process of validating the Spanish translation of the FTD-FRS yielded satisfactory results for validity and unidimensionality (severity) in the assessment of patients with FTD (AU)

No aparecen más síntomas obsesivo-compulsivos en madres de hijos con dermatitis atópica / Mothers of Children With Atopic Dermatitis Are Not More Prone to Obsessive-Compulsive Symptoms

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Náuseas y vómitos postoperatorios: fisiopatología, factores de riesgo, profilaxis y tratamiento / Postoperative nausea and vomiting: physiopathology, risk factors, prophylaxis and treatment

Reconocer la importancia de prevenir y tratar precozmente las náuseas y los vómitos postoperatorios (NVPO) es fundamental para evitar complicaciones postoperatorias, mejorar la satisfacción del paciente y permitir el desarrollo de la cirugía mayor ambulatoria y de la cirugía fast-track. El tema de las NVPO podría parecer estancado, pero seguimos avanzando. Aparecen nuevos conceptos y problemas como las náuseas y vómitos postalta, nuevos factores de riesgo y nuevos fármacos. Por otro lado, siguen existiendo ideas erróneas, como asociar las NVPO con la estancia en la unidad de recuperación postanestésica o asumir como factores de riesgo características del paciente, de la anestesia o de la cirugía que realmente no lo son. Debemos enfrentarnos a las NVPO de otro modo, implementando el uso de las guías clínicas en nuestros centros y apostando por una profilaxis más agresiva en determinados grupos de pacientes. Presentamos a continuación una amplia revisión del tema (AU)

Recognising the importance of the prevention and early treatment of postoperative nausea and vomiting (PONV) is essential to avoid postoperative complications, improve patient satisfaction and enable the development of major outpatient surgery and fast-track surgery. The topic of PONV might seem to have become stagnant, but we are moving forward. New concepts and problems like post-discharge nausea and vomiting, new risk factors and new drugs are appearing. However, there continue to be mistaken notions about PONV, such as the association between PONV and post-anaesthesia care unit stays, or assuming that it is a risk factore characteristic of the patient, anaesthesia or surgery when it is not. Perhaps, now is the moment to tackle PONV in a different manner, implementing guidelines and going for more aggressive prophylaxis in some groups of patients. We present an extensive review of this topic (AU)

Postoperative nausea and vomiting: physiopathology, risk factors, prophylaxis and treatment. / Náuseas y vómitos postoperatorios: fisiopatología, factores de riesgo, profilaxis y tratamiento.

Recognising the importance of the prevention and early treatment of postoperative nausea and vomiting (PONV) is essential to avoid postoperative complications, improve patient satisfaction and enable the development of major outpatient surgery and fast-track surgery. The topic of PONV might seem to have become stagnant, but we are moving forward. New concepts and problems like post-discharge nausea and vomiting, new risk factors and new drugs are appearing. However, there continue to be mistaken notions about PONV, such as the association between PONV and post-anaesthesia care unit stays, or assuming that it is a risk factore characteristic of the patient, anaesthesia or surgery when it is not. Perhaps, now is the moment to tackle PONV in a different manner, implementing guidelines and going for more aggressive prophylaxis in some groups of patients. We present an extensive review of this topic.

Adaptation and validation of a Spanish-language version of the Frontotemporal Dementia Rating Scale (FTD-FRS). / Adaptación y validación de la Frontotemporal Dementia Rating Scale (FTD-FRS) al castellano.

INTRODUCTION: The Frontotemporal Dementia Rating Scale (FTD-FRS) is a tool designed to aid with clinical staging and assessment of the progression of frontotemporal dementia (FTD-FRS). OBJECTIVE: Present a multicentre adaptation and validation study of a Spanish version of the FRS. METHODOLOGY: The adapted version was created using 2 translation-back translation processes (English to Spanish, Spanish to English) and verified by the scale's original authors. We validated the adapted version in a sample of consecutive patients diagnosed with FTD. The procedure included evaluating internal consistency, testing unidimensionality with the Rasch model, analysing construct validity and discriminant validity, and calculating the degree of agreement between the Clinical Dementia Rating scale (CDR) and FTD-FRS for FTD cases. RESULTS: The study included 60 patients with DFT. The mean score on the FRS was 12.1 points (SD=6.5; range, 2-25) with inter-group differences (F=120.3; df=3; P<.001). Cronbach's alpha was 0.897 and principal component analysis of residuals delivered an acceptable eigenvalue for 5 contrasts (1.6-2.7) and 36.1% raw variance. FRS was correlated with the Mini-mental State Examination (r=0.572; P<.001) and functional capacity (DAD; r=0.790; P<.001). FTD-FRS also showed a significant correlation with CDR (r=-0.641; P<.001), but we did observe variability in the severity levels; cases appeared to be less severe according to the CDR than when measured with the FTD-FRS (kappa=0.055). CONCLUSIONS: This process of validating the Spanish translation of the FTD-FRS yielded satisfactory results for validity and unidimensionality (severity) in the assessment of patients with FTD.

Randomized comparison of three transducer orientation approaches for ultrasound guided internal jugular venous cannulation.

BACKGROUND: Ultrasound-guided internal jugular venous access increases the rate of successful cannulation and reduces the incidence of complications, compared with the landmark technique. Three transducer orientation approaches have been proposed for this procedure: short-axis (SAX), long-axis (LAX) and oblique-axis (OAX). Our goal was to assess and compare the performance of these approaches. METHODS: A prospective randomized clinical trial was conducted in one teaching hospital. Patients aged 18 yr or above, who were undergoing ultrasound-guided internal jugular cannulation, were randomly assigned to one of three intervention groups: SAX, LAX and OAX group. The main outcome measure was successful cannulation on first needle pass. Incidence of mechanical complications was also registered. Restricted randomization was computer-generated. RESULTS: In total, 220 patients were analysed (SAX n=73, LAX n=75, OAX n=72). Cannulation was successful on first needle pass in 51 (69.9%) SAX patients, 39 (52%) LAX patients and 53 (73.6%) OAX patients. First needle pass failure was higher in the LAX group than in the OAX group (adjusted OR 3.7, 95% CI 1.71-8.0, P=0.002). A higher mechanical complication rate was observed in the SAX group (15.1%) than in the OAX (6.9%) and LAX (4%) groups (P=0.047). CONCLUSIONS: As OAX showed a higher first needle pass success rate than LAX and a lower mechanical complications rate than SAX, we recommend it as the standard approach when performing ultrasound-guided internal jugular venous access. Further clinical studies are needed to confirm this conclusion. CLINICAL TRIAL REGISTRATION: NCT 01966354.

Economic assessment of fidaxomicin for the treatment of Clostridium difficile infection (CDI) in special populations (patients with cancer, concomitant antibiotic treatment or renal impairment) in Spain.

The objective of this paper was to assess the cost-utility of fidaxomicin versus vancomycin in the treatment of Clostridium difficile infection (CDI) in three specific CDI patient subgroups: those with cancer, treated with concomitant antibiotic therapy or with renal impairment. A Markov model with six health states was developed to assess the cost-utility of fidaxomicin versus vancomycin in the patient subgroups over a period of 1 year from initial infection. Cost and outcome data used to parameterise the model were taken from Spanish sources and published literature. The costs were from the Spanish hospital perspective, in Euros (€) and for 2013. For CDI patients with cancer, fidaxomicin was dominant versus vancomycin [gain of 0.016 quality-adjusted life-years (QALYs) and savings of €2,397 per patient]. At a cost-effectiveness threshold of €30,000 per QALY gained, the probability that fidaxomicin was cost-effective was 96 %. For CDI patients treated with concomitant antibiotic therapy, fidaxomicin was the dominant treatment versus vancomycin (gain of 0.014 QALYs and savings of €1,452 per patient), with a probability that fidaxomicin was cost-effective of 94 %. For CDI patients with renal impairment, fidaxomicin was also dominant versus vancomycin (gain of 0.013 QALYs and savings of €1,432 per patient), with a probability that fidaxomicin was cost-effective of 96 %. Over a 1-year time horizon, when fidaxomicin is compared to vancomycin in CDI patients with cancer, treated with concomitant antibiotic therapy or with renal impairment, the use of fidaxomicin would be expected to result in increased QALYs for patients and reduced overall costs.

Resultados perinatales en gestantes mayores de 40 años / Perinatal outcomes in women older than 40 years

Objetivo: Evaluar la morbimortalidad obstétrica y neonatal en gestantes con gestaciones únicas de nuestro ámbito mayores de 40 años. Material y método Se seleccionaron los partos asistidos en el Hostipal Parc Taulí de Sabadell durante un periodo de 12 meses, excluyendo los partos múltiples. Se incluyeron un total de 3.308 gestantes, dividiéndolas en 2 grupos, de menos de 40 años (grupo 1), y mayores o igual a 40 años (grupo 2). Analizando la morbimortalidad materna y neonatal en ambos grupos de edad para determinar si hubo diferencias. Resultados: Solo 115 (3,5%) gestantes tenían > 40 años. Encontramos en el grupo de más de 40 años mayor número de técnicas de reproducción asistida, y mayor incidencia de estados hipertensivos del embarazo, diabetes y parto por cesárea con p < 0,05. Conclusiones: Las gestantes de edad avanzada ≥ 40 años presentan mayor morbilidad materna, sin que la edad avanzada tenga que repercutir directamente en la morbimortalidad neonatal

Objective: To evaluate obstetric and neonatal morbidity and mortality in pregnant women aged40 years or more with singleton pregnancies in our hospital. Material and methods: We selected deliveries occurring in Hospital Parc Taulí in Sabadell, Spain, in a 12-month period. Multiple deliveries were excluded. A total of 3308 pregnant women were divided into two groups: group 1 consisted of women aged less than 40 years and group 2 consisted of women aged 40 years or more. Maternal and neonatal morbidity were analyzed in both groups to identify any differences. Results: Only 115 (3.5%) pregnant women were aged 40 years or more. Compared with group2, group 1 had undergone a higher number of assisted reproductive technologies and showed a higher incidence of hypertensive diseases, diabetes, and cesarean delivery (p <0.05). Conclusions: Pregnant women aged 40 years more have higher morbidity but advanced age does not directly infuence neonatal morbidity and mortality

Flavodoxin overexpression confers tolerance to oxidative stress in beneficial soil bacteria and improves survival in the presence of the herbicides paraquat and atrazine.

AIM: To determine whether expression of a cyanobacterial flavodoxin in soil bacteria of agronomic interest confers protection against the widely used herbicides paraquat and atrazine. METHODS AND RESULTS: The model bacterium Escherichia coli, the symbiotic nitrogen-fixing bacterium Ensifer meliloti and the plant growth-promoting rhizobacterium Pseudomonas fluorescens Aur6 were transformed with expression vectors containing the flavodoxin gene of Anabaena variabilis. Expression of the cyanobacterial protein was confirmed by Western blot. Bacterial tolerance to oxidative stress was tested in solid medium supplemented with hydrogen peroxide, paraquat or atrazine. In all three bacterial strains, flavodoxin expression enhanced tolerance to the oxidative stress provoked by hydrogen peroxide and by the reactive oxygen species-inducing herbicides, witnessed by the enhanced survival of the transformed bacteria in the presence of these oxidizing agents. CONCLUSIONS: Flavodoxin overexpression in beneficial soil bacteria confers tolerance to oxidative stress and improves their survival in the presence of the herbicides paraquat and atrazine. Flavodoxin could be considered as a general antioxidant resource to face oxidative challenges in different micro-organisms. SIGNIFICANCE AND IMPACT OF THE STUDY: The use of plant growth-promoting rhizobacteria or nitrogen-fixing bacteria with enhanced tolerance to oxidative stress in contaminated soils is of significant agronomic interest. The enhanced tolerance of flavodoxin-expressing bacteria to atrazine and paraquat points to potential applications in herbicide-treated soils.

Effects of salt stress and rhizobial inoculation on growth and nitrogen fixation of three peanut cultivars.

Increasing soil salinity represents a major constraint for agriculture in arid and semi-arid lands, where mineral nitrogen (N) deficiency is also a frequent characteristic of soils. Biological N fixation by legumes may constitute a sustainable alternative to chemical fertilisation in salinity-affected areas, provided that adapted cultivars and inoculants are available. Here, the performance of three peanut cultivars nodulated with two different rhizobial strains that differ in their salt tolerance was evaluated under moderately saline water irrigation and compared with that of N-fertilised plants. Shoot weight was used as an indicator of yield. Under non-saline conditions, higher yields were obtained using N fertilisation rather than inoculation for all the varieties tested. However, under salt stress, the yield of inoculated plants became comparable to that of N-fertilised plants, with minor differences depending on the peanut cultivar and rhizobial strain. Our results indicate that N fixation might represent an economical, competitive and environmentally friendly choice with respect to mineral N fertilisation for peanut cultivation under moderate saline conditions.

Low radiation and low-contrast dose pulmonary CT angiography: Comparison of 80 kVp/60 ml and 100 kVp/80 ml protocols.

AIM: To determine the image quality and diagnostic performance of an optimized pulmonary computed tomography angiography (CTA) protocol in terms of radiation and contrast volume saving. MATERIALS AND METHODS: Seventy consecutive patients weighting ≤80 kg with clinical suspicion of pulmonary embolism (PE) were prospectively enrolled. Two pulmonary CTA protocols (group A: n = 35, 80 kV/60 ml; group B: n = 35, 100 kV/80 ml) were compared. The presence of PE, image quality parameters [contrast attenuation, contrast-to-noise ratio (CNR) and signal-to-noise ratio (SNR)] and effective radiation dose (mSv) were assessed. RESULTS: PE was found in 11 patients (five of group A, six of group B). The total mean attenuation of the pulmonary arteries was significantly higher in group A (362.4 ± 100.2 HU) than in group B (262.4 ± 134.3 HU), whereas the CNR and SNR did not differ statistically (14.8 ± 7.4 and 16.3 ± 7.5 for group A and 12.5 ± 8.6 and 13.8 ± 9.1 for group B, respectively). The estimated effective radiation dose was significantly lower in group A (1.1 ± 0.7 mSv) than in group B (2.7 ± 1.2 mSv). CONCLUSION: In individuals weighting ≤80 kg, the evaluated pulmonary CTA protocol allows similar image quality to be achieved as compared with the conventional pulmonary CTA protocol while reducing radiation exposure by 60% and contrast media volume by 25%.

Dual source CT: state of the art in the depiction of coronary arteries anatomy, anatomical variants and myocardial segments.

Cardiovascular disease is the leading cause of death in adults in western countries. Coronary angiography remains the gold standard for the diagnosis of coronary artery disease, a procedure that carries risks. Nowadays, a significant number of the coronary angiographies performed every year are only diagnostic. Multidetector computed tomography (MDCT) allows non-invasive evaluation of coronary arteries. It is a continuously developing technique, and actually the top technology is represented by Dual Source CT. This scanner of new conception permits an improvement in image quality, and visualization of distal vessels and small collateral branches. The aim of our work is to illustrate the actual state of the art in non-invasive coronary arteries evaluation represented by Dual Source CT, presenting images of coronary arteries normal anatomy, anatomical variants and myocardial segment.