Clinical outcomes of a digitally supported approach for self-management of type 2 diabetes mellitus.

Background: Self-management of Type 2 diabetes mellitus (T2D) is challenging. Regular self-monitoring of blood glucose and healthy lifestyles are required to improve glycometabolic control, thus delaying diabetes complications, and reducing hospitalizations. Digital technologies can empower patients in their disease management promoting self-management and motivation to change behaviors. We report the results of an exploratory trial aimed at evaluating the metabolic outcomes of using digital solutions for T2D self-management developed in the ProEmpower project, a European Commission funded Pre-Commercial Procurement. Methods: Two digital solutions, DM4All and DiaWatch, which were codesigned with providers, patients, and caregivers, enabled the collection of clinical parameters by the patient using a smartphone integrated with the medical devices (glucometer, sphygmomanometer, scale, smart watch for heart rate monitoring and step counter). Data were automatically sent to the shared care plan allowing professionals to monitor adherence to treatment, set goals, and communicate more effectively with patients. At baseline and after an average follow-up of 8 months, glycosylated hemoglobin (HbA1c), body weight, blood pressure, and blood lipids were measured in 100 T2D patients using the ProEmpower solutions across different diabetes centers in Campania Region, age 45-79 years, both genders, and compared with a Control cohort of T2D patients (n = 100) with similar clinical characteristics and followed for a comparable period of observation in the same centers. Results: At baseline, the ProEmpower participants and the Control subjects were on average overweight, with a similar BMI in the two cohorts, and mean HbA1c was at acceptable levels (around 7.0%). After the 8 month exploratory trial, body weight, HbA1c, systolic and diastolic blood pressure, and plasma and LDL-cholesterol significantly decreased in the ProEmpower participants compared to baseline (p < 0.05 for all). The changes in systolic and diastolic blood pressure, and plasma and LDL-cholesterol were significantly different from those observed in the Control cohort (p < 0.05 for all). Conclusion: This pilot study showed positive effects on metabolic outcomes relevant to cardiovascular risk in T2D of adopting digital telemedicine self-monitoring solutions based on automation of measurements and coaching on healthy lifestyles promotion.

Leaf Proteomic Analysis in Seedlings of Two Maize Landraces with Different Tolerance to Boron Toxicity.

Boron (B) toxicity is an important stressor that negatively affects maize yield and the quality of the produce. The excessive B content in agricultural lands is a growing problem due to the increase in arid and semi-arid areas because of climate change. Recently, two Peruvian maize landraces, Sama and Pachía, were physiologically characterized based on their tolerance to B toxicity, the former being more tolerant to B excess than Pachía. However, many aspects regarding the molecular mechanisms of these two maize landraces against B toxicity are still unknown. In this study, a leaf proteomic analysis of Sama and Pachía was performed. Out of a total of 2793 proteins identified, only 303 proteins were differentially accumulated. Functional analysis indicated that many of these proteins are involved in transcription and translation processes, amino acid metabolism, photosynthesis, carbohydrate metabolism, protein degradation, and protein stabilization and folding. Compared to Sama, Pachía had a higher number of differentially expressed proteins related to protein degradation, and transcription and translation processes under B toxicity conditions, which might reflect the greater protein damage caused by B toxicity in Pachía. Our results suggest that the higher tolerance to B toxicity of Sama can be attributed to more stable photosynthesis, which can prevent damage caused by stromal over-reduction under this stress condition.

Comparative physicochemical analysis of chitin quality of the two tagmata in the exoskeleton of the horseshoe crab Limulus polyphemus.

Recently, chitin biopolymer has received much attention as a wide variety of biomedical application for this and its derivatives have been reported, in fact, the study of non-conventional species as alternative sources of them compounds has taken particular interest. Here, we present a comparative physicochemical survey of the two tagmata in the exoskeleton of the horseshoe crab Limulus polyphemus: the prosoma and the opisthosoma, collected in Yucatán, Mexico. The characterization included CHNSO analysis, FTIR, TGA, DSC, XRD, and SEM. The CHNSO analysis revealed that C is present in the highest proportion (∼45 %) and that chemical composition did not show significant differences (P < 0.05) between the two tagmata. FTIR spectra of two tagmata presented a wide characteristic band of the chitin between 3600 and 3000 cm-1, confirming the presence of this biopolymer in the exoskeleton studied. TGA and DTGA profiles resulted very similar for both tagmata being the residual mass at 650 °C of around 30 % for both samples; these values were associated to the presence of minerals. SEM micrographs showed a porous matrix with infinite large number of irregularly shaped particles. Results show that both tagmata are made up of chitin, and they seem to have a high mineral content.

Phase Angle, a Cornerstone of Outcome in Head and Neck Cancer.

In patients with head and neck cancer, malnutrition is common. Most cases are treated by chemo-radiotherapy and surgery, with adverse effects on the aerodigestive area. Clinical and biochemical characteristics, health-related quality of life, survival, and risk of death were studied. The selected subjects were divided into normal- and low-phase-angle (PA) groups and followed up for at least two years. Mean ages were 67.2 and 59.3 years for low and normal PA, respectively. Patients with PA < 4.42° had significant differences in age, anthropometric and biochemical indicators of malnutrition, and inflammatory status compared to patients with PA > 4.42°. Statistical differences were found in the functional and symptom scales, with lower functional scores and higher symptom scores in patients with low PA. Median survival was 19.8 months for those with PA < 4.42° versus 34.4 months for those with PA > 4.42° (p < 0.001).The relative risk of death was related to low PA (2.6; p < 0.001). The percentage of living patients (41.7%) is almost the same as the percentage of deceased subjects (43.1%; p = 0.002), with high death rates in patients with PA < 4.42°. Phase angle was the most crucial predictor of survival and a risk factor for death in the studied cases.

Mixofibrosarcoma mandibular de bajo grado en un adulto / Low grade mandibular myxofibrosarcoma in an adult

Se describe el caso clínico de un paciente de 61 años de edad, con antecedente de buena salud, atendido en el St. Paul's Milennium Medical Hospital de Etiopía por presentar, desde hacía 2 años, una lesión en la encía marginal, con abombamiento de ambas corticales, que se extendía del primer premolar inferior derecho al izquierdo, por lo cual se decidió ingresarlo en el Servicio de Cirugía Maxilofacial para su estudio y tratamiento. Se trataba de un tumor poco frecuente y de gran tamaño, con amplia diseminación ganglionar hacia los niveles IV y V de ambas partes del cuello, de manera que se realizó el procedimiento quirúrgico. La evolución fue favorable en el posoperatorio inmediato y egresó de la institución 7 días después, pero continuó con radioterapia. Y seguimiento por consulta externa durante 24 meses después.

The clinical case of a 61-year-old patient, with a history of good health, treated at St. Paul's Milennium Medical Hospital in Ethiopia for presenting, for 2 years, a lesion in the marginal gum, with bulging of the gums, is described. both cortices, which extended from the lower right to the left first premolar, for which it was decided to admit him to the Maxillofacial Surgery Service for study and treatment. It was a rare and large tumor, with extensive lymph node dissemination to levels IV and V in both parts of the neck, so the surgical procedure was performed. The evolution was favorable in the immediate postoperative period and he was discharged from the institution 7 days later, but continued with radiotherapy. And follow-up by outpatient service for 24 months afterwards.

Ventilator-associated events in children: A multicentre prospective cohort study.

BACKGROUND: The Centres for Disease Control and Prevention (CDC) broadened the focus of surveillance from ventilator-associated pneumonia to ventilator-associated event (VAE) for quality purposes. No paediatric definition of VAE (PaedVAE) has been accurately validated. We aimed to analyse the incidence and impact on patient outcomes resulting from the application of the adult and two paediatric VAE (PaedVAE) criteria. SECONDARY OBJECTIVE: to evaluate VAE/PaedVAE as factors associated with increased duration of mechanical ventilation (MV) and Paediatric Intensive Care Unit (PICU) stay. METHODS: Multicentre observational prospective cohort study in 15 PICUs in Spain. VAEs were assessed using the 2013/2015 CDC classification. PaedVAE were assessed using the CDC definition based on mean airway pressure (MAP-PaedVAE) versus a paediatric definition based on positive end-expiratory pressure (PEEP-PaedVAE). Children who underwent MV ≥ 48 h were included. RESULTS: A total of 3626 ventilator-days in 391 patients were analysed. The incidence of VAE, MAP-PaedVAE and PEEP-PaedVAE was 8.55, 5.24 and 20.96 per 1000 ventilator-days, respectively. The median time [IQR] for VAE, MAP-PaedVAE and PEEP-PaedVAE development from the MV onset was 4 [3-12.5], 4 [3-14], and 5 [3-7.75] days, respectively. Among survivors, all three were associated with increased MV duration (> 7 days) and PICU stay (> 10 days) at univariate analysis. Multivariate analysis showed that PEEP-PaedVAE was the only definition independently associated with MV above 7 days [OR = 4.86, 95% CI (2.41-10.11)] and PICU stay [OR = 3.49, 95% CI (1.68-7.80)] above ten days, respectively. CONCLUSIONS: A VAE definition based on slight PEEP increases should be preferred for VAE surveillance in children.

Quality of Life and Functionality of Head and Neck Cancer Patients Are Diminished As a Function of Sarcopenia and Obesity.

BACKGROUND: Health-related quality of life (QoL) is a measure that allows us to know the patient's perception of well-being and how it is affected by their disease and treatments. In cancer patients, sarcopenia has been associated with low scores on various instruments used to assess the QoL; however, little information is available on the effects of sarcopenia and sarcopenic obesity on the QoL of patients with head and neck cancer (H&NC). METHODS: In this cross-sectional study with 71 H&NC patients aged between 40 and 80 years, we describe the scores on the instruments EORTC QLQ C-30 and EORTC QLQ-H&N35 according to the sarcopenia phenotype (NSG, nonsarcopenic group; SG, sarcopenic group; and SOG, sarcopenic obesity group), hand-grip strength, gait speed, total lymphocyte count, albumin, cholesterol and C-reactive protein, and the relationships between these variables. RESULTS: The prevalence of sarcopenia and sarcopenic obesity was 48% and 28%, respectively. The QoL analysis showed that NSG had higher scores on the physical functioning scale [NSG 93 (83-100); SG 73 (52-88); SOG 83 (53-93), P = .009] and lower scores on the fatigue scale [NSG 11 (0-22); S 39 (30-67); SOG 44 (14-56); P = .004]. The NSG had a higher hand-grip strength (31.1 kg) than SG (24.1 kg, P = .007) and SOG (26.3 kg, P = .001), and a lower C-reactive protein. The SG and SOG showed no differences between them. CONCLUSIONS: Patients with sarcopenia or sarcopenic obesity have lower physical performance and a higher level of fatigue than nonsarcopenic patients. This loss of function can maintain or worsen sarcopenia due to the patient's self-restraint in physical exertion that encourages an increase in muscle tissue.

Factores hereditarios y síndromes de predisposición genética relacionados con sarcomas de partes blandas / Hereditary factors and syndromes of genetic predisposition related to sarcomas of soft parts

Los sarcomas de partes blandas son tumores malignos que se originan en el tejido conectivo, a partir del mesénquima embrionario. Teniendo en cuenta la existencia de nuevos y constantes cambios en la naturaleza de estos tumores, se realizó una revisión de las publicaciones más recientes para profundizar en las alteraciones genéticas, los síndromes de predisposición y su relación con los sarcomas. Se pudo concluir que aún siguen siendo muy pocos los registros que describen la identificación de dichos síndromes como principal eslabón en el desarrollo de los sarcomas.

The sarcomas of soft parts are malignancies that originate in the connective tissue, starting from the embryonic mesenchyme. Taking into account the existence of new and constant changes in the nature of these tumors, a review of the most recent publications was carried out to deepen in the genetic disorders, the predisposing syndromes and its relationship with sarcomas. It was concluded that the records that describe the identification of these syndromes are still very few as main link in the development of sarcomas.

Physicochemical composition, phytochemical analysis and biological activity of ciricote (Cordia dodecandra A. D.C.) fruit from Yucatán.

The physicochemical properties, proximate composition, minerals, total polyphenols, carotenoids, phenolic compounds, antioxidant, and antibacterial activities of ciricote (Cordia dodecandra A. DC.) tropical fruit were investigated. Minerals were quantified by using micro-Energy Dispersive X-Ray Fluorescence. Lutein and ß-carotene were identified in ciricote fruit by using UPLC-PDA analysis. The highest values of the total polyphenols content and antioxidant activity were presented in ethanolic crude extracts obtaining by the ultrasonic-assisted method with freeze-dried fruit. The phenolic acids profile was identified and quantified by UPLC-PDA-ESI-MS. The main phenolic acids were caffeoyl hexoside, rufescenolide, quercetin 3-O-rutinoside, and rosmarinic acid. The ciricote extracts presented antibacterial activity against Staphylococus aureus (Gram+) and Salmonella typhymurium (Gram-). In conclusion, the ciricote (Cordia dodecandra A. DC.) tropical fruits could be very useful source of biological macromolecules, micro-elements, and phytochemical compounds for the food and pharmaceutical industry.

Sublingual dermoid cyst in an infant: A case report and review of the literature.

Dermoid cysts usually occur later in the second decade of life; we present the approach of an unusual case of an infant who presented a cyst within the oral cavity, which is important because it can be confused with other pathologies.

The History of Spanish Neuroscience: Thematic Papers Issue.

To commemorate the 100th anniversary of the creation of the Instituto Cajal, we bring this thematic issue to honor Spanish neuroscience. The issue includes several papers written by scientists, most of them being direct descendants of those who lived on the front lines of the dawn of Spanish neuroscience. These pages reflect a summary of the main achievements of this unique group of neuroscientists, all of them belonging to the Cajal School. Finally, this school of scientists became the forerunner of the modern worldwide neuroscience. Anat Rec, 303:1179-1180, 2020. © 2020 American Association for Anatomy.

Pedro Ramón y Cajal: The Legacy of a Neurohistologist, a Medical Doctor, and a Pathologist.

The work of Santiago Ramón y Cajal is difficult to understand without knowing the personalities of Justo, his father, and his brother Pedro. His father practically forced the two brothers to study medicine. Thanks to that, Santiago was able to combine his artistic talent with histology and wonderfully describe cerebral architecture. Pedro was a faithful brother and above all a friend of Santiago, and they worked together for years. Pedro was able to demonstrate the theories of his brother in nonmammalian amniotes, concluding that the basic elements of the nervous system are common to these animals and he provided images that served Santiago to formulate the theory of dynamic polarization. Pedro, who decided to remain in the shadow of his brother, was a very complete doctor, pathologist and gynecologist, who made interesting contributions in all these fields and above all was a great humanist who left an important personal and scientific legacy. Anat Rec, 2019. © 2019 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists. Anat Rec, 303:1189-1202, 2020. © 2019 The Authors. The Anatomical Record published by Wiley Periodicals, Inc. on behalf of American Association of Anatomists.

Cajal's Interactions with Sherrington and the Croonian Lecture.

Sherrington was a major proponent of the neuron doctrine and he was inspired by Santiago Ramón y Cajal's theory of dynamic polarization of nerve cells (Ley de la polarización dinámica de la célula nerviosa). Sherrington coined the term "synapse" to name the Cajal description of interneuronal contact and he gave the term, for functional nerve endings, as "Boutons terminaux," still used today. These two giants of neuroscience met only once, but they had a life-long friendship. It was Sherrington who wrote Cajal's Obituary for the Royal Society. We review here some of the scientific exchanges between Cajal and Sherrington, with particular attention to 1894, when the two neuroscientist met in London during Cajal's visit to deliver the Croonian Lecture to the Royal Society. We shall examine not only the scientific exchanges but also their friendship, which was immediate and strong. Anat Rec, 303:1181-1188, 2020. © 2019 American Association for Anatomy.

A los diecisiete años desaparecen del EEG las polipuntas y polipunta ondas: a propósito del síndrome de Lance-Adams / At the seventeen years they disappear from the EEG The little and little waves: About the Lance-Adams syndrome

Objetivo: la inesperada ausencia del signo de polipunta o de polipunta onda (PPO) en el electroencefalograma (EEG) de dos casos, de 29 y 51 años, respectivamente, del Síndrome Lance Adams (SLA), que hemos visto y publicado con anterioridad, nos motivó a investigar la edad cuando este signo tiende a extinguirse, dejando de ser obligatorio para diagnosticar SLA a pacientes de edad madura. Métodos: de una muestra de 7137 trazados se incluyeron 6939, tras excluir 198 por referimientos no identificables. Estos EEG del Centro de Rehabilitación y el Centro Médico de la Universidad Central del Este (UCE), fueron realizados con electroencefalógrafos Nervus y Cadwell, de manera respectiva. Se revisaron buscando la presencia de PPO para estudiar la edad, la patología sospechada en cada indicación y el género de los pacientes. Resultados: PPO fue encontrada en 293 casos: 4.22 % de la muestra total. En 272 habría ocurrido antes de los 17 años, con la gráfica mostrando una elevación inicial máxima a las nueve. En cambio, de los 18 a los 65 solo apareció la PPO en 18 casos. 14 pacientes mostraron supresión de paroxismo o patrones de electro depresión sin PPO. Conclusión: la polipunta/polipunta onda prácticamente desaparece a los 17 años, a mayor edad, por lo tanto, el signo PPO deja de ser obligatorio para el diagnóstico del SLA en pacientes mayores. Es más frecuente en epilépticos y en varones

Objective: Unexpected absence of polyspike/polyspike & wave sign (PPW) in the EEG of our 29 and 51-year old published cases of Lance Adams Syndrome (LAS), prompted us to investigate the age when this sign may nearly disappear. This in order of considering it not obligatory for late LAS diagnosis. Methods: Inclusion consisted of a sample of 7137 recordings performed at the Rehabilitation Center and the Universidad Central del Este's (UCE) teaching clinic (Nervus and Cadwell respectively). Excluded were 198 for unidentifiable indications. PPW was searched in order to study patient's age, suspected pathology plus gender. Results: PPW was found in 293cases: 4.22% of the total sample: in 275.it occurred before the age of 17 with curve showing an initial tip at nine while between 18 and 65 only 18 cases showed it. Incidentally 14 patients showed Burst suppression or electro-decrement patterns without PPW. The most common indication pathology was Epilepsy followed by learning disability. Finally it was more frequent in 176(63.9%) male vs. 113(36.1%) in female cases: ratio 1.56 to 1. however not significant for the gender ratio in the total EEG sample is 1.55 to 1. Conclusion: PPW nearly disappears after the age of seventeen, perhaps explaining rarity in advanced aged SLA. It is more frequent in Epilepsy EEG indications and in the male

Cómo perciben los niños el jaguar, Panthera onca (Carnivora: Felidae) en Jalisco, México

Los estudios sobre percepción humana hacia depredadores, generalmente se realizan con adultos. Sin embargo, es importante entender las percepciones de los niños, para diseñar estrategias de conservación y educación ambiental efectivas a largo plazo, ya que muchos de ellos serán los futuros manejadores de los recursos naturales. Analizamos las percepciones sobre el jaguar en niños de 8-12 años (n = 89) en comunidades dentro de la Reserva de la Biosfera Sierra de Manantlán (RBSM) y en su zona de influencia (ZI). Para conocer la percepción del jaguar, organizamos talleres con los niños, guiándolos con preguntas abiertas que respondieron con dibujos: ¿Qué animales viven en el monte/bosque? ¿Qué animales peligrosos viven en el monte/bosque? ¿Cómo es el jaguar y qué come? En todas las preguntas se especificó que nos referíamos a los animales presentes en los alrededores de su comunidad. Aparentemente el miedo colectivo hacia los animales influye en que animales se perciben en el entorno, ya que casi nadie dibujó al jaguar como parte del paisaje, pero si como animal peligroso. Las serpientes fueron las que más se relacionan como parte del entorno, y a la vez fueron las que más se mencionaron como animales peligrosos en ambas zonas. En el dibujo de animales peligrosos, hubo 72 menciones de animales no nativos. En ambas áreas, poco más de la mitad de los niños reconoce la forma básica del jaguar. Sobre todo, en la RBSM, la mayoría dibujó ganado vacuno en la dieta del jaguar, representando uno de los conflictos jaguar-humanos. Casi la mitad de los niños dibujó a los venados como parte de la dieta del jaguar en la RBSM y un tercio en la ZI. Un número considerable de niños incluyeron humanos en la dieta en ambas zonas. Concluimos que con el fin de mejorar la percepción es deseable desarrollar estrategias para cambiar las percepciones negativas del jaguar. Por ende, es importante generar material educativo y llevar a cabo campañas de educación ambiental resaltando la importancia ecológica del jaguar, enfatizando que el buen manejo del ganado reduce la depredación y que los humanos no son elementos de la dieta del jaguar. En resumen, es importante generar mayor empatía con el jaguar, y aclarar creencias erradas que puedan afectar la supervivencia del jaguar a largo plazo en estas áreas.

Predator perception studies generally only regard adults. However, it is necessary to also understand children perceptions in order to achieve more effective long term conservation and environmental educational strategies, since many of them will be the future resource managers. We analyze perceptions of the jaguar amongst children (n = 89) between 8 and 12 years old, in the Sierra de Manantlán Biosphere Reserve (SMBR) and its influence zone (ZI). To understand their perceptions, we organized workshops, using open-ended questions, to be answered with drawings: What animals live in the forest? Which dangerous animals live in the forest? What do jaguars look like and what do they eat? In all questions, we specified that we referred to animals close to their community. Apparently collective apprehension influences, which animals are perceived as part of the environment. Our results suggest that the jaguar is not conceived as part of the (direct) environment, but is conceived as dangerous animal in the area. Snakes are most mentioned as part of the environment; at the same time, they are perceived as the most dangerous. In the dangerous animal drawings, there were 72 mentions of no native animals. In all cases, more than half of the children knew the basic shape of a jaguar. Overall in the SMBR, most children drew cattle as the main food staple for the jaguar, representing one of the human-jaguar conflicts. Half of children drew deer as jaguar diet in the SMBR and one third in the ZI. A considerable number of children included humans in the jaguar diet in both zones. We conclude that it is necessary to develop strategies to change the negative perceptions of the jaguar. As such, it is important to generate educational material and carry out educational campaigns that highlight the ecological importance of the jaguar, and emphasizing those livestock management actions to reduce predation and the disappearance of false beliefs; which include jaguar as a people eater. In summary, is important to generate greater empathy with the jaguar, and clarify misconceptions that may affect the long-term survival of the jaguar in these areas.

Empiema del Muñón Ureteral: Secretos Para un Buen Diagnóstico / Empyema of the Ureteral Stump: Secrets for a Correct Diagnosis

El muñón ureteral es el segmento de uréter remanente posterior a una nefrectomía, que puede, ocasionalmente, dar origen a un cuadro sintomático infeccioso poco frecuente, conocido como empiema del muñón ureteral (EMU). El mismo suele atribuirse a otra patología por desconocimiento médico y no es reconocido hasta que el cuadro clínico avanza significativamente o se realiza la exploración quirúrgica. Los muñones ureterales que se encontraban sanos en la cirugía inicial no suelen desarrollar patología. Por el contrario, los uréteres obstruidos, crónicamente infectados o asociados a litiasis o reflujo distal, son los que se encuentran en riesgo de desarrollar complicaciones futuras. En esta revisión, se repasa la literatura y se presentan casos de pacientes con antecedentes de nefrectomía que por diferentes causas transcurrieron con empiema en el muñón ureteral, con el fin de analizar las posibles causas y factores predisponentes de la patología, describir los hallazgos radiológicos en los diferentes métodos diagnósticos y poder reconocer las posibles complicaciones para su correcto manejo terapéutico. Las infecciones urinarias a repetición son útiles para sospechar la presencia de EMU. Ellas se deben al reflujo urinario o disfunción en el vaciamiento del uréter remanente, con estasis e infección del mismo. Por lo tanto, en pacientes con antecedentes de nefrectomía que presentan dolor abdominal difuso, fiebre y antecedentes de infecciones urinarias a repetición, es necesario sospechar empiema del muñón ureteral para poder realizar un correcto análisis imagenológico y posterior tratamiento.

The ureteral stump is the segment of the ureter that remains after a nephrectomy, and it can occasionally give rise to a rare symptomatic infectious disorder known as an empyema of the ureteral stump. The syndrome is usually attributed to another disease due to the radiologist's or ED physician's unawareness, and diagnosis is delayed until there is significant clinical progression, complimentary images or exploratory surgery is performed. Ureteral stumps that were healthy at the initial surgery, usually do not pose further problems. On the other hand, ureters that are obstructed, chronically infected or associated with nephrolithiasis or distal reflux, are at risk for developing future complications. This review goes over the available literature on the subject and presents cases of patients who underwent a nephrectomy and, for different reasons, developed an empyema of the ureteral stump in order analyze the possible causes and predisposing factors, describing the main radiologic findings in each of the different imaging modalities, and recognize the possible complications and their according therapeutic management. Repeated urinary tract infections are useful for suspecting the presence of an empyema, and are due to vesicoureteral reflux or ureteral dysfunction, with consequent urinary stasis and infection. Thus, patients with a history of nephrectomy presenting with diffuse abdominal pain, fever and repeat urinary infections, should raise the suspicion of empyema of the ureteral stump, leading to a correct imaging analysis and posterior treatment.

Lead uptake by the symbiotic Daucus carota L.-Glomus intraradices system and its effect on the morphology of extra- and intraradical fungal microstructures.

This work examines the strategies adopted by an arbuscular mycorrhizal symbiotic system to ameliorate environmental Pb stress by examining the concentrations of P, Fe, and Pb in the fungal microstructures and the host's root. In vitro cultures of Ri-T DNA-transformed carrot (Daucus carota L.) roots were inoculated with Glomus intraradices and treated with Pb(NO3)2 solution and the extraradical spores and mycelia (S/M) and the root with the vesicles, mycelia, and root cells were subsequently analyzed by polarized energy dispersive x-ray fluorescence (PEDXRF) spectrometry. Upon Pb treatment, within the root, the percentages of mycorrhizal colonization, the vesicles, and mycelia increased as well as the areas of the vesicles and the (extraradical) spores, although the number of spores and arbuscules decreased. The S/M and the mycorrhizal root showed enhanced concentrations of Pb, Fe, and P. These were particularly marked for Fe in the Pb-treated cultures. This indicates a synergistic relationship between the arbuscular mycorrhizal fungus and the host that confers a higher Pb tolerance to the latter by the induction of higher Fe absorption in the host. The intraradical vesicle, mycelia, and arbuscule numbers are interpreted as a "tactic to divert" the intraradical Pb traffic away from the root cells to the higher affinity cell walls of the arbuscular mycorrhizal fungi (AMF) microstructures in the apoplast. The results of this work show that the symbiosis between the AMF G. intraradices and the host plant D. carota distinctly improves the latter's Pb tolerance, and imply that the appropriate metal tolerant host-AMF combinations could be employed in process designs for the phytoremediation of Pb.