Amyloidosis is a systemic disorder produced by the deposition of insoluble protein fibrils that fold and deposit in the myocardium. Patients with amyloidosis and cardiac involvement have higher mortality than patients without cardiac involvement. The two most prevalent forms of amyloidosis associated with cardiac involvement are AL amyloidosis, due to the deposition of immunoglobulin light chains, and ATTR amyloidosis, due to the deposition of the transthyretin (TTR) protein in mutated or senile form. This article aims to review the different cardiac imaging modalities (echocardiography, cardiac magnetic resonance imaging, nuclear medicine and tomography) that allow to determine the severity of cardiac involvement in patients with amyloidosis, the type of amyloidosis and its prognosis. Finally, we suggest a diagnostic algorithm to determine cardiac involvement in amyloidosis adapted to locally available diagnostic tools, with a practical and clinical approach.

Currently there is a great acceptance in medicine and dentistry that clinical practice should be “evidence-based” as much as possible. That is why multiple works have been published aimed at decreasing radiation doses in the different types of imaging modalities used in dentistry, since the greater effect of radiation, especially in children, forces us to take necessary measures to rationalize its use, especially with Cone Beam computed tomography (CBCT), the method that provides the highest doses in dentistry. This review was written using such an approach with the purpose of rationalizing the radiation dose in our patients. In order to formulate recommendations that contribute to the optimization of the use of ionizing radiation in dentistry, the SEDENTEXCT project team compiled and analyzed relevant publications in the literature, guidelines that have demonstrated their efficiency in the past, thus helping to see with different perspectives the dose received by patients, and with this, it is recommended taking into account this document so as to prescribe more adequately the complementary examinations that we use on a daily basis.

Background: Multiple sclerosis is often a longitudinal disease continuum with an initial relapsing-remitting phase (RRMS) and later secondary progression (SPMS). Most currently approved therapies are not sufficiently effective in SPMS. Early detection of SPMS conversion is therefore critical for therapy selection. Important decision-making tools may include testing of partial cognitive performance and magnetic resonance imaging (MRI). Aim of the work: To demonstrate the importance of cognitive testing and MRI for the prediction and detection of SPMS conversion. Elaboration of strategies for follow-up and therapy management in practice, especially in outpatient care. Material and methods: Review based on an unsystematic literature search. Results: Standardized cognitive testing can be helpful for early SPMS diagnosis and facilitate progression assessment. Annual use of sensitive screening tests such as Symbol Digit Modalities Test (SDMT) and Brief Visual Memory Test-Revised (BVMT-R) or the Brief International Cognitive Assessment for MS (BICAMS) test battery is recommended. Persistent inflammatory activity on MRI in the first three years of disease and the presence of cortical lesions are predictive of SPMS conversion. Standardized MRI monitoring for features of progressive MS can support clinically and neurocognitively based suspicion of SPMS. Discussion: Interdisciplinary care of MS patients by clinically skilled neurologists, supported by neuropsychological testing and MRI, has a high value for SPMS prediction and diagnosis. The latter allows early conversion to appropriate therapies, as SPMS requires different interventions than RRMS. After drug switching, clinical, neuropsychological, and imaging vigilance allows stringent monitoring for neuroinflammatory and degenerative activity as well as treatment complications.

Introduction: Stenoses in the path of arteriovenous fistulas (AVF) for hemodialysis are a very prevalent problem and there is long experience in their treatment by percutaneous angioplasty (PTA). These procedures, however, involve non-negligible equipment requirements, exposure to radiation and intravenous contrast that are not beneficial for the patient and make their performance more complex. This study reviews our initial experience with Doppler ultrasound-guided angioplasty. Methods: Prospective cohort of patients with native AVF dysfunction due to significant venous stenosis treated by Doppler echo-guided PTA. AVF puncture, lesion catheterization, balloon localization and inflation, and outcome verification were performed under ultrasound guidance. Only one fistulography was performed before and another one after dilatation. As a control, the cases performed during the same period by the usual angiographic method were also collected. Results: Between February 2015 and September 2018, 51 PTAs were performed on native AVF, of which 27 were echogenic (mean age, 65.3 years; 63% male). The technical success rate was 96%. In 26% of cases, PTA was repeated due to residual stenosis after angiographic imaging. There were 7.3% periprocedural complications. 92% of the AVFs were punctured at 24 hours. Primary patency at 1 month, 6 months and 1 year was 100%, 64.8% and 43.6%, and assisted patency was 100%, 87.2% and 74.8%. There were no significant differences in immediate or late results with respect to angiographically guided AVF angioplasty. Conclusions: AVF-PTA can be performed safely and effectively guided by Doppler ultrasound, which simplifies the logistics required for its performance, although we still need to improve the capacity for early verification of the result with this imaging technique.

To investigate the possible role of arbuscular mycrrhizal fungi (AMF) in alleviating the negative effects of salinity on Stevia rebaudiana (Bert.), the regenerated plantlets in tissue culture was transferred to pots in greenhouse and inoculated with Glomus intraradices. Salinity caused a significant decrease in chlorophyll content, photosynthesis efficiency and enhanced the electrolyte leakage. The use of AMF in salt –affected plants resulted in improved all above mentioned characteristics. Hydrogen peroxide and malondialdehyde (MDA) contents increased in salt stressed plants while a reduction was observed due to AMF inoculation. CAT activity showed a significant increase up to 2 g/l and then followed by decline at 5 g/l NaCl in both AMF and non-AMF treated stevia, however, AMF inoculated plants maintained lower CAT activity at all salinity levels (2 and 5 g/l). Enhanced POX activities in salt- treated stevia plants were decreased by inoculation of plants with AMF. The addition of NaCl to stevia plants also resulted in an enhanced activity of SOD whilst, AMF plants maintained higher SOD activity at all salinity levels than those of non-AMF inoculated plants. AMF inoculation was capable of alleviating the damage caused by salinity on stevia plants by reducing oxidative stress and improving photosynthesis efficiency. 

The objective of this study was to evaluate the growth of four lettuce cultivars in Southern Piauí to recommend the best ones for the region. The experiment was conducted in a greenhouse with randomized blocks, with evaluation in subdivided time plots, evaluated in six seasons (20, 24, 28, 32, 36, 40 days after sowing—DAS) and with treatments corresponding to four cultivars (Americana Rafaela^®, Grand Rapids TBR^®, Crespa Repolhuda^® and Repolhuda Todo ano^®) with five repetitions. Leaf area, number of leaves, collar diameter, aboveground fresh mass, aboveground dry mass, root dry mass and total and the physiological indices of growth analysis were evaluated. The lettuce cultivars interfered significantly in the studied parameters, being that Americana Rafaela^® and Repolhuda todo ano^®, in the conditions that they were submitted, presented better performances and bigger morphophysiological indexes, cultivated in pot. The cultivars Americana Rafaela^® and Repolhuda todo ano^® can be produced under the conditions of the south of Piauí.