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Ascending aorta replacement can be performed safely in high-volume centers. What remains unknown is whether concomitant coronary revascularization with bypass grafting affects postoperative outcomes. This study retrospectively reviewed a prospectively maintained institutional database for patients who underwent ascending aorta replacement (AAR) during the period from 1997 to 2018. Patients were stratified into AAR alone (AAR) vs AAR and coronary artery bypass graft (AAR with CABG), further categorized as 1 or more than 1 CABG. Aortic dissection and root replacement cases were excluded. The primary end point consisted of major adverse events (MAE), including operative mortality, perioperative myocardial infarction, stroke, need for tracheostomy, and need for dialysis. Secondary end points were operative mortality, each MAE component, and late survival. A total of 951 patients were included in the analysis; 725 (76.2%) underwent isolated AAR, and 226 (23.8%) underwent AAR with CABG. Operative mortality was similar across the 2 groups (1.8% for AAR with CABG and 0.8% for AAR; P =.40). The unadjusted incidence of MAE was higher in the AAR with CABG group (5.8% vs 1.9%; P =.005).). On multivariable analysis, the performance of 1 CABG (odds ratio [OR], 1.90; 95% confidence interval [CI], 0.67 to 5.33; P =.23) and more than 1 CABG (OR, 2.65; 95% CI, 0.93 to 7.53; P =.07) was not associated with higher rates of MAE. Preoperative pulmonary dysfunction (OR, 2.51; 95% CI, 1.07 to 5.85; P =.03) was the only independent predictor of MAE. In patients undergoing concomitant CABG with AAR, the performance of concomitant CABG is not associated with an increased risk of MAE. [ABSTRACT FROM AUTHOR]

Spodoptera exigua (Hübner) has a worldwide distribution with a high capacity for damaging a wide range of food, forage and fiber crops. It has been reported extensively from all over the world that populations of this pest species have developed field resistance against many insecticides. The objectives of this study were to determine whether an emamectin benzoate resistant field population of S. exigua re-selected with emamectin benzoate in the laboratory (Ema-SEL) showed cross-resistance to other insecticides, whether resistance was stable under laboratory conditions, and whether there were fitness costs associated with emamectin benzoate resistance. Bioassays at G 1 for the field population, gave resistance ratios (RRs) of 220, 149 and 38-fold for emamectin benzoate, spinosad and lufenuron, respectively, compared with a susceptible laboratory population (Lab-PK). Resistance ratios were increased by 526-fold and 6-fold compared with Lab-PK and the unselected field population (Ema-UNSEL, G 6 ), respectively after selection with emamectin benzoate (Ema-SEL) for five generations (G 6 ). Selection with emamectin benzoate had no apparent effect on susceptibility of Ema-SEL to spinosad and lufenuron, instead toxicity to the latter insecticides reduced, suggesting there was no cross-resistance between these compounds. Analysis of various life history traits suggested that the Ema-SEL population had a lower overall fitness (0.38) compared with the Lab-PK (1.0). Lack of cross-resistance and the apparent instability of resistance to emamectin benzoate suggest that spinosad and lufenuron are suitable alternatives for use with emamectin benzoate in resistance management. In addition, the high relative fitness costs observed suggests that emamectin benzoate-resistant insects are at a considerable disadvantage to susceptible populations in the absence of selection pressure although this remains to be tested under field conditions. [ABSTRACT FROM AUTHOR]

Abstract: The present studies were carried out to evaluate resistance in Pakistani populations of beet armyworm, Spodoptera exigua (Hubner) to various insecticides. Different field populations of S. exigua from four districts of the Punjab were monitored from 2008 to 2010 for resistance against insecticides using a standard leaf dip bioassay method. For pyrethroids and organophosphates, resistance ratios compared with a susceptible Lab-Pk population were in the range of 7–105-fold for deltamethrin, 12–136-fold for cypermethrin, 20–134-fold for chlorpyrifos and 37–143-fold for profenofos. For new chemistry insecticides, resistance levels were 3–73-fold for spinosad, 5–226-fold for abamectin, 6–88-fold for indoxacarb, 3–75-fold for emamectin benzoate, 2.4–59-fold for lufenuron and 3–41-fold for methoxyfenozide. The pairwise correlation coefficients of LC50 values indicated a positive correlation with cross-resistance among deltamethrin, cypermethrin and chlorpyrifos, whereas resistance to profenofos showed correlations with resistances to other insecticides except chlorpyrifos. The new chemistry insecticides showed no correlations among any of the tested insecticides. There were high to very high levels of resistance to organophosphates in most of the populations, which suggested that these should be avoided against this pest. Selective use of pyrethroids in some areas including Multan and Khanewal, where they showed a low level of resistance, would appear to be acceptable. The new chemistry insecticides; lufenuron, methoxyfenozide, indoxacarb and emamectin had no, very low, low and moderate resistance levels for most of the tested populations, respectively. These are also considered to be environmentally safe and safer to natural enemies. Due to these characteristics they could be used in IPM programs supplemented with bio-control agents such as Nuclear Polyhedrosis Virus (NPV), and natural enemies such as parasitoids and predators. Rotation of insecticides with different mode of action where populations have no, very low or low levels of resistance could also be helpful in the management of insecticide resistance in S. exigua. [Copyright &y& Elsevier]

We report the case of a 66-year-old man who presented with a prodromal type illness and pre-sternal swelling after having coronary artery bypass grafts 4 years earlier. Computed tomography showed that the mass had a retrosternal extension, to join a collection anterior to the right ventricle. Candida famata was isolated from operative specimens and he was treated with aggressive antifungal therapy. We believe that this is the first reported case of mediastinal Candida famata. [Copyright &y& Elsevier]