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The most common cause of pulmonary hypertension (PH) in developed countries is left heart disease (LHD, group 2 PH). The development of PH in heart failure (HF) patients is indicative of worse outcomes. The aim of this study was to evaluate the long term outcomes of HF patients with PH in a national long-term registry. Study included 9 cardiology centers across Israel between 01/2013–01/2015, with a 12-month clinical follow-up and 24-month mortality follow-up. Patients were age ≥18 years old with HF and pre-inclusion PH due to left heart disease determined by echocardiography [estimated systolic pulmonary arterial pressure (SPAP) ≥ 50 mmHg]. Patients were categorized into 3 groups: HF with reduced (HFrEF < 40%), mid-range (HFmrEF 40–49%), and preserved (HFpEF ≥ 50%) ejection fraction. The registry included 372 patients, with high prevalence of cardiovascular risk factors. Median HF duration was 4 years and 65% were in severe HF New York Heart Association (NYHA) classification ≥3. Mean systolic pulmonary artery pressure (SPAP) was 62 ± 11 mmHg. During 2-years of follow-up, 54 patients (15%) died. Univariable predictors of mortality included NYHA grade 3–4, chronic renal failure, and SPAP ≥ 65 mmHg. Severe PH was associated with mortality in HFpEF, but not HFmrEF or HFrEF, and remained significant after multivariable adjustment with an adjusted hazard ratio of 2.99, (95%CI 1.29–6.91, p = 0.010). The combination of HFpEF with severe PH was independently associated with increased mortality. Currently, HFpEF patients are included with group 2 PH patients. Defining HFpEF with severe PH as a sub-class may be more appropriate, as these patients are at increased risk and deserve special consideration. [ABSTRACT FROM AUTHOR]

Background In patients with ankylosing spinal disease, including ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis, even low-impact trauma can lead to complex injuries. The injuries seem to be highly unstable and associated with greater mortality rates compared with the general spine trauma population. Methods We reviewed the medical records of a consecutive series of 41 patients (34 men, 7 women) with ankylosing spinal disease and unstable traumatic spine injuries who were admitted to our department from 2007 to 2016. Results The mean patient age was 73.4 ± 12.7 years. Of the 41 patients, 24 (58.5%) had ankylosing spondylitis and 17 (41.5%) had diffuse idiopathic skeletal hyperostosis. Low-velocity accidents were documented in 38 patients (92.7%). The most frequent injuries were type B spine fractures (61.0%). Accompanying spinal epidural hematoma was detected using magnetic resonance imaging in 12 patients (29.3%) but was not found by radiography or computed tomography. Of the 41 patients, 24 (58.5%) presented with American Spinal Injury Association impairment scale (AIS) grade E, 6 (14.6%) with grade D, and 8 (19.6%) with grade C or worse. All the patients had undergone internal fixation. All but 1 (97.6%) had received posterior fixation. In 25 (61%), a combined approach was performed. Five patients died of early complications. Of the 36 discharged patients, 11 died during the follow-up period and 1 was lost to follow-up. The surviving 24 patients had a median follow-up of 733 ± 576 days; 21 had AIS grade E, 2 had AIS grade D, and 1 had AIS grade C. Conclusions A thorough diagnostic evaluation with multislice computed tomography and magnetic resonance imaging can reveal injuries that would remain undetected on conventional radiographs. A combined approach or posterior-only fixation seems safe. [ABSTRACT FROM AUTHOR]

The effect of Stroop test (ST)-induced stress on autonomic nervous system activity is often examined via measurement of heart rate variability (HRV). However, HRV may be significantly affected by interfering factors, including vocalization and inappropriate body position. Surprisingly, published studies ignore these issues, so the aim of our study was to test the innovative procedure for correct HRV measurement in individuals exposed to ST. Moreover, we examined possible gender differences in HRV and heart rate (HR) during ST. Healthy participants (21 men, 34 women) were placed in a supine position (no orthostatic activation) and then exposed to a 5 min relaxation period and a 5 min period of computerized ST (no vocalization). We found significant differences in HR and HRV parameters in both genders during ST when compared to relaxation (baseline) values. On the other hand, there were no significant differences in HR and HRV between males and females (except for a higher baseline HR in women). Also, reactivity to ST stress (difference between baseline and ST value) showed no gender differences. In conclusion, when performed in a supine position and without vocalization, the ST induces significant stress-related changes of HR and HRV in both genders, with no gender differences in the magnitude of reaction to ST stress. This experimental procedure can be used for correct examination of mental stress-related changes in the autonomic nervous system, and is particularly useful for examining mixed-gender experimental groups. [ABSTRACT FROM AUTHOR]

Abstract: Increasing environmental and economic concerns have resulted in considering the potential for the successful use of herbicides at lower doses within an integrated approach to weed management. Therefore, field experiments were carried out to evaluate the efficiency of mesosulfuron-methyl and clodinafop-propargyl dose to control Lolium perenne in pure stand and in mixture with wheat. The herbicides at 5 different doses were assigned in a factorial arrangement (subplots) within planting systems (mainplots). L. perenne biomass was totally different in pure stand and in mixed planting system, irrespective of the herbicide effect. More than 3-fold decrease was caused in the L. perenne biomass by the presence of wheat. Mesosulfuron-methyl was more potent than clodinafop-propargyl in the L. perenne control. Mixed planting enhanced the herbicide performance, increasing the relative potency value of mesosulfuron-methyl. The wheat grain yield received no additional benefit from applying mesosulfuron-methyl at the full recommended dose rather than at half dose. This study demonstrates that L. perenne suppression involving sub-lethal herbicide dose is associated with the wheat competitiveness. Combining competitive cropping systems with reduced herbicide could be an approach to reducing weed populations over time with lower crop production costs. [Copyright &y& Elsevier]

Methicillin-resistant Staphylococcus aureus (MRSA) has recently become a significant pathogen in ocular and systemic disease. Both community- and nosocomial-acquired MRSA orbital cellulitis have been reported in adults. However, there exist only very few published case reports of pediatric MRSA orbital cellulitis, and it is unclear whether these infections were hospital or community acquired and if these children were immunocompromised. We report the first documented case of orbital cellulitis secondary to community-acquired MRSA in a non-immunocompromised child. [Copyright &y& Elsevier]

Changes in the quantity and/or quality of food intake have been shown to be associated with morphological and functional alterations of the gastrointestinal system. To examine this, we investigated the effect of chronic liquid nutrition intake (Fresubin) on stomach and duodenum morphology in Wistar rats fed liquid nutrition during different developmental periods. We used four groups of rats: a) control group (CON) fed pelleted chow for 130 days; b) liquid nutrition group (LN) fed liquid nutrition for 130 days; c) liquid nutrition juvenile group (LNJ) fed liquid nutrition for 70 days and then pelleted food for 60 days; d) liquid nutrition adult group (LNA) fed pelleted chow for 70 days and then liquid nutrition for 60 days. We found that LN and LNA rats showed a significant reduction of empty stomach mass compared to CON animals, while stomach and duodenal longitudinal muscle layer thickness did not differ between groups. Villus height was increased only in LNA animals, while villus width was increased in both LN and LNA rats. Crypt depth was reduced in LNJ. However, liquid nutrition intake did not affect villus height/crypt depth ratio, nor number of goblet cells. We found that chronic intake of liquid nutrition affects some morphological parameters of the stomach and duodenum but these changes were not homogenous between experimental groups. Interestingly, transition from liquid nutrition to solid food reversed the alterations of stomach weight as well as villus width induced by intake of liquid nutrition in LNA rats. Our data indicate that morphological and functional changes in the gastrointestinal system induced by qualitative and quantitative changes in food intake are at least partially reversible. Therefore, specific diets may be used potentially as adjuvant treatment for modulating the progression of gastrointestinal diseases by affecting stomach and small intestine morphology. [ABSTRACT FROM AUTHOR]

Erythrocyte deformability is an important property of erythrocytes that considerably affects blood flow and hemodynamics. The high content of polyphenols present in dark chocolate has been reported to play a protective role in functionality of erythrocytes. We hypothesized that chocolate might influence erythrocytes not only after repeated chronic intake, but also immediately after its ingestion. Thus, we determined the acute effect of dark chocolate and milk (with lower content of biologically active substances) chocolate intake on erythrocyte deformability. We also focused on selected factors that may affect erythrocyte deformability, specifically nitric oxide production in erythrocytes and total antioxidant capacity of plasma. We determined posttreatment changes in the mentioned parameters 2 hours after consumption of chocolate compared with their levels before consumption of chocolate. In contrast to milk chocolate intake, the dark chocolate led to a significantly higher increase in erythrocyte deformability. Nitric oxide production in erythrocytes was not changed after dark chocolate intake, but significantly decreased after milk chocolate. The plasma total antioxidant capacity remained unaffected after ingestion of both chocolates. We conclude that our hypothesis was confirmed. Single ingestion of dark chocolate improved erythrocyte deformability despite unchanged nitric oxide production and antioxidant capacity of plasma. Increased deformability of erythrocytes may considerably improve rheological properties of blood and thus hemodynamics in humans, resulting in better tissue oxygenation. [ABSTRACT FROM AUTHOR]

Purpose There is a lack of studies highlighting the outcome by different scores or parameters after surgery for recurrent disc herniations of the lumbar spine at the initial herniation site. This study assessed the quality of life after surgical treatment of recurrent herniations with different standardized validated outcome instruments. Methods During a 24-month period, 64 patients underwent (microscope assisted) surgery for recurrent disc herniations of the lumbar spine. The postoperative quality of life was tested with Short Form-36, the Oswestry Disability Index, the EuroQol health status 5D, and Prolo questionnaires. Leg and back pain before and after surgery was assessed. Results The patients showed a good overall outcome, but still not satisfying enough compared with the very good surgical results reported in the literature, for the surgical treatment of primary disc herniations. Conclusions Patients have to be informed carefully before surgery of recurrent lumbar disc herniations because of the less-promising outcome than after first time surgery for a lumbar disc herniation. [ABSTRACT FROM AUTHOR]

Abstract: Of the 13 principles of drug addiction treatment disseminated by the National Institute on Drug Abuse (NIDA), 7 were meta-analyzed as part of the Evidence-based Principles of Treatment (EPT) project. By averaging outcomes over the diverse programs included in the EPT, we found that 5 of the NIDA principles examined are supported: matching treatment to the client''s needs, attending to the multiple needs of clients, behavioral counseling interventions, treatment plan reassessment, and counseling to reduce risk of HIV. Two of the NIDA principles are not supported: remaining in treatment for an adequate period and frequency of testing for drug use. These weak effects could be the result of the principles being stated too generally to apply to the diverse interventions and programs that exist or unmeasured moderator variables being confounded with the moderators that measured the principles. Meta-analysis should be a standard tool for developing principles of effective treatment for substance use disorders. [Copyright &y& Elsevier]