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Background: Studies aimed at assessing whether the emboli lodged in the central pulmonary arteries carry a worse prognosis than more peripheral emboli have yielded controversial results. Aims: To explore the impact on survival and long-term prognosis of central pulmonary embolism. Patients and Methods: Consecutive patients diagnosed with acute symptomatic pulmonary embolism by means of computed tomography (CT) angiography were evaluated at episode index and traced through the computed system of clinical recording and followingup. Central pulmonary embolism was diagnosed when thrombi were seen in the trunk or in the main pulmonary arteries and peripheral pulmonary embolism when segmental or subsegmental arteries were affected. Results: A total of 530 consecutive patients diagnosed with pulmonary embolism were evaluated; 255 patients had central pulmonary embolism and 275 patients had segmental or subsegmental pulmonary embolism. Patients with central pulmonary embolism were older, had higher plasma levels of N-terminal of the prohormone brain natriuretic peptide (NT-ProBNP), troponin I, D-dimer, alveolar-arterial gradient, and shock index (P < .001 for each one). Patients with central pulmonary embolism had an all-cause mortality of 40% while patients with segmental or subsegmental pulmonary embolism (PE) had an overall mortality of 27% and odds ratio of 1.81 [confidence interval (CI) 95% 1.16-1.9]. Survival was lower in patients with central PE than in patients with segmental or subsegmental pulmonary embolism, even after avoiding confounders (P = .018). Conclusions: Apart from a greater impact on hemodynamics, gas exchange, and right ventricular dysfunction, central pulmonary embolism associates a shorter survival and an increased long-term mortality. [ABSTRACT FROM AUTHOR]

During the war in Bosnia and Herzegovina (1992-1995) cultural heritage was explicitly targeted and the state of destruction was extensive to both sacral and secular monuments. Two decades after the end of hostilities the perception of the historic environment is still defined from the angles of national, religious or ethnic belonging. Enabling recognition, reconciliation, tolerance and respect within the community of Stolac, Bosnia & Herzegovina through a better understanding and sharing of cultural heritage was the focus of this project. Stolac is representative of the problems in the region and stands out for its particularly sharp divisions. Until recently there was segregation with local schools and their curriculum was divided with cultural heritage generally not addressed. How can this small community engage with heritage and develop a dialogue that encourages tolerance, respect and as a base for development? How does one understand, then document areas significance to the community? Finally, how can technology assist? The focus of this paper is to relate the experiences and findings of a project that incorporated participatory imaging mapping and the use of technology to bridge between the internal borders of this small community. It will outline a methodology, experiences of the participants and results from their exercises in order to assist other communities facing similar issues. [ABSTRACT FROM AUTHOR]

BACKGROUND: There has been concern about the increase of antimicrobial resistant bacteria and protection of animal and public health, along with food safety. In the present study, we evaluate the incidence of antimicrobial resistance among 192 strains of Escherichia coli isolated from faecal samples of healthy food-producing animals at slaughter in Portugal. RESULTS: Ninety-seven % of the pig isolates, 74% from sheep and 55% from cattle were resistant to one or more antimicrobial agents, with the resistances to ampicillin, streptomycin, tetracycline and trimethoprim-sulfamethoxazole the most common phenotype detected. Genes encoding resistance to antimicrobial agents were detected in most of the resistant isolates. Ninety-three % of the resistant isolates were included in the A or B1 phylogenetic groups, and the virulence gene fimA (alone or in association with papC or aer genes) was detected in 137 of the resistant isolates. Five isolates from pigs belonging to phylogroup B2 and D were resistant to five different antimicrobial agents. CONCLUSION: Our data shows a high percentage of antibiotic resistance in E. coli isolates from food animals, and raises important questions in the potential impact of antibiotic use in animals and the possible transmission of resistant bacteria to humans through the food chain. © 2012 Society of Chemical Industry [ABSTRACT FROM AUTHOR]