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Background: Cardiac tamponade (CT) has an atypical presentation in patients with underlying pulmonary hypertension (PH). Evidence regarding the impact of PH on CT in-hospital outcomes is lacking., Methods: We used the National Inpatient Sample database to identify adult hospitalizations with a diagnosis of CT between 2016 and 2020, using relevant ICD-10 diagnostic codes. Baseline characteristics and in-hospital outcomes were compared in patients with and without a PH. Multivariate logistic regression analyses and case-control matching were performed, adjusting for age, race, gender, and statistically significant co-morbidities between cohorts., Results: A total of 110,285 inpatients with CT were included, of which 8,670 had PH. Patients with PH tended to be older (66 ± 15.7) and female (52.5%), had significantly higher rates of hypertension (74% vs 65%), CAD (36.9% vs. 29.6%), CKD (39% vs 23%), DM (32.1%, vs. 26.9%), chronic heart failure (19.0% vs 9.7%) and COPD (26% vs 18%)(P<0.001 for all). After multivariate logistic regression, PH was associated with higher all-cause mortality (aOR 1.29; 95% CI: 1.11-1.49), higher rates of cardiogenic shock (aOR: 1.19; 95% CI: 1.01-1.41), ventricular arrythmias (aOR: 1.63; 95% CI: 1.33-2.01), longer length of stay (11 days vs 15 days), and higher total hospitalization costs ($228,314 vs $327,429) in patients presenting with CT. Despite pericardiocentesis being associated with lower in-hospital mortality, patients with PH were less likely to undergo pericardiocentesis (aOR: 0.77; 95% CI: 0.69-0.86)., Conclusion: PH was associated to increased in-hospital mortality and a higher rate of cardiovascular complications in an inpatient population with CT. Pericardiocentesis was associated with reduced mortality in patients with CT, regardless of whether they had PH. However, patients with PH underwent pericardiocentesis less frequently than those without PH., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Vasquez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Aims: To determine incidence and levels of ochratoxin A (OTA) in California raisins and to isolate and characterize OTA-producing fungi from California raisin vineyard populations., Methods and Results:  Forty raisin clusters sampled from four California vineyards in the San Joaquin Valley were analysed for OTA content using immunoaffinity and HPLC methods. OTA was detected in 93% of the samples, at levels from 0·06 to 11·4 ng g⁻¹. From these raisin samples, a total of 400 strains of Aspergillus were isolated and analysed for OTA production. Twelve isolates (3%), from five raisin samples, produced OTA. These isolates were identified as Aspergillus carbonarius, based on morphological characteristics and multilocus sequence analysis. Levels of OTA produced by these isolates on raisin agar ranged from 0·9 to 15 μg g⁻¹., Conclusions: OTA is a common contaminant of raisin vineyards, but average levels are much lower than EU regulatory limits for dried fruit. The primary species responsible for OTA contamination in California raisins is A. carbonarius., Significance and Impact of the Study: This study illustrates that low-level OTA contamination of raisins occurs in California and that ecological studies of A. carbonarius within the Aspergillus section Nigri population on raisins are warranted to monitor ochratoxigenic potential of the crop., (No claim to US Government works. Letters in Applied Microbiology © 2011 The Society for Applied Microbiology.)

A grapevine decline of unknown etiology is currently under investigation in California. Two- to 5-year-old vines show low vigor with undersized trunks, short internodes, uneven wood maturity, sparse foliage, and stunted, chlorotic leaves with interveinal chlorosis and necrosis. Trunks viewed in cross section show dark streaking in few to most of the vascular elements. Pith is compacted and discolored; the surrounding wood is dry with a silvery sheen. Primary roots also show dark streaking in the vascular elements and total root biomass is reduced. Phaeoacremonium spp. were consistently isolated from the roots, crowns, and lower portions of the rootstocks of declining vines but not from adjacent healthy vines. Phaeoacremonium spp. grew slowly out of infected tissues, but sporulated abundantly in culture. Identification was verified from a published key (1). Phaeoacremonium chlamydosporum and P. inflatipes were isolated throughout the northern and central California production areas, but P. aleophilum was isolated only in Riverside County. Koch's postulates were completed for Phaeoacremonium spp. by dipping roots of 2-month-old Carignane grape seedlings (n = 80) in a 10 8 spores per ml suspension for 30 min. Plants were potted in an artificial soil mix and held in a growth chamber at 25°C. Over 50% of plants inoculated with Phaeo-acremonium spp. developed root, stem, and vascular symptoms within 8 weeks. Each of the individual pathogen species was reisolated from over 75% of the inoculated plants but never from the controls. Similarly, all three Phaeoacremonium spp. are associated with wilt and decline diseases in grapevines in Africa (1) and Europe (2) but this is the first report in North America. While several names for this disease have been used previously with older grapevines, including Esca, apoplexy, and black measles (3), we propose using Phaeoacremonium grapevine decline to describe the diseases caused by P. aleophilum, P. chlamydosporum, and P. inflatipes on young vines. References: (1) P. W. Crous et al. Mycologia 88:786, 1996. (2) P. Larignon and B. Dubos. Euro. J. Plant Pathol. 103:147, 1997. (3) R. Pearson and A. Goheen. 1988. Compendium of Grape Diseases. American Phytopathological Society, St. Paul, MN.

Black-foot disease, caused by Cylindrocarpon obtusisporum (Cook & Harkn.) Wollenweb., impacts young table and wine grape (Vitis vinifera) plantings throughout California. Two- to 5-year-old grapevines showed reduced vigor with small-sized trunks, shortened internodes, uneven wood maturity, sparse foliage, and small leaves with interveinal chlorosis and necrosis. In cross-section, trunks showed dark brown to black streaking in a few to most of the vascular elements. Symptoms included a reduction in root biomass and root hairs with sunken, necrotic root lesions. Pith of affected vines was compacted and discolored. Isolations made from roots, vascular elements, and pith tissue consistently yielded colonies of C. obtusisporum as verified by descriptions in standard texts. Koch's postulates were completed by dipping the roots of cv. Carignane seedlings in a 10 8 spore per ml suspension for 30 min. Plants were repotted in an artificial soil mix and held in a controlled environment facility at 24°C. Typical black-foot symptoms developed on 92% of the plants within 8 weeks. Control plants dipped in distilled water remained healthy. Cylindrocarpon destructans, a species closely related to C. obtusisporum, was first reported to cause "black-foot disease" on young vines in 1961 (2). In 1975, C. obtusisporum was reported to produce similar "black-foot" symptoms (1). We propose the common name Cylindrocarpon black-foot disease be used with both species. References: (1) S. Grasso et al. Vitis 14:36, 1975. (2) D. R. Maluta and P. Larignon. Viticulture 11:71, 1991.