Search

Late blight caused by the oomycete Phytophthora infestans is considered to be one of the most severe diseases of potato and tomato worldwide. Whilst current synthetic fungicides are efficient at controlling this disease, they are an environmental and economic burden. In line with EU directives to reduce the use of synthetic pesticides and increase the use of sustainable alternative disease control strategies that can form part of integrated pest management systems, practical biological control solutions are urgently needed. Despite the fact that there has been a large body of scientific research into microorganisms with potential for the biological control of late blight disease, relatively few commercial biocontrol agents, licensed to control late blight, exist. Furthermore, the practical uptake of those in Europe is lower than might be expected, suggesting that such solutions are not yet feasible, or effective. Here we review the scientific literature, focusing on the most recent developments in the hunt for efficient and sustainable biological control of late blight disease. We discuss the progress in our mechanistic understanding of mycoparasite–prey interactions, in the context of late blight and the challenges and limitations to the use of such knowledge in practical disease control within a European context. • Over 96 peer-reviewed papers on late blight biocontrol in the last 20 years. • The challenge is to move away from pure in vitro studies to in agro applications. • We need an IPM systems approach to biocontrol of late blight. • We must incorporate pathogen and BCA evolutionary ecological knowledge into IPM. • BCAs could be bioengineered as "cell factories" to produce late blight biopesticides. [ABSTRACT FROM AUTHOR]

In multiple system atrophy (MSA), increased venous compliance with excessive venous pooling is assumed to he a major contributor to orthostatic hypotension (OH); however, venous compliance has never been assessed in MSA patients. We evaluated the severity and distribution of adrenergic, cardiovagal, and sudomotor failure in 11 patients with probable MSA, 14 age- and sex-matched control subjects, and 8 patients with Parkinson's disease (PD) but not OH. Calf venous compliance, venous filling, and capillary filtration were measured using calf plethysmography. The response to the directly acting [alpha]-adrenergic stimulation (10 mg midodrine) on calf venous compliance was additionally evaluated. Contrary to our hypothesis, pressure-volume curves in the legs of MSA patients were flatter than in PD patients (P < 0.05) or controls (P < 0.001); this indicated reduced calf venous compliance in MSA. The MSA group had reduced venous filling compared with control (P < 0.001) or PD subjects (P < 0.001) but had a normal capillary filtration rate (P = 0.73). Direct [alpha]-adrenergic stimulation resulted in a slight but significant reduction of calf venous compliance in controls (P = 0.001) and PD subjects (P < 0.001) but not in the MSA group. The compliance change in MSA significantly regressed with autonomic failure (composite autonomic severity scale, [r.sup.2] = 0.56) but not with parkinsonism (Unified MSA Rating Scale, [r.sup.2] = 0.12). Our data indicate that MSA patients with chronic OH have reduced, rather than increased, venous compliance in the lower leg. We postulate that chronic venous distension that is associated with OH results in structural remodeling of veins, leading to reduced compliance, a change which may protect patients against orthostatic stress. veins; vascular capacitance; orthostatic hypotension; vasoconstriction doi:10.1152/ajpheart.01208.2006

Injury of the afferent limb of the baroreflex from neck radiation causes radiation-induced afferent baroreflex failure (R-ABF). Identification and management of R-ABF is challenging. We aimed to investigate the pattern of autonomic dysfunction on standardized autonomic testing in patients with probable R-ABF. We retrospectively analyzed all autonomic reflex screens performed at Mayo Clinic in Rochester, MN, between 2000 and 2020 in patients with probable R-ABF. Additional tests reviewed included ambulatory blood pressure monitoring, plasma norepinephrine, and thermoregulatory sweat test. We identified 90 patients with probable R-ABF. Median total composite autonomic severity score (range, 0-10) was 7 (interquartile range, 6-7). Cardiovascular adrenergic impairment was seen in 85 patients (94.4%), increased blood pressure recovery time after Valsalva maneuver in 71 patients (78.9%; median 17.4 seconds), and orthostatic hypotension in 68 patients (75.6%). Cardiovagal impairment was demonstrated by abnormal heart rate responses to deep breathing (79.5%), Valsalva ratio (87.2%), and vagal baroreflex sensitivity (57.9%). Plasma norepinephrine was elevated and rose appropriately upon standing (722-1207 pg/mL). Ambulatory blood pressure monitoring revealed hypertension, postural hypotension, hypertensive surges, tachycardia, and absence of nocturnal dipping. Blood pressure lability correlated with impaired vagal baroreflex function. Postganglionic sympathetic sudomotor function was normal in most cases; the most frequent thermoregulatory sweat test finding was focal neck anhidrosis (78.9%). Standardized autonomic testing in R-ABF demonstrates cardiovascular adrenergic impairment with orthostatic hypotension, blood pressure lability, and elevated plasma norepinephrine. Cardiovagal impairment is common, while sudomotor deficits are limited to direct radiation effects. [ABSTRACT FROM AUTHOR]

Hemineglect, also called spatial neglect, sometimes develops as a consequence of stroke. The patient ceases to notice stimuli in half the visual space. In the majority of cases, the patient stops noticing stimuli in the left side of the visual space in response to a stroke lesion on the right side of the brain. One popular notion is that the right hemisphere is critical for the processes of attention. The patient suffering hemineglect is thought to have perfectly normal sensory processing, but is thought to be deficient in paying attention to sensations. To explore this hypothesis, a study was conducted of three patients with left hemineglect and right-side stroke lesions. Three patients with left-side stroke lesions and no neglect served as controls. All patients had hemianesthesia or hemianopia. (Hemianesthesia is a loss of sensation in half the body; hemianopia is the loss of vision in half the visual field, not to be confused with the loss of vision in one eye.) Electrophysiological recordings were made of evoked potentials; these are the electrical changes in the brain that occur in response to a sensory stimulation. Evoked potentials resulting from visual stimuli and evoked potentials from stimulation of the body were both measured. As would be expected, the response to ipsilateral stimulation (on the same side as the stroke lesion) was perfectly normal. The response to contralateral stimulation of the left-hemisphere stroke patients was virtually nil, indicating that their deficits were due to a primary failure of sensation in the brain. In contrast, the patients with neglect had normal evoked responses to contralateral stimulation, even though the patients reported no conscious perception of the stimuli. These results support the notion of hemineglect as a disorder of attention. The early processes of sensory processing appear to be normal in these patients, but the patients appear to be unable to make use of this sensory processing. The study also provides an illustration of the fact that primary sensory processing within the brain is insufficient for the conscious perception of a stimulus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aims To evaluate the safety and effectiveness of photobiomodulation1 therapy in addition to the standard of care (SoC) for managing diabetic foot ulceration (DFU), we designed a prospective randomised double-blind trial for neuro-ischemic patients (HERMES study), whose design and study protocol we describe in this paper. Patients and methods All patients with a chronic neuro-ischemic DFU wider than 1 cm² attending the S. Donato Hospital DF Clinic in Arezzo, Italy (I), will be screened for enrolment. After two weeks, while patients are treated with SoC, those whose lesions have not decreased by 50% or more in size will be randomised into two groups: the control group will be managed with SoC, while the study group will be treated with photobiomodulation + SoC twice weekly for 20 weeks, or until healing. Both groups will be managed in the community by visiting nurses. The outcomes [healing rates at 24 weeks (primary endpoint), healing times, speed of area reduction, pain, quality of life, adverse events] will be blinded to the treatment. Results As a pilot study, we cannot anticipate results, but we expect a positive difference of at least 15% in the study group's primary outcomes, compared to controls, with no worsened safety profile. Conclusions and implications for clinical practice The interest of the HERMES study, beyond the findings related to the efficacy and safety of photobiomodulation, lies in the characteristics of this low-cost, no-waste technology and its integration in specialist and community-based care. [ABSTRACT FROM AUTHOR]