Cardiac Tamponade Causing Predominant Left Atrial and Ventricular Compression After Left Ventricular Assist Device Placement.

BACKGROUND Cardiac tamponade is a life-threatening condition that occurs when pericardial fluid accumulates in the pericardial sac, causing compression of the heart and obstructive shock. This hemodynamic event typically occurs in right-sided cardiac chambers due to the low pressures of the right atrium and right ventricle. Patients undergoing left ventricular assist device (LVAD) placement are at particularly high risk of pericardial effusion development and potential cardiac tamponade because of the need for postoperative anticoagulation. CASE REPORT A 47-year-old man underwent LVAD placement for deteriorating biventricular function. After several days of stability postoperatively, he experienced dyspnea and had evidence of increasing hemodynamic compromise. He was immediately taken to the operating room, where transesophageal echocardiography showed near-complete collapse of the left atrium and left ventricle with preservation of the right heart chamber sizes in the setting of a large heterogenous posterior pericardial effusion. With swift surgical intervention, the cardiac tamponade was successfully evacuated and the patient regained hemodynamic stability. CONCLUSIONS Cardiac tamponade can present overtly or covertly, and should be high on the list of differential diagnoses in a patient with deterioration in hemodynamic status after cardiac surgery, especially after LVAD placement. Although cardiac tamponade usually affects right-sided cardiac chambers, the left-sided chambers can also be involved. Isolated left-sided cardiac tamponade is rare but can occur in the presence of a loculated posterior pericardial effusion, as seen in this patient.

Assessment of Two Novel Host-Derived Beauveria bassiana (Hypocreales: Cordycipitaceae) Isolates Against the Citrus Pest, Diaphorina citri (Hemiptera: Liviidae).

The Asian citrus psyllid (ACP), Diaphorina citri Kuwayama (Hemiptera: Liviidae), vectors 'Candidatus Liberibacter spp.', the causative agent of Citrus Greening Disease (CGD) or Huanglongbing (HLB). Managing populations of psyllids in the Lower Rio Grande Valley (LRGV), TX, United States is imperative given a continuous increase in HLB-positive trees. A component of integrated pest management (IPM) program is the use of strains of entomopathogenic fungi for the biological control of D. citri. In an attempt to find endemic strains of entomopathogenic fungi that grow favorably under LRGV environmental conditions and naturally infect D. citri, psyllids were collected from local residential areas, surface sterilized, and plated on a semi-selective agar medium. Collection of over 9,300 samples from 278 sites throughout the LRGV led to the positive identification of two Beauveria bassiana (Balsamo-Crivellii) Vuillemin (Hypocreales: Cordycipitaceae) isolates, ACP18001 and ACP18002. Chi-square analysis of primary and secondary acquisition bioassays revealed that both field isolated strains outperformed Cordyceps (Isaria) fumosorosea (Wize) (Hypocreales: Cordycipitaceae) Apopka97 under both primary (direct spray) and secondary acquisition (adult exposure to sprayed foliage) bioassays with ACP18002 marginally outperforming ACP18001 under secondary acquisition. Slopes of the dose response regression lines for the three fungi were not significantly different. In addition, the thermal profiles for vegetative growth of each isolate indicated that the field isolates grew at higher rates than the standard at higher temperatures. The new isolates may prove to be good candidates for the management of D. citri populations in the LRGV.