Translocation and confinement of tetraamines in adaptable microporous cavities.

Metal-Organic Frameworks can be grafted with amines by coordination to metal vacancies to create amine-appended solid adsorbents, which are being considered as an alternative to using aqueous amine solutions for CO2 capture. In this study, we propose an alternative mechanism that does not rely on the use of neutral metal vacancies as binding sites but is enabled by the structural adaptability of heterobimetallic Ti2Ca2 clusters. The combination of hard (Ti+4) and soft (Ca2+) metal centers in the inorganic nodes of the framework enables MUV-10 to adapt its pore windows to the presence of triethylenetetramine molecules. This dynamic cluster response facilitates the translocation and binding of tetraamine inside the microporous cavities to enable the formation of bis-coordinate adducts that are stable in water. The extension of this grafting concept from MUV-10 to larger cavities not restrictive to CO2 diffusion will complement other strategies available for the design of molecular sorbents for decarbonization applications.

Major determinants of primary non function from kidney donation after Maastricht II circulatory death: A single center experience.

PURPOSE: Organ shortage greatly limits treatment of patients with end-stage chronic kidney. Maastricht type 2 donation after circulatory death (DCD) has been shown to have similar results in long term outcomes in kidney transplantation, when compared with brain dead donation. Our main goal was to assess Maastricht type 2 DCD and evaluate factors that impact on early graft function. METHODS: A retrospective study was conducted in an ECMO Referral Centre. All patients who received a kidney transplant from Maastricht type 2 DCD were included in study. Early graft function and short term outcomes were assessed. RESULTS: From October 2017 to December 2022, 47 renal grafts were collected from 24 uDCD donors. Median warm ischemia time was 106 min (94-115), cannulation time was 10 min (8; 20) and duration of extracorporeal reperfusion (ANOR) was 180 min (126-214). Regarding early graft function, 25% had immediate graft function, 63.6% had delayed graft function and 11.4% had primary non-function (PNF). There was a correlation between cannulation time (p = 0.006) and ANOR with PNF (p = 0.016). CONCLUSIONS: Cannulation time and ANOR were the main factors that correlated with PNF. Better understanding of underlying mechanisms should be sought in future studies to reduce the incidence of PNF.

Synthetic control of correlated disorder in UiO-66 frameworks.

Changing the perception of defects as imperfections in crystalline frameworks into correlated domains amenable to chemical control and targeted design might offer opportunities for the design of porous materials with superior performance or distinctive behavior in catalysis, separation, storage, or guest recognition. From a chemical standpoint, the establishment of synthetic protocols adapted to control the generation and growth of correlated disorder is crucial to consider defect engineering a practicable route towards adjusting framework function. By using UiO-66 as experimental platform, we systematically explored the framework chemical space of the corresponding defective materials. Periodic disorder arising from controlled generation and growth of missing cluster vacancies can be chemically controlled by the relative concentration of linker and modulator, which has been used to isolate a crystallographically pure "disordered" reo phase. Cs-corrected scanning transmission electron microscopy is used to proof the coexistence of correlated domains of missing linker and cluster vacancies, whose relative sizes are fixed by the linker concentration. The relative distribution of correlated disorder in the porosity and catalytic activity of the material reveals that, contrarily to the common belief, surpassing a certain defect concentration threshold can have a detrimental effect.

Glutaric Acidemia Type 1: Diagnosis, Clinical features, and Outcome in a Portuguese Cohort.

INTRODUCTION: Glutaric acidemia type 1 (GA1) is a rare autosomal recessive disorder characterized by a deficiency of glutaryl-CoA dehydrogenase, resulting in the accumulation of glutaric acid (GA), 3-hydroxyglutaric acid, and glutarylcarnitine, especially in the brain. GA1-affected children are clinically characterized by macrocephaly. Neurological abnormalities usually appear between 6 and 18 months of age, often triggered by a catabolic event. On the other hand, several biochemically affected individuals may remain asymptomatic or experience an insidious onset of mild neurological abnormalities. METHODS: Retrospective study of GA1 patients followed at a Portuguese Hereditary Metabolic Disease Center, to characterize the phenotypic and genotypic variations associated with GA1. Therefore, we analyzed the clinical, neuroradiological, biochemical, and genetic information from 14 patients. RESULTS: 14 patients (four months-27 years old) were identified in the last 26 years, 9 were male, 1 was from a consanguineous family. 11 were diagnosed by newborn screening (NBS), and 3 identified following clinical symptoms (later diagnosed, LD). There were 3 phenotypic presentations: 6 asymptomatic, 3 with a motor disability after encephalopathic crisis (EC), and 5 with insidious onset. Acute EC occurred in 1/3 of the LD patients and in 2/11 NBS-identified patients. About urinary GA concentrations: 5 were low excretors (LE), 9 were high excretors (HE). All LE showed symptoms, and 2 had EC. Concerning HE, 3 showed symptoms and 1 had EC. GCDH analysis showed: 6 compound heterozygotes and 8 homozygotes. most frequent variant was c.1204C>T (p.R402W). All of them received appropriate therapy from the time of diagnosis, with a mean age of 23.3 months in LD patients and 13.3 days in NBS-identified patients. CONCLUSION: The outcomes were different between the two groups: all the LD patients presented motor dysfunction however in the NBS-identified patients only 5 developed this symptom. Patients identified by NBS had better outcomes showing that NBS enables an early diagnosis, and treatment, and consequently improves the clinical outcomes for these patients. No correlation was observed with clinical phenotype between LE and HE, as both groups can suffer the most severe neurological manifestations. These conclusions are in agreement with previous cohorts described in the literature.

Chromosomal instability-induced cell invasion through caspase-driven DNA damage.

Chromosomal instability (CIN), an increased rate of changes in chromosome structure and number, is observed in most sporadic human carcinomas with high metastatic activity. Here, we use a Drosophila epithelial model to show that DNA damage, as a result of the production of lagging chromosomes during mitosis and aneuploidy-induced replicative stress, contributes to CIN-induced invasiveness. We unravel a sub-lethal role of effector caspases in invasiveness by enhancing CIN-induced DNA damage and identify the JAK/STAT signaling pathway as an activator of apoptotic caspases through transcriptional induction of pro-apoptotic genes. We provide evidence that an autocrine feedforward amplification loop mediated by Upd3-a cytokine with homology to interleukin-6 and a ligand of the JAK/STAT signaling pathway-contributes to amplifying the activation levels of the apoptotic pathway in migrating cells, thus promoting CIN-induced invasiveness. This work sheds new light on the chromosome-signature-independent effects of CIN in metastasis.

Leukocyte Imbalances in Mucopolysaccharidoses Patients.

Mucopolysaccharidoses (MPSs) are rare inherited lysosomal storage diseases (LSDs) caused by deficient activity in one of the enzymes responsible for glycosaminoglycans lysosomal degradation. MPS II is caused by pathogenic mutations in the IDS gene, leading to deficient activity of the enzyme iduronate-2-sulfatase, which causes dermatan and heparan sulfate storage in the lysosomes. In MPS VI, there is dermatan sulfate lysosomal accumulation due to pathogenic mutations in the ARSB gene, leading to arylsulfatase B deficiency. Alterations in the immune system of MPS mouse models have already been described, but data concerning MPSs patients is still scarce. Herein, we study different leukocyte populations in MPS II and VI disease patients. MPS VI, but not MPS II patients, have a decrease percentage of natural killer (NK) cells and monocytes when compared with controls. No alterations were identified in the percentage of T, invariant NKT, and B cells in both groups of MPS disease patients. However, we discovered alterations in the naïve versus memory status of both helper and cytotoxic T cells in MPS VI disease patients compared to control group. Indeed, MPS VI disease patients have a higher frequency of naïve T cells and, consequently, lower memory T cell frequency than control subjects. Altogether, these results reveal MPS VI disease-specific alterations in some leukocyte populations, suggesting that the type of substrate accumulated and/or enzyme deficiency in the lysosome may have a particular effect on the normal cellular composition of the immune system.

CEREBRAL AMYLOID ANGIOPATHY-RELATED INFLAMMATION PRESENTING WITH A STROKE-LIKE EPISODE.

Cerebral amyloid angiopathy (CAA) is characterised by ß-amyloid deposition in the walls of small to medium sized arteries of the cerebral cortex and the leptomeninges. In a significant proportion of patients, CAA is the probable cause of non-traumatic primary cerebral haemorrhage, particularly in those who are over 55 years of age and have controlled blood pressure. Cerebral amyloid angiopathy-related inflammation (CAA-ri) is an uncommon and aggressive subtype of CAA, which is thought to be caused by an immune reaction to the deposits of ß-amyloid. It has a variety of presentations that can mimic other focal and diffuse neurological disorders. Radiographically, its classic presentation is asymmetric cortical or subcortical white matter hyperintense foci due to multiple microhaemorrhages on T2-weighted or fluid attenuated inversion recovery (FLAIR) images. Although definite diagnosis requires brain and leptomeningeal biopsy, diagnostic criteria for probable CAA-ri based on a combination of clinical and radiological features were validated in 2015. We describe a patient with probable CAA-ri mimicking stroke and review the clinical and radiological features important for a proper differential diagnosis between ischaemic stroke (IS) and CAA-ri, and its subsequent appropriate treatment. LEARNING POINTS: MRI is a crucial tool for the diagnostic evaluation of cerebral amyloid angiopathy-related inflammation (CAA-ri).A high index of suspicion and awareness of CAA-ri is necessary for correct diagnosis in stroke-like presentations of the condition.The treatment of choice for CAA-ri is empirical corticosteroid therapy, which is associated with clinical and radiological improvement.

Association between blood pressure and angiotensin-converting enzymes activity in prepubertal children ∗.

OBJECTIVES: Angiotensin-converting enzymes' (ACEs) relationship with blood pressure (BP) during childhood has not been clearly established. We aimed to compare ACE and ACE2 activities between BMI groups in a sample of prepubertal children, and to characterize the association between these enzymes' activities and BP. METHODS: Cross-sectional study of 313 children aged 8-9 years old, included in the birth cohort Generation XXI (Portugal). Anthropometric measurements and 24-h ambulatory BP monitoring were performed. ACE and ACE2 activities were quantified by fluorometric methods. RESULTS: Overweight/obese children demonstrated significantly higher ACE and ACE2 activities, when compared to their normal weight counterparts [median (P25-P75), ACE: 39.48 (30.52-48.97) vs. 42.90 (35.62-47.18) vs. 43.38 (33.49-49.89) mU/ml, P for trend = 0.009; ACE2: 10.41 (7.58-15.47) vs. 21.56 (13.34-29.09) vs. 29.00 (22.91-34.32) pM/min per ml, P for trend < 0.001, in normal weight, overweight and obese children, respectively]. In girls, night-time systolic BP (SBP) and diastolic BP (DBP) increased across tertiles of ACE activity ( P < 0.001 and P  = 0.002, respectively). ACE2 activity was associated with higher night-time SBP and DBP in overweight/obese girls ( P  = 0.037 and P  = 0.048, respectively) and night-time DBP in the BMI z-score girl adjusted model ( P  = 0.018). Median ACE2 levels were significantly higher among nondipper girls (16.7 vs. 11.6 pM/min per ml, P  = 0.009). CONCLUSIONS: Our work shows that obesity is associated with activation of the renin-angiotensin-aldosterone system, with significant increase of ACE and ACE2 activities already in childhood. Also, we report sex differences in the association of ACE and ACE2 activities with BP.

Observation of Exchange Interaction in Iron(II) Spin Crossover Molecules in Contact with Passivated Ferromagnetic Surface of Co/Au(111).

Spin crossover (SCO) complexes sensitively react on changes of the environment by a change in the spin of the central metallic ion making them ideal candidates for molecular spintronics. In particular, the composite of SCO complexes and ferromagnetic (FM) surfaces would allow spin-state switching of the molecules in combination with the magnetic exchange interaction to the magnetic substrate. Unfortunately, when depositing SCO complexes on ferromagnetic surfaces, spin-state switching is blocked by the relatively strong interaction between the adsorbed molecules and the surface. Here, the Fe(II) SCO complex [FeII (Pyrz)2 ] (Pyrz = 3,5-dimethylpyrazolylborate) with sub-monolayer thickness in contact with a passivated FM film of Co on Au(111) is studied. In this case, the molecules preserve thermal spin crossover and at the same time the high-spin species show a sizable exchange interaction of > 0.9 T with the FM Co substrate. These observations provide a feasible design strategy in fabricating SCO-FM hybrid devices.

Metal Node Control of Brønsted Acidity in Heterobimetallic Titanium-Organic Frameworks.

Compared to indirect framework modification, synthetic control of cluster composition can be used to gain direct access to catalytic activities exclusive of specific metal combinations. We demonstrate this concept by testing the aminolysis of epoxides with a family of isostructural mesoporous frameworks featuring five combinations of homometallic and heterobimetallic metal-oxo trimers (Fe3, Ti3, TiFe2, TiCo2, and TiNi2). Only TiFe2 nodes display activities comparable to benchmark catalysts based on grafting of strong acids, which here originate from the combination of Lewis Ti4+ and Brønsted Fe3+-OH acid sites. The applicability of MUV-101(Fe) to the synthesis of ß-amino alcohols is demonstrated with a scope that also includes the gram scale synthesis of propranolol, a natural ß-blocker listed as an essential medicine by the World Health Organization, with excellent yield and selectivity.

Persistence of left superior vena cava: a rare cause of hemodialysis tunneled catheter malposition / Persistência de veia cava superior esquerda: uma causa rara de posicionamento inadequado do cateter tunelizado para hemodiálise

Abstract Hemodialysis central venous catheter (CVC) insertion can be complicated in patients with anomalous vessel anatomy. In such cases detailed knowledge of thoracic vessel anatomy is necessary to identify the exact location of the catheter. Central venous placement under ultrasound control has significantly reduced the complications associated with blind puncture and allows an appropriate puncture of the desired vessel, but the CVC can still get misplaced if it follows an anomalous route. Herein, we report a case of dialysis catheter placed into a left sided superior vena cava, only diagnosed after CT scan study.

Resumo A inserção do cateter venoso central (CVC) para hemodiálise pode ser complicada em pacientes com anatomia anômala dos vasos. Nesses casos, o conhecimento detalhado da anatomia do vaso torácico é necessário para identificar a localização exata do cateter. A colocação venosa central sob controle de ultrassom tem reduzido significativamente as complicações associadas à punção às cegas e permite uma punção apropriada do vaso desejado, mas o CVC ainda pode ficar mal posicionado se seguir uma rota anômala. Aqui, relatamos um caso de cateter de diálise colocado em uma veia cava superior esquerda, apenas diagnosticado após estudo de tomografia computadorizada.

Severe Leptospirosis: A Case Report.

Leptospirosis is an infection caused by Leptospira. Leptospirosis causes disease in humans mainly in developing countries and also in countries with poor housing and sanitation, due to animals (mainly rats) that are potential sources of contamination. The clinical manifestations and the severity of leptospirosis are highly variable. We present the case of a 56-year-old female that was admitted to the emergency department with a three-week history of fever (38.4ºC), headache, dyspnea, and cough. There was a worsening of the patient's clinical status with respiratory failure and the necessity of admission to the intensive care unit for respiratory support with mechanical ventilation. The treatment was initiated with piperacillin and tazobactam, azithromycin, and steroids. There was a favorable evolution, and the patient was transferred to the internal medicine ward after 12 days with a suspected diagnosis of small vessel vasculitis and pneumonia. In the medical ward, after a careful anamnesis, leptospirosis was suspected and confirmed. The aim of this case report is to highlight the importance of a good anamnesis and the fact that an elaborate clinical history helps to consider new diagnostic hypotheses. Also intends to alert to the existence of leptospirosis in developed countries, a disease underdiagnosed in these countries.

Acquired Vitamin B12 Deficiency in Newborns: Positive Impact on Newborn Health through Early Detection.

The early diagnosis of and intervention in vitamin B12 deficiency in exclusively breastfed infants by mothers with low vitamin B12 is crucial in preventing possible irreversible neurologic damage, megaloblastic anemia, and failure to thrive. We assess the usefulness of the early detection of asymptomatic B12 deficiency related to acquired conditions and highlight the importance of monitoring serum vitamin B12 levels during pregnancy. We describe demographic, clinical, dietary, and biochemical data, including the evolution of a vitamin B12 deficiency's functional biomarkers. We enrolled 12 newborns (5 males) with an age range of 1-2 months old that were exclusively breastfed and asymptomatic. These cases were referred to our metabolic unit due to alterations in expanded newborn screening: high levels of methylmalonic acid and/or total homocysteine (tHcy). All mothers were under a vegetarian diet except three who had abnormal B12 absorption, and all presented low or borderline serum B12 level and high plasma levels of tHcy. Supplementation with oral vitB12 re-established the metabolic homeostasis of the mothers. In infants, therapy with an intramuscular injection of 1.0 mg hydroxocobalamin led to the rapid normalization of the metabolic pattern, and a healthy outcome was observed. Acquired B12 deficiency should be ruled out before proceeding in a differential diagnosis of cobalamin metabolism deficits, methylmalonic acidemia, and homocystinuria.

Lemongrass (Cymbopogon citratus)-incorporated chitosan bioactive films for potential skincare applications.

Circular economy, and concerns about environmental waste, is fostering the development of sustainable alternative products in a range of industries. In the dermo-cosmetic field, the market for sustainable anti-aging skincare products has increasingly grown over the last years. The innovation of this work was to develop chitosan films incorporating lemongrass essential oil (LEO) that could potentially be applied as a green cosmetic skin treatment due to their anti-oxidant and antimicrobial properties, using renewable and biodegradable materials. Different concentrations of LEO (i.e., 0.5, 1.0, and 1.5 % w/w) were formulated into chitosan filmogenic matrices, forming skincare bioactive films. Their antioxidant properties and water vapor permeability were strongly governed by the LEO concentration. Chitosan bioactive films containing 0.5 % LEO showed cellular viability over 70 %, while those with 1.5 % LEO had similar antioxidant capacity as NAC (N-acetyl-L-cysteine), used as the positive control to inactivate intracellular reactive oxygen species (ROS) in HaCat cells not treated with H2O2. The developed bioactive films showed activity against Escherichia coli and Staphylococcus aureus. Our LEO-loaded chitosan biofilms may be used as sheet masks with antioxidant and antimicrobial properties for skincare, with high flexibility and selected permeability, and without cytotoxic risks.

Inborn Errors of Metabolism in a Tertiary Pediatric Intensive Care Unit.

Few studies exist describing resources and care of pediatric patients with inborn errors of metabolism (IEM) admitted to pediatric intensive care unit (PICU). This study aims to characterize the PICU admissions of these patients to provide better diagnostic and therapeutic care in the future. Retrospective analysis of pediatric patients with IEM admitted to the PICU of a tertiary care center at a metabolic referral university hospital from 2009 to 2019 was included. Clinical information and demographic data were collected from PICU clinical records. During this period, 2% ( n = 88 admissions, from 65 children) out of 4,459 PICU admissions had clinical features of IEM. The median age was 3 years (range: 3 days-21 years) and 33 were male. Median age at diagnosis was 3 months; 23/65 patients with intoxication disorders, 21/65 with disorders of energy metabolism, 17/65 with disorders of complex molecules, and 4/65 with other metabolic diseases (congenital lipodystrophy, Menkes' disease, hyperammonemia without a diagnosis). From a total of 88 admissions, 62 were due to metabolic decompensation (infection-38, neonatal period decompensation-14, external accident-5, prolonged fasting-2, and therapeutic noncompliance-3) and 26 elective admissions after a scheduled surgery/elective procedure. The most frequent clinical presentations were respiratory failure (30/88) and neurological deterioration (26/88). Mechanical ventilation was required in 30 patients and parenteral nutrition in 6 patients. Extracorporeal removal therapy was required in 16 pediatric patients (12 with maple syrup urine disease and 4 with hyperammonemia) with a median duration of 19 hours. The median length of PICU stay was 3.6 days (3 hours-35 days). Eight patients died during the studied period (cerebral edema-2, massive hemorrhage-5, and malignant arrhythmia-1). Acute decompensation was the main cause of admission in PICU in these patients. The complexity of these diseases requires specialized human and technical resources, with an important impact on the recovery and survival of these patients.

COVID-19-related changes in outpatient CPAP setup pathways for OSA are linked with decreased 30-day CPAP usage.

The COVID-19 pandemic changed continuous positive airway pressure (CPAP) setup pathways. We evaluated patients commenced on CPAP in 2019 (prepandemic) and 2020 (post-first UK wave). Face-to-face (F2F) setup numbers, with CPAP turned on, decreased from 613 patients (98.9%) in 2019, to 6 (1.1%) in 2020. In 2020, setups were F2F without CPAP turned on (403 (71.1%)), or remote (158 (27.9%)). Prepandemic median CPAP usage at first follow-up was 5.4 (2.7-6.9) hours/night and fell by 0.9 hours/night (95% CI 0.5 to 1.2, p<0.0001) in 2020. We found clinically relevant reductions in CPAP usage with pathway changes post-COVID-19.

Continuous erector spinae block for postoperative analgesia in a partial colectomy by subcostal incision / Bloqueo continuo de los erectores espinales para la analgesia postoperatoria en una colectomía parcial por incisión subcostal

Abstract: Erector spinae plane block is an ultrasound-guided technique who has seen a growing role as a perioperative analgesic technique due to its safety profile and versatility. We describe a case of an elderly female with a history of ischemic heart disease and atrial fibrillation, who underwent segmental colectomy by left subcostal laparotomy under general anesthesia, for removal of a colon tumor. An erector spinae plane catheter was placed at the T7 level under ultrasound guidance, and then used for postoperative analgesia. Ropivacaine 0.2% (initial bolus + infusion at 8 mL/h) was used through the catheter, together with intravenous paracetamol and metamizol. This analgesic regimen was maintained for 72 hours, with excellent pain control, after which the catheter was removed. The patient's pain remained controlled and rescue analgesia was not required until her discharge at seven days postoperative. Continuous ESP block was an effective technique for postoperative analgesia in this case, allowing excellent pain control with a low risk of complications and avoiding the use of opioids.

Resumen: El bloqueo del plano del músculo erector espinal es una técnica ecoguiada que ha ganado popularidad como técnica analgésica perioperatoria debido a su perfil de seguridad y versatilidad. Se describe el caso de una anciana con cardiopatía isquémica y fibrilación auricular, a la que se le realizó colectomía segmentaria mediante laparotomía subcostal izquierda bajo anestesia general, para la escisión de un tumor de colon. Se colocó un catéter en el plano del músculo erector espinal al nivel T7 bajo guía ultrasónica y luego se utilizó para analgesia postoperatoria (ropivacaína 0.2% bolo + infusión a 8 mL/h) junto con paracetamol intravenoso y metamizol. Este régimen analgésico se mantuvo durante 72 horas, con excelente control del dolor, tras lo cual se retiró el catéter. La paciente permaneció con adecuada analgesia sin opioides de rescate hasta su alta a los siete días del postoperatorio. El bloqueo del plano del erector espinal torácico continuo fue una técnica eficaz para la analgesia postoperatoria en cirugía abdominal abierta, con bajo riesgo de complicaciones y evitando el uso de opioides.

Response of Different Grapevine Cultivars to Infection by Lasiodiplodia theobromae and Lasiodiplodia mediterranea.

Botryosphaeria dieback is a grapevine trunk disease that affects all viticulture regions of the world. Species of the genus Lasiodiplodia have been reported as pathogenic toward grapevine in several growing regions and have also been previously reported from Portuguese vineyards. Species in this genus, particularly Lasiodiplodia theobromae, have been reported in previous studies to be more aggressive than other Botryosphaeriaceae species most commonly associated with Botryosphaeria dieback. The aim of this study was to assess the response of some of the more representative cultivars planted throughout Portuguese vineyards, 'Touriga Nacional,' 'Touriga Franca,' 'Alvarinho,' 'Aragonez' (= 'Tempranillo'), and 'Cabernet Sauvignon,' by performing artificial inoculations with Lasiodiplodia spp. collected in different geographic locations worldwide. Two experiments, one that involved inoculating 2-year-old grapevines kept in greenhouse-controlled conditions with six isolates of L. theobromae and one isolate of L. mediterranea and one that involved inoculating 7-year-old field-grown grapevines with two isolates of L. theobromae, were conducted twice. We assessed the response of the cultivars by evaluating the length of lesions caused by the isolates 5 months after inoculation. The results showed that all isolates studied were able to infect the annual shoots because they were always reisolated and produced internal wood discoloration. Significant differences were found for all isolate-cultivar combinations. In both experiments, Touriga Nacional showed the largest lesions and while Aragonez recorded the smallest lesions of the cultivars inoculated with Lasiodiplodia spp. In general, Portuguese isolates were more aggressive than those from Peru, which were mildly aggressive. These results are a first insight into the response of selected Portuguese cultivars to Lasiodiplodia species, which are present in Portugal but not commonly associated with Botryosphaeria dieback. This research contributes to our knowledge of the impact that Botryosphaeria dieback causal agents have on crucial national cultivars, which may help winegrowers not only manage current cultural practices but also optimize decision making when planning new vineyards.

Persistence of left superior vena cava: a rare cause of hemodialysis tunneled catheter malposition.

Hemodialysis central venous catheter (CVC) insertion can be complicated in patients with anomalous vessel anatomy. In such cases detailed knowledge of thoracic vessel anatomy is necessary to identify the exact location of the catheter. Central venous placement under ultrasound control has significantly reduced the complications associated with blind puncture and allows an appropriate puncture of the desired vessel, but the CVC can still get misplaced if it follows an anomalous route. Herein, we report a case of dialysis catheter placed into a left sided superior vena cava, only diagnosed after CT scan study.