Notes

Long-term follow-up regarding ultrasound-guided botulinum toxin-A shots for sialorrhea within neural dysphagia.
In Mediterranean Europe and the United States, oak species (Quercus spp.) have been in various states of decline for the past several decades. Several insect pests and pathogens contribute to this decline to varying degrees including Phytophthora cinnamomi, Armillaria spp., various insect defoliators, and additionally in the U.S., the oak wilt pathogen, Bretziella fagacearum. More recently, two emerging canker pathogens, Diplodia corticola (Dc) and Diplodia quercivora (Dq) have been implicated in causing dieback and mortality of oak species in Europe and in several regions in the United States. In 2019, a fungal survey was conducted in the Mid-Atlantic region of the Eastern U.S., including Maryland, Pennsylvania, Virginia, and West Virginia to determine the range and impact of Dc and Dq on forest health within the U.S. click here A total of 563 oak trees between red and white oak family members were evaluated across 33 forests spanning 18 counties. A total of 32 Diplodia isolates encompassing three Diplodia spp. were reassessed. Across all isolates and geographic regions, Dc formed a strongly supported monophyletic clade sister to Dq and included two strongly supported subclades, one that included isolates from Spain and California and a second that included isolates from Italy, Maryland, and West Virginia. Both subclades also exhibited overlapping spore measurements. These results support Dc as a cosmopolitan pathogen, native to both Europe and the U.S. with the possibility of secondary introductions.Cigar tobacco (Nicotiana tabacum L.), sun air-cured tobacco, originally from South America, with a main use to rolling cigar wrapper that is different from flue-cured tobacco. In April, 2018, diseased leaves were observed in cigar tobacco in some fields in Danzhou city (109.58°E, 19.53°N) and Wuzhishan city (109.52°E, 18.78°N), Hainan. 20 to 40% of plants were infected (total 8 ha), thereby affecting local leaf production. The symptoms appeared as small, circular or irregular, sunken, brown patches developing into white centers and obvious dark brown margins with necrotic spots of 0.2-0.8 cm in most middle and lower leaves at mature stage. To determine the causal agent, ten leaves from five cigar tobacco plants (cv. Nuowei 2) collected from Danzhou were used for pathogen isolation (Fig. 1). Sections of infected leaf tissues were surface-sterilized by 5% NaClO for 3 min, 70% ethanol for 40 sec, rinsed in sterilized distilled water (SDW) and then placed onto potato dextrose agar (PDA) plates, under aseptic condtively, but not on control leaves. C. nicotianae was re-isolated from lesions by cultural and morphological characteristics, fufilling Koch's postulates. All tests were repeated once. To the best of our knowledge, this is the first report of C. nicotianae causing frog eye spot in cigar tobacco in Hainan, China. As we all known, appearance integrity and uniformity are playing an important role in high quality of cigar-wrapper, but the incidence of frog eye spot can seriously affect appearance quality of cigar-wrapper and led to increase direct losses to local cigar tobacco production. In addition, symptom of frog eye spot is similar to brown spot disease caused by Alternaria alternata, often cause their symptoms confused and then delay prevention at the right time. Since the cigar tobacco is a major industry in Hainan, better understanding of its diseases is relevant in order to establish disease control strategies.
Fluid overload is associated with mortality in haemodialysis patients, and 30% of patients remain fluid-overloaded after dialysis. The aim of this study was to evaluate if implementation of Recova
, a decision aid combining clinical assessment with bioimpedance spectroscopy, facilitates individualization of target weight determination and thereby contributes to improved fluid status in maintenance haemodialysis patients.

The impact of the implementation was measured as the proportion of participants at an adequate target weight at the end of the study, assessed as change in symptoms, hydration status, and N-terminal pro-brain natriuretic peptide (NT-proBNP). Nurses were instructed to use Recova every 2 weeks, and the process of the intervention was measured as frequencies of fluid status assessments, bioimpedance measurements, and target weight adjustments.

Forty-nine patients at two haemodialysis units were enrolled. In participants with fluid overload (
 = 10), both overhydration and fluid overload symptom score decreased. In fluid-depleted participants (
 = 20), target weight adjustment frequency and the estimated target weight increased. The post-dialytic negative overhydration was reduced, but NT-proBNP increased.

Implementation of Recova in haemodialysis care increased the monthly frequencies of bioimpedance measurements and target weight adjustments, and it contributed to symptom reduction.

The Uppsala County Council Registry of Clinical Trials FoU 2019-0001-15.
The Uppsala County Council Registry of Clinical Trials FoU 2019-0001-15.
Malignant otitis externa is an uncommon but critical challenging disease with some degree of cranial nerve involvement.

to examine the factors leading to facial paralysis in these patients and clarify indications for aggressive treatment in the group most at risk.

In a case-control study, demographic, clinical, laboratory, audiometric, imaging, and treatment characteristics of 139 patients in groups with and without facial paralysis were analysed.

45 patients (32.4%) had facial paralysis. Compared to patients without facial nerve involvement, patients with facial palsy had a higher rate of inflammatory markers (mean erythrocyte sedimentation rate on admission [67.71 vs 51.16 mm/h], and the average of total ESR [64.27 vs 54.46 mm/h], as well as the mean C-reactive protein [38.96 vs 27.53 mg/L]). Also, the involvement of the facial canal (
 < .01) and nasopharyngeal space (
 < .05) were related to the incidence of facial paralysis.

Nasopharyngeal extension of the inflammation and facial nerve canal erosion might be useful as predictors of facial nerve dysfunction. The elevated erythrocyte sedimentation rate is correlated with the increased risk of facial paralysis, and aggressive medical management is more crucial.

Improvement in predicting the outcome of patients with malignant otitis externa.
Improvement in predicting the outcome of patients with malignant otitis externa.
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