Colletotrichum acutatum var. fioriniae (teleomorph: Glomerella acutata var. fioriniae var. nov.) infection of a scale insect.

An epizootic has been reported in Fiorinia externa populations in New York, Connecticut, Pennsylvania and New Jersey. Infected insects have profuse sclerotial masses enclosing their bodies. The most commonly isolated microorganism from infected F. externa was Colletotrichum sp. A morphological and molecular characterization of this fungus indicated that it is closely related to phytopathogenic C. acutatum isolates. Isolates of Colletotrichum sp. from F. externa in areas of the epizootic were similar genetically and were named Colletotrichum acutatum var. fioriniae var. nov. based on our findings. In vitro and in planta mating observed between isolates of C. acutatum var. fioriniae could serve as a possible source of genetic variation and might give rise to new biotypes with a propensity to infect insects. Only one other strain, C. gloeosporioides f. sp. ortheziidae, has been reported to show entomopathogenic activity

Carvedilol Increases Atrial Natriuretic Peptide Plasma Levels in Hypertensive Patients

Twenty five patients with moderate essential hypertension were studied for 30 days in order to evaluate the medium term effects of carvedilol on atrial natriuretic peptide (ANP) levels. This drug blocks the β 1 and β 2 adrenenergic receptors as well as α 1 adrenergic receptors. In addition, it has strong antioxidative and antiproliferative properties. The drug was given orally at a dose of 12.5 mg b.i.d. Quantitative determination of human ANP was made by radioimmunoassay procedure (RIA). At the end of this clinical trial, mean plasma levels of ANP had risen during treatment by 21.18% (from 37.60 pg/ml to 45.83 pg/ml) while both systolic (SBP) and diastolic (DBP) blood pressure as well as diameters of the left cardiac cavities had decreased in a statistically significant way. The ratio ANP/SBP was also increased by 46.6% in a statistically significant way. These findings support the suggestion that the increase in plasma ANP following the administration of β-adrenergic blockers to hypertensive patients is a primary effect of beta blockade and not a mechanical one secondary to a negative inotropic action on the left ventricle and obviously contributes to the anti-hypertensive action

Evidence of primary aldosteronism in a predominantly female cohort of normotensive individuals: A very high odds ratio for progression into arterial hypertension

Context: Primary aldosteronism (PA) is an established cause of hypertension, whereas high-normal serum aldosterone levels have been linked to an increased risk for hypertension. Objective: We aimed to define the post-fludrocortisone-dexamethasone suppression test (FDST) normal cutoff values of aldosterone and the aldosterone to renin ratio and evaluate the presence of PA in normotensive individuals. Design: This study was designed as a case-control study. Setting: The study was performed in a tertiary general hospital. Patients: One hundred normotensive participants (80 females), mean age 53 years, were studied. Main Outcome Measures: All participants underwent baseline biochemical and hormonal evaluation, FDST, and adrenal computerized tomography. Blood pressure was assessed at baseline and after 5 years. Results: Sixty-nine participants with normal adrenal computerized tomography who remained normotensive after 5 years were used as a control population to calculate the cutoff values of adequate aldosterone suppression. PA was defined as a combination of post-FDST aldosterone to renin ratio of 0.93 ng/dL · μU/mL or greater (100% sensitivity and 96% specificity) and post-FDST aldosterone of 2.96 ng/dL or greater (100% sensitivity and 61% specificity on receiver-operating characteristic analysis). Thirteen of 100 participants had PA at baseline and 11 (85%) developed hypertension, whereas only 20 of 87 without PA (23%) developed hypertension at 5 years [odds ratio (OR) 18.42, 95% confidence intervals (CI) 3.76-90.10, P < .0001]. Logistic regression analysis showed a positive relation of PA [odds ratio (OR) 16.30, confidence interval (CI) 1.78-150.30, P = .01] and a negative relation of serum potassium (OR 0.39, CI 0.19-0.79, P = .01) with the development of hypertension. Conclusions: Normotensive PA represents a clinical entity referring to normotensive individuals with PA who are at increased risk for hypertension. Copyright © 2013 by The Endocrine Society

Primary aldosteronism in hypertensive patients: Clinical implications and target therapy

Background: The prevalence of primary aldosteronism (PA) in hypertensive patients varies according to diagnostic testing and ascertained normal cut-offs. The aim of this case-control study was to confirm the high prevalence of PA in a large hypertensive population and evaluate the antihypertensive effect of mineralocorticoid receptor antagonists (MRA) treatment. Material and methods: We investigated 327 hypertensive and 90 matched normotensive subjects with normal adrenal imaging. Serum aldosterone (ALD), active renin (REN) levels and aldosterone/active renin (ALD/REN) ratio were measured before and after a combined sodium chloride, fludrocortisone and dexamethasone suppression test (FDST). Post-FDST values were compared to cut-offs obtained from controls (post-FDST ALD 2·96 ng/dL and post-FDST ALD/REN 0·93 ng/dL/μU/mL). PA patients received MRA treatment. Results: By applying the combination of post-FDST ALD levels and ALD/REN ratio, 28·7% of the hypertensive patients had PA. There was a positive, albeit weak, correlation between systolic (SBP) and diastolic blood pressure (DBP) and ALD levels and/or ALD/REN ratio after the FDST (P < 0·0001). SBP was associated with a post-FDST ALD of 3·24 ng/dL and ALD/REN ratio of 0·90 ng/dL/μU/mL, whereas post-FDST ALD had an inverse association at serum K+ values of less than 3·9 mEq/L. MRA treatment in 69 PA patients, resulted in a significant reduction in the maximum SBP and DBP values (28 ± 15 and 14 ± 7 mmHg, respectively, P < 0·0001). Conclusions: Using the FDST, an increased prevalence of PA in hypertensives was observed. A. significant blood pressure lowering effect was obtained with MRA treatment, implying that these agents may be beneficial in a significant number of hypertensive patients. © 2014 Stichting European Society for Clinical Investigation Journal Foundation