Kinematics of the Southern Rhodope Core Complex (North Greece)

The Southern Rhodope Core Complex is a wide metamorphic dome exhumed in the northern Aegean as a result of large-scale extension from mid-Eocene to mid-Miocene times. Its roughly triangular shape is bordered on the SW by the Jurassic and Cretaceous metamorphic units of the Serbo-Macedonian in the Chalkidiki peninsula and on the N by the eclogite bearing gneisses of the Sideroneron massif. The main foliation of metamorphic rocks is flat lying up to 100 km core complex width. Most rocks display a stretching lineation trending NEâ SW. The Kerdylion detachment zone located at the SW controlled the exhumation of the core complex from middle Eocene to mid-Oligocene. From late Oligocene to mid-Miocene exhumation is located inside the dome and is accompanied by the emplacement of the synkinematic plutons of Vrondou and Symvolon. Since late Miocene times, extensional basin sediments are deposited on top of the exhumed metamorphic and plutonic rocks and controlled by steep normal faults and flat-ramp-type structures. Evidence from Thassos Island is used to illustrate the sequence of deformation from stacking by thrusting of the metamorphic pile to ductile extension and finally to development of extensional Plio-Pleistocene sedimentary basin. Paleomagnetic data indicate that the core complex exhumation is controlled by a 30� dextral rotation of the Chalkidiki block. Extensional displacements are restored using a pole of rotation deduced from the curvature of stretching lineation trends at core complex scale. It is argued that the Rhodope Core Complex has recorded at least 120 km of extension in the North Aegean, since the last 40 My

Sex- and age-related differences in the management and outcomes of chronic heart failure: an analysis of patients from the ESC HFA EORP Heart Failure Long-Term Registry

Aims: This study aimed to assess age- and sex-related differences in management and 1-year risk for all-cause mortality and hospitalization in chronic heart failure (HF) patients. Methods and results: Of 16 354 patients included in the European Society of Cardiology Heart Failure Long-Term Registry, 9428 chronic HF patients were analysed [median age: 66 years; 28.5% women; mean left ventricular ejection fraction (LVEF) 37%]. Rates of use of guideline-directed medical therapy (GDMT) were high (angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers and mineralocorticoid receptor antagonists: 85.7%, 88.7% and 58.8%, respectively). Crude GDMT utilization rates were lower in women than in men (all differences: P\ua0 64 0.001), and GDMT use became lower with ageing in both sexes, at baseline and at 1-year follow-up. Sex was not an independent predictor of GDMT prescription; however, age >75 years was a significant predictor of GDMT underutilization. Rates of all-cause mortality were lower in women than in men (7.1% vs. 8.7%; P\ua0=\ua00.015), as were rates of all-cause hospitalization (21.9% vs. 27.3%; P\ua075 years. Conclusions: There was a decline in GDMT use with advanced age in both sexes. Sex was not an independent predictor of GDMT or adverse outcomes. However, age >75 years independently predicted lower GDMT use and higher all-cause mortality in patients with LVEF 6445%

Association between loop diuretic dose changes and outcomes in chronic heart failure: observations from the ESC-EORP Heart Failure Long-Term Registry

[Abstract] Aims. Guidelines recommend down-titration of loop diuretics (LD) once euvolaemia is achieved. In outpatients with heart failure (HF), we investigated LD dose changes in daily cardiology practice, agreement with guideline recommendations, predictors of successful LD down-titration and association between dose changes and outcomes. Methods and results. We included 8130 HF patients from the ESC-EORP Heart Failure Long-Term Registry. Among patients who had dose decreased, successful decrease was defined as the decrease not followed by death, HF hospitalization, New York Heart Association class deterioration, or subsequent increase in LD dose. Mean age was 66±13 years, 71% men, 62% HF with reduced ejection fraction, 19% HF with mid-range ejection fraction, 19% HF with preserved ejection fraction. Median [interquartile range (IQR)] LD dose was 40 (25–80) mg. LD dose was increased in 16%, decreased in 8.3% and unchanged in 76%. Median (IQR) follow-up was 372 (363–419) days. Diuretic dose increase (vs. no change) was associated with HF death [hazard ratio (HR) 1.53, 95% confidence interval (CI) 1.12–2.08; P = 0.008] and nominally with cardiovascular death (HR 1.25, 95% CI 0.96–1.63; P = 0.103). Decrease of diuretic dose (vs. no change) was associated with nominally lower HF (HR 0.59, 95% CI 0.33–1.07; P = 0.083) and cardiovascular mortality (HR 0.62 95% CI 0.38–1.00; P = 0.052). Among patients who had LD dose decreased, systolic blood pressure [odds ratio (OR) 1.11 per 10 mmHg increase, 95% CI 1.01–1.22; P = 0.032], and absence of (i) sleep apnoea (OR 0.24, 95% CI 0.09–0.69; P = 0.008), (ii) peripheral congestion (OR 0.48, 95% CI 0.29–0.80; P = 0.005), and (iii) moderate/severe mitral regurgitation (OR 0.57, 95% CI 0.37–0.87; P = 0.008) were independently associated with successful decrease. Conclusion. Diuretic dose was unchanged in 76% and decreased in 8.3% of outpatients with chronic HF. LD dose increase was associated with worse outcomes, while the LD dose decrease group showed a trend for better outcomes compared with the no-change group. Higher systolic blood pressure, and absence of (i) sleep apnoea, (ii) peripheral congestion, and (iii) moderate/severe mitral regurgitation were independently associated with successful dose decrease

Chemical composition of ferromanganese nodules from the Western Sicily Jurassic limestone beds

The stratigraphic study focuses on the description of lithofacies and geological sections of secondary, tertiary and quaternary formations in different parts of western Sicily. The tectonic analysis derived from field studies is used to trace the history and effects of the Alpine orogeny on the geology of Western Sicily. During his field study the author conducted several chemical element analysis on fossil manganese nodules extracted from Jurassic limestone beds