Secondary metabolites and related genes in Vitis vinifera L. cv. Tempranillo grapes as influenced by ultraviolet radiation and berry development

The effects of UV radiation on Vitis vinifera cv Tempranillo grapes were studied under field conditions as influenced by ultraviolet (UV) band (UV-A and UV-B), UV-B level (ambient vs enhanced), grape phenological stage (pea-size, veraison, and harvest), grape component (skin, flesh, and seeds), and fraction from which phenolic UV-absorbing compounds (UVACs) were extracted (soluble vs insoluble). Ambient UV-B levels caused stronger effects than ambient UV-A. These effects included increases in flavonol contents (particularly quercetins and kaempferols), the expression of flavonol synthase and chalcone synthase genes (VvFLS4 and VvCHS1), and grape weight and size. In addition, the contents of flavanols and hydroxycinnamic acids increased under UV-B radiation at pea-size stage. All these compounds play physiological roles as antioxidants and UV screens. Synergic effects between UV-B and UV-A were observed. The responses of anthocyanins, stilbenes, and volatile compounds to UV were diffuse or nonexistent. Enhanced UV-B led to rather subtle changes in comparison with ambient UV-B, but differences between both treatments could be demonstrated by multivariate analysis. Pea-size and harvest were the phenological stages where the most significant responses to UV were found, while the skin was the most UV-responsive grape component. Soluble phenolic compounds were much more UV-responsive than insoluble compounds. In conclusion, UV radiation was essential for the induction of specific grape phenolic and volatile compounds. Given the physiological roles of these compounds, as well as their contribution to grape and wine quality, and their potential use as nutraceuticals, our results may have implications on the artificial manipulation of UV radiation

Natural history of patients with venous thromboembolism and hereditary hemorrhagic telangiectasia. Findings from the RIETE registry

Background: Limited data exist about the clinical presentation, ideal therapy and outcomes of patients with hereditary hemorrhagic telangiectasia (HHT) who develop venous thromboembolism (VTE). Methods: We used the data in the RIETE Registry to assess the clinical characteristics, therapeutic approaches and clinical outcomes during the course of anticoagulant therapy in patients with HHT according to initial presentation as pulmonary embolism (PE) or deep venous thrombosis (DVT). Results: Of 51,375 patients with acute VTE enrolled in RIETE from February 2009 to January 2019, 23 (0.04%) had HHT: 14 (61%) initially presented with PE and 9 (39%) with DVT alone. Almost half (47.8%) of the patients with VTE had a risk factor for VTE. Most PE and DVT patients received low-molecular-weight heparin for initial (71 and 100%, respectively) and long-term therapy (54 and 67%, respectively). During anticoagulation for VTE, the rate of bleeding events (major 2, non-major 6) far outweighed the rate of VTE recurrences (recurrent DVT 1): 50.1 bleeds per 100 patient-years (95%CI: 21.6-98.7) vs. 6.26 recurrences (95%CI: 0.31-30.9; p = 0.020). One major and three non-major bleeding were epistaxis. No patient died of bleeding. One patient died shortly after being diagnosed with acute PE. Conclusions: During anticoagulation for VTE in HHT patients, there were more bleeding events than VTE recurrences. Most bleeding episodes were non-major epistaxis

Systolic blood pressure and mortality in acute symptomatic pulmonary embolism

BACKGROUND: The optimal cutoff for systolic blood pressure (SBP) level to define high-risk pulmonary embolism (PE) remains to be defined. METHODS: To evaluate the relationship between SBP levels on admission and mortality in patients with acute symptomatic PE, the current study included 39,257 consecutive patients with acute symptomatic PE from the RIETE registry between 2001 and 2018. Primary outcomes included all-cause and PE-specific 30-day mortality. Secondary outcomes included major bleeding and recurrent venous thromboembolism (VTE). RESULTS: There was a linear inverse relationship between admission SBP and 30-day all-cause and PE-related mortality that persisted after multivariable adjustment. Patients in the lower SBP strata had higher rates of all-cause death (reference: SBP 110-129 mmHg) (adjusted odds ratio [OR] 2.9; 95% confidence interval [CI], 2.0-4.2 for SBP 190 mmHg). Consistent findings were also observed for 30-day PE-related death. CONCLUSIONS: In patients with acute symptomatic PE, a low SBP portends an increased risk of all-cause and PE-related mortality. The highest mortality was observed in patients with SBP <70 mmHg.status: publishe