The Legume–Rhizobia Symbiosis

The symbiotic nitrogen fixation (SNF) with legumes is the primary source of biologically fixed nitrogen for agricultural system. It is performed by a group of bacteria commonly called rhizobia. It is characterized by a host preference, and the differences among symbioses between rhizobial strains and legume genotypes are related to infection, nodule development and effectiveness in N2 fixation. The interaction between a rhizobia and the legume is mediated by a lipochitin oligosaccharide secreted by the rhizobia, and called “Nod factor”. It is recognized by transmembrane receptors on the root-hair cells of the legume. It can regulate the nodule organogenesis by inducing changes in the cytokinin balance of the root, during nodule initiation. N2 fixation in legume nodules is catalyzed by the nitrogenase enzyme depending upon the photosynthate supply, the O2 concentration, and the fixed-N export. Among environmental factors that influence the SNF, the temperature is essential for nodule formation; the salinity and drought decrease the nodule permeability to O2 and the photosynthate supply to the nodule, the phosphorus deficiency inhibits the nodule development and the total N2 fixation. Rhizobia strains differ in their efficiency in N2 fixation with host legume. There is evidence of genotypic variability for SNF at different levels of available P which show a possibility of selecting cultivars able to support biological N2 fixation under low P soils

Venous thromboembolism risk and prophylaxis in hospitalised medically ill patients The ENDORSE Global Survey

Limited data are available regarding the risk for venous thromboembolism (VIE) and VIE prophylaxis use in hospitalised medically ill patients. We analysed data from the global ENDORSE survey to evaluate VTE risk and prophylaxis use in this population according to diagnosis, baseline characteristics, and country. Data on patient characteristics, VIE risk, and prophylaxis use were abstracted from hospital charts. VTE risk and prophylaxis use were evaluated according to the 2004 American College of Chest Physicians (ACCP) guidelines. Multivariable analysis was performed to identify factors associated with use of ACCP-recommended prophylaxis. Data were evaluated for 37,356 hospitalised medical patients across 32 countries. VIE risk varied according to medical diagnosis, from 31.2% of patients with gastrointestinal/hepatobiliary diseases to 100% of patients with acute heart failure, active noninfectious respiratory disease, or pulmonary infection (global rate, 41.5%). Among those at risk for VTE, ACCP-recommended prophylaxis was used in 24.4% haemorrhagic stroke patients and 40-45% of cardiopulmonary disease patients (global rate, 39.5%). Large differences in prophylaxis use were observed among countries. Markers of disease severity, including central venous catheters, mechanical ventilation, and admission to intensive care units, were strongly associated with use of ACCP-recommended prophylaxis. In conclusion, VIE risk varies according to medical diagnosis. Less than 40% of at-risk hospitalised medical patients receive ACCP-recommended prophylaxis. Prophylaxis use appears to be associated with disease severity rather than medical diagnosis. These data support the necessity to improve implementation of available guidelines for evaluating VIE risk and providing prophylaxis to hospitalised medical patients

Venous Thromboembolism Risk and Prophylaxis in the Acute Care Hospital Setting (ENDORSE Survey) Findings in Surgical Patients

Objective: To evaluate venous thromboembolism (VTE) risk in patients who underwent a major operation, including the use of, and factors influencing, American College of Chest Physicians-recommended types of VTE prophylaxis