ANTHEM-HF evaluated a novel autonomic regulation therapy (ART) via either left or right vagus nerve stimulation (VNS) in patients with heart failure (HF) and reduced ejection fraction (HFrEF). Sixty subjects (New York Heart Association [NYHA] functional class II-III, left ventricular ejection fraction (LVEF) ≤ 40%, left ventricular end-diastolic diameter ≥ 50 mm to < 80 mm) receiving optimal pharmacologic therapy were randomized at 10 sites. VNS systems were randomly implanted on the left (n = 31) or right (n = 29) side. All patients were successfully implanted and 59 were titrated over 10 weeks to a well tolerated stimulation intensity. One patient died 3 days after an embolic stroke that occurred during implantation. Common device-related adverse events after VNS titration were transient mild dysphonia, cough, and oropharyngeal pain, which were similar for left- and right-side VNS. After 6 months of ART, the adjusted left-right differences in LVEF, left ventricular end-systolic volume (LVESV), and left ventricular end-systolic diameter (LVESD) were 0.2% (95% CI -4.4 to 4.7), 3.7 mL (95% CI -7.0 to 14.4), and 1.3 mm (95% CI -0.9 to 3.6), respectively. In the combined population, absolute LVEF improved by 4.5% (95% CI 2.4-6.6), LVESV improved by -4.1 mL (95% CI -9.0 to 0.8), and LVESD improved by -1.7 mm (95% CI -2.8 to -0.7). Heart rate variability improved by 17 ms (95% CI 6.5-28) with minimal left-right difference. Six-minute walk distance improved an average of 56 m (95% CI 37-75); however, improvement was greater for right-side ART (77 m [95% CI 49-105]). NYHA functional class improved in 77% of patients (baseline to 6 months). Chronic open-loop ART via left- or right-side VNS is feasible and well tolerated in HFrEF patients. Safety and efficacy measures are encouraging and warrant further study.

The most viable and practical option for the management of plant diseases is disease resistance. However, in most of the crop plants, natural resistance against pathogens is rare. Breeding resistant varieties is a long-term process and the possibility of resistance being broken always exists. Induced resistance exploiting natural defense machinery of plants is indeed an alternative, nonconventional and ecologically friendly approach for plant protection. Its introduction into agricultural practice could minimize the scope of chemical control, thus contributing to the development of sustainable agriculture. Induced resistance can be defined as an increased expression of natural defense mechanisms of plants against various types of pathogens, provoked by a range of factors: pathogens causing hypersensitive necrotic reaction, avirulent or attenuated pathogenic strains, and elicitors of pathogenic origin (glucans, proteins, lipids, etc.). Induced resistance, being based on the expression of latent genetic information present in plants, is not underlaid by genome alterations (mutations, introgression of foreign genetic material), thus enhancing its biological safety. In this communication, classes of elicitor, their signal perception, transduction and induced defense gene activation has been described.

Evaluate the effects of a novel autonomic regulation therapy (ART) via vagus nerve stimulation (VNS) in patients with chronic heart failure (HF) and reduced left ventricular ejection fraction during a 12-month follow-up period. The Autonomic Regulation Therapy for the Improvement of Left Ventricular Function and Heart Failure Symptoms (ANTHEM-HF) study enrolled 60 subjects with New York Heart Association class II-III HF and low left ventricular ejection fraction (≤40%), who received open-loop ART using VNS randomized to left or right cervical vagus nerve placement and followed for 6 months after titration to a therapeutic output current (2.0 ± 0.6 mA). Patients received chronic stimulation at a frequency of 10 Hz and pulse duration of 250 µsec. Forty-nine subjects consented to participate in an extended follow-up study for an additional 6 months (12 months total posttitration) to determine whether the effects of therapy were maintained. During the 6-month extended follow-up period, there were no device malfunctions or device-related serious adverse effects. There were 7 serious adverse effects unrelated to the device, including 3 deaths (2 sudden cardiac deaths, 1 worsening HF death). There were 5 nonserious adverse events that were adjudicated to be device-related. Safety and tolerability were similar, and there were no significant differences in efficacy between left- and right-sided ART. Overall, mean efficacy measure values at 12 months were not significantly different from mean values at 6 months. Chronic open-loop ART via left- or right-sided VNS continued to be feasible and well-tolerated in patients with HF with reduced EF. Improvements in cardiac function and HF symptoms seen after 6 months of ART were maintained at 12 months.

Guillain–Barré syndrome is characterized by progressive motor weakness, sensory changes, dysautonomia, and areflexia. Cranial nerve palsies are frequent in Guillain–Barré syndrome. Among cranial nerve palsies in Guillain–Barré syndrome, facial nerve palsy is the most common affecting around half of the cases. Facial palsy in Guillain–Barré syndrome is usually bilateral. We describe a pediatric Guillain–Barré syndrome variant presenting with unilateral peripheral facial palsy and dysphagia. A 5-year-old boy had progressive lower extremity weakness and pain 3 days prior to onset of unilateral peripheral facial palsy. On presentation, diagnosis of Guillain–Barré syndrome was supported by areflexia and albuminocytologic dissociation. His condition deteriorated with a decline in his respiratory effort and inability to handle secretions. He was given non-invasive ventilation to prevent worsening of his acute respiratory failure. Brain and spine magnetic resonance imaging scans showed enhancement of the left bulbar nerve complex and anterior and posterior cervical nerve roots with gadolinium. Treatment with intravenous immunoglobulin led to an uneventful clinical course with partial recovery within 2 weeks. In summary, Guillain–Barré syndrome should be considered as a possible cause of unilateral peripheral facial palsy. Guillain–Barré syndrome patients with facial nerve and bulbar palsy require close monitoring as they are at risk of developing acute respiratory failure. Early intervention with intravenous immunoglobulin may benefit these patients. Magnetic resonance imaging findings may lend support to early intervention.

Introduction: Although the COVID‐19 vaccination is deemed safe, exact incidence and nature if adverse effects, particularly dermatological ones, are still unknown.Objective: To describe the demographic, clinical, morphological characteristics, outcomes, and timing of development of herpes zoster to the various COVID‐19 vaccines. And to identify on whether COVID‐19 vaccine has temporal relationship between development of herpes zoster (HZ).Methods: We have performed a systemic review of articles from PubMed and Embase using MeSH and keywords like “Shingles,” “Herpes zoster,” “Varicella zoster,” “COVID‐19,” “Vaccine,” “SARS‐CoV‐2.” No filters including country of publication, language, type of articles were applied. Individual case report references were filtered for any pertinent cases.Results: A total of 54 cases consisting of 27 male and 27 female patients have been reported. There were cases with known risk factors for herpes zoster, which included age more than 50 years (n = 36), immunological disorders (n = 10), chronic disease (n = 25), metabolic disorder (n = 13), malignancy (n = 4), and psychiatric disorder (n = 2). The mean (SD) period between development of herpes zoster and COVID‐19 vaccination was 7.64 (6.92) days. Majority of the cases were from the high‐income and/or middle‐income countries. 86.27% of the cases of HZ were reported due to mRNA vaccine. Thirty‐six patients 36/45 (80%) developed herpes zoster following the priming dose of COVID‐19 vaccine among those who received mRNA vaccine.Conclusion: We could not establish definite link but there may be possible association between COVID‐19 vaccine and shingles. Large‐scale studies may help to understand the cause‐effect relationship.