The diagnosis of pulmonary embolism (PE) is still one of the most common clinical problems and yet more difficult to resolve. The total non-specificity of signs and symptoms of cardiovascular disease, commonly present in many cardiac and pulmonary diseases, hinders the correct formulation of clinical suspicion, especially in the elderly, so the incidence of this disease is underestimated clinically to measure growing age of the patients. As shown by several reliable studies autopsy, PE was correctly diagnosed in living in less than half the cases, and the accuracy drops to below 30% in the elderly population.

Paradoxically, then, are not rare false positive clinical diagnosis, with the result that patients without EP undergo unnecessary and potentially dangerous therapeutic effect of diagnostic approaches insufficient or incorrect.


The EP is still very high mortality in the absence of adequate treatment.

But as can be seen in the figure below, the mortality in patients who have survived at least one hour to insult embolic down from around 32% in patients not diagnosed in about 8% in cases where the disease is recognized and adequately treated.


Given the protean nature of the EP and the different modes of clinical presentation, diagnosis therefore requires a high index of suspicion and the initiation of the appropriate diagnostic procedure to allow a safe setting every time you deliver clinical suspicion.


The signs and symptoms of cardiovascular disease are extremely varying and nonspecific, being correlated with the magnitude of hemodynamic changes, in turn dependent on the number and volume of emboli, both with the existing apparatus cardiopulmonary conditions. In subjects without previous heart disease or pulmonary emboli are small in most cases clinically completely silent.


In Tables IIa and IIb lists the main symptoms and signs present at onset of PE, derived from the results of major multicenter U.S., broken forms massive (i.e. with decreased pulmonary vasculature angiographically documented> 50%) and submassive forms ( 18.19). None of the symptoms or objective signs listed, or considered separately or in various associations between them, is pathognomonic of EP. They are in fact shared by many common cardiac and pulmonary acute and chronic. This explains the high incidence of misdiagnoses, especially in old age, given the frequent concurrence of chronic pulmonary heart disease or other, whose symptoms are often indistinguishable from those of PE.


In elderly patients, especially with preexisting cardiorespiratory failure, the diagnosis of PE is particularly difficult because the symptoms can be masked by the clinical substrate of the condition of the base. In some cases the embolism may occur simply as a sudden worsening of clinical conditions, such as increased dyspnea, the onset of left ventricular failure or atrial fibrillation.


The diagnosis of PE, therefore, requires a high index of suspicion and initiation of appropriate diagnostic lung scan inclusive request whenever clinical findings have suggested the possibility of embolism.

I have been asked to write an article on cardiovascular disease symptoms. Here are presented some cardiovascular disease symptoms. Met with good story out is invaluable in diagnosing heart disease and in charge. There is overlap between symptoms due to cardiovascular disease and those from other pathology. The following symptoms occur with heart disease:

- Chest pain

- Palpitations

- Syncope

- Fatigue

- Peripheral edema


The severity of pain, dyspnea, palpitations or angina of fatigue may be classified according to the classification of association of the heart of New York's heart condition.


Chest pain


This is the symptom most commonly associated with heart disease.The pain of angina pectoris and myocardial infarction is due to hypoxia. Classically, it is considered as a crushing pain, heavy or moving behind the breastbone in the center of the chest, radiating more rarely in the neck, shoulder or jaw, or teeth, the back or abdomen. May be associated with pain, numbness or heaviness in a '(usually the left) or both arms. Typically, the pain of angina pectoris is caused by exercise and immediately relieved by rest or nitrates of short duration. Angina happens on lying flat is called angina decubitus. The level of effort required to cause pain - for example, after walking on the floor for 200 yards - should be taken.


Angina is becoming more frequent or unpredictable, or happening at rest is classified as unstable, a component of acute coronary syndrome. Neither ischemia / infarction significant enough cannot be associated with chest pain but with dyspnea, nausea and sweating. What is silent ischemia due to loss of sensing fibers within the heart and is more common in diabetics and the elderly. Ischemia may also present with Atypical dyspeptic pain.


Central chest pain that radiates to the back may be due to ischemic heart disease but a thoracic aortic aneurysm dissection or magnification also produces a similar pain and sometimes changes in ECG.


The pain of pericarditis is also considered the center of the box. However, its character is similar to pleural pain, ie sharp, exacerbated the movement, breathing and coughing. Unlike pleural pain, however, some relief may be allowed by sitting forward.


The stabbing pain sub-mammary the left precordial moratoria, is usually associated with anxiety (called effort syndrome or syndrome Da Costa), although the terms cardiac mitral valve prolapse which can produce such a sensation. The disease can also produce the esophageal chest pain (retrosternal) station, which can be difficult to differentiate from cardiac pain.


Dyspnea


Dyspnea is an abnormal awareness of dyspnea. Hell, especially in the chest and abdomen may also lead to dyspnea. However, the main causes are heart disease and lung, the cardiovascular system, this is left ventricular failure is most commonly due (LVF). Left ventricular failure due to dyspnea due to interstitial edema and pulmonary alveoli. This makes the lungs stiff (less compliant), thus increasing the breathing effort required to ventilate the lungs. Tachypnea (increased breathing rate) is usually also present due to stimulation of pulmonary stretch receptors.


It is clinically useful to classify dyspnea in a similar manner to chest pain (see above), the level of effort required to cause its inception and the patient's heart condition as this is an indication of severity. LVF while serious, other forms of dyspnea such as paroxysmal nocturnal dyspnea and orthopnoea happen.

Old age can be 'a beast' for dogs and cats. Just as happens in humans, in fact, over time their bodies become more fragile and prone to physical problems and ailments. But when are our faithful companions can be defined elderly? The parameters vary from subject to subject depending on age, race and individual characteristics. The larger animals, for example, tend to age faster than small ones.

'Without exception - says Dr. Julian Pellegrini, veterinary surgeon - the threshold that separates the aging maturity is eight years for medium sized dogs, five and eight large ones for cats. And if going on over the years our animals change their attitude, the cause may be just one of many age-related diseases. Arthritis, for example, is widespread and can cause severe problems walking, while heart and lung diseases that occur with coughing, difficulty in breathing or weakness are always lurking. In fact, their hearing, as well as smell and sight, most affected age.


Patience, then, if our friend does not respond to commands as before, or looks at us bewildered, over the years, could be deaf or have cataracts. Using 'old men', such as those related to teeth (periodontal disease) or urinary incontinence due to a loss of bladder control, and females may be caused by too many pregnancies and male prostatic hypertrophy. And what about weight? Obesity in older animals can cause trouble on all fronts - explains Dr. Pellegrini.


Dog heart disease symptoms are excessive stress on the joints, problems with spinal arthritis and worsening of any particular cardiovascular damage. Consider that a pound of fat requires m capillaries in which the heart has to push blood! The dog heart disease symptoms can also be caused by diabetes, hypertension and pancreatitis, which begin to be taken into consideration for the animals.

The thinness, however, in itself is not bad. But a person excessively underweight may bear a worse illness, changes in temperature and fasting '. And the diet must be appropriate, considering the needs of protein, carbohydrates and fiber in each case. 'Starving our little friends does not need it - our vet warned - indeed we must avoid any food stress, especially in cats.


In them, in fact, excessive and rapid reduction of fatty deposits can cause irreparable damage to the liver and kidneys'. The 'DIY', then, in this case could be counterproductive. Finally do not forget, now that summer is approaching and the barbaric ritual of abandonment resurface unfortunately, that these faithful companions, albeit with problems, can still give us joy and love. And I know who writes that for fifteen years agrees with the existence of a 'Chan'. Is now completely deaf yet, just the one eye and a caress for their 'feel'!

Interstitial lung diseases are characterized by abnormalities involving initially the alveolar epithelium and endothelial cells, interstitium support and to a lesser extent, variable, other vascular structures and airways. They form a heterogeneous group of diseases, some of which result from causes easily identifiable, while in others the underlying cause remains obscure.

Although much less common disease of the airways such as COPD, interstitial lung diseases are an important group of diseases associated with disabling symptoms of interstitial lung disease and a rapid clinical deterioration. The terms pneumonia and alveolitis are frequently used to describe the inflammatory process involving the alveolar cells in many diseases, interstitial. In some of these diseases an abnormal arrangement of collagen following the acute inflammatory process, so that pulmonary fibrosis is the term used almost interchangeably with that of interstitial lung disease.


Classification etiology. It is convenient and clinically correct split diffuse pulmonary fibrosis in two broad categories: those with known etiology, which represents about one third of cases, and the etiology unknown. Diagnostic procedures become more sensitive and specific. In the group of known causes, one can still distinguish three main subgroups of interstitial pulmonary fibrosis:


1. That determined by extensive granuloma


2. That result from chronic pulmonary exudates


3. That due to inorganic fibrogenic dust.


After the exclusion of forms of known cause, remains a large group of fibrotic interstitial lung disease. In this group there are diseases with characteristic histopathological aspects, which have become known under the names: idiopathic pulmonary fibrosis (IPF), diffuse interstitial fibrosis of unknown origin, and cryptogenic fibrosis alveolitis (ACF). Hamman-Rich syndrome, is a rare pathological entity, and characterized by temporal uniformity of the disease, a fibrotic form, rapidly progressive IPF.

In this chapter we will use the first of these synonyms, idiopathic pulmonary fibrosis (IPF) will be first considered some aspects of diffuse pulmonary fibrosis fibrotic diseases common to all, regardless of the cause, then the diseases will be discussed from time to time based on pathogenesis, clinical history, pathophysiology, diagnosis and therapy.


Radiographic


The distribution of radiographic interstitial lung disease is often characteristic of the underlying disease in the upper lobe pulmonary fibrosis is observed in silicosis and in ankylosing spondylitis. Belatedly, in certain interstitial lung diseases, lung fields taking on a beehive, they have observed many shadows ring between 5 and 8 cm in diameter with thin walls from 0.5 to 1 mm. Some authors describe the radiographic changes in the interstitial and air paintings.

This description assumes a perfect correlation between radiographic appearance and histological changes. The description of nodular or reticular shadows, however, is not based on this assumption. Fibrosis of the upper lobe, with loss of lung volume may increase the horizontal fissure and small if any unilateral contracture, because the deviation of the trachea.


Fibrosis of the lower lobe may be accompanied by a progressive elevation of the diaphragm and a loss of lung volume. In any region of the lung may develop emphysematous bubbles, which are commonly a sign of silicosis or advanced sarcoidosis. Most patients present with shortness of breath during physical exercises that, with the progression of the disease manifests itself even at rest. The degree of dyspnea can be extreme and not commensurate with the severity of radiological changes.

The opposite can be observed in sarcoidosis, in which, despite impressive radiographic changes of the lungs, dyspnea may be minimal. And a nonproductive cough is a symptom frequently associated with and often debut. Nonspecific systemic symptoms of interstitial lung disease such as fatigue and weight loss may be observed in about half of cases of interstitial lung disease.

Since there are so many diseases that can affect the heart, the symptoms of heart disease can be very numerous. But there are some common symptoms of heart disease that can tell you if something is wrong and if you should go and see a doctor. This article will discuss some of the most common symptoms of heart disease and will describe them.

One of the most common symptoms of heart disease is of course chest pain. This symptom is believed to be number one alarming sign that something is wrong. Most people believe that chest pain is the same with heart pain. In some cases this is true, but in other cases is just an impression. But no matter if this is a heart problem or not, if you feel chest pain you should go see a doctor. You will never be sure what it is until you make some tests, because this term is very imprecise and people describe it in different ways. Moreover, chest pain can last for a few second, minutes or even for a few days.


Another heart disease symptom is heart palpitation. This is a very common symptom and many times can be started by other factor than heart diseases. But just like in the case of chest pain, the doctor is the best person to tell you if everything is all right or not. Heart palpitation means irregular heartbeats.


The next symptom on our list is dizziness. Dizziness will never signify just a heart disease, because dizziness can have a lot of causes and can mean a lot of things. You can get dizzy because you are tired or because you made too much effort. You can be dizzy because you dehydrated or because you did not ate enough. All in one, dizziness is an alarming sign, but does not necessarily mean you have a heart disease. Like in the case of the other symptoms I described, you have to check with the doctor to see if everything is all right.


Fainting or the loss of consciousness is the next symptom on our list. This symptom, which can be very alarming for the patient, as well as for the family and friends, is usually temporary and sudden. Fortunately, this symptom does not necessarily mean you have a heart disease, because fainting usually does not have a medical cause, but sometimes fainting can be very dangerous and you should go and see a doctor.

Another sign is fatigue. And I not talking about the fact that you come home from work and you are tired.



I am talking about constant fatigue, the kind you feel tired all the time, even if you sleep more than usual. This kind of fatigue makes you feel like you do not have energy for anything, not even for a slow walk. You feel tired all the time and you want to sleep constantly. This symptom may mean a lot of other disturbances, but mostly it signifies you have a heart condition.

What are the symptoms of heart disease? If you are curious of what are the symptoms of heart disease, read this article. What is the aortic valve and what is its function?

The aortic valve is a structure composed of three leaflets (or flaps) crescent-shaped, that open and close regularly during systole respectively (corresponding to a cardiac contraction) and diastole (relaxation and subsequent filling of the heart). It is between the left ventricle, ie the part of the heart that pumps oxygen-rich blood throughout the body, the aorta artery, the largest and most important artery leaving the heart and gives rise to all other arterial branches that distribute blood in all districts of the organism.

When the heart contracts, the arterial blood (oxygen) in the left ventricle through the aorta is pushed open the valve leaflets to be distributed throughout the body, the thrust force and the pressure in the left ventricle determines the opening of valve that allows the passage of blood at the end of contraction, ventricular emptying and the consequent loss of pressure in it causing the closure of the valve to be sealed to prevent the aorta blood this "go back" and accumulate what slowly again fills the ventricle during diastole until the ventricle is full (systole) leading again to open the valve and thus giving rise to a new cardiac cycle described.



Those symptoms felt when the aortic valve tells you are sick and that some tests need to be carried out. Symptoms of an aortic valve disease are different and their intensity varies greatly by level of severity and impairment of the valve being initially present in the effort and later at rest;


They include dyspnea (shortness of breath), decreased exercise tolerance, fatigue, palpitations, angina-like pain, dizziness, syncope, signs of heart failure, peripheral edema. These symptoms can be alleviated by medical treatment at least in the initial stages after the 'intervention is the only guard for the final resolution of the problem and to avoid irreversible damage and death itself if the patient's severe valve disease is corrected. The tests that are performed are routine electrocardiogram, an echocardiogram that displays the morphology of the heart and very well describe and quantify the valvular defect and coronary highlighting any disorders of the coronary that often can valvular defect associated with the above in the case of aortic stenosis.



When and how the aortic valve is replaced?


The intervention becomes inevitable when the valvular defect causes significant impairment of the functioning of the valve, resulting in worsening of symptoms that can no longer be governed by medical therapy or in cases of initial sign of impairment of the heart to prevent establish mechanisms failure of which become irreversible and would not improve significantly even with assistance if that proves too late and it is therefore essential that the patient who is diagnosed with aortic valve disease to submit to regular checks and is followed by a cardiologist with the heart surgeon will estimate the right timing for the possible intervention by drawing the maximum benefit with the least possible risk to the patient.

Heart disease in 50’s symptoms are not worse than in any other age. Heart disease in 50’s symptoms are mainly pain against the chest, tingling sensations and sense of fullness in the chest area and mild chest pain. Diseases involving the heart valves give rise to a broad spectrum of diseases, some deserving only periodic checks, and others that require surgical repair or replacement work is also urgent.

The causes

Between a root cause of diseases of the heart valves, and developed in industrialized countries, the most common degenerative diseases is most definitely the basis of valvular disease, especially aortic valve and valvular dysfunction secondary to cardiomyopathy, often ischemic origin .

Another cause of valve disease is increasing endocarditis, especially the valves of the right heart (tricuspid on lung), linked to intravenous drug use. Besides the acquired forms, there are congenital valvular abnormalities such as mitral valve prolapsed or bicuspid aortic valve, which predispose to the development of valvular disease.


The symptoms of valve disease can appear suddenly (linked to valvular damage resulting from a sudden acute process) or be phased in over time. usually patients who are regarded, complaining easy fatigue during normal daily activities, difficulty breathing (dyspnea), initially on exertion, then at rest or at night, fainting, swelling (edema) in the legs, chest pain or palpitations (arrhythmias).

In more advanced cases and not subjected to proper treatment, the patient may have a serious embolism or heart failure. Properly diagnose valve disease is now very easy by color-Doppler echocardiography, completely harmless and non-invasive, or by cardiac catheterization, an invasive test that requires the use of catheters capable of tracing the vascular bed to the heart. In any case, next cardiac auscultation and clinical examination, the cardiologist has sophisticated instrumental techniques, widely scattered, allowing immediate identification of the problem and complete evaluation of the same magnitude.

Treatment

The treatment of severe valvular disease is usually surgical and involves replacing or repairing diseased valve. The replacement is done through mechanical prosthesis (made with carbon materials), which have a theoretically unlimited duration, but requiring anticoagulation therapy for life, or by biological prosthesis (consisting of material from body or other animals) which, by their shorter time (8-10 years) and for the avoidance of anticoagulant therapy, are recommended in the elderly.


Today cardiac surgery has evolved considerably and is often possible to preserve its own valve tinkering with sophisticated techniques. Along with surgical techniques, some valvular disease may benefit by correction by percutaneous interventions, using balloon catheters capable of dilating the stenotic valves, the type used to dilate the coronary stenosis (see angioplasty and coronary stents).

This technique is applicable to non-calcified mitral stenosis and most recently, for some selected cases particularly aortic stenosis. The significant advances in diagnostic techniques such as in surgical and interventional enabled improved prognosis and quality of life of patients suffering from valvular disease, unimaginable until only a few decades ago.

This is an article on heart disease symptoms in women. Heart disease symptoms in women infarcts should be discussed more often, because people need to be informed.

Coronary heart disease is a condition most common among the cardiovascular diseases. Angina pectoris is the most characteristic symptom:

Angina pectoris (chest pain)

Angina occurs when the myocardium does not receive enough oxygen and / or nutrients because of the closure of the coronary arteries

(myocardial ischemia). When this happens, cells begin to work using its energy reserves. This is an emergency system that produces many toxic factors. Products issued by this type of metabolism (catabolism), such as lactic acid, accumulate, as they can not be removed effectively.

The accumulation of these substances leads to pain. This is similar to that experienced in the muscles when they struggle; the pain is there as well as the accumulation of lactic acid. The cardiac cell can use these deposits energy only for a short time when they exhaust the cell is permanently damaged.



The typical symptoms of angina include a wide variety of sensations. For example, a simple feeling of discomfort is not a real pain. Its most typical location is behind the breastbone but may also be located differently. Pain in the arms, shoulders, neck, jaw or back may be other forms of presentation. It is frequently associated with sweating, shortness of breath and sudden pallor. Blood pressure and heart rate may be higher than the norm.


There are two types of angina: stable and unstable.


Stable angina: is usually triggered by physical exertion that increases oxygen demand by the myocardium. Usually the pain disappears with rest or with one tablet of nitroglycerin. Commonly, the crisis does not last more than a few minutes.

Unstable angina: is characterized by a progressive increase in the number, severity or duration of episodes of chest pain. The pain is more intense, longer lasting, also appears with less effort or even at rest. This is a situation that requires urgent admission to hospital, as one third of patients with this clinical picture may be affected with a high probability of acute myocardial infarction, within three months.

Heart attack (myocardial infarction): In the U.S., every 20 seconds, someone is hit by an acute myocardial infarction. In Italy the situation is comparable, as in all industrialized countries. In 25% of cases, the episode can be fatal. Half of these deaths happen within half an hour since the crisis. Despite these horrific numbers, technological advances have reduced significantly the probability of dying from myocardial infarction.

In 90% of cases of myocardial infarction is due to complete closure of a coronary artery. This happens because the plate, in a certain size, breaks, and forms a clot that completely obstructs the artery. As explained for angina, the coronary infarction behind this remains without oxygen / nutrients, and therefore, the initial situation of myocardial ischemia, rapidly evolving toward necrosis or cell death.

The MI is thus a disease of the heart secondary to coronary artery disease. This insult caused to the heart muscle, causing an alteration in pump function, more or less important depending on the affected area after infarction, and extent of it.

The motor neuron diseases are diseases characterized by degeneration of neurons in early motorcycle or motor neurons. This article will also discuss the symptoms of motor neuron disease.

When motor neurons are damaged the performance of this operation is interrupted movements become increasingly difficult and muscle mass decreases (muscle wasting). Among the motor neuron diseases, which are a heterogeneous group of diseases, the best known is the Amyotrophic Lateral Sclerosis (ALS).

The problems presented by patients vary depending on the part of the body affected by motor neuron degeneration: a lack of strength is often the first symptom: it can manifest as weakness of a hand, a leg (weakness) or muscle weakness that allow to speak (dysarthria) or swallowing (dysphagia). Frequently at the beginning are muscle cramps, especially night and may also be observed "file", medical term used to indicate the spontaneous contraction of muscle fibers, visible in the form of "flashes" subcutaneous.

Typically, some disorders are observed in these diseases almost never. In particular there is not a decay of intellectual functions, sensitivities are not damaged, and patients have no pain or urinary problems. The evolution of the disease is variable depending on the clinical form: when it is impossible for each individual patient, to predict with certainty how the disease progresses. It is therefore impossible to formulate an accurate prognosis on the evolution functional mobility.

To put the correct diagnosis of motor neuron disease is important to perform well as a thorough neurological examination, tax instrument, also needed to exclude other diseases that resemble ALS. These findings, which vary depending on the form of motor neuron diseases, essentially comprise a series of blood tests, detailed neurophysiological studies (electromyography-Electroneurography and motor evoked potentials), a neuron-radiological study of the brain and spinal cord, through nuclear magnetic resonance.

Despite numerous scientific research permits to identify promising hypotheses, the cause of motor neurone disease remains unknown, therefore, has not yet processed “etiological” capable of curing the disease or improves muscle strength. It is therefore essential to research, clinical and basic, to improve scientific knowledge and to identify new therapeutic approaches.

The aim of drug treatments is currently proposed to slow progression of the disease: this aim was partly achieved by a molecule with anti-glutamatergi, the drug, the one at the moment, to have obtained the 'approval by the competent bodies of the Ministry of Health in Europe and the United States, is subject to distribution subsidiary hospital.

Beyond treatment "causal", and those directed to the correction of some symptoms of motor neuron disease such as salivation, cramps and sleep disorders, the care of patients suffering from this disease consists mainly of a round care , which is based on coordinated action of several medical specialists and paramedics.

Kinesiology has a particularly important role in the takeover of the disease: it does preserve the mobility and actively oppose the onset of joint stiffness. If you have important respiratory disorders, these can be improved through non-invasive ventilation, undertaken in Hospital under the guidance of respiratory specialist and continued home. If the disease causes difficulty in swallowing, may be useful to the placement of PEG, by specialist gastro-enterology.

Get the plants in good health, which hence the aesthetic sense is the goal that we aim to plant protection interventions: this approach requires a commitment not materialistic.

Proper pest plant takes advantage of the fundamentals of plant pathology, the science that traditionally studied the disease of trees and symptoms, consider the real needs, taking into account the presence of non-target insects, brings attention to not overwhelm the balance.

Similar to human medicine, treating disease of trees and symptoms must be entrusted to more modern methods and instruments that are more advanced.

Becomes important collaboration with research institutions, public and private, can set schedule and industry analysis. Starting from the studies are developed practices and intervention services to high technology.

Eurogreen ensures a correct approach to the problems of plant seedlings, because he has accepted the modern definition of phytoiatric, understood as a discipline that regulates all the means to care for the sick plant organisms.

Eurogreen is distinguished by the attention and professionalism, as it provides the services using media of chemical, biological, biotechnology, and agronomic practices, physical and mechanical nature.

Eurogreen is aware that in a biotic community living things interact dynamically, that relates to environmental factors in a delicate balance, which is why all our services meet the requirements of eco-friendly and have as their objective the achievement of the result to lower ecological cost.

The battery of walnut, commonly known as "Mal dry", is caused by Xanthomonas rural pv. juglandis (Pierce) Dye. Reported in Italy since 1884 by Savastano Sorrento Peninsula, as reported by Ferraris (1938) and Ercolani (1962), is now widespread in all areas of cultivation.

The disease affects the epigeal organs occurring herbaceous and succulent as buds, leaves including rachis and petioles, shoots, male and female flowers and fruits. The symptoms already evident at the end of spring, at first punctiform spots consist of pale-green, translucent, then blackish-brown, round or angular, isolated or confluent, or less surrounded by chlorotic halo.

Cancers on the woody organs appear more lately, reaching the highest expression after the fall of leaves. The success of the infection process is linked to the high degree of tissue swelling and fluid retention of a veil; 24-48 hours is enough to cause serious injury (Adeskaveg et al., 1994).

The activity of bacteria, mainly in the wintering buds begin to vegetative growth, it penetrates inside the host tissue through interruption (stomata, wounds, etc...) Distribution is ensured by infected pollen, water, especially if flying action, insects, mites and man through the use of slips, stocks and instruments infected, and with practices of collecting the fruits traumatic, such as the shaking. The inoculums represented the secondary bacterial yellowish-translucent appearance that is out of the necrotic lesions.

Damage the battery case is mainly due to reduced production and premature fruit drop to be compromised because the fruits are unmarketable. The disease is also present in the nursery (Belisarius and Zoin, 1995) where losses can be high for the elimination of those patients with cancers on the trunk or bud so detrimental to proper development as well as favoring the spread of bacteria. As for wood orchards, the disease is well tolerated and black walnut can be considered resistant.