A mycotoxin-dedicated total diet study in the Netherlands in 2013: Part II – occurrence

The occurrence of 59 natural toxins was determined in 88 composite food and drink samples of a mycotoxin-dedicated total diet study performed in the Netherlands in 2013. Composite food samples were prepared by pooling foods from a food category (as consumed, e.g. peeled, cooked, etc.) according to their consumption by population groups in the Netherlands. A multi-targeted method based on QuEChERs extraction, dilute and shoot and analysis by liquid chromatography-tandem mass spectrometry was applied to the 88 composite samples. Dedicated methods with lower detection limits for patulin, aflatoxins and trichothecenes were also applied to specific food types. Thirty samples (34%) were positive for one or more mycotoxins. Patulin, aflatoxin M1, zearalenone and plant toxins, with the exception of scopolamine in liquorice, were not detected in any of the composite samples. Aflatoxin B1 was only detected, but not at quantifiable levels, in the composites that contained peanuts. Fumonisin B1 was only found at 18 μg/kg in breakfast cereals consumed by the population group of 7-69 years, whereas ochratoxin A occurred at low levels around 1 μg/kg in liquorice, legumes and coffee. Grains and grain-based food composites were positive for ergot alkaloids, enniatins B and B1 and deoxynivalenol (DON). The levels of DON in the positive samples were lower compared to other studies, with the exception of breakfast cereals for infants with a DON concentration of 116 μg/kg. This specific composite sample may have contained an ingredient with a concentration exceeding the maximum legal limit of 200 μg/kg. Alternaria toxins (alternariol and alternariol methyl ether) were detected at levels ranging from 1.0 to 8.9 μg/kg in a number of composite samples, including tomato products, nuts, cereal products, chocolate and wine. Mycophenolic acid and roquefortine C cooccurred in mould-ripened cheese composites, while mycophenolic acid also was found in dried fruit and liquorice composite samples.

Cannabis and bipolar disorder: does quitting cannabis use during manic/mixed episode improve clinical/functional outcomes?

OBJECTIVE

To examine whether bipolar disorder patients who stop cannabis use during a manic/mixed episode have better clinical and functional outcomes than continued use or never use.

METHOD

Data from the European Mania in Bipolar Longitudinal Evaluation of Medication (EMBLEM), a 2-year prospective observational study in adults with a manic/mixed episode of bipolar disorder, was used. Three cannabis use groups were: current use (between 12-week and 24-month visits); no current but previous use (during first 12 weeks); and never use. Associations between cannabis use and outcomes were analyzed using regression models.

RESULTS

Of 1922 patients analyzed, 6.9% were current users, 4.6% previous users, and 88.5% never users. Clinical outcomes differed between groups (P<0.019): previous users had highest rates of remission (68.1%) and recovery (38.7%), and lowest rates of recurrence (42.1%) and relapse (29.8%). Logistic regression showed previous users had similar outcomes to never users (all P>0.05), whereas current users had lower recovery (P=0.004) and remission (P=0.014), higher recurrence (P=0.014), greater work impairment (P=0.016), and were more likely not to be living with partner (P=0.006) than never users.

CONCLUSION

Bipolar patients who stop using cannabis during manic/mixed episode have similar clinical and functional outcomes to never users, while continued use is associated with higher risk of recurrence and poorer functioning.

Microsatellite isolation and characterization for Colletotrichum spp, causal agent of anthracnose in Andean blackberry

The genus Colletotrichum, comprised of pathogenic fungi that affect plants grown worldwide, causes the disease known as anthracnose in several fruit and vegetable species. Several studies conducted on plants have shown that the disease is characterized by the presence of one or several species of the fungus attacking the fruit or other organs of the same host. To develop and implement effective control strategies, it is vital to understand the genetic structure of the fungus in agricultural systems, identify associated Colletotrichum species, and define the subpopulations responsible for the disease. Molecular tools were accordingly developed to characterize genotypic populations of Colletotrichum spp, causal agent of anthracnose in commercial crops of Andean blackberry (Rubus glaucus Benth.). A microsatellite-enriched library for Colletotrichum gloeosporioides was developed to identify and characterize microsatellite loci among isolates collected in R. glaucus plantations. Thirty microsatellites were developed and tested in 36 isolates gathered from eight different blackberry-production areas of Colombia. Ten pairs of microsatellites were polymorphic.

Inhibition of PKC-dependent extracellular Ca2+ entry contributes to the depression of contractile activity in long-term pressure-overloaded endothelium-denuded rat aortas

We examined the contractile responsiveness of rat thoracic aortas under pressure overload after long-term suprarenal abdominal aortic coarctation (lt-Srac). Endothelium-dependent angiotensin II (ANG II) type 2 receptor (AT₂R)-mediated depression of contractions to ANG II has been reported in short-term (1 week) pressure-overloaded rat aortas. Contractility was evaluated in the aortic rings of rats subjected to lt-Srac or sham surgery (Sham) for 8 weeks. ANG I and II levels and AT₂R protein expression in the aortas of lt-Srac and Sham rats were also evaluated. lt-Srac attenuated the contractions of ANG II and phenylephrine in the aortas in an endothelium-independent manner. However, lt-Srac did not influence the transient contractions induced in endothelium-denuded aortic rings by ANG II, phenylephrine, or caffeine in Ca²⁺-free medium or the subsequent tonic constrictions induced by the addition of Ca²⁺ in the absence of agonists. Thus, the contractions induced by Ca²⁺ release from intracellular stores and Ca²⁺ influx through stored-operated channels were not inhibited in the aortas of lt-Srac rats. Potassium-elicited contractions in endothelium-denuded aortic rings of lt-Srac rats remained unaltered compared with control tissues. Consequently, the contractile depression observed in aortic tissues of lt-Srac rats cannot be explained by direct inhibition of voltage-operated Ca²⁺ channels. Interestingly, 12-O-tetradecanoylphorbol-13-acetate-induced contractions in endothelium-denuded aortic rings of lt-Srac rats were depressed in the presence but not in the absence of extracellular Ca²⁺. Neither levels of angiotensins nor of AT₂R were modified in the aortas after lt-Srac. The results suggest that, in rat thoracic aortas, lt-Srac selectively inhibited protein kinase C-mediated activation of contraction that is dependent on extracellular Ca²⁺ entry.

Anti-ribosomal P antibodies are associated with elevated circulating IFNα and IL-10 levels in systemic lupus erythematosus patients

OBJECTIVE

The objective of this paper is to analyze the relationship of anti-protein ribosomal P (RibP) antibodies with circulating levels of IFNα, TNFα, IFNγ, IL-17 and IL-10 in SLE. Disease activity and other systemic lupus erythematosus (SLE) features were also analyzed.

METHODS

Anti-RibP and other SLE-related antinuclear antibodies (ANA) were determined by fluoro-enzyme immunoassay in the sera of 107 SLE patients. Circulating cytokines were quantified by flow cytometry (IFNα, IL-10 and IL-17) or ELISA (TNFα and IFNγ).

RESULTS

Anti-RibP-positive patients (14.9%) displayed significantly higher serum levels of IFNα (p = 0.023) and IL-10 (p = 0.016) than their negative counterparts. This cytokine upregulation was independent of the presence of other ANA even though, in our patient cohort, anti-dsDNA was found to be associated with anti-RibP (OR, CI 95%: 6.03, 1.32-27.93, p = 0.021) and to correlate with IL-10 levels (r = 0.204, p = 0.036). In fact, patients positive for anti-RibP but negative for anti-dsDNA exhibited the highest amounts of both IL-10 and IFN-α that were not related to disease activity since these patients showed lower SLEDAI than patients also positive for anti-dsDNA (p = 0.018). Anti-RibP positivity was also associated with early diagnosis, hypocomplementemia and leukopenia.

CONCLUSIONS

Presence of anti-RibP was found to be related to increased serum IFNα and IL-10 levels independently of both antibody status and disease activity.

Health care costs of complex perianal fistula in Crohn's disease

AIM

To evaluate the use of health care resources and the associated costs of complex perianal Crohn's disease (CD) from the National Health System perspective.

METHODS

We conducted a multicenter, retrospective, observational study in which gastroenterologists from 11 hospitals in the Community of Madrid took part. Data was collected on the direct healthcare resources (pharmacological treatments, surgical procedures, laboratory/diagnostic tests, visits to specialists and emergency departments, and hospitalizations) consumed by 97 adult patients with complex perianal CD which was active at some point between January 1, 2005, and case history review.

RESULTS

We recorded 527 treatments: 73.1% pharmacological (32.3% antibiotic, 20.5% immunomodulator, 20.3% biological) and 26.9% surgical. Mean annual global cost was €8,289/patient, 75.3% (€6,242) of which was accounted for by pharmacological treatments (€13.44 antibiotics; €1,136 immunomodulators; €5,093 biological agents), 12.4% (€1,027) by hospitalizations and surgery, 7.7% (€640) by medical visits, 4.2% (€350) by laboratory/diagnostic tests, and 0.4% (€30) by emergency department visits.

CONCLUSIONS

Pharmacological therapies, and in particular biological agents, are the main cost driver in complex perianal CD; costs due to surgery and hospitalizations are much lower.

Potential adverse effects of inorganic pollutants on clinical parameters of loggerhead sea turtles (Caretta caretta): results from a nesting colony from Cape Verde, West Africa

A large number of nesting loggerhead sea turtles (n = 201) were sampled to establish the blood levels of 11 elements (Cu, Mn, Pb, Zn, Cd, Ni, Cr, As, Al, Hg, and Se). Almost all of the samples showed detectable levels of these 11 elements, and Zn and Se exhibited the highest concentrations (median values as high as 6.05 and 2.28 μg/g, respectively). The median concentrations of the most toxic compounds, As, Cd, Pb, and Hg, were relatively low (0.38, 0.24, 0.06, and 0.03 μg/g, respectively). We also determined the haematological and biochemical parameters in a subsample of 50 turtles to evaluate the potential effects of these contaminants on clinical parameters and found several associations. Our study reinforces the usefulness of blood for the monitoring of the levels of contaminating elements and their adverse effects on blood parameters in sea turtles.

A new β⁰-thalassemia frameshift mutation [β 48 (-T)] in a Uruguayan family

We describe here a new frameshift mutation of β-thalassemia in a Uruguayan family with Italian ancestry [β48 (-T); HBB:c.146delT]. This frameshift results in formation of premature stop codon (TGA) 40 bp downstream and in a short unstable product that is degraded in the cell.

Increased fertilization rates after in vitro culture of frozen-thawed testicular immotile sperm in nonobstructive azoospermic patients

Objective. To optimise the use of freeze/thaw testicular immotile spermatozoa from nonobstructive azoospermia patients and to analyse the outcome of intracytoplasmic sperm injection (ICSI) of such spermatozoa. Methods. Testicular specimens were retrieved and cryopreserved from forty patients with nonobstructive azoospermia and underwent one cycle with thawed spermatozoa (Group I) that led to pregnancy in sixteen cases. Twenty-four patients of group I underwent treatment with the same batch of thawed spermatozoa (Group II). For the first ICSI attempt, injection was performed when motile spermatozoa were found. In group II, injection was performed when maximum motility was reached. We compared mean of fertilization rate, embryo quality, clinical pregnancy rate and embryo implantation rate. Results. The mean percentage of motility was significantly higher in the group II than in the group I (18, 6 versus 8, 2). Group I showed a significant decrease in fertilization rates when compared with cryopreserved testicular spermatozoa in group II (54% versus 72%, P < 0.05). No difference was noted between the cleavage rate, embryo quality, clinical pregnancy rates and implantation rates among group II and I. Conclusion. Fecundation rate can be significantly improved after in-vitro culture and sperm selection of frozen-thawed immotile testicular spermatozoa in patients with nonobstructive azoospermia.

Evaluation of yogurt and various beverages as carriers of lactic acid bacteria producing 2-branched (1,3)-β-D-glucan

Probiotic cultures are increasingly being incorporated into a wide variety of food products. Although lactobacilli and bifidobacteria are the most frequently used, other lactic acid bacteria (LAB) have been reported to be potential probiotics. Of these, the cider isolates Pediococccus parvulus (strains 2.6 and CUPV22) and Lactobacillus suebicus CUPV221 produce a 2-branched (1,3)-β-d-glucan exopolysaccharide that decreases serum cholesterol levels and affects the activation of human macrophages. For this reason, these 3 strains were incorporated into yogurt, orange juice, and 2 juice-milk beverages to evaluate the effect of the food matrix on the resistance of these strains to simulated gastrointestinal tract conditions. Our results showed that incorporation of the LAB did not significantly affect the physical and rheological properties of the food matrices tested. When incorporated in yogurt, LAB strains population decreased by 2 to 3 log orders of magnitude during the shelf life of the product (28 d). However, no significant decrease was observed in the juice and juice-milk beverages during the same storage period, except for Lb. suebicus, whose viability decreased by 3 log orders of magnitude. When strains were subjected to gastrointestinal tract conditions, a decrease in the survival was observed at the lower pH (1.8). However, incorporation of these LAB strains into orange juice increases their resistance to lower pH conditions, thus improving survival to gastrointestinal stress. Moreover, a protective effect was observed for P. parvulus CUPV22 and 2.6 to gastric stress in juice-milk beverages and to gastrointestinal stress in yogurt. Lactobacillus suebicus CUPV221 did not survive when incorporated into yogurt and juice-milk beverage.

Molecular and flow cytometry characterization during the follow-up of three simultaneous lymphoproliferative disorders: hairy cell leukemia, monoclonal B-cell lymphocytosis, and CD4(++) /CD8(+/- dim) T-large granular lymphocytosis--a case report

The simultaneous diagnosis of hairy cell leukemia and monoclonal B-cell lymphocytosis with the characteristics of "indolent" chronic lymphocytic leukemia is rare but not unknown. However, an association with a third clonal lymphoproliferative disorder has not previously been described. We report the simultaneous presence of hairy cell leukemia, monoclonal B-cell lymphocytosis, and alpha beta CD4(++) /CD8(+) T-cell large granular lymphocytosis in a 63-year-old man. After the diagnosis, the three lymphoproliferative disorders (i.e., two of B-cell lineage and one of T-cell lineage) were characterized by analysis of multiple sequential bone marrow and peripheral blood samples using flow cytometry and molecular techniques. We discuss these findings in the context of chronic antigen stimulation, immunosuppression, and apoptotic pathway alterations, which might be implicated in the accumulation of these abnormal clones in the same patient. Because the phenotype of the three clones is compatible with fully differentiated B lymphocytes (consistent with a postgerminal origin) and T-CD4(++) cells, we favor the possibility of an antigen-driven mechanism and a dysregulation of homeostatic apoptosis in this patient.

Optimization and development of analytical methods for the determination of new brominated flame retardants and polybrominated diphenyl ethers in sediments and suspended particulate matter

With more stringent legislation on brominated flame retardants, it is expected that increasing amounts of substitutes would replace polybrominated diphenylethers (PBDEs). Therefore, the development and optimization of analytical methodologies that allow their identification and quantification are of paramount relevance. This work describes the optimization of an analytical procedure to determine pentabromochlorocyclohexane, tetrabromo-o-chlorotoluene, 2,3,5,6-tetrabromo-p-xylene, tetrabromophthalic anhydride, 2,3,4,5,6-pentabromotoluene, tris(2,3-dibromopropyl)phosphate, decabromodiphenylethane and 1,2-bis(2,4,6-tribromophenoxy)ethane together with PBDEs in sediments and in suspended particulate matter. This method comprises a pressurized liquid extraction followed by three cleanup steps (gel permeation chromatography and solid phase extraction on Oasis™ HLB and on silica cartridges). Gas chromatography-mass spectrometry, using electron capture negative chemical ionization, is used for the final analysis. The proposed method provides recoveries >85%. The method was applied to sediment and suspended particulate matter samples from different locations in the Western Scheldt estuary (the Netherlands). To the best of our knowledge, this is the first time that the occurrence of the additive flame retardants 2,3,5,6-tetrabromo-p-xylene, 3,4,5,6-tetrabromo-o-chlorotoluene and 2,3,4,5,6-pentabromochlorocyclohexane is reported in the literature. The concentrations of these new flame retardants ranged from 0.05 to 0.30 μg/kg dry weight.

Anti-inflammatory effect of Lithrea molleoides extracts and isolated active compounds

AIM OF THE STUDY

In this study the anti-inflammatory activity of aqueous, dichloromethane (CH₂Cl₂) and methanolic (MeOH) extracts and two major compounds isolated from Lithrea molleoides (Vell.) Engl. (Anacardiaceae) were evaluated.

MATERIALS AND METHODS

Two classical experimental models were used, carrageenan-induced rat paw edema and 12-O-tetradecanoylphorbol-13 acetate (TPA) induced mouse ear edema.

RESULTS

MeOH extracts exhibited a significant systemical anti-inflammatory effect in the carrageenan (inhibition of 46% at 3 h) and in the TPA-ear edema test (inhibition of 21%). The presence of methyl gallate (inhibition of 63% in TPA ear edema), as one of the main compounds in the active fraction from MeOH extract may be explained the effect observed. Also, 1,3-dihydroxy-(Z,Z)-5-(tridec-4',7́dienyl) benzene obtained from CH₂Cl₂ extract showed a significant topical anti-inflammatory activity (inhibition of 68%). Furthermore, no signs of toxicity were observed with doses up to 3g/kg in an acute toxicity assay.

CONCLUSIONS

The results of this study present evidence that Lithrea molleoides given either systemically or topically has anti-inflammatory properties.

Observational transversal study to relate functional status and age with the doublet or triplet chemotherapy based on capecitabine in advanced gastric cancer patients

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Background: The available evidence suggests that selection of treatment for advanced gastric cancer (AGC) correlates with age and ECOG PS. This study was conducted to analyze whether previously mentioned variables are relevant for the choice of doublet or triplet regimens with capecitabine and determining prognosis.

Methods: Multicenter, cross-sectional, observational study in patients with AGC who received at least 2-cycles of capecitabine-based doublet or triplet chemotherapy, with or without measurable disease. The age, as a continuous and categorical (> 64 vs ≤ 64) variable, and ECOG PS were analyzed by logistic regression.

Results: A total of 175 patients were evaluated. Median age 65.5 (56-72) years, male: 68% ECOG 0/1/2: 32.7%/55.6%/11.1%. 33% underwent doublet and 67% triplet chemotherapy. Tumour histology: signet-ring cell carcinoma (29%), papillary (13%), mucinous (12%) and tubular (3.5%). Most common sites of metastases: lymph nodes (48%), peritoneum (41%), liver (38%) and lung (12%). Multivariante analysis demonstrated that age ≤ 64 (OR 2.326; p = 0.016) and ECOG 0 (vs 2) (OR 3.937; p = 0.016) were risk factors for the choice of triplet chemotherapy, and failed to show an association between ECOG 1 and regimen. While in patients underwent triplet regimen 51% were aged ≤ 64 and 49% > 64, in those treated with doublet these rates were 32% and 68% respectively; (p = 0.016, Chi-square test). A statistical difference was found for ECOG 0/1/2/4 and regimen chosen. Concretely, among patients who received triplet regimen, 15% had ECOG 2 and 85% ECOG 0 while in case of doublet regimen these rates changed to 43 and 57%; (p = 0.01, Fisher's exact test). Main grade 1/2 capecitabine-related toxicities: diarrhea (10%), mucositis (7%), hand-foot syndrome (5%) and emesis (4%). Most frequent grade 3 were diarrhea in 5% and emesis, asthenia and febrile neutropenia in 2%. No toxicity grade 4 occurred.

Conclusions: Age ≤ 64 years and ECOG 0 are risk factors of choice of capecitabine-based triplet chemotherapy in AGC. These results support previous reports showing that age and ECOG PS are associated with treatment choices for AGC.

No significant financial relationships to disclose.