A review of the efficacy of mycotoxin detoxifying agents used in feed in light of changing global environment and legislation

In the recent years, mycotoxins have undoubtedly gained a keen interest of the scientific community studying food safety. The main reason is their profound impact on both human and animal health. International surveys reveal a low percentage of feed samples being contaminated above permitted/guideline levels, developed to protect consumers of animal derived products. However, the deleterious impact of feed co-contaminated at low levels with numerous both known and regulated as well as novel mycotoxins on producing animals has been described. Associated effects on agro-economics world-wide include substantial pecuniary losses which are borne by the society as a whole. Even though good agronomic practice is thought to be the most effective way of preventing animal feed contamination, the EC have recognised the need to introduce an additional means of management of feed already contaminated with low-levels of mycotoxins to alleviate detrimental effects on agricultural production efficiency. This review discusses types of feed detoxifying agents described in scientific literature, their reported efficacy in both in vitro and in vivo systems, and comparison with available commercial formulations in the light of increasing knowledge regarding mycotoxin prevalence in the changing global environment.

Developments in mycotoxin analysis: an update for 2014-2015

This review summarises developments in the determination of mycotoxins over a period between mid-2014 and mid-2015. In tradition with previous articles of this series, analytical methods to determine aflatoxins, Alternaria toxins, ergot alkaloids, fumonisins, ochratoxins, patulin, trichothecenes and zearalenone are covered in individual sections. Advances in proper sampling strategies are discussed in a dedicated section, as are new methods used to analyse botanicals and spices and newly developed LC-MS based multi-mycotoxin methods. The critical review aims to briefly discuss the most important developments and trends in mycotoxin determination as well as to address shortcomings of current methodologies.

Transfusion support by a UK Role 1 medical team: a 2-year experience from Afghanistan

INTRODUCTION

This paper describes the clinical governance, training, equipment and infrastructure developed to enable a UK Role 1 medical team to deliver forward transfusion in Southern Afghanistan. The aim was to explore the utility and feasibility of forward blood transfusion by a Role 1 medical team in an austere military environment.

METHODS

An audit of prospectively collected transfusion regulatory and cold chain data using standard-issue equipment and governance systems. TempIT tags were read before and after each mission to record blood storage temperature. Two years' data were analysed to review the use of blood products, cold chain compliance and equipment issues.

RESULTS

Over 24 months, blood products were carried on over 1000 mission hours. Two clinical cases required transfusion and were successfully resuscitated. The team was able to correctly transport, store and deploy red cells and plasma on missions using standard Ministry of Defence (MOD) issue equipment. There were seven cold chain failures, all of which were addressed locally. Current cold chain and diagnostic equipment would require further optimisation for use at Role 1.

CONCLUSIONS

An isolated Role 1 medical team can safely deliver blood transfusion on vehicle, helicopter or foot patrols. The transport and storage of blood created a large logistical burden for a relatively small clinical output. However, with further developments, this capability may have utility in contingency operations especially for isolated teams.

The risk of a first and a recurrent venous thrombosis associated with an elevated D-dimer level and an elevated thrombin potential: results of the THE-VTE study

BACKGROUND

D-dimer and thrombin generation have been associated with the risk of recurrent venous thrombosis. However, for both measurements, different assays are available, and in vitro thrombin generation may be affected by the problem of contact activation during blood sampling.

OBJECTIVES

To determine the association between hypercoagulability and first and recurrent thrombosis by the use of different D-dimer and thrombin generation assays, to assess whether the addition of corn trypsin inhibitor (CTI) prior to blood sampling to inhibit contact activation improved the association between thrombin generation and thrombosis risk, and to calculate the DASH score with two different D-dimer assays.

METHODS

A case-control study (626 patients and 361 controls) with subsequent follow-up of the cases was performed (2987 patient-years after stopping of anticoagulant therapy). Blood was drawn 2-3 months after discontinuation of anticoagulation for the first event in citrate tubes with and without CTI.

RESULTS/CONCLUSIONS

An elevated D-dimer level and elevated thrombin generation were associated with an increased risk of a first event regardless of the assay used (odds ratios: 1.8-3.4). An elevated D-dimer level but not elevated thrombin generation was associated with the risk of recurrence. Patients with elevated D-dimer levels had a more than two-fold increased recurrence rate (Vidas - hazard ratio [HR] 2.3, 95% confidence interval [CI] 1.4-3.8; HemosIL - HR 2.4, 95% CI 1.5-3.9; Thrombinoscope and Technoclone assay - HR 1.3). Elimination of contact factor activation did not improve the predictive value of thrombin generation. In patients with unprovoked first events, the DASH score had a similar predictive value for deep vein thrombosis and pulmonary embolism, both when calculated with Vidas D-dimer and when calculated with HemosIL D-dimer.

Developments in mycotoxin analysis: an update for 2013-2014

This review highlights developments in the determination of mycotoxins over a period between mid-2013 and mid-2014. It continues in the format of the previous articles of this series, emphasising on analytical methods to determine aflatoxins, Alternaria toxins, ergot alkaloids, fumonisins, ochratoxins, patulin, trichothecenes and zearalenone. The importance of proper sampling and sample preparation is briefly addressed in a dedicated section, while another chapter summarises new methods used to analyse botanicals and spices. As LC-MS/MS instruments are becoming more and more widespread in the determination of multiple classes of mycotoxins, another section is focusing on such newly developed multi-mycotoxin methods. While the wealth of published methods during the 12 month time span makes it impossible to cover every single one, this exhaustive review nevertheless aims to address and briefly discuss the most important developments and trends.