Stromal SLIT2 impacts on pancreatic cancer-associated neural remodeling

Pancreatic ductal adenocarcinoma (PDA) is a critical health issue in the field of cancer, with few therapeutic options. Evidence supports an implication of the intratumoral microenvironment (stroma) on PDA progression. However, its contribution to the role of neuroplastic changes within the pathophysiology and clinical course of PDA, through tumor recurrence and neuropathic pain, remains unknown, neglecting a putative, therapeutic window. Here, we report that the intratumoral microenvironment is a mediator of PDA-associated neural remodeling (PANR), and we highlight factors such as 'SLIT2' (an axon guidance molecule), which is expressed by cancer-associated fibroblasts (CAFs), that impact on neuroplastic changes in human PDA. We showed that 'CAF-secreted SLIT2' increases neurite outgrowth from dorsal root ganglia neurons as well as from Schwann cell migration/proliferation by modulating N-cadherin/β-catenin signaling. Importantly, SLIT2/ROBO signaling inhibition disrupts this stromal/neural connection. Finally, we revealed that SLIT2 expression and CAFs are correlated with neural remodeling within human and mouse PDA. All together, our data demonstrate the implication of CAFs, through the secretion of axon guidance molecule, in PANR. Furthermore, it provides rationale to investigate the disruption of the stromal/neural compartment connection with SLIT2/ROBO inhibitors for the treatment of pancreatic cancer recurrence and pain.

[Analysis of the question-answer activity of a hospital pharmacy. Example of the handling of drug interactions]

INTRODUCTION

The medical care of patients generates questions among healthcare professionals. Some will necessitate an advanced research. The hospital pharmacist is at the interface between prescribers, caregivers and the medicines and is requested to answer these requests. Studies conducted in other countries showed that this question-answer activity represents a significant amount of time in daily work. In France, this topic was poorly explored. The objective of our work was to study the volume and the type of questions, the clinical situations, the time required, the medicines implicated and the sources of information used.

MATERIALS AND METHODS

A prospective study was conducted in the pharmacy of a university hospital. All the requests answered by the pharmaceutical team, which needed a specific research, analysis and writing of an answer were collected.

RESULTS

A hundred and one questions were analyzed, originating from doctors or medicals interns. Almost half concerned drug interactions, and among them, almost a fourth were not mentioned in the Summary of Product Characteristics of the medicines involved. A pharmaceutical advice was provided in 91.5% of the cases. Time dedicated to the research varied between less than 30 minutes and more than 8 hours.

DISCUSSION AND CONCLUSION

This study illustrates the question-answer activity of a hospital pharmacy, which is currently not taken into account as an indicator of pharmaceutical activity. A large part concerns analysis and management of drug interactions and requires a significant amount of pharmaceutical time.

Identification of de novo mutations of Duchénnè/Becker muscular dystrophies in southern Spain

BACKGROUND

Duchénnè/Becker muscular dystrophies (DMD/BMD) are X-linked diseases, which are caused by a de novo gene mutation in one-third of affected males. The study objectives were to determine the incidence of DMD/BMD in Andalusia (Spain) and to establish the percentage of affected males in whom a de novo gene mutation was responsible.

METHODS

Multiplex ligation-dependent probe amplification (MLPA) technology was applied to determine the incidence of DMD/BMD in 84 males with suspicion of the disease and 106 female relatives.

RESULTS

Dystrophin gene exon deletion (89.5%) or duplication (10.5%) was detected in 38 of the 84 males by MLPA technology; de novo mutations account for 4 (16.7%) of the 24 mother-son pairs studied.

CONCLUSIONS

MLPA technology is adequate for the molecular diagnosis of DMD/BMD and establishes whether the mother carries the molecular alteration responsible for the disease, a highly relevant issue for genetic counseling.

Rupture of Extensively Porous Coated Stems. - A Case Series of 2 Patients

Introduction:

Mechanical failure of femoral stems of revision hip arthroplasty has been rarely reported. In the current study, the cause of two stem fractures, which occurred in vivo, was analysed with use of clinical and radiological data, and the functional result after revision is presented.

Case Report:

Two patients, A 70-year-old male and a 73-year-old female, both of Mediterranean ethnic, and both patients underwent a revision total hip replacement to an uncemmented extensively porous coated stem. Both stems suffered an implant fatigue in vivo at three years and at two years follow-up respectively.

Conclusion:

Revision total hip arthroplasty is a procedure that will be performed more often the following years due to aging of population. Any orthopaedic surgeon performing hip surgery should be aware of the risk factors that can lead to total hip arthroplasty failure. In the analysed cases we can learn that the main factors related to this failure included the use of a small size stem (inferior to 14mm), an inadequate proximal osseous support because of trochanteric osteotomy, and a reduced preoperative bone stock. Although the use of cables has not been stated as a predisposing factor, we consider that they could also play a role in the development of this rare complication.

Emergence of Klebsiella pneumoniae clinical isolates producing KPC-2 carbapenemase in Cuba

The emergence of Klebsiella pneumoniae producing carbapenemase (KPC) has now become a global concern. As a part of a nationwide multicentre surveillance study in Cuba, three K. pneumoniae clinical isolates resistant to carbapenems were detected for a 1-month period (September to October 2011). PCR and sequence analysis revealed that the three strains harboured bla KPC-2. They showed resistance or intermediate susceptibility to expanded-spectrum cephalosporins, other β-lactams, a β-lactam/β-lactamase inhibitor combination, and gentamicin. Two strains were susceptible only to colistin, whereas the other strain showing colistin resistance was susceptible to fluoroquinolones. These bla KPC -2-positive K. pneumoniae strains were classified into ST1271 (CC29), a novel clone harbouring bla KPC -2, and were revealed to be genetically identical by PCR-based DNA fingerprinting. The three patients infected with the KPC-producing K. pneumoniae had common risk factors, and had no overseas travel experience outside Cuba, suggesting local acquisition of the resistant pathogen. This is the first report of a KPC-producing K. pneumoniae in Cuba. Although detection of KPC in Enterobacteriaceae is still rare in Cuba, our finding indicated that KPC-producing bacteria are a global concern and highlighted the need to identify these microorganisms in clinical laboratories.

Perfect nematic order in confined monolayers of spindle-shaped cells

Elongated, weakly interacting, apolar, fibroblast cells (mouse fibroblasts NIH-3T3) cultured at confluence align together, forming large domains (correlation length ∼ 500 μm) where they are perfectly ordered. We study the emergence of this mesoscopic nematic order by quantifying the ordering dynamics in a two-dimensional tissue. Cells are initially very motile and the monolayer is characterized by anomalous density fluctuations, a signature of far-from-equilibrium systems. As the cell density increases because of proliferation, the cells align with each other forming these large oriented domains while, at the same time, the cellular movements and the density fluctuations freeze. Topological defects that are characteristic of nematic phases remain trapped at long times thereby preventing the development of infinite domains. When confined within adhesive stripes of given widths (from 30 μm to 1.5 mm) cells spontaneously align with the domain edges. This orientation then propagates toward the pattern center. For widths smaller than the orientation correlation length, cells perfectly align in the direction of the stripe. Experiments performed in cross-shaped patterns show that in the situation of two competing populations, both the number of cells and the degree of alignment impact the final orientation.

Levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain

The adverse health effects of airborne particles have been subjected to intense investigation in recent years; however, more studies on the chemical characterization of particles from pollution emissions are needed to (1) identify emission sources, (2) better understand the relative toxicity of particles, and (3) pinpoint more targeted emission control strategies and regulations. The main objective of this study was to assess the levels and spatial distribution of airborne chemical elements in a heavy industrial area located in the north of Spain. Instrumental and biomonitoring techniques were integrated and analytical methods for k0 instrumental neutron activation analysis and particle-induced x-ray emission were used to determine element content in aerosol filters and lichens. Results indicated that in general local industry contributed to the emissions of As, Sb, Cu, V, and Ni, which are associated with combustion processes. In addition, the steelwork emitted significant quantities of Fe and Mn and the cement factory was associated with Ca emissions. The spatial distribution of Zn and Al also indicated an important contribution of two industries located outside the studied area.

Influence of the operation conditions on CO2 capture by CaO-derived sorbents prepared from synthetic CaCO3

In this work, a statistical experimental design is performed in order to prepare CaCO3 materials for use as CaO-based CO2 sorbent precursors. The influence of different operational parameters such as synthesis temperature (ST), stirring rate (SR) and surfactant percent (SP) on CO2 capture is studied by applying Response Surface Methodology (RSM). The samples were characterized using different analytical techniques including X-ray diffraction, N2 adsorption isotherm analysis and Scanning Electron Microscopy-X-ray Energy Dispersive Spectroscopy (SEM-EDX). CO2 capture capacity was determined by means of a thermogravimetric analyzer which recorded the mass uptake of the samples when these were exposed to a gas stream containing diluted (15%) CO2. The statistical approach used in this work provides a rapid way of predicting and optimizing the main preparation variables of CaO-derived sorbents for CO2 sorption. The results obtained clearly indicate that four parameters statistically influence CO2 uptake: SR, the square of SR, its interaction with SP and the square of SP.

Relationship of sociodemographic variables with outcomes after cataract surgery

PURPOSE

The objective of this study is to analyse the relationship between sociodemographic characteristics of patients undergoing cataract extraction and their outcomes.

METHODS

The method comprised a prospective cohort study of patients recruited from 17 hospitals of different areas of Spain. Data gathered before surgery included sociodemographic variables, visual acuity, and visual function (using the Visual Function Index-14). After surgery, we assessed visual acuity and visual function at 6 weeks and at 3 months, respectively. Multivariate multilevel analysis was performed to assess the relationship of sociodemographic variables with changes in visual acuity and function, analysing whether improvements surpassed the minimal clinically important differences (MCIDs).

RESULTS

Multivariate analysis showed that for visual acuity, (i) older men had a lower odds ratio (OR) of surpassing the MCID (OR: 65-75 years, 0.64; >75 years, 0.51); (ii) those with primary (1.65) or secondary (1.41) education had higher ORs than those with no formal education; and (iii) those living in a residential home had a lower OR than men living alone (0.36). In women, we found that the higher the educational level, the greater the improvement in visual acuity (primary, 1.41; secondary, 1.76), whereas socially dependent women (0.70) were less likely to exceed the MCID. With regards to predictors related to achievement of an MCID in visual function, only dependency was associated with more improvement in men (OR: 1.39), whereas in women the educational level was the only predictor (primary: 0.72; secondary: 0.61).

CONCLUSIONS

This study found that patients with certain sociodemographic characteristics were less likely to experience an MCID in visual acuity or visual function after cataract surgery.

[Health risk for the vulnerable population exposed to arsenic in the province of Buenos Aires, Argentina]

OBJECTIVE

To analyze the concentration of arsenic in water collected in localities of the province of Buenos Aires, Argentina, and the epidemiological relationship of that concentration to factors of susceptibility and associated pathologies.

METHODS

In 152 samples from 52 localities of Buenos Aires from 2003-2008, the concentration of arsenic was quantified through the generation of hydride spectrophotometry of atomic absorption. A composite index of health (CIH) was constructed using the content of arsenic and the percentages of households with unmet basic needs and dwellings without access to the potable water. Through the CIH, risk areas associated with mortality from malignant neoplasms related to arsenic were defined.

RESULTS

Concentrations of arsenic spanned a broad range from 0.3 to 187 mg/L, with a median of 40 mg/L. Of the samples, 82% presented levels of arsenic higher than the acceptable limit of 10 mg/L, and more than half of those came from households with potable water connections. In the departments studied, the average mortality (deaths/100 000 inhabitants) from tumors was greater in men than in women: respiratory tract (310 versus 76), urinary tract (44 versus 11), and skin (21 versus 11), respectively. The regions with greater concentrations of arsenic and of poverty, together with the lack of potable water connections, had a two-to-four times greater risk.

CONCLUSIONS

The findings from the composite index of health summarized the health risk from exposure to arsenic for lower socioeconomic levels of the population for a broad area of the province of Buenos Aires.

Swarm of terminal 35S in Cheirolophus (Asteraceae, Centaureinae)

Island radiation constitutes a playground for species diversification, which has long fascinated researchers and still does today. Because only a small subset of taxa within the pool of island colonizers is concerned by this process, the question is raised on whether some factors could make a taxon prone to radiate. Cheirolophus is the only genus of Centaureinae subtribe to have experienced a radiation in the Canary Islands. Cytogenetic characterization through FISH of 5S and 35S ribosomal RNA genes in eight Cheirolophus species from continent and Canary Islands revealed an unusually high number of 35S predominantly at terminal position, together with a single interstitial 5S rDNA locus in all the studied taxa. Such an abundance of 35S rDNA signals is unique among Centaureinae and predates Cheirolophus arrival in Canary Islands. The possible link of the rDNA profile with radiation process is discussed through a comparison with two other case studies, the closely related Rhaponticum group and the genus Centaurea.

Outcomes after total hip replacement based on patients' baseline status: what results can be expected?

OBJECTIVE

We evaluated patient satisfaction with total hip replacement (THR) to establish cut points of sufficient improvement based on the patient acceptable symptom state (PASS) and receiver operating characteristic (ROC) curves, and compared them with measures derived from the minimum clinically important difference (MCID), taking into account patients' baseline status.

METHODS

Two cohorts of prospectively recruited patients on waiting lists for THR were studied. Sociodemographic data and comorbidities were recorded. Patients completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and other patient-reported outcomes questionnaires before THR and 6 months afterward. Cut points of sufficient improvement were established by the PASS, ROC, and MCID and were compared.

RESULTS

Patients satisfied with THR had, by preintervention WOMAC tertiles, gains of 19.4, 34.1, and 49.3 in the WOMAC pain domain and 17.8, 30.8, and 41.4 in the WOMAC functional limitation domain. The PASS cut points determined were 20, 25, and 25 for postintervention WOMAC pain and 28, 35, and 42 for functional limitation. ROC cut points were 19, 25, and 25 for postintervention pain and 26.4, 39, and 40 for functional limitation. Agreement among cut points classifying patients as responders to THR was 1.0 for pain with both PASS and ROC, and 0.85 for functional limitation; 0.6 for pain between MCID and PASS or ROC, and 0.58 and 0.60 for functional limitation.

CONCLUSION

Cut points of expected gain after THR can help clinicians, researchers, and managers to identify suitable candidates for THR, although such measures must be used with caution.

Changes in stature of Portuguese women born between 1966 and 1982, according to educational level

Studies which document secular change in stature are almost exclusively based on males, while similar data on females is less common. In addition, secular trends in socioeconomic differences of height are seldomly reported. This study aims to document changes in mean stature in a sample of Portuguese women born between 1966 and 1982 (n = 30,629). For this study self-reported stature data was obtained from a large sample of women who delivered their children at the Dr. Alfredo da Costa Maternity Hospital, in Lisbon, between 1991 and 2004. Reported data on educational level was used as a proxy for socioeconomic status to assess changes in female stature in relation to their social class. Results show that female stature in the sample increases during the time period considered (mean stature: 160.8 cm in 1966 and 161.1 cm in 1982), but not consistently. In addition, women of higher educational level are systematically taller than their lower educational level counterparts (mean stature difference between highest and lowest educational level groups is 4.2 cm). Compared to males, mean stature increase in females was about 75% less. Although the time period considered is short, this study documents important socioeconomic differences in female stature and is the first to report stature changes over time in Portuguese women.

Dysbindin-1 modulates prefrontal cortical activity and schizophrenia-like behaviors via dopamine/D2 pathways

Dysbindin-1 regulates D2-receptor trafficking and is implicated in schizophrenia and related cognitive abnormalities, but whether this molecular effect mediates the clinical manifestations of the disorder is unknown. We explored in dysbindin-1-deficient mice (dys-/-) (1) schizophrenia-related behaviors, (2) molecular and electrophysiological changes in medial prefrontal cortex (mPFC) and (3) the dependence of these on D2-receptor stimulation. Dysbindin-1 disruption altered dopamine-related behaviors and impaired working memory under challenging/stressful conditions. Dys-/- pyramidal neurons in mPFC layers II/III were hyperexcitable at baseline but hypoexcitable following D2 stimulation. Dys-/- were also respectively more and less sensitive to D2 agonist- and antagonist-induced behavioral effects. Dys-/- had reduced expression of Ca(2+)/calmodulin-dependent protein kinase II (CaMKII) and CaMKKβ in mPFC. Chronic D2 agonist treatment reproduced these changes in protein expression, and some of the dys-/- behavioral effects. These results elucidate dysbindin's modulation of D2-related behavior, cortical activity and mPFC CaMK components, implicating cellular and molecular mechanisms of the association of dysbindin with psychosis.

Bioabsorbable staple-line reinforcement for pancreatectomy in a porcine model: a preliminary study

BACKGROUND

We conducted an exploratory study to assess the use of FOREseal® bioabsorbable reinforcement sleeves in stapling of the pancreatic parenchyma.

METHODS

A left pancreatectomy was carried out with linear stapler on 12 pigs: in the FOREseal group (n = 6), the stapling was reinforced with FOREseal, while in the control group (n = 6), simple stapling was applied.

RESULTS

The mean operating time was not different between the two groups. No additional haemostasis of the stapling transection was necessary with FOREseal, while in the control group, four pigs required additional haemostasis (p = 0.03). The mean postoperative drainage volume and the mean duration of drainage were, respectively, in the FOREseal group versus the control group: 82 versus 204 ml (p = 0.2) and 3.2 versus 4.7 days (p = 0.3). No adverse event occurred in the FOREseal group. There was no anatomopathological difference between the two groups.

CONCLUSION

A good tolerance of FOREseal was observed when used on the pancreatic stump. In this study, it was demonstrated a better haemostatic control of the pancreatic stump with FOREseal which also tends to reduce the volume of postoperative drainage liquid.

P4-09-12: Clinical Validation of Immunohistochemical Signature Predictive of Patients' 8 Year Outcome in Node Negative Breast Carcinomas

Background

Immunohistochemical (IHC) signatures predictive of prognosis can be a cost effective alternative to genomic signature suitable in clinical practice for patients’ management in early stages of breast carcinoma (BrCa) in clinical. IHC procedures are very easy to handle in pathology laboratories, since require very few amount of formalin fixed tissue samples since assessed on consecutive 4 μm thick sections of paraffin embedded tumors fragments validated by pathologists’ expertise. We recently reported (C Charpin et al Int J Cancer 2009) that standardized IHC assays using high throughput densitometry on digitized microscopic images allow to predict an adverse outcome of patients with BrCa, provided that identified the IHC predictive signatures can be validated in other patients’ cohorts. In this regard we have repeated our previously reported IHC procedures on 418 series of BrCa (Marseille University) on a second series including 303 BrCa diagnosed at Yale University.

Material and Methods: TMA(s) of two cohorts of patients with BrCa (418/Marseille University and 303 Yale University) were respectively investigated for immunohistochemical expression of 15 markers, including (i) those of the best signature predictive of patients outcome in N- patients in our previous studies and (ii) new markers reported in the literature as EMT cells and Stem cells. Monoclonal antibodies against HIFa, PI3, pAKT, pmTOR, moesin, P21, 4EBP-1, P27, Ker 5.6, pMAPKAPK-2, SHARP2, Claudin, ALDH, AF6, CD24, IHC was screened using standardized (Ventana Benchmark XT) on consecutive 4 μm thick sections of TMAs from both series, Quantitative measurements of immunoprecipitates were automatically assessed with TRIBVN device, and correlated to 8 year patients’ outcome. Logistic regression determined the best combination of markers to predict patients’ prognosis and results of the two cohorts were compared.

Results: In node negative BrCa the best predictive combination of markers signature was HIF-1a, PI3K, Claudin, AF6, pAKT independently of ER PR and HER-2 status. When results of logistic regression with these markers was compared very similar results were obtained with 92.34 % (333/418) of well classified patients in the first set (Marseille University series) and 89.8 % (158/176) in the second set from Yale University.

Discussion: The results suggest that the new optimal IHC signature predictive of prognosis identified in BrCa including HIF-1a, PI3K, Claudin, AF6 and pAKT is validated by this study with very similar results in two different cohorts of patients.

This validation also suggests (1) that IHC signatures investigated in individual patients can be considered as suitable in clinical practice offering a cost effective convenient mean to predict patients’ outcome at diagnostic time (2) and to select those patients with poor prognosis, particularly in N- BrCa subset, requiring more aggressive adjuvant therapies, and to avoid useless expensive therapies and their side effects in N- patients with favourable prognosis.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-09-12.

The impact of cash transfers to poor women in Colombia on BMI and obesity: prospective cohort study

Introduction

Prevalence of obesity is rising in Latin America, is increasingly affecting socially disadvantaged groups, particularly women. Conditional cash transfers are recently established welfare interventions in the region. One, Familias en Accion, transfers ~20% of average monthly income to women in Colombia’s poorest families. Previous work has found that families buy more food as a result.

We tested the hypothesis that participation in Familias would be associated with increasing body mass index (BMI) in participating women

Methods

Women from participating areas and control areas (matched on environmental and socioeconomic criteria) were surveyed in 2002 and 2006. Pregnant, breast-feeding or women aged<18 or with BMI<18.5kg/m² were excluded. The sample comprises 835 women from control and 1238 from treatment areas. Because some treatment areas started Familias shortly before baseline data collection, a dummy variable was created that identified exposure independent of time-point or area. Follow-up was 61.5%.

BMI was measured by trained personnel using standardized techniques. Overweight was defined as BMI>25kg/m² and obesity as >30kg/m². The effect of Familias was estimated using linear regression (or logistic regression for dichotomous outcomes) in a double-difference technique, controlling for several individual, household and area characteristics, including parity and baseline BMI, using robust standard-errors clustered at area-level in an intention-to-treat analysis.

Results

At baseline, women’s mean age was 33.3 years and mean BMI 25.3kg/m²; 12.3% women were obese. After adjustment, exposure to Familias was significantly associated with increased BMI (β=0.25, 95% CI 0.03, 0.47; p=0.03). Age (β=0.09; 95%CI 0.06, 0.13; p<0.001) and household wealth (β=0.78; 95%CI 0.41, 1.15; p<0.001) were also positively associated with BMI. Familias was also associated with increased odds of obesity (O.R.=1.27 95%CI 1.03, 1.57; p=0.03), as was age (O.R.=1.04; 95%CI 1.02, 1.06; p=0.001).

Conclusion

Conditional cash transfers to poor women in Colombia are independently associated with increasing BMI and obesity risk. Although conditional cash transfers are generally regarded as popular and successful schemes, parallel interventions at individual, household and community level are needed to avoid unanticipated adverse outcomes.

Epidemiology of multiple myeloma and the role of M-band detection on serum electrophoresis in a small developing country. A retrospective study

OBJECTIVE

The objective of the study was to determine the role of M-band component on serum protein electrophoresis and bone marrow biopsy in the diagnosis.

METHODS

Data was collected on 34 patients with MM diagnosed and/or treated.

RESULTS

There were equal numbers of men 17 (50%) and women 17 (50%). All patients were first screened for the presence of M-Band using serum protein electrophoresis (SPE) followed by bone marrow biopsy as the confirmatory test. Only two patients screened negative by SPE. On the other hand six patients who tested positive by SPE were negative on biopsy. Thus the sensitivity of the SPE was 96% and specificity 71%. This means that 29 patients had an established diagnosis of MM. There was a slight male predominance when compared to females.

CONCLUSION

The data showed that the SPE and bone biopsy are the important tools in the diagnosis of multiple myeloma in a small developing country.

Use of the patient acceptable symptom state and the minimal clinically important difference to evaluate the outcomes of cataract extraction

PURPOSE

To determine the minimal clinically important difference and the patient acceptable symptom state for visual acuity and visual function, 2 key visual outcomes for patients undergoing cataract extraction, as an aid for evaluating the outcome of cataract extraction.

DESIGN

Prospective cohort study.

METHODS

SETTING

Multicenter study of 17 hospitals.

PATIENTS

A total of 4335 consecutive patients advised to undergo cataract extraction.

MAIN OUTCOME MEASURES

Sociodemographic and clinical data, including visual acuity (VA), patient satisfaction, and responses to the Visual Function Index 14 (VF-14) and transitional questions were collected before and after cataract extraction. The patient acceptable symptom state and minimal clinically important difference were estimated for the entire sample and for subgroups by preintervention status and presence of ocular comorbidities.

RESULTS

Among patients with simple cataract, postintervention patient acceptable symptom state values for VA ranged from 0.67 to 0.80, depending on preintervention VA, while VF-14 scores ranged from 88 to 90. For patients with any additional ocular comorbidity, VA ranged from 0.63 to 0.75, depending on preintervention VA, while VF-14 scores ranged from 86 to 92. For the entire sample, postintervention patient acceptable symptom state values were 0.75 for VA and 86.1 for VF-14 scores. Minimal clinically important difference for patients who reported being a little better ranged from 0.17 to 0.5 in VA and 0.41 to 37.46 in VF-14 scores, depending on preintervention status and presence of ocular comorbidities.

CONCLUSION

The minimal clinically important difference and patient acceptable symptom state values are complementary parameters that may help in the clinical decision-making process by providing more meaningful estimates of the impact of cataract extraction on 2 important outcomes, visual acuity and visual function.

Lactic acid bacteria in the inhibition of Fusarium graminearum and deoxynivalenol detoxification

AIMS

Considering the agronomic and industrial damage that is caused by the fungus Fusarium graminearum, as well as the serious health risks it poses to humans and animals exposed to F. graminearum-produced mycotoxin deoxynivalenol (DON), this study evaluated the ability of different lactic acid bacteria (LAB) strains to inhibit fungal development and remove DON in vitro.

METHODS AND RESULTS

The antagonistic effects of strains and commercial cultures of LAB were evaluated against F. graminearum IAPAR 2218 by the agar diffusion method. Additionally, the influence of the culture media, pH and the presence of lactic and acetic acid on these effects was tested. The capacity to remove DON by viable cells and heat-inactivated cells was analysed in liquid media and quantified by high performance liquid chromatography (HPLC). All isolated strains and commercial cultures inhibited the fungus and removed DON. The pH and culture media concentration did not influence these abilities, but heat inactivation had a strong effect on the ability of bacteria to remove mycotoxin.

CONCLUSIONS

The isolated bacteria are able to inhibit F. graminearum growth and remove DON in vitro.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study suggests potential application of the isolated LAB strains in the inhibition of F. graminearum IAPAR 2218 and DON removal in vitro.