The association of bone mineral density Z-score with the early postoperative remission and characteristics of bone mineral loss in patients with Cushing's disease: a retrospective study

AIM

To investigate the association of bone mineral density (BMD) Z-scores with early-postoperative remission rate and clinical parameters in patients with Cushing's disease (CD).

METHODS

We retrospectively evaluated the records of patients diagnosed with CD. After the exclusion of 230 patients, 87 CD patients were finally enrolled. BMD was determined by dual-energy x-ray absorptiometry (DXA) at the lumbar spine 1-4 (L1-4) and left femur. Early-postoperative remission was defined as a morning cortisol concentration on the first day after surgery of less than 5 μg/dL. The diagnosis of BMD "below the expected range for age" was defined as a Z-score≤-2.00 standard deviations.

RESULTS

DXA results were not significantly associated with early postoperative remission. They also did not significantly differ between eugonadal and menopausal groups. Preoperative morning cortisol significantly negatively but weakly correlated with Z-score of the total femur, while preoperative adrenocorticotropic hormone/cortisol ratio positively but weakly correlated with DXA results of L1-4.

CONCLUSION

The severity of bone loss was not significantly related to the failure of transsphenoidal surgery for Cushing's disease.

The association of bone mineral density Z-score with the early postoperative remission and characteristics of bone mineral loss in patients with Cushing's disease: a retrospective study

AIM

To investigate the association of bone mineral density (BMD) Z-scores with early-postoperative remission rate and clinical parameters in patients with Cushing's disease (CD).

METHODS

We retrospectively evaluated the records of patients diagnosed with CD. After the exclusion of 230 patients, 87 CD patients were finally enrolled. BMD was determined by dual-energy x-ray absorptiometry (DXA) at the lumbar spine 1-4 (L1-4) and left femur. Early-postoperative remission was defined as a morning cortisol concentration on the first day after surgery of less than 5 μg/dL. The diagnosis of BMD "below the expected range for age" was defined as a Z-score≤-2.00 standard deviations.

RESULTS

DXA results were not significantly associated with early postoperative remission. They also did not significantly differ between eugonadal and menopausal groups. Preoperative morning cortisol significantly negatively but weakly correlated with Z-score of the total femur, while preoperative adrenocorticotropic hormone/cortisol ratio positively but weakly correlated with DXA results of L1-4.

CONCLUSION

The severity of bone loss was not significantly related to the failure of transsphenoidal surgery for Cushing's disease.

Evaluation of rapid test kits for quantification of HT-2 and T-2 toxins in naturally contaminated oats

The aim of this study was to evaluate the performance and usefulness of three rapid test kits for analysis of HT-2 and T-2 toxins (HT-2 and T-2), two of the most potent trichothecenes commonly found in European oats. Concentrations of these two toxins combined (HT-2+T-2) were analysed in naturally contaminated oat samples (n=68) using the following test kits: Ridascreen® FAST T-2 Toxin (‘Fast ELISA’), DRAFT Ridascreen® HT-2/T-2 (‘Standard ELISA’, not commercially available), and the lateral flow device ROSA® HT-2-T-2 (‘Rosa LFD’). Mycotoxin analysis by LC-MS/MS was used as a reference method. Rosa LFD offered the best reliability, achieving detection that was stable across toxin levels, whereas detection by both ELISA kits differed significantly among toxin levels (P<0.01). The kits were also evaluated regarding agreement with the reference method (measured as Cohen's kappa) at a HT-2+T-2 concentration of 1000 μg/kg in naturally contaminated oats. Agreement was greatest for Rosa LFD (89.2%), intermediate for Standard ELISA (66.8%), and lowest for Fast ELISA (62.2%). Rosa LFD showed cross-reaction of 100% with both T-2 and HT-2. For the ELISA kits, cross-reactions were 100% with T-2 but below 100% with HT-2. Therefore, to estimate the sum of HT-2 and T-2 in an oat sample, it was necessary to re-calculate the data from both ELISA kits according to the known cross-reaction of each kit with HT-2 and the concentration ratio of HT-2 to T-2 in Norwegian oats. Rosa LFD had the highest correlation with LC-MS/MS (R2=0.94), and the corresponding R2 values for Fast and Standard ELISA were 0.61 and 0.83, respectively. Rosa LFD was well suited for on-site detection. Standard ELISA allows simultaneous testing of several samples that are useful for centralised laboratories.

Evaluation of rapid test kits for quantification of deoxynivalenol in naturally contaminated oats and wheat

The aim of this study was to evaluate the performance of rapid test kits for analysis of deoxynivalenol (DON), a mycotoxin commonly found in small-grain cereals. Concentrations of DON and its acetylated derivative 3-acetyldeoxynivalenol (3-ADON) were analysed in naturally contaminated wheat (n=56) and oats (n=81) using two enzyme-linked immunosorbent assays, i.e. Ridascreen® DON (‘Standard ELISA’) and Ridascreen® FAST DON (‘Fast ELISA’), and two lateral flow devices, i.e. Rida® QUICK DON (‘Quick LFD’) and Rosa® DON (‘Rosa LFD’). Analysis by the LC-MS/MS reference method showed a median DON + 3-ADON concentration of 1,168 μg/kg (90th percentile 3,264 μg/kg) in wheat and 2,250 μg/kg (90th percentile of 9,008 μg/kg) in oats. Rosa LFD offered the best reliability, achieving detection that was stable across toxin levels in both matrices. In addition, Rosa LFD had the highest accuracy (i.e. proportion of correct results) at a DON level of 1,250 μg/kg in wheat (0.83) and 8,000 μg/kg in oats (0.96). Standard ELISA achieved the highest accuracy at a DON level of 1,750 μg/kg in oats (0.85). Detection by Quick LFD in wheat and Fast ELISA in both wheat and oats differed significantly among toxin levels (P≤0.05), with recoveries outside European Union requirements (70-120%) in some cases. The correlation with results from LC-MS/MS analysis in oats was best for Rosa LFD (R2=0.79). In wheat, however the correlation was best for Fast ELISA (R2=0.81). Rosa LFD was regarded as well-suited for on-site detection. Standard ELISA allowed simultaneous testing of several samples and achieved detection that was stable across toxin levels in both matrices, making it a useful alternative in laboratories. To our knowledge, this is the first report describing the performance of rapid test kits for detection of DON in naturally contaminated oats.

Modeling deoxynivalenol contamination of wheat in northwestern Europe for climate change assessments

Climate change will affect mycotoxin contamination of feed and food. Mathematical models for predicting mycotoxin concentrations in cereal grains are useful for estimating the impact of climate change on these toxins. The objective of the current study was to construct a descriptive model to estimate climate change impacts on deoxynivalenol (DON) contamination of mature wheat grown in northwestern Europe. Observational data from 717 wheat fields in Norway, Sweden, Finland, and The Netherlands were analyzed, including the DON concentrations in mature wheat, agronomical practices, and local weather. Multiple regression analyses were conducted, and the best set of explanatory variables, mainly including weather factors, was selected. The final model included the following variables: flowering date, length of time between flowering and harvest, wheat resistance to Fusarium infection, and several climatic variables related to relative humidity, temperature, and rainfall during critical stages of wheat cultivation. The model accounted for 50 % of the variance, which was sufficient to make this model useful for estimating the trends of climate change on DON contamination of wheat in northwestern Europe. Application of the model in possible climate change scenarios is illustrated.

Development of a highly sensitive nested-PCR method using a single closed tube for detection of Fusarium culmorum in cereal samples

AIMS

The aim of the study was to develop a sensitive detection method of Fusarium culmorum contamination in cereal samples.

METHODS AND RESULTS

A nested-PCR method using a single closed tube was developed for the detection of F. culmorum in infected cereal samples. The concentrations of the first primer pair was diluted 10,000 times compared to the concentration used for the second primer pair. Differing annealing temperatures allowed both first and second polymerase chain reaction (PCR) reactions to be performed subsequently in the same closed tube. The detection limit was 5-50 fg of purified target DNA and allowed the detection of 1% infected seeds of wheat in a mixture with uninfected grains.

CONCLUSIONS

F. culmorum can be specifically detected in cereal samples by the highly sensitive method of nested-PCR in a single closed tube.

SIGNIFICANCE AND IMPACT OF THE STUDY

This work describes the detection of F. culmorum in cereal samples that is approximately 100 times more sensitive than previous PCR methods, involves low risk of cross contaminations between samples, low costs and reduced hands-on time as compared to standard nested-PCR protocols.