D-lactic acidosis: an unusual cause of encephalopathy in a patient with short bowel syndrome.

A 24-year-old woman with a short bowel syndrome following post-ischemic small bowel resection, developed several episodes of lethargy, echolalia and ataxia. D-lactic acidosis was identified as the cause of neurological disturbances. This infrequent disorder can be precipitated by intake of a large amount of sugars, in patients with short bowel syndrome. It should be suspected in the presence of metabolic acidosis with increased anion gap and a normal level of L-lactic acid. The diagnosis relies on the specific dosage of D-lactic stereoisomer. Proper management involves rehydration, diet adaptation and oral administration of poorly absorbed antibiotics in order to modify the colonic flora responsible for D-lactic production.

Cross reaction between proteins from Larrea divaricata Cav. (jarilla) and cellular and extracellular proteins of Pseudomonas aeruginosa.

Larrea divaricata is widely used in folk medicine to treat different pathologies, but little is known about its immunological properties. Pseudomonas aeruginosa is an opportunistic pathogen which causes several intrahospitalary infections. We aimed to assess the immunological relation between proteins from a crude extract of L. divaricata Cav. (JPCE) and cellular and extracellular proteins (EP) of P. aeruginosa, as well as to establish the cross reactivity between proteins of both species using a mouse anti-JPCE serum. Protein profiles of JPCE and P. aeruginosa were analyzed by SDS-PAGE. The percentage of similarity of protein bands between these two species was 43-57%. However, JPCE proteins were immunogenic. The reactivity of mouse anti-JPCE antibodies against different fractions was studied by western blot. The anti-JPCE serum detected several antigenic bands on different bacterial proteins. Several common immunoreactive bands were detected (27-100%) when bacterial proteins were incubated with anti-JPCE serum (heterologous reaction) and anti-bacterial proteins serum (homologous reaction). By enzyme-linked immunosorbant assay (ELISA) assays, high titers of anti-JPCE against different types of cellular bacterial fractions were observed (1/1280-1/2080). Our data clearly demonstrate that antibodies elicited with L. divaricata crude extract are able to cross-react with cellular and EP of P.aeruginosa. These findings could be relevant in the development of alternatives therapies for patients suffering intrahospitalary opportunistic infections with P.aeruginosa.

Effect of pentosanase and oxidases on the characteristics of doughs and the glutenin macropolymer (GMP).

Rheological characteristics of dough and glutenin macropolymer (GMP) extracted thereof were investigated. Three single enzymes, pentosanase (PP), glucoseoxidase (GLZ), and laccase (LAC), and their combinations were used. GLZ gave the least extensible and most resistant dough, and pentosanase/glucoseoxidase (PPGLZ) resulted in dough with improved extensibility. The enzymes improved gluten quality. The glutenin macropolymer (GMP) was characterized in terms of wet weight, protein content, pentosan association, and dynamic rheological properties. Enzymatic addition decreased the wet weight of GMP but increased the protein content. PP decreased the content of pentosans on the GMP, but single oxidases increased the content of pentosans associated with GMP. PP did not modify the elastic modulus (G') of the GMP, whereas GLZ increased G' by increasing the polymerization of proteins and LAC diminished G'. The combination PPGLZ produced a synergic increase of G'.

The implementation of Prime Vendor Europe and its successful impact on an overseas naval medical treatment facility.

Prime Vendor Europe (PVE) is the commercial pharmaceutical ordering and delivery program that is revolutionizing overseas health care delivery at military health care treatment facilities located in the European theater. Mirroring civilian programs already available and replacing the Federal Supply System, PVE offers many benefits never before realized at overseas military health care treatment facilities, including: diminished order turnaround times with resultant decreased Operating Target requirements; rapid order confirmation after order placement; lower carrying costs and inventory needs; better dating of pharmaceuticals received; redistribution and increased efficiency of the current manhours needed to operate a pharmacy supply system; order tracking capabilities; and enhancement of the present cooperative and constructive dichotomous relationship between medical logistics and pharmacy regarding pharmaceutical purchasing practices. This paper will explore the fundamentals, past performance, continuous quality improvement of logistical functions, frame-work establishment for PVE, implementation of PVE, and subsequent observed command benefits of PVE realization.

Regulation of acetic acid production by homo- and heterofermentative lactobacilli in whole-wheat sour-doughs.

The efficiency of sour-dough as a possible preservative agent of microbial spoilage of bread depends on its acetic acid content. As a secondary metabolite of sugar fermentation by lactic acid bacteria, acetic acid may be promoted in the presence of O2 or H+ acceptors. This paper studies the influence of O2 and high fructose content products (pure sugar, invert sugar, fructose syrup) addition on acetic acid production by hetero- (Lactobacillus brevis 25a, B-21, L-62; L. sanfrancisco L-99) and homofermentative (L. plantarum B-39) lactobacilli in whole-wheat sour-doughs [280 and 250 dough yield (DY)]. The pH and total titratable acidity (TTA) of sour-doughs after 44 h fermentation varied with DY and strain. As expected, the addition of O2 promoted greater increases in TTA with heterofermentative lactobacilli (15-42%) than with L. plantarum (15%). Fructose addition was only effective for heterofermentative strains, but the overall effects were smaller than those observed for oxygenation. The ability of lactobacilli to produce acetic acid in sour-doughs without treatment varied from 0.16 g/100 g flour at 44 h (B-39, 280, 350 DY) to 0.47-0.65% (L-62, 280, 350 DY). The production of acetic acid was positively promoted by all treatments. Oxygenation was again the most effective way of inducing acetic acid production; increases ranged from 54% (B-21) to 269% (L-99, 350 DY). The addition of H+ acceptors had variable effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of processing conditions on acidification properties of wheat sour doughs.

The pH, total titratable acidity (TTA) and lactic and acetic acids production have been investigated for wheat sour doughs with and without yeast addition, inoculated with two strains of Lactobacillus plantarum (B33, B39). To study the effect of flour extraction rate (0.54, 11.11 and 1.68% ash content), dough yield (DY) (160, 200 and 240 of sour dough/100 g flour), and fermentation temperature (25, 30 and 35 degrees C) a response surface regression, factor analysis and K-means clustering analysis were used. Results from factor analysis point out that the extraction rate of fluor governs TTA and acetic acid content; this factor accounts for the 53% of variability of the data. Dough yield is highly correlated with lactic acid content, explaining 27% of the total variance. Finally, temperature explains the remaining 16% of variation, but it is not related to any analytical variable. From K-means clustering analysis, flour extraction rate of 1.68% ash content leads to the highest TTA and acetic acid values, whereas DY of 240 g sour dough/100 g flour gives the greatest lactic acid content, and DY of 160 leads to the lowest levels of TTA and organic acids.

Sugar uptake and involved enzymatic activities by yeasts and lactic acid bacteria: their relationship with breadmaking quality.

The uptake kinetics of sugars present in wheat doughs and alpha-glucosidase as well as beta-fructosidase activities were determined in different strains of yeasts and lactic acid bacteria. These strains were previously selected according to their breadmaking quality. Saccharomyces cerevisiae (P6), Candida guilliermondii (P40), Lactobacillus plantarum (B31 and La18) and L. brevis (B21) showed good performance, while Sacch. fructuum (P43), L. cellobiosus (B37) and Enterococcus faecium (B11) yielded bread of lower quality. Leuconostoc mesenteroides (B10), when used in combination with other strains led also to high quality starters. All yeast strains used assimilated glucose, fructose and maltose, exhibiting saturable kinetics. Lactic acid bacteria showed saturable kinetics only for hexoses, whereas disaccharide uptake was linear. Sacch. cerevisiae, Leuconostoc mesenteroides, L. brevis and L. plantarum (B31) displayed better sugar uptake properties. For all the strains used alpha-glucosidase and beta-fructosidase activities were detected. The highest specific activities were found for Sacch. cerevisiae, C. guilliermondii and L. plantarum (B31). These results indicate good correlation between the parameters evaluated and the breadmaking potential of the microorganisms.

Headspace flavour compounds produced by yeasts and lactobacilli during fermentation of preferments and bread doughs.

Production of volatile flavour compounds during fermentation with pure cultures of Saccharomyces cerevisiae and Candida guilliermondii, Lactobacillus brevis and Lactobacillus plantarum have been investigated, using wheat doughs and several preferements as substrates. For yeast, preferments consisted of 10% (w/v) glucose, maltose and sucrose solutions, whereas for lactobacilli they consisted of supplemented and unsupplemented (3% and 10% (w/v)) glucose solutions, and a 10% (w/v) wheat flour slurry. Seven volatile compounds (acetaldehyde, acetone, ethyl acetate, ethanol, hexanal+isobutyl alcohol, and propanol) were detected when using yeasts. All these compounds, except propanol, appeared for all the substrates assayed, with ethanol as the predominant component. Generally, S. cerevisiae produced higher amounts of the different components than C. guilliermondii. Both yeasts produced larger amounts of volatile flavour compounds during fermentation in glucose and sucrose solutions than in maltose or wheat dough. In general the yeasts examined produced more flavour components than the lactobacilli. For the lactobacilli the highest number of volatile flavour compounds were observed for substrates containing flour.