Delphi-based study and analysis of key risk factors for invasive fungal infection in haematological patients.

OBJECTIVE: Mortality caused by invasive fungal infections due to filamentous fungi (IFI-FF) is high. Predisposing factors to IFI-FF are multiple and should be stratified. The objective of this study was to identify key risk factors for IFI-FF in onco-haematological patients in different clinical settings. METHODS: Prospective national Delphi study. Risk factors for IFI-FF in patients with onco-haematological diseases were identified by a systematic review of the literature. An anonymous survey was sent by e-mail to a panel of experts. A key risk factor was defined when at least 70% of the surveyed participants assigned a "maximal" or "high" risk. RESULTS: In allogenic stem cell transplantation, 18 of the 42 risk factors analyzed were classified as key risk factors, including neutropenia, previous IFI-FF, grade III/IV acute or extensive chronic graft-versus-host disease (GVHD), umbilical cord blood transplantation, HLA mismatching transplantation, graft failure, absence of HEPA filters, absence of laminar air flow, diagnosis of acute myeloid leukaemia, haploidentical transplantation, anti-TNF-α drugs, alemtuzumab, anti-thymocyte globulin, immunosuppressive prophylaxis for GVHD, lymphocytopenia, cytomegalovirus infection, and proximity to construction areas. In acute leukaemia/myelodysplastic syndrome (AL/MDS), 7 of 25 risk factors were defined as key risk factors, including neutropenia, consolidation therapy without response, induction therapy, antifungal prophylaxis with azoles, proximity to construction areas, and absence of HEPA filters. In lymphoma/multiple myeloma (MM), the five key risk factors among 21 analyzed were use of steroids, neutropenia, progressive disease, anti-CD52 therapies, and proximity to construction areas. CONCLUSIONS: The Delphi method was useful for the classification and stratification of risk factors for IFI-FF in patients with onco-haematological diseases. Identifying key risk factors will contribute to a better management of IFI-FF in this group of patients at high or changing risk.

Combined effects of chitosan and MAP to improve the microbial quality of amaranth homemade fresh pasta.

In this work a study on the combined effects of chitosan and modified atmosphere packaging (MAP) to improve the microbiological quality of amaranth-based homemade fresh pasta is presented. In particular, two different chitosan concentrations were combined to three different MAP conditions and tested against the following spoilage microorganisms: mesophilic bacteria, Staphylococcus spp., yeasts, moulds and total coliforms. Their viable cell concentrations were monitored for about 2 months at 4 degrees C. Results suggest that there is a combined effect between MAP and chitosan in delaying the microbial quality loss of pasta during storage. Moreover, it was also found that among the tested MAP conditions, the combination of 30:70 N2:CO2 is the most efficient, promoting an extension of the microbial acceptability limit beyond two months.

Use of natural compounds to improve the microbial stability of Amaranth-based homemade fresh pasta.

A study on the use of natural antimicrobial compounds to improve the microbiological stability of refrigerated amaranth-based homemade fresh pasta is presented in this work. In particular, the antimicrobial activity of thymol, lemon extract, chitosan and grapefruit seed extract (GFSE) has been tested against mesophilic and psychrotrophic bacteria, total coliforms, Staphylococcus spp., yeasts and moulds. A sensory analysis on both fresh and cooked pasta was also run. Results suggest that chitosan and GFSE strongly increase the microbial acceptability limit of the investigated spoilage microorganisms, being the former the most effective. Thymol efficiently reduces the growth of mesophilic bacteria, psychrotrophic bacteria and Staphylococcus spp., whereas it does not affect, substantially, the growth cycle of total coliforms. Lemon extract is the less effective in preventing microbial growth. In fact, it is able to delay only total mesophilic and psychrotrophic bacterial evolution. From a sensorial point of view no significant differences were recorded between the control samples and all the types of loaded amaranth-based pasta.

Body mass index does not change before Parkinson's disease onset.

BACKGROUND AND PURPOSE: Previous studies on the association between Parkinson's disease (PD) and body mass index (BMI) have reported conflicting results. We investigated the relationship between PD and BMI by a case-control study. METHODS: PD patients were randomly matched to healthy individuals by sex and age. BMI distribution in cases has been compared with BMI of controls and odd ratios (ORs) with 95% CI were calculated. RESULTS: We included 318 PD patients and 318 controls. We observed no association between PD and BMI. BMI distribution in cases and controls was similar also when we adjusted for diabetes, hypercholesterolemia and the time elapsed between PD onset and the interview (OR = 0.99; CI = 0.94-1.03; P = 0.51). CONCLUSIONS: These results did not confirm the previously reported association between PD and BMI. Population characteristics and methodological issues may partially account for the differences observed between the present study and the others.

Dropped head as an unusual presenting sign of myasthenia gravis.

Prominent or isolated weakness of cervical extensor muscles is a relatively rare clinical sign. Commonly, this is known as "dropped-head syndrome". This abnormal flexion of the head may occur in a variety of neuromuscular diseases and in a few non-neurological disorders as well. The case we describe concerns a 61-year-old woman with dropped-head syndrome as the unique complaint of myasthenia gravis.

Fumonisin levels in commercial corn products in Buenos Aires, Argentina.

Fumonisins B1 (FB1) and B2 (FB2) were determined in 35 samples of corn flour and corn grits destined for human consumption and purchased directly from Buenos Aires food shops and supermarkets from October 1996 to January 1997 and during the month of January 1998. During the first period of sample collecting, 16 out of 19 samples were found to be contaminated. Considering all 19 samples, contamination levels were between not detected and 1860 ng/g FB1, and from not detected to 768 ng/g FB2. During the second period all 16 samples were found to be contaminated with levels ranging from 75 to 4987 ng/g FB1, and from not detected to 1818 ng/g FB2. The levels of FB1 and FB2 in the samples collected during January 1998 were significantly higher than the samples collected during the period from October 1996 to January 1997. No significant difference was found in terms of fumonisin levels between the branded and unbranded samples.

Solid-phase extraction cleanup for ivermectin in liver tissue.

Extraction of liver tissue with organic solvent produces coextractants with compounds of interest. The solid-phase extraction (SPE) cleanup of liver tissue developed for ivermectin removes nonpolar coextractants. Liver extract that has been reduced to dryness is reconstituted in 0.5 mL acetonitrile. The mixture is passed through 0.1 g C18 SPE column, and the eluate is collected. The column is eluted further with 2 mL acetonitrile. Combined eluates are derivatized with 1-methylimidazole and trifluoroacetic anhydride, and the ivermectin derivative is determined by liquid chromatography with fluorescence detection.