Probiotic Properties and Safety Evaluation in the Invertebrate Model Host Galleria mellonella of the Pichia kudriavzevii YGM091 Strain Isolated from Fermented Goat Milk.

Potential probiotic yeast strains isolated from fermented food need to meet safe and beneficial conditions for the host's health. The Pichia kudriavzevii YGM091 strain isolated from fermented goat milk has outstanding probiotic characteristics, including: the high survival percentage in digestive system conditions (reaching up 247.13 ± 0.12 and 145.03 ± 0.06% at pH 3.0 and bile salt 0.5%, respectively); good tolerance to temperature, salt, phenol, ethanol; good surface properties such as high hydrophobicity percentage (> 60%), the high auto-aggregation percentage rate (66.56 ± 1.45% after 45 min of incubation) and the high co-aggregation percentage rate with pathogenic bacteria in a short time (> 40% after 2 h of incubation); biofilm forming after 24 h of incubation on abiotic surfaces; antioxidant activity reached excellent level after only 24 h of incubation (The percentage free radical scavenging and the Trolox equivalent reaching up 79.86 ± 0.70% and 92.09 ± 0.75 µg/mL after 72 h of incubation); extracellular enzymes production protease and cellulase with high activity, amylase and pectinase with moderate activity and non-lipase activity. Simultaneously, the YGM091 strain is the in vitro safety yeast: insensitive to antibiotics and fluconazole, negative for gelatinase, phospholipase, coagulase, and non-hemolysis activities. Furthermore, this strain is in vivo safety yeast with the dosages below 106 CFU/larva in the Galleria mellonella model with over 90% survival larvae and the yeast density reduced to just 102-103 CFU/larva after 72 h post-injection. Research results have demonstrated that the Pichia kudriavzevii YGM091 strain is a safe potential probiotic yeast and could become a candidate probiotic food to be used in the future.

A fast and reproducible method to estimate left atrial volume using cardiac computed tomography.

PURPOSE: The purpose of this study was to do better than the simple maximal axial area (MAreaax) and to validate simple, fast and robust orthogonal methods for determining the left atrium volume (LAV) with cardiac CT (CCT). MATERIAL AND METHODS: A total of 60 patients who underwent CTT were retrospectively included. There were 30 men and 30 women with a mean age of 59±12 (SD) years (range: 27-80 years), using four methods to assess LAV beyond the MAreaax: two orthogonal methods requiring the measurements of axial, coronal and sagittal planes of 3 diameters LAV3diam or 3 area LAV3Areas; Area-length biplane method LAVbiplane; and volumetric method LAVvolumetric using a semi-automated tool that served as the reference standard. The orthogonal methods were applied on contrast-enhanced (IV+) and unenhanced (IV-) CCT images. Comparisons were performed using Pearson correlation test (r) and Bland-Altman analysis. Inter- and intra-observer variability were assessed using intraclass correlation coefficient (ICC) with a two-way mixed-effects model. RESULTS: On IV+ CCT, LAVbiplane, LAV3diam-IV+, LAV3Areas-IV+ underestimated LAV (-15±1.99mL; -21±1.37mL; -15±1.98mL; all P<0.001). LAV3diam-IV+, LAV3Areas-IV+ better correlated with reference standard (r=0.97 and 0.98) than LAVbiplane (r=0.79) as well as MAreaax (r=0.90). Estimating LAV on IV- further showed high correlation against the reference (r=0.93 and 0.95 for LAV3diam-IV- and LAV3Areass-IV-, respectively). Intra- and inter-observer ICC increased from LAVvolumetric (2.43% and 3.09%); LAV3Areas-IV+ (3.04 and 3.30%); LAV3Areas-IV-(3.34 and 4.23%), LAV3diam-IV+ (3.36 and 5.11%); LAV3diam-IV- (5.16 and 6.90%); to LAVbiplane (9.65 and 10.28%). CONCLUSIONS: Better than MAreaax, orthogonal methods using either diameter or surface are fast and reproducible methods to assess LAV on CCT when performed with or without intravenous administration of contrast material.

Visual lung damage CT score at hospital admission of COVID-19 patients and 30-day mortality.

OBJECTIVES: Chest CT has been widely used to screen and to evaluate the severity of COVID-19 disease in the early stages of infection without severe acute respiratory syndrome, but no prospective data are available to study the relationship between extent of lung damage and short-term mortality. The objective was to evaluate association between standardized simple visual lung damage CT score (vldCTs) at admission, which does not require any software, and 30-day mortality. METHODS: In a single-center prospective cohort of COVID-19 patients included during 4 weeks, the presence and extent of ground glass opacities(GGO), consolidation opacities, or both of them were visually assessed in each of the 5 lung lobes (score from 0 to 4 per lobe depending on the percentage and out of 20 per patient = vldCTs) after the first chest CT performed to detect COVID-19 pneumonia. RESULTS: Among 210 confirmed COVID-19 patients, the number of survivors and non-survivors was 162 (77%) and 48 (23%), respectively at 30 days. vldCTs was significantly higher in non-survivors, and the AUC of vldCTs to distinguish survivors and non-survivors was 0.72 (95%CI 0.628-0.807, p < 0.001); the best cut-off vldCTs value was 7. During follow-up, significant differences in discharges and 30-day mortality were observed between patients with vldCTs ≥ 7 versus vldCTs < 7: (98 [85.2%] vs 49 [51.6%]; p < 0.001 and 36 [37.9%] vs 12 [12.4%]; p < 0.001, respectively. The 30-day mortality increased if vldCTs ≥ 7 (HR, 3.16 (1.50-6.43); p = 0.001), independent of age, respiratory rate and oxygen saturation levels, and comorbidities at admission. CONCLUSIONS: By using chest CT in COVID-19 patients, extensive lung damage can be visually assessed with a score related to 30-day mortality independent of conventional risk factors of the disease. KEY POINTS: • In non-selected COVID-19 patients included prospectively during 4 weeks, the extent of ground glass opacities(GGO) and consolidation opacities evaluated by a simple visual score was related to 30-day mortality independent of age, respiratory rate, oxygen saturation levels, comorbidities, and hs-troponin I level at admission. • This severity score should be incorporated into risk stratification algorithms and in structured chest CT reports requiring a standardized reading by radiologists in case of COVID-19.

Isolated aspergillosis myocardial abscesses in a liver-transplant patient.

Cardiac abscess is an uncommon and fatal complication after transplantation. We report a case of an initially isolated aspergillosis myocardial abscess diagnosed by cardiac magnetic resonance imaging (CMRI). At that time, there was no other biological evidence or other extracardiac manifestations. A three-month course of dual antifungal therapy followed by a single antifungal therapy was empirically given. Six month after admission, Aspergillus fumigatus was isolated for the first time and the patient deceased from a disseminated aspergillosis.

Severe excessive dynamic airway collapse in a patient with primary Sjögren's syndrome.

Airway and cystic lung diseases can be observed in patients with Sjögren's syndrome. We report a case of such a patient suffering from respiratory failure due to recurrent episodes of right pneumothorax, requiring invasive mechanical ventilation. Despite thoracic drainage and adequate pneumothorax management, the patient could not be weaned from the ventilator. Fiberoptic bronchoscopy revealed severe central excessive dynamic airway collapse of the lower part of the trachea and proximal bronchi. The severity of airway collapse was maximal at the intermediate bronchus level, with a near-complete obstruction during expiration. Inspiratory and expiratory computed tomography studies confirmed the fiberoptic findings and suggested a possible expiratory posterior compression of the intermediate bronchus by parenchymal lung cysts. Stenting was considered, but the patient died from ventilator-associated pneumonia before the procedure could be performed. This case is the first description of severe central excessive dynamic airway collapse in a patient with primary Sjögren's syndrome complicated by diffuse airway and cystic lung disease.

Type B intramural hematoma of the aorta: evolution and prognostic value of intimal erosion.

PURPOSE: The prognosis and treatment of type B intramural hematoma (IMH) remain unclear. Intimal erosions could be the target of preventive endovascular treatment, but we have no therapeutic criterion on which to decide preventive treatment. MATERIALS AND METHODS: A prospective multislice computed tomography (CT) study was carried out in 44 patients with type B IMH to assess morphologic evolution and intimal erosion to determine reliable predictive factors that would permit endovascular treatment. Follow-up range was 24-1,440 days. RESULTS: Intimal anomalies consisted of intimal erosion and aortic branch artery lesions. Fifty-eight intimal anomalies were seen on initial CT in 38 patients (86%). Twenty-five anomalies in 22 patients were considered as intimal erosions, of which nine (36%) were visible only on delayed-phase CT. Hematoma regressed in 23 patients (53%). Twenty-one patients (47%) showed morphologic progression. Eleven of these (52%) required endovascular treatment. Twenty of the 25 initial intimal erosions (80%) progressed and caused 19 of the 21 morphologic evolutions (90%). Progression was related to initial intimal erosion and to IMH thickness. Intimal erosion measuring greater than 10 mm had unfavorable progression at 1 month (positive predictive value, 100%). CONCLUSIONS: Complications or morphologic progression were related to a preexisting intimal anomaly visualized on initial CT. Multislice CT with systematically delayed phase and millimetric thin slices could increase the detection rate of intimal anomalies.

Thyroid cartilage ossification and multislice computed tomography examination: a useful tool for age assessment?

Many authors have studied the thyroid cartilage ossification process using radiographic features for age estimation of individuals. Their results were various: Sugiyama reported excellent correlation coefficients between ossification rates and civil age, unlike most other authors. We hypothesized that recent advances in imaging techniques would enable more precise evaluation of the ossification of the thyroid cartilage. We retrospectively analyzed the CT scans of 312 French patients using postprocessing software to examine the pattern of thyroid cartilage ossification, calculating the ossified volume of the cartilage on 3D reconstructions. Pearson's correlation coefficients for volume were 0.73 for men and 0.75 for women (standard error 18.02 and 17.06), indicating considerable inter-individual variability. Although a correlation between civil age and morphological changes was found, these methods based on thyroid cartilage ossification were not accurate enough for the assessment of individual age.