Inter-strain variability on the cardinal parameters (pH and Aw) of clinical and food isolates of Listeria monocytogenes using turbidimetric measurements.

Listeria monocytogenes is a foodborne pathogen which, in 2021, was considered the fifth most commonly reported zoonosis in humans in the European Union (EU). Ready-to-eat (RTE) fishery products, deli meats or soft cheeses have been mostly involved in food safety alerts and outbreaks in the last years. Hurdle technology by food industries has been widely used to enhance the safety of foods. Among the barriers, the application of acid and osmotic stress during processing is extensively used worldwide. This study aims to gain knowledge about the inter-strain variability of twenty-six clinical and food L. monocytogenes isolates with the estimation of their cardinal parameters using turbidimetric measurements. To analyse the data and to obtain the estimated cardinal values, a common statistical procedure was set up. The estimation of cardinal parameters showed a high inter-strain variability of L. monocytogenes, and no correlation was observed between Aw min and pHmin values for the studied strains. By grouping the strains in clinical, meat and fish origin, it was observed that strains from the meat group presented the lowest average pHmin values (4.57), thus showing potential acid adaptation. This work contributes to gain knowledge of the inter-strain variability of L. monocytogenes in relation with pH and Aw cardinal values, as well as provide a starting point for future validation studies in fish and meat food matrices.

Effects of carbon dioxide and oxygen on the growth rate of various food spoilage bacteria.

The growth of six bacterial species (Carnobacterium maltaromaticum, Bacillus weihenstephanensis, Bacillus cereus, Paenibacillus spp., Leuconostoc mesenteroides and Pseudomonas fragi) was studied in various gas compositions. Growth curves were obtained at various oxygen concentrations (between 0.1 and 21%), or various carbon dioxide concentrations (between 0 and 100%). Decreasing the O2 concentration from 21% to about 3-5% has no effect on the bacterial growth rates, which are only affected by low oxygen levels. For each strain studied, the growth rate decreased linearly with carbon dioxide concentration, except for L. mesenteroides which remained insensible to this gas. Conversely, the most sensitive strain was totally inhibited by 50% of carbon dioxide in the gas phase at 8 °C. Predictive models were fitted, and the parameters characterizing the inhibitory effect of these two gases were estimated. This study provides new tools to help the food industry design suitable packaging for MAP storage.

Modeling of Growth and Organic Acid Kinetics and Evolution of the Protein Profile and Amino Acid Content during Lactiplantibacillus plantarum ITM21B Fermentation in Liquid Sourdough.

The application of mathematical modeling to study and characterize lactic acid bacterial strains with pro-technological and functional features has gained attention in recent years to solve the problems relevant to the variabilities of the fermentation processes of sourdough. Since the key factors contributing to the sourdough quality are relevant to the starter strain growth and its metabolic activity, in this study, the cardinal growth parameters for pH, temperature (T), water activity (aw), and undissociated lactic acid of the sourdough strain Lactiplantibacillus plantarum ITM21B, were determined. The strain growth, pH, organic acids (lactic, acetic, phenyllactic, and hydroxy-phenyllactic), total free amino acids, and proteins were monitored during fermentation of a liquid sourdough based on wheat flour and gluten (Bio21B) after changing the starting T, pH, and inoculum load. Results demonstrated that the different fermentation conditions affected the strain growth and metabolite pattern. The organic acid production and growth performance were modeled in Bio21B, and the resulting predictive model allowed us to simulate in silico the strain performances in liquid sourdough under different scenarios. This mathematical predictive approach can be useful to optimize the fermentation conditions needed to obtain the suitable nutritional and technological characteristics of the L. plantarum ITM21B liquid sourdough.

A Predictive Growth Model for Pro-technological and Probiotic Lacticaseibacillus paracasei Strains Fermenting White Cabbage.

Bacterial strains belonging to Lacticaseibacillus paracasei species are generally used as starters in food fermentations and/or as probiotics. In the current study, the growth cardinal parameters of four L. paracasei strains (IMPC2.1, IMPC4.1, P40 and P101), isolated from table olives or human source, were determined. Strains were grown in liquid medium and incubated at several temperatures (10 values from 5.5°C-40°C) and pH (15 values from 3.2 to 9.1) along the growth range. The cardinal temperature model was used to describe temperature effects on the maximum specific growth rate of L. paracasei whereas new equations were developed for the effect of pH. The estimated Tmin values ranged between -0.97°C and 1.95°C and were lower than 0°C for strains IMPC4.1 and P101. Strain P40 was able to grow in the most restricted range of temperature (from 1.95°C to 37.46°C), while strain IMPC4.1 was estimated to survive at extreme conditions showing the lowest pHmin . Maximum specific growth rates of L. paracasei IMPC2.1 in white cabbage (Brassica oleracea var. capitata) were used to calculate the correction factor (Cf ) defined as the bias between the bacterial maximum specific growth rate in broth and in the food matrix. A simple bi-linear model was also developed for the effect of temperature on the maximum population density reached in white cabbage. This information was further used to simulate the growth of L. paracasei strains in cabbage and predict the time to reach the targeted probiotic level (7 log10 CFU/g) using in silico simulations. This study demonstrates the potential of the predictive microbiology to predict the growth of beneficial and pro-technological strains in foods in order to optimize the fermentative process.

Modelling the thermal inactivation of spores from different phylogenetic groups of Bacillus cereus.

The objective of this work is to match available phylogenetic information for Bacillus cereus strains with published thermal resistance parameters (D90°C, z) and to use this information to develop refined inactivation models for B. cereus sensu lato. To do so, the thermal resistance parameters were retrieved for 57 strains of B. cereus that could be assigned to a phylogenetic group. This information was used to build specific distributions for D90°C and z for the different phylogenetic groups of B. cereus to build refined thermal inactivation models for B. cereus. For validation purposes, thermal parameters were also retrieved for additional strains of unknown groups, but which had been classified as psychrotrophic or mesophilic. Monte Carlo simulations were first performed assuming that the model parameters D90°C and z are independent. However, based on the observation that combinations of very high D90°C and high z-values were not reported, an alternative Monte Carlo simulation set was explored for the phylogenetic Groups with very high z-values (i.e.i.e. Groups IV and VI). With both simulation sets, the predicted lower and upper limits of the D-values are close to the lowest and highest D-values reported in two previous meta-analysis studies. However, a better correspondence between the predicted and observed limits is obtained when using the alternative simulation set.

The effect of pH on the growth rate of Bacillus cereus sensu lato: Quantifying strain variability and modelling the combined effects of temperature and pH.

In this study, the effect of pH, alone or in combination with temperature, on the maximum growth rate (µmax) of B. cereus sensu lato was investigated. In phase 1, the effect of pH at 30 °C was studied for 16 mesophilic strains and 2 psychrotrophic strains of Bacillus cereus sensu lato. The µmax vs. pH relationship was found to show a similar pattern for all the strains. Several pH models from literature were evaluated and the best performing 'growth rate vs. pH' model selected. A stochastic model was then developed to predict the maximum specific growth rate of mesophilic B. cereus at 30 °C as a function of pH, the intra-species variability being incorporated via considering the model parameters (e.g. pHmin) randomly distributed. The predicted maximum specific growth rates were acceptably close to independent published data. In phase 2, the combined effects of temperature and pH were studied. Growth rates were also generated at 15, 20 and 40 °C for a selection of strains and the pH model was fitted at each temperature. Interestingly, the results showed that the estimates for the pHmin parameter for mesophilic strains were lower at 20-30 °C than near the optimum temperature (40 °C), suggesting that experiments for the determination of this parameter should be conducted at lower-than-optimum temperatures. New equations were proposed for the relationship between temperature and the minimum pH-values, which were also consistent with the experimental growth boundaries. The parameters defining this equation quantify the minimum temperature for growth observed experimentally, the temperature of maximum enzyme stability and the maximum temperature for growth. Deviations from the Gamma hypothesis (multiplicative effects of environmental factors on the maximum specific growth rate) were observed near the growth limits, especially at 40 °C. To improve model performance, two approaches, one based on a minimum pH-term (doi: https://doi.org/10.3389/fmicb.2019.01510) and one based on an interaction term (doi: http://dx.doi.org/10.1016/S0168-1605(01)00640-7) were evaluated.

A stochastic approach for modelling the effects of temperature on the growth rate of Bacillus cereus sensu lato.

A stochastic model that predicts the maximum specific growth rate (µmax) of Bacillus cereus sensu lato as a function of temperature was developed. The model integrates the intra-species variability by incorporating distributions of cardinal parameters (Tmin, Topt, Tmax) in the model. Growth rate data were generated for 22 strains, covering 5 major phylogenetic groups of B. cereus, and their cardinal temperatures identified. Published growth rate data were also incorporated in the model fitting, resulting in a set of 33 strains. Based on their cardinal temperatures, we identified clusters of Bacillus cereus strains that show similar response to temperature and these clusters were considered separately in the stochastic model. Interestingly, the µopt values for psychrotrophic strains were found to be significantly lower than those obtained for mesophilic strains. The model developed within this work takes into account some correlations existing between parameters (µopt, Tmin, Topt, Tmax). In particular, the relationship highlighted between the b-slope of the Ratkowsky model and Tmin (doi: https://doi.org/10.3389/fmicb.2017.01890) was adapted to the case of the popular Cardinal Temperature Model. This resulted in a reduced model in which µopt is replaced by a function of Tmin, Topt and 2 strain-independent parameters. A correlation between the Tmin parameter and the experimental minimal growth temperature was also highlighted and integrated in the model for improved predictions near the temperature growth limits. Compared to the classical approach, the model developed in this study leads to improved predictions for temperatures around Tmin and more realistic tails for the predicted distributions of µmax. It can be useful for describing the variability of the Bacillus cereus Group in Quantitative Microbial Risk Assessment (QMRA). An example of application of the stochastic model to Reconstituted Infant Formulae (RIF) was proposed.

Interferon regulatory factor 6 is required for proper wound healing in vivo.

BACKGROUND: Van der Woude syndrome (VWS) is the most common form of syndromic orofacial cleft caused predominantly by mutations in Interferon Regulatory Factor 6 (IRF6). We previously reported that individuals with VWS have increased risk of wound healing complications following cleft repair compared with individuals with nonsyndromic orofacial clefts (nonsyndromic cleft lip and palate-NSCLP). In vitro, absence of IRF6 leads to impaired keratinocyte migration and embryonic wound healing. However, there is currently no data on tissue repair in adult animals and cells with reduced levels of IRF6 like in VWS. RESULTS: Excisional wounds of Irf6+/- and wild-type animals were analyzed 4 and 7 days post-wounding. Although all wounds were reepithelialized after 7 days, the epidermal and wound volume of repaired wounds was larger in Irf6+/- . These data were supported by increased keratinocyte proliferation in the neoformed epidermis and a less mature granulation tissue with increased cytokine levels. This effect was not cell autonomous, as Irf6+/- neonatal keratinocytes in vitro did not exhibit defects in scratch wound closure or proliferation. Keratinocytes from individuals with VWS also migrated similarly to keratinocytes from NSCLP individuals. CONCLUSIONS: These data support a role for IRF6 in wound healing by regulating keratinocyte proliferation, granulation tissue maturation, and cytokine levels.

The consistent differential expression of genetic pathways following exposure of an industrial Pseudomonas aeruginosa strain to preservatives and a laundry detergent formulation.

Pseudomonas aeruginosa is a common contaminant associated with product recalls in the home and personal care industry. Preservation systems are used to prevent spoilage and protect consumers, but greater knowledge is needed of preservative resistance mechanisms used by P. aeruginosa contaminants. We aimed to identify genetic pathways associated with preservative exposure by using an industrial P. aeruginosa strain and implementing RNA-Seq to understand gene expression changes in response to industry relevant conditions. The consistent differential expression of five genetic pathways during exposure to multiple industrial growth conditions associated with benzisothiazolone (BIT) and phenoxyethanol (POE) preservatives, and a laundry detergent (LD) formulation, was observed. A MexPQ-OpmE Resistance Nodulation Division efflux pump system was commonly upregulated in response to POE, a combination of BIT and POE, and LD together with BIT. In response to all industry conditions, a putative sialic acid transporter and isoprenoid biosynthesis gnyRDBHAL operon demonstrated consistent upregulation. Two operons phnBA and pqsEDCBA involved in Pseudomonas quinolone signaling production and quorum-sensing were also consistently downregulated during exposure to all the industry conditions. The ability to identify consistently differentially expressed genetic pathways in P. aeruginosa can inform the development of future targeted preservation systems that maintain product safety and minimise resistance development.

Nodular Regenerative Hyperplasia Induced by Trastuzumab Emtansine: Role of Emtansine?

Trastuzumab is a monoclonal antibody targeted against the Human Epidermal Growth Factor Receptor 2 (HER2) overexpressed in some breast cancer. This targeted therapy significantly improves the prognosis of these cancers. Recently an anti-HER2 antibodydrug conjugate was shaped in order to facilitate the targeted delivery of potent cytotoxic drug to cancer cells and to reduce resistance. This formulation, called trastuzumab emtansine (T-DM1), consists of the monoclonal antibody trastuzumab linked to a cytotoxic drug (a derivative of maytansine) via a chemical linker. Little is known about adverse reactions due to this new formulation. Herein we described the case of a woman suffering from a HER2-positive breast cancer, treated with trastuzumab for 30 months followed by T-DM1 monotherapy. After 12 months of T-DM1 treatment, a nodular regenerative hyperplasia confirmed by liver biopsy occurred. T-DM1 was stopped and medical imagery showed a resolution of the nodular regenerative hyperplasia. Unfortunately, hepatic metastasis progressed. Few cases of nodular regenerative hyperplasia induced by T-DM1 have been described so far. Further studies are needed to explore pathogenesis of nodular regenerative hyperplasia with this new antibody-drug conjugate treatment.

Postoperative follow-up of Cushing's disease using cortisol, desmopressin and coupled dexamethasone-desmopressin tests: a head-to-head comparison.

OBJECTIVE: Predicting the outcome of patients operated on for Cushing's disease (CD) is a challenging task. Our objective was to assess the accuracy of immediate postsurgical plasma cortisol, desmopressin test and the coupled dexamethasone-desmopressin test (CDDT) as predictors of outcome. DESIGN AND PATIENTS: Sixty-seven patients with initial remission and a minimal postsurgical follow-up greater than 18 months were included in this retrospective bicentre study. MEASUREMENTS: Follow-up included 3-6 months followed by yearly 24-h urinary-free cortisol, ACTH and cortisol plasmatic levels, a 1-mg overnight dexamethasone suppression test (1-mg DST), desmopressin test and the CDDT. ROC curves were performed to define the optimal threshold of immediate postsurgical cortisol level and 3- to 6-month desmopressin test and CDDT, as predictors of final outcome in comparison with classical biological markers of recurrence. RESULTS: Eleven patients presented recurrence. The patient's median follow-up was 52 months (range, 18-180). As early predictors of outcome, immediate postsurgical plasma cortisol level <35 nmol/l predicted the lack of recurrence with 93% negative predictive value (NPV), whereas predictive positive value (PPV) was 25%. During the follow-up, the CDDT was more precise than the desmopressin test in predicting the lack of recurrence (100% NPV) when performed in the first 3 years after surgery. Positivity of the CDDT was defined based on ROC curves by ACTH and cortisol increments >50%. The CDDT was highly reproducible, as the same response was observed every year in 91% of the patients. CONCLUSIONS: Adding the CDDT the first 3 years after surgery to immediate postsurgical cortisol evaluation should allow obtaining an optimal follow-up management of patients operated for Cushing's disease.

Applications of omics approaches to the development of microbiological risk assessment using RNA virus dose-response models as a case study.

The last decade has seen a huge increase in the amount of 'omics' data available and in our ability to interpret those data. The aim of this paper was to consider how omics techniques can be used to improve and refine microbiological risk assessment, using dose-response models for RNA viruses, with particular reference to norovirus through the oral route as the case study. The dose-response model for initial infection in the gastrointestinal tract is broken down into the component steps at the molecular level and the feasibility of assigning probabilities to each step assessed. The molecular mechanisms are not sufficiently well understood at present to enable quantitative estimation of probabilities on the basis of omics data. At present, the great strength of gene sequence data appears to be in giving information on the distribution and proportion of susceptible genotypes (for example due to the presence of the appropriate pathogen-binding receptor) in the host population rather than in predicting specificities from the amino acid sequences concurrently obtained. The nature of the mutant spectrum in RNA viruses greatly complicates the application of omics approaches to the development of mechanistic dose-response models and prevents prediction of risks of disease progression (given infection has occurred) at the level of the individual host. However, molecular markers in the host and virus may enable more broad predictions to be made about the consequences of exposure in a population. In an alternative approach, comparing the results of deep sequencing of RNA viruses in the faeces/vomitus from donor humans with those from their infected recipients may enable direct estimates of the average probability of infection per virion to be made.

Does proximity to neighbours affect germination of spores of non-proteolytic Clostridium botulinum?

It is recognised that inoculum size affects the rate and extent of bacterial spore germination. It has been proposed that this is due to spores interacting: molecules released from germinated spores trigger germination of dormant neighbours. This study investigated whether changes to the total number of spores in a system or proximity to other spores (local spore density) had a more significant effect on interaction between spores of non-proteolytic Clostridium botulinum strain Eklund 17B attached to defined areas of microscope slides. Both the number of spores attached to the slides and local spore density (number of spores per mm(2)) were varied by a factor of nine. Germination was observed microscopically at 15 °C for 8 h and the probability of, and time to, germination calculated from image analysis measurements. Statistical analysis revealed that the effect of total spore number on the probability of germination within 8 h was more significant than that of proximity to neighbours (local spore density); its influence on germination probability was approximately four-times greater. Total spore number had an even more significant affect on time to germination; it had a nine-fold greater influence than proximity to neighbours. The applied models provide a means to characterise, quantitatively, the effect of the total spore number on spore germination relative to the effect of proximity to neighbouring spores.

Modelling the effects of temperature and osmotic shifts on the growth kinetics of Bacillus weihenstephanensis in broth and food products.

Bacillus weihenstephanensis is a psychrotolerant bacterium belonging to the Bacillus cereus group. Some strains may be cytotoxic although they have not been described as food-poisoning agents so far. The objective of this work is to model the effects of temperature and a(w) downshifts on the lag time of B. weihenstephanensis and the dependence of µ(max) on the growth conditions (temperature and a(w)). Effects of temperature downshifts were studied on 30 experimental conditions (shifts magnitude ranging from 2 to 20 °C, temperature after shift from 10 to 20 °C and a(w) ranging from 0.977 to 0.997). Osmotic shifts were studied for 13 conditions (shift magnitude ranging from 0.008 to 0.020 units of a(w), temperature from 10 to 30 °C, a(w) after shift from 0.977 to 0.997). Experimental results show that temperature downshifts were able to induce considerable lag times (up to 20 days) when occurring near the growth limits. At lower temperatures, osmotic shifts had also a significant effect. Validation experiments in food subjected to changing conditions of temperature showed that the model provided valid predictions in diluted creamed pasta but overestimated bacterial growth in carrot soup (fail safe predictions).

Establishing equivalence for microbial-growth-inhibitory effects ("iso-hurdle rules") by analyzing disparate listeria monocytogenes data with a gamma-type predictive model.

Preservative factors act as hurdles against microorganisms by inhibiting their growth; these are essential control measures for particular food-borne pathogens. Different combinations of hurdles can be quantified and compared to each other in terms of their inhibitory effect ("iso-hurdle"). We present here a methodology for establishing microbial iso-hurdle rules in three steps: (i) developing a predictive model based on existing but disparate data sets, (ii) building an experimental design focused on the iso-hurdles using the model output, and (iii) validating the model and the iso-hurdle rules with new data. The methodology is illustrated with Listeria monocytogenes. Existing data from industry, a public database, and the literature were collected and analyzed, after which a total of 650 growth rates were retained. A gamma-type model was developed for the factors temperature, pH, a(w), and acetic, lactic, and sorbic acids. Three iso-hurdle rules were assessed (40 logcount curves generated): salt replacement by addition of organic acids, sorbic acid replacement by addition of acetic and lactic acid, and sorbic acid replacement by addition of lactic/acetic acid and salt. For the three rules, the growth rates were equivalent in the whole experimental domain (γ from 0.1 to 0.5). The lag times were also equivalent in the case of mild inhibitory conditions (γ ≥ 0.2), while they were longer in the presence of salt than acids under stress conditions (γ < 0.2). This methodology allows an assessment of the equivalence of inhibitory effects without intensive data generation; it could be applied to develop milder formulations which guarantee microbial safety and stability.

Adaptive growth responses of Listeria monocytogenes to acid and osmotic shifts above and across the growth boundaries.

The effect of acid and osmotic shifts on the growth of Listeria monocytogenes was evaluated at 10°C. Two types of shifts were tested: (i) within the range of pH and water activity (a(w)) levels that allow growth of L. monocytogenes and (ii) after habituation at no-growth conditions back to growth-permitting conditions. A L. monocytogenes cheese isolate, with high survival capacity during cheesemaking, was inoculated (10(2) CFU/ml) in tryptic soy broth supplemented with 0.6% yeast extract at six pH levels (5.1 to 7.2; adjusted with lactic acid) and 0.5% NaCl (a(w) 0.995), or four a(w) levels (0.995 to 0.93, adjusted with 0.5 to 10.5% NaCl) at pH 7.2 and grown to early stationary phase. L. monocytogenes was then shifted (at 10(2) CFU/ml) to each of the aforementioned growth-permitting pH and a(w) levels and incubated at 10°C. Shifts from no-growth to growth-permitting conditions were carried out by transferring L. monocytogenes habituated at pH 4.9 or a(w) 0.90 (12.5% NaCl) for 1, 5, and 10 days to all pH and a(w) levels permitting growth. Reducing a(w) or pH at different levels in the range of 0.995 to 0.93 and 7.2 to 5.1, respectively, decreased the maximum specific growth rate of L. monocytogenes. The lag time of the organism increased with all osmotic downshifts, as well as by the reduction of pH to 5.1. Conversely, any type of shift within pH 5.5 to 7.2 did not markedly affect the lag times of L. monocytogenes. The longer the cells were incubated at no-growth a(w) (0.90), the faster they initiated growth subsequently, suggesting adaptation to osmotic stress. Conversely, extended habituation at pH 4.9 had the opposite effect on subsequent growth of L. monocytogenes, possibly due to cell injury. These results suggest that there is an adaptation or injury rate induced at conditions inhibiting the growth of the pathogen. Thus, quantifying adaptation phenomena under growth-limiting environments, such as in fermented dairy and meat products or products preserved in brine, is essential for reliable growth simulations of L monocytogenes during transportation and storage of foods.

Survival of Lactobacillus rhamnosus strains in the upper gastrointestinal tract.

In the present study six probiotic Lactobacillus rhamnosus strains were investigated for their ability to survive in the human upper gastrointestinal tract through a dynamic gastric model of digestion. MRS broth was used as delivery vehicle and survival was investigated during in vitro gastric and gastric plus duodenal digestion. Results highlighted that all tested strains showed good survival rate during both gastric and duodenal digestion. In particular, three strains exhibited a great survival showing a recovery percentage in the range between 117 and 276%. In agreement with survival data, high lactic acid production was detected for all strains, confirming their metabolic activity during digestion.

Modeling the effect of abrupt acid and osmotic shifts within the growth region and across growth boundaries on adaptation and growth of Listeria monocytogenes.

This study aims to model the effects of acid and osmotic shifts on the intermediate lag time of Listeria monocytogenes at 10°C in a growth medium. The model was developed from data from a previous study (C. I. A. Belessi, Y. Le Marc, S. I. Merkouri, A. S. Gounadaki, S. Schvartzman, K. Jordan, E. H. Drosinos, and P. N. Skandamis, submitted for publication) on the effects of osmotic and pH shifts on the kinetics of L. monocytogenes. The predictive ability of the model was assessed on new data in milk. The effects of shifts were modeled through the dependence of the parameter h(0) ("work to be done" prior to growth) induced on the magnitude of the shift and/or the stringency of the new environmental conditions. For shifts across the boundary, the lag time was found to be affected by the length of time for which the microorganisms were kept at growth-inhibiting conditions. The predicted concentrations of L. monocytogenes in milk were overestimated when the effects of this shift were not taken into account. The model proved to be suitable to describe the effects of osmotic and acid shifts observed both within the growth domain and across the growth boundaries of L. monocytogenes.

[Evaluation of the follow-up of women aged 50-74 years after cervical cytological Ascus abnormalities in cancer screening: adherence to clinical practice guidelines in Isere, France; 1991-2000]. / Evaluation de la prise en charge des femmes de 50 à 74 ans après frottis du col de l'utérus répondu Ascus dans un dépistage organisé en Isère 1991-2000 : application de la conduite à tenir de l'Agence nationale d'accréditation et d'évaluation en santé.

OBJECTIVES: The aim of this study is to compare to the guideline (1998 and 2001) the follow-up of Ascus cytological abnormalities among women aged 50-74 years who have participated at the combined breast, cervical and colorectal cancer screening programme from 1991 to 2000 in Isère, France. PATIENTS AND METHODS: The follow-up of 1154 women with Ascus smear was analysed. A woman was defined according follow-up if she have made a colposcopy or biopsy less than four months after one positive smear or if she has repeated three smears: 3-7 months and 10-14 months after the positive smear and 1 year after the last negative smear. RESULTS: The follow-up was according to guidelines for 28.4% of the 1154 women (150 women are unknowns), 58.6% had a follow-up with too long delay and 17.2% had an uncompleted follow-up. The follow-up did not differ before 1998. It did not differ from women age. Women who were treated by gynaecologist (548) had a better follow-up (according: 35.4%) than the women who were treated by a general practitioner (595). DISCUSSION AND CONCLUSION: The follow-up of Ascus cytological abnormalities is not according to guideline. The follow-up in the screening program will be intensified.

Modelling the effect of the starter culture on the growth of Staphylococcus aureus in milk.

The competitive growth of a starter culture of lactic acid bacteria (Fresco 1010, Chr. Hansen, Hørsholm, Denmark) and Staphylococcus aureus was studied in milk. The lactic bacteria (LAB) were able to induce an early stationary state in S. aureus. The developed model highlights that the growth of S. aureus is inhibited when the LAB have reached a critical density. The model was tested in different conditions of temperature (from 12 degrees to 25 degrees C), for various inoculum sizes of LAB and S. aureus. The results show that the model accurately quantifies the kinetics of S. aureus as a function of the starter culture.