Preliminary Results on the Comparative Evaluation of Alkaline Phosphatase Commercial Tests Efficiency in Non-Cow Milk Pasteurization.

The demand for non-cow milk and the products derived from it, is constantly increasing; thus, correct and effective pasteurization becomes necessary. Typical practices for evaluating milk pasteurization are mainly based on the thermal inactivation of an endogenous enzyme, alkaline phosphatase (ALP). The ALP tests, originally designed and applied to pasteurized cow milk, are often used to control pasteurization in non-cow milk, without sufficient data on their suitability; EFSA calls on the scientific world for collecting more information on the subject. In this study, the pertinent details of the ALP assay for non-cow milk products are summarized, and a comparison is performed regarding the evaluation of the adequacy of commercially available tests for the determination of ALP activity in non-cow milk. At the same time, raw and pasteurized non-cow milk was analyzed microbiologically using standard ISO methods and MALDI-TOF MS in order to confirm the thermal effect on common microorganisms. In these preliminary results, various ALP tests do not appear to be fully reliable as indicators for the pasteurization of some types of non-cow milk such as camel and donkey milk or even goat and sheep milk, using the EFSA proposed limits. ALP commercial kits may not be suitable as pasteurization indicators for various types on non-cow milk, and alternatives should be investigated.

Exposure assessment on aflatoxin M1 from milk and dairy products-relation to public health.

BACKGROUND-AIM: Aflatoxin M1 (AFM1) contaminates milk and dairy products that are widely consumed foods. Therefore, there is increased concern for human exposure to the toxic action and the negative health effects that AFM1 presents. The aim of this study was to assess the contamination levels with AFM1, of dairy products available in the Greek market (Thessaly), and also to estimate the relevant nutritional exposure. METHODS: A total of 52 infant milk, 25 Feta cheese and 32 pasteurized milk samples were randomly selected from the market. The determination of AFM1 was based on indirect immunoenzymatic ELISA method with two analytical packages; namely Tecna (Italy) and Prognosis Biotech (Greece), for comparison purposes, strictly following the manufacturer's instructions. The estimated daily intake (EDI) of AFM1 through dairy consumption and the relevant hazard index (HI) were calculated. RESULTS: The levels of AFM1, in all samples tested, were below the tolerable maximum level of 50 ng/L for milk and 25 ng/L for infant formulas (EC Regulation 1881/2006), while concentrations were very low (0.23-9.38 ng/L for infant formula, 0.54-4.09 ng/L for cheese and 0.20-17.84 ng/L for pasteurized milk). The exposure assessment revealed that infants, toddlers and children were the most exposed groups in AFM1 via milk and formula consumption (0.65, 0.35 and 0.35 respectively). The HI was also noticed higher in those ages, with the maximum value to reach 1.90. Though, for feta cheese the exposure was calculated as very low (EDI: 0.01 and HI: 0.05). Comparing the two analytical packages used, no statistically significant difference was found (p-value >0.05). CONCLUSIONS: Milk and dairy products tested were found safe for consumption, regarding the AFM1 levels. From a public health perspective, the results are satisfactory, given that the population exposure to AFM1, based on the nutrient profile, was rather limited.

The effect of a diverting ileostomy formation on nutritional status and energy intake of patients undergoing colorectal surgery.

BACKGROUND AND AIMS: The effects of ileostomy construction and colonic bypass on the general nutritional status of the patients have not yet received much attention. The aim of the present study was to assess the effect of a diverting ileostomy formation, on the nutritional intake, body composition and nutritional status biochemical markers of patients with a newly formed ileostomy. METHODS: This was an observational study. Patients scheduled for elective rectosigmoid resection at a surgical unit of a public university hospital, were considered for study inclusion. Patients in whom a diverting ileostomy was created were assigned to the ileostomy group (n = 41), and patients who underwent rectosigmoid resection without requiring a diverting ileostomy served as a control group (n = 37). Anthropometric characteristics, body composition, dietary intake and biochemical markers representative of nutritional status were assessed preoperatively and at 40 days postdischarge (NCT02036346). RESULTS: Anthropometric and body composition characteristics (weight, BMI and body fat percentage) significantly declined from 75 to 71.6 kg, 26.9 to 25.6 kg/m2 and 28.6 to 25.6% respectively (p = 0.001 for all) in the ileostomy group, between the preoperative stage and 40 days postdischarge from the hospital. Furthermore, a significant reduction in mean daily energy intake from 1871 to 1713 kcal/day (p = 0.046) was observed in the ileostomy group 40 days after discharge compared to preoperative assessment. No significant changes in the above measured parameters were observed in the non-ileostomy group. CONCLUSION: Diverting ileostomy can have a negative effect on general nutritional status and dietary intake of patients, during the first postoperative period. Nutritional assessment might need to be included in the routine clinical management of this patient category to prevent weight loss and impaired energy intake.

Administration of an Oral Hydration Solution Prevents Electrolyte and Fluid Disturbances and Reduces Readmissions in Patients With a Diverting Ileostomy After Colorectal Surgery: A Prospective, Randomized, Controlled Trial.

BACKGROUND: Patients with a newly formed ileostomy often develop electrolyte abnormalities and dehydration. OBJECTIVE: The study assessed the prophylactic effect of an isotonic hydration solution on dehydration and electrolyte abnormalities in patients with a newly formed ileostomy. DESIGN: This was a prospective, randomized, controlled trial (NCT02036346). SETTINGS: The study was conducted at a single surgical unit of a public university hospital. PATIENTS: Patients scheduled for elective rectosigmoid resection were considered for study inclusion. INTERVENTION: Patients in whom a diverting ileostomy was created were randomly assigned to the intervention group (n = 39), which received an oral isotonic glucose-sodium hydration solution for 40 days postdischarge and the control group (n = 41) which did not receive an intervention. The 2 groups were compared with a group of patients who underwent rectosigmoid resection without diverting ileostomy (n = 37). MAIN OUTCOME MEASURES: Serum electrolyte and renal function markers were assessed preoperatively and at 20 and 40 days postdischarge. RESULTS: At 20 days postdischarge, the serum sodium of the control group appeared lower than the serum sodium of the intervention group and the nonileostomy group (p = 0.007). At the same time point, urea and creatinine levels of the control group were higher than the urea and creatinine levels of the other 2 groups (p = 0.01 and p = 0.02). At 40 days postdischarge, mean sodium and renal function markers improved in the control group, but sodium and creatinine continued to differ in comparison with the intervention and nonileostomy groups (p = 0.01 and p = 0.04). The readmission rate for fluid and electrolyte abnormalities was higher in the control group (24%) than in the other 2 groups, where no rehospitalization for such a reason was required (p = 0.001). LIMITATIONS: The study was limited by its single-center design. CONCLUSION: An oral isotonic drink postdischarge can have a prophylactic effect on patients with a newly formed ileostomy, preventing readmission for fluid and electrolyte abnormalities. See Video Abstract at http://links.lww.com/DCR/A603.

Differences in sheep and goats milk microbiological profile between conventional and organic farming systems in Greece.

The aim of this study was to examine differences in the microbiological profile and antimicrobial resistance of bacteria isolated from milk from organic and conventional sheep and goat farms. Twenty-five organic and 25 conventional sheep and goat farms in the region of Thessaly, Greece participated in this study. A standardised detailed questionnaire was used to describe farming practices. A total of 50 samples were collected and analysed for total viable count (TVC), total coliform count (TCC) and somatic cell count (SCC), while Staphylococcus aureus and Escherichia coli were isolated using standard methods. Isolates were identified at species level by Api-test and Matrix-Assisted Laser Desorption/Ionisation-Time of Flight Mass Spectrometry (MALDI-TOF MS). Susceptibility to a panel of 20 for E. coli and 16 for S. aureus antimicrobials was determined by the agar dilution method. Pulsed Field Gel Electrophoresis (PFGE) was performed for S. aureus and E. coli isolates to determine predominant clones. Lower counts of TVC, TCC and SCC were identified in milk from the organic farms, possibly due to differences in the hygienic farming practices found on those farms. API-tests and MALDI-TOF MS showed no significant differences in the S. aureus and E. coli isolates. Overall, antimicrobial resistance rates were low, while a statistically higher percentage was estimated among strains originating from conventional farms in comparison with organic farms, possibly due to the restriction of antibiotic use in organic farming. PFGE revealed diversity among S. aureus and E. coli populations in both organic and conventional farms indicating circulation of 2-3 main clones changing slightly during their evolution. Consequently, there is evidence that milk from the organic farms presents a better microbiological profile when compared with milk from conventional farms.

Evaluating the Efficacy of the Feeding Exercise Randomized Trial in Overweight and Obese Adolescents.

BACKGROUND: The Feeding Exercise Trial in Adolescents (FETA) aimed to evaluate whether a community-based, parents-involving, combined physical activity and nutritional education program was effective in improving adiposity profiles in overweight and obese adolescents. METHODS: A total of 181 overweight and obese adolescents aged 13-15 years old were randomized in the three study groups ("Diet & Activity," "Activity," and Control). The Activity intervention included a 45-minute, 3-day per week supervised training program, while the Diet & Activity intervention included a supplementary 15 minutes of group-based sessions attended by the parents. The intervention lasted 3 months and the participants were followed for another 3 months after the intervention. The participants were assessed for anthropometric measures and activity and fulfilled the modified version of the questionnaire "Family Eating and Activity Habits Questionnaire" (FEAHQ). RESULTS: Both "Activity" only and "Diet & Activity" groups reduced significantly (p < 0.001) their mean body mass index (BMI) (-1.1, 95% CI -1.3, -0.8, and -1.4, 95% CI -1.7, -1.2, respectively), waist circumference, systolic and diastolic blood pressure, pulses per minute, and 50 m sprint run test at 3 months, while greater reductions in BMI were observed at 6 months (-2.3, 95% CI -2.6, -2.0, and -3.1, 95% CI -3.3, -2.8). Significant changes in the total FEAHQ score were achieved only in the "Diet & Activity" group both at 3 months and at 6 months. CONCLUSIONS: FETA resulted in significant effects on improving adiposity profiles in overweight and obese adolescents, as well as family activity and feeding habits, maintained at 3 months follow-up.

Prevalence and Risk Factors of Overweight and Obesity among Adolescents and Their Parents in Central Greece (FETA Project).

The increasing obesity trend in adolescence is a public health concern. The initial phase of Feeding Exercise Trial in Adolescents (FETA) aimed in investigating the prevalence of overweight and obesity in adolescents and their parents and in identifying associated factors among parents' and adolescents' demographics, eating habits, and parental style. The sample consisted of 816 adolescents, aged 12-18 years old, and their parents from 17 middle and high schools in Larissa, central Greece. During school visits, anthropometric measurements were performed along with examination of blood pressure. The students completed the study tool that comprised of demographics and the modified versions of Parental Authority Questionnaire (PAQ), the Parent-Initiated Motivational Climate Questionnaire-2 (PIMCQ-2) and the Family Eating and Activity Habits Questionnaire (FEAHQ). Their parents completed a questionnaire with demographics, anthropometrics and FEAHQ. Normal Body Mass Index was found in 75.2% of the adolescents, 2.6% of the adolescents were underweight, 18% overweight and 4.2% obese. Regarding the parents, 76.3% of the fathers and 39.2% of the mothers were overweight or obese. The logistic regression analysis revealed that, overweight or obesity in adolescence was associated with gender (boy), maternal overweight or obesity, lower maternal educational level, eating without feeling hungry, eating in rooms other than kitchen and having a father that motivates by worrying about failing. A significant proportion of adolescents and their parents are overweight or obese. Future interventions should focus both on the parents and children, taking into account the role of parental authority style, in preventing adolescents' obesity.

Assessment of hygiene standards and Hazard Analysis Critical Control Points implementation on passenger ships.

The level of hygiene on ferries can have impact on travellers' health. The aim of this study was to assess the hygiene standards of ferries in Greece and to investigate whether Hazard Analysis Critical Control Points (HACCP) implementation contributes to the hygiene status and particularly food safety aboard passenger ships. Hygiene inspections on 17 ferries in Greece were performed using a standardized inspection form, with a 135-point scale. Thirty-four water and 17 food samples were collected and analysed. About 65% (11/17) of ferries were scored with >100 points. Ferries with HACCP received higher scores during inspection compared to those without HACCP (p value <0.001). All 34 microbiological water test results were found negative and, from the 17 food samples, only one was found positive for Salmonella spp. Implementation of management systems including HACCP principles can help to raise the level of hygiene aboard passenger ships.

Seroprevalence of IgG antibodies against Echinococcus granulosus in the population of the region of Thessaly, Central Greece.

Echinococcosis notification rate in Greece, based on the most recent data, is below 0.25 per 100,000 population. To further investigate the epidemiology of echinococcosis in Greece a study was designed to determine the seroprevalence of Echinococcus granulosus antibodies in the population of Thessaly, Central Greece. Five hundred and forty two left over blood samples in Thessaly laboratories, were collected using a stratified convenient sampling procedure. Samples were analyzed with enzyme linked immunosorbent assay. The seropositivity found was 1.1%(95% C.I., 0.5-2.5), with 5 out of 6 seropositive results to be in the age group of over 65 (OR = 17.95, 95%CI 2.04-157.11, p value 0.009). Rural residence was also found as a risk factor to seropositivity (RR = 7.60, 95% CI 0.89-64.64, p value 0.039). Surveillance data and our study results converge that echinococcosis is being reduced in Greece, with older population to be affected mostly. These might be due to the disease transmission restriction, by the control measures being implemented. Efforts should be continued, in both animals and humans side, by increasing training campaigns and public awareness.