Search

PURPOSE: Further diagnostic testing may be required after a coronary computed tomography angiography (CTA) showing suspected coronary stenosis. Whether myocardial perfusion imaging (MPI) provides further prognostic information post-CTA remains debated. We evaluated the prognosis for patients completing CTA stratified for post-CTA diagnostic work-up using real-world data.METHODS: We identified all patients in our uptake area with angina symptoms undergoing first-time CTA over a 10-year period. Follow-up time was a median of 3.7 years [1.9-5.8]. The primary endpoint was a composite of myocardial infarction or death. The secondary endpoint was late revascularization.RESULTS: During the study period 53,351 patients underwent CTA. Of these, 24% were referred for further down-stream testing, 3,547 (7%) to MPI and 9,135 (17%) to invasive coronary angiography (ICA). The primary and secondary endpoints occurred in 2,026 (3.8%) and 954 (1.8%) patients. Patient-characteristic-adjusted hazard ratios for the primary and secondary endpoint using patients with a normal CTA as reference were 1.37 (1.21-1.55) and 2.50 (1.93-3.23) for patient treated medically, 1.68 (1.39-2.03) and 6.13 (4.58-8.21) for patients referred to MPI and 1.94 (1.69-2.23) and 9.18 (7.16-11.78) for patients referred for ICA, respectively. Adjusted analysis with stratification for disease severity at CTA showed similar hazard ratios for patients treated medically after CTA and patients referred for MPI and treated medically after the MPI.CONCLUSION: In patients completing coronary CTA, second-line MPI testing seems to identify patients at low risk of future events. MPI seems to have the potential to act as gatekeeper for ICA after coronary CTA.

BACKGROUND: Enlargement of left atrium (LA) is a valuable marker of cardiovascular events, and LA size is readily available while performing non-contrast cardiac computed tomography (NCCT) for preventive purposes. We aimed to evaluate the predictive value of a single LA area from NCCT in a population-based cohort.METHOD: Mainly men aged 60-75 years from DANCAVAS were included. Traditional risk factors were recorded, and an NCCT scan performed at baseline. Coronary artery calcifications (CAC) score and the largest LA area were measured. LA was indexed to body surface area and categorised into four groups. Data on incident atrial fibrillation (AF), thromboembolic events, heart failure (HF) and death were obtained from Danish national registries.RESULTS: In total, 14,557 individuals were eligible, excluding those without LA measurement (N = 232) and with heart valve replacement (N = 197). Known AF or HF were respectively excluded from follow-up. Median follow-up time was 2.1 to 3.4 years. In total, 304 developed AF, 149 had thromboembolism, 129 developed HF and 482 died. In adjusted analysis, LA enlargement was associated with AF (HR (95% CI): large 1.99 (1.46-2.71) and very large LA 3.77 (2.31-6.14)) and HF (large 2.40 (1.50-3.85) and very large LA 6.54 (4.07-10.51)). A very large LA significantly increased mortality (HR: 2.01 (1.44-2.82)), and was associated with a two-fold increased risk of thromboembolism; however, not significantly in adjusted analysis (p = 0.09).CONCLUSION: We demonstrated that determination of LA area from NCCT was an important predictor of AF, HF and death. This knowledge could inform current risk assessment beyond CAC score.

Introduction According to the Clinical Laboratory Improvement Amendments 1988 regulations, 5-year retrospective review (5YRR) of normal Papanicolaou tests in patients with a newly diagnosed high grade squamous intraepithelial lesion or above (HSIL+) is mandatory. Since this mandate has been in place, a multitude of changes have taken place in the screening and management guidelines of cervical cancer. The aim of this study is to assess the role of this mandate in our laboratory and to investigate the lessons learned. Material and methods The cytopathology electronic database and institutional quality assurance records at Loyola University Medical Center were searched from January 2009 to December 2019 to identify all Papanicolaou tests diagnosed as new “HSIL and above” (HSIL+). Major discrepancy (2+) was defined as initial negative diagnosis changed to HSIL+. Results A total of 153,083 Papanicolaou tests were performed during this period; out of these, 1452 (0.94%) were diagnosed as HSIL+. A total of 695 HSIL+ Papanicolaou tests had a negative prior Papanicolaou and in 615 of 695 there was agreement with the initial negative diagnosis. In 61 Papanicolaou tests, the initial diagnosis was changed from negative and they were reclassified on review as 3 HSIL, 9 ASC-H, 7 AGC, and 42 ASCUS or LSIL. Major discrepancy rate was calculated as 3 of 695 (0.43%). None required an amended report. Conclusions It is important to revisit the 5YRR as a method of implementing the quality indicators in gynecologic cytology so that the process retains its value without overburdening cytology laboratories and personnel.

Objectives This study was designed to compare head-to-head fractional flow reserve (FFR) derived from coronary computed tomography angiography (CTA) (FFRCT) and cardiac magnetic resonance (CMR) stress perfusion imaging for prediction of standard-of-care–guided coronary revascularization in patients with stable chest pain and obstructive coronary artery disease by coronary CTA. Background FFRCT is a novel modality for noninvasive functional testing. The clinical utility of FFRCT compared to CMR stress perfusion imaging in symptomatic patients with coronary artery disease is unknown. Methods Prospective study of patients (n=110) with stable angina pectoris and 1 or more coronary stenosis ≥50% by coronary CTA. All patients underwent invasive coronary angiography. Revascularization was FFR-guided in stenoses ranging from 30% to 90%. FFRCT ≤0.80 in 1 or more coronary artery or a reversible perfusion defect (≥2 segments) by CMR categorized patients with ischemia. FFRCT and CMR were analyzed by core laboratories blinded for patient management. Results A total of 38 patients (35%) underwent revascularization. Per-patient diagnostic performance for identifying standard-of-care–guided revascularization, (95% confidence interval) yielded a sensitivity of 97% (86 to 100) for FFRCT versus 47% (31 to 64) for CMR, p 0.05, respectively. Conclusions In patients with stable chest pain referred to invasive coronary angiography based on coronary CTA, FFRCT and CMR yielded similar overall diagnostic accuracy. Sensitivity for prediction of revascularization was highest for FFRCT, whereas specificity was highest for CMR.

In this work, three allergen-encoding genes (Ana o 1, Ana o 2, Ana o 3) were investigated for the detection of cashew nut as an allergenic food. Normalised and single-tube nested real-time PCR approaches targeting the Ana o 2 or Ana o 3 genes are proposed and compared. Normalised real-time PCR detected 10 pg, while single-tube nested real-time PCR achieved 1 pg of cashew nut DNA. Single-tube nested real-time PCR targeting Ana o 3 allowed the best relative sensitivities (10 mg/kg cashew nut in dough/biscuit), being successfully validated regarding precision/accuracy. The normalised real-time PCR did not show acceptable accuracy for both targets. Sensitivity of single-tube nested real-time PCR was affected by the matrix (pasta), but not by thermal processing (dough/biscuit). Herein, two highly sensitive and specific single-tube nested real-time PCR targeting allergen-encoding genes are proposed for the first time as quantitative/validated tools for cashew nut analysis as an allergenic food.

Honey is the natural sweet substance produced by Apis mellifera honeybees in Europe. Depending on the country/region, the A. mellifera subspecies native to Europe belong to three different lineages: A (A. m. iberiensis), M (A. m. iberiensis and A. m. mellifera) and C (A. m. ligustica and A. m. carnica). In this work, two DNAbased approaches were developed with the aim of entomological authentication of European honeys. A cytb specific PCR assay was proposed to identify A-lineage honeybees, while a second method based on real-time PCR coupled to high resolution melting analysis targeting the COI gene was developed to differentiate C- and Mlineages honeybees. The proposed methodologies were validated successfully with honeys of known origin and applied to the entomological authentication of 20 commercial samples from different European countries. The results highlight the predominance of honeys from C-lineage honeybees in Europe, except in Iberian Peninsula countries (honey from A-lineage honeybees). The authors are grateful to Dora Henriques for assembling the mitogenomes and to Pilar de la Rua and António Pajuelo for supplying authentic honey samples. This work was supported by FCT (Fundação para a Ciência e Tecnologia) through project UID/QUI/50006/2013 – POCI/01/0145/FEDER/007265 with financial support from FCT/MEC through national funds and co-financed by FEDER, under the Partnership Agreement PT2020 and by the projects NORTE-01-0145- FEDER-000011 and BeeHappy – POCI-01-0145-FEDER-029871 (financed by FEDER through the COMPETE 2020 – Operational Programme for Competitiveness and Internationalisation (POCI) and FCT). S. Soares, L. Grazina and J. Costa are grateful to FCT grants (SFRH/BD/75091/2010, SFRH/BD/132462/2017 and SFRH/BPD/102404/2014, respectively) financed by POPH-QREN (subsidised by FSE and MCTES). info:eu-repo/semantics/publishedVersion

Introducao O sistema MNS foi o segundo sistema sanguineo a ser descoberto. Atualmente sao conhecidos 46 antigenios pertencentes a este grupo sanguineo, embora sem provada relevância clinica. Os anticorpos para o antigenio M e N pertencem a classe IgM sao naturais, reagem a frio e raramente causam hemolise sendo dito, por isso, que nao sao clinicamente significativos. No caso do S e s os anticorpos sao imunes (surgem apos exposicao ao antigenio), pertencem a classe IgG reagindo maioritariamente a 37°C e por isso sao tidos como clinicamente significativos. O sistema P, a semelhanca do sistema MNS, foi descoberto por Landsteiner e Levine em 1927 com a descricao dos antigenios P, P1 e Pk. A expressao destes antigenios traduz-se em cinco fenotipos possiveis nomeadamente P1, P2,p, P1K e P2K. Os anticorpos do sistema P1 pertencem a classe IgM sao anticorpos naturais e caracterizam-se por apresentar maior reatividade a temperatura ambiente (TA). Embora raramente originem reacoes transfusionais hemoliticas, existem casos descritos na literatura de anti-P1 reativos a 37°C, capazes de provocar estas reacoes. Objetivos Rever a literatura, determinar a prevalencia e caracterizar os anticorpos dos Sistemas MNS e P identificados no SIMU do IPOC. Metodos Estudo retrospetivo de dados relativos a doentes do IPOC, a quem foram identificados aloanticorpos no periodo entre julho de 2020 a junho 2021. A detecao de aloanticorpos ocorreu na populacao de doentes que efetuaram determinacao do grupo sanguineo completo/provas de compatibilidade. A identificacao e efetuada recorrendo a um painel de identificacao constituido por 16 celulas comerciais, pela tecnica de referencia, em tubo, nos meios Salino TA, salino 37°C, enzimatico e antiglobulina (AGH). Resultados No periodo em analise, foram identificados 32 aloanticorpos: 5 Anti-Lea, 5 Anti-D,4 Anti-Leb, 4 Anti-E, 4 Anti-M, 2 Anti-C, 2 Anti-P1, 2 Anti- Lua, 1 Anti- Jka, 1 Anti-K, 1 Anti- Cw e 1 Anti-Jkb. Os anticorpos dos sistemas MNS e P representam aproximadamente 20% da totalidade dos anticorpos identificados no periodo descrito. Estes anticorpos reagiram preferencialmente em meio Salino a TA (100%). Obteve-se ainda reacao em salino a 37°C em 16% e em AGH em 83%. Conclusao As carateristicas evidenciadas por estes anticorpos vao de encontro ao descrito na literatura, sendo, o meio preferencial de reacao o meio salino, a TA. Os meses em que foram identificados estes anticorpos, periodo de novembro a abril, correspondem a meses com temperatura ambiente mais baixa, o que podera ter potenciado as reacoes e aumentado a probabilidade de detecao. Devido as caracteristicas evidenciadas neste estudo (16% reativos a 37°C e 83% reativos em AGH), e apesar de habitualmente serem considerados sem significado clinico, na pratica transfusional do SIMU serao sempre transfundidos concentrados de eritrocitos sem o antigenio em causa.

Fusarium graminearum is the main causal agent of Fusarium head blight (FHB) of small grain cereals, but the importance of weeds in the FHB disease cycle and the establishment of F. graminearum in agroecosystems are still not fully understood. The objective of this study was to determine the potential role of weeds present within cereal crop rotations as alternative hosts. F. graminearum was isolated from different organs of asymptomatic weeds sampled from six fields with cereal-crop rotations in Lithuania for two consecutive years (2015 and 2016). The fungi were identified using morphological and molecular methods. Out of 57 weed species that were investigated, 41 (71.9%) harboured F. graminearum isolates. Twenty five weed species were identified as new, previously undocumented, hosts. The majority (73.3%) of the isolates of F. graminearum from this study belonged to the 15ADON genotype while a smaller proportion (23.4%) belonged to the 3ADON genotype. All F. graminearum isolates that were assessed induced FHB symptoms on artificially inoculated spring wheat tested in the field.

For sustainable plant drinks production, the biorefinery concept of obtained press cakes (PC) using ultrasonication, mechanical separation, and ultra-filtration was designed in Fraunhofer UMSICHT (Germany). In this study obtained permeates, as wastes after ultrafiltration of PC (soyabeans, almonds, coconut, oats, and rice) were analyzed and their bio-stimulatory effect on the growth of wheatgrass in vivo was investigated. Permeates with higher soluble protein content (soy, almonds, and coconut) resulted in a significant increase in germination parameters (germination percentage (GP), length of stem and root as well as biomass of stem and root increased on averge by 8.3%, 15.8%, 9.2%, 2.22 times and 1.8 times, respectively) compared to the control treatment. Additionally, the fermentation using antimicrobial lactic acid bacteria (LAB) strains (Lactobacillus brevis LUHS173, Pediococcus acidilactici LUHS236 and Lactobacillus farraginis LUHS206) was applied for bio-treatment of permeates. The efficiency of fermentation process was evaluated on the changes of pH, TTA, LAB growth kinetics and lactic acid and its isomers production. Furthermore, the antifungal activity of selected fermented products against fungi (Fusarium graminearum F, F. graminearum, and F. culmorum) was determined. It was found that the highest antifungal activity (18.0 mm and 16.5 mm, respectively) was obtained by 48 h fermentation of permeates from grain press cake (oats and rice), containing the most reducing saccharides, and they significantly improved the germination of contaminated grains. Innovations in the sustainable production of plant-origin drinks enable to implementation of new, environmentally friendly technologies in food sector.

This study was dedicated to apply biological treatment using Lactobacillus (LAB) fermentation separately or in combination with an acoustic screening method for the prevention of mycotoxins in Fusarium spp. contaminated wheat-based products. Wheat samples of different contamination were treated separately using antimicrobial LAB strains (L. casei, L. plantarum, L. paracasei, and L. uvarum) and the changes on the level of deoxynivalenol (DON) and its conjugates such as 3-acetyldeoxynivalenol (3-ADON), 15-acetyldeoxynivalenol (15-ADON), and DON-3-β-D-glucoside (D3G)) were evaluated using UHPLC-QqQ-MS/MS and UHPLC-Orbitrap-HRMS. Additionally, an acoustic device was used to analyse DON in the wheat raw samples (without treatment). High linear correlations were obtained between HPLC results and the penetrated acoustic signal amplitude (Ap) for DON and D3G (R2 = 0.85 and R2 = 0.82, respectively). The results of fermentation demonstrated that bio-treatment of contaminated wheat was very effective for DON and masked toxin reduction in the media. Contaminated wheat-based products fermentation using L. uvarum allowed to reduce DON and D3G content in the media up to 75.0% and 84.1%, respectively, while the values of DON conjugates (3-ADON, 15-ADON) were reduced below LOD/LOQ. Fusarium spp. contaminated wheat grains demonstrated different enzymatic profiles (amylolytic, xylanolytic, and proteolytic) which could be related with biological degradation of mycotoxins during fermentation. The amylolytic and xylanolytic activities of fungi correlated well with DON content (R2 = 0.8235, R2 = 0.8694, respectively) as well as with D3G (R2 = 0.9314, R2 = 0.9937, respectively). The findings of this study indicate that bio-treatment of contaminated wheat could efficiently reduce Fusarium mycotoxin levels below the LOD/LOQ in wheat-based products and improve the sustainability of grain production. However, before mycotoxin analysis LAB cells were not removed from the substrate and the results are focused on possible contaminants biodegradation. The acoustic technique could identify DON as well as D3G contamination in raw wheat grains and is a promising tool in the wheat grain processing chain.

Cereal by-products represent abundant and low-cost resources of nutrients. The study is dedicated to the development of a rapid method for the treatment of corn grits to obtain value added ingredients for breadmaking. The infrared irradiation (IR) at 76 °C and 90 °C and vacuum microwave (VM) heating at 60 °C have been applied for stabilization of corn grits. The corn grit particles were fractionated by size and it was found that the particle size fraction significantly (p

This work aims to evaluate the fermentability of brown rice polish for the growth of eleven Lactobacillus spp. and Pediococcus spp. strains in a single step process at a solid-state fermentation (SSF) conditions. In addition, technological and functional properties of the tested lactic acid bacteria (LAB) were assessed. The brown rice polish was a suitable substrate for the cultivation of newly isolated LAB without supplements. The acidification rate, lactic acid (LA) production ability, endo-xylanase and protease activities significantly (p

The aim of the study was to investigate the usability of wheat straw in the production of L-lactic acid via fermentation applying by newly isolated lactic acid bacteria (LAB) strains belonging to the genus Lactobacillus and its combinations. Biotreatment of wheat straw was carried out through a three-step procedure consisting of: (i) physical pre-treatment, (ii) enzymatic hydrolysis and (iii) fermentation with LAB strains under laboratory conditions. Lactic acid production, residual sugar, cell biomass, pH medium and the influence of ions such as magnesium, calcium and sodium on efficiency of enzymatic hydrolysis of wheat straw were the main features examined. Moreover, optimal parameters for enzymatic hydrolysis were selected. Increased lactic acid production was observed, when mixed LAB cultures were used in comparison to individual ones. The results confirmed that tested wheat straw could be used for lactic acid and L-lactic acid production using selected enzymes and combined LAB strains.

A crispy crust is one of the most prominent characteristics used to evaluate the level of freshness and quality of ciabatta bread. In this study, the qualitative effects of different bread dough formulations (control, wheat malt, and protease) on ciabatta crust crispness and water adsorption under different storage conditions (45% RH and 75% RH) were studied. The acoustic emission measurements of dough rheology and crust crispness versus texture analysis were performed. Of the different formulations used, only particular doses of wheat malt increased the initial crispness of the crust and its crispness retention under both storage conditions. The positive effect of the wheat malt was due to a lower initial water content in the crusts of these breads compared to breads prepared from other formulations. The relationship between formulation and crispness was dominated by the dependence on storage conditions. The acoustic parameters relating to the dough and bread texture were correlated with instrumental texture evaluation. Fast and non-destructive acoustic techniques are promising tools for monitoring the texture properties of bakery products during processing.

This study mainly focuses on finding a strategy for reduction of Fusarium mycotoxin in malting wheat grains, predominantly used in the production of beverages and certain baked goods. The effect of treatment with lactic acid bacteria (LAB) on deoxynivalenol (DON), zearalenone (ZEN), T-2 and HT-2 toxins contained in malting wheat grains was studied. Additionally, the impact of bio-treatment with bio-products based on cheese whey permeate previously fermented with LAB on microbial contamination and germination capacity of grains was studied. Treatment with Lactobacillus sakei KTU05-6, Pediococcus acidilactici KTU05-7, and Pediococcus pentosaceus KTU05-8, KTU05-09, and KTU05-10 strains resulted in reduction of ZEN, DON, T-2 and HT-2 toxin concentrations in malting grains by 23, 34, 58 and 73% respectively. Moreover, the test of LAB strains revealed a broad spectrum of antimicrobial activity against fungi, especially Fusarium culmorum and Fusarium poae. Treatment of contaminated wheat grains with permeate previously fermented with P. acidilactici KTU05-7 and P. pentosaceus KTU05-10 strains resulted in increased germination of wheat grains by 9.5 and 7.9% respectively comparing with grains that were not pre-treated.