Knowledge of community pharmacists on infantile haemangioma: Gaps and lack confidence to deliver propranolol still need to be filled

AIM

To evaluate the knowledge, practices and self-confidence of community pharmacists, pharmacy technicians and pharmacy students about infantile haemangioma (IH) and propranolol treatment.

METHODS

A national survey was conducted in France from May 2022 to October 2022. A 42-item online questionnaire was used to assess pharmacists' knowledge of the epidemiology, clinical features and management of IH and propranolol treatment.

RESULTS

The survey included 255 participants. The mean age was 34.9 years (±9.0); 225 (88%) were women. In all, 193 (76%) practised in urban pharmacies. Altogether, 83 participants (33%) had delivered oral propranolol solution for IH in the last 6 months. Participants' median score for self-confidence regarding propranolol dispensing was five (interquartile range, 2.5-6) on a scale of 1 to 10. Overall, 96 (38%) had more than 50% correct answers on the questionnaire. Multinomial regression models showed high scores on the questionnaire associated with high self-confidence when delivering oral propranolol solution, low number of years since graduation and having already delivered propranolol treatment.

CONCLUSION

This study highlights a lack of knowledge of IH and modalities of propranolol treatment by community pharmacists and slight self-confidence when delivering propranolol. Greater cooperation between healthcare professionals could improve the proper use of medicine.

Evaluation of the efficacy, in terms of pain and disability, of a functional restoration programme in patients with chronic low back pain according to the presence of Modic 1 discopathy

OBJECTIVES

Modic type 1 disc disease (MD1) appears to be related to severe Chronic Low Back Pain (CLBP). Functional Restoration Programmes (FRP) recommended in CLBP may not be suitable for patients with MD1. The main objective was to evaluate the effectiveness of a FRP, on the perceived incapacity and the pain intensity, in patients with non-specific CLBP according to the presence of MD1.

METHODS

We performed a single-centre retrospective cohort study in which 271 patients were included. After one month in the FRP, this programme was considered "successful" if the pain visual analog scale had decreased by at least 20/100 millimetres and if the score of the French version of the Roland-Morris disability questionnaire had decreased by at least 4/24 points.

RESULTS

The 271 patients had an average age of 43.2 (8.0) years and 58.3% were women. Out of our entire population, 128 (47.2%) patients were considered successful, and 51 (18.8%) patients had MD1. In patients without MD1, there was 49.1% success while this rate was 39.2% in those with MD1, but this difference was not statistically significant.

CONCLUSIONS

We found no significant difference in the combination of pain and perceived disability after one month of a FRP in patients with CLBP without MD1 compared to those with CLBP with MD1. It therefore seems legitimate to offer FRP-type rehabilitation in patients with non-specific CLBP with MD1.

Impact of rewarming rate on interleukin-6 levels in patients with shockable cardiac arrest receiving targeted temperature management at 33 °C: the ISOCRATE pilot randomized controlled trial

Purpose

While targeted temperature management (TTM) has been recommended in patients with shockable cardiac arrest (CA) and suggested in patients with non-shockable rhythms, few data exist regarding the impact of the rewarming rate on systemic inflammation. We compared serum levels of the proinflammatory cytokine interleukin-6 (IL6) measured with two rewarming rates after TTM at 33 °C in patients with shockable out-of-hospital cardiac arrest (OHCA).

Methods

ISOCRATE was a single-center randomized controlled trial comparing rewarming at 0.50 °C/h versus 0.25 °C/h in patients coma after shockable OHCA in 2016–2020. The primary outcome was serum IL6 level 24–48 h after reaching 33 °C. Secondary outcomes included the day-90 Cerebral Performance Category (CPC) and the 48-h serum neurofilament light-chain (NF-L) level.

Results

We randomized 50 patients. The median IL6 area-under-the-curve was similar between the two groups (12,389 [7256–37,200] vs. 8859 [6825–18,088] pg/mL h; P = 0.55). No significant difference was noted in proportions of patients with favorable day-90 CPC scores (13/25 patients at 0.25 °C/h (52.0%; 95% CI 31.3–72.2%) and 13/25 patients at 0.50 °C/h (52.0%; 95% CI 31.3–72.2%; P = 0.99)). Median NF-L levels were not significantly different between the 0.25 °C/h and 0.50 °C/h groups (76.0 pg mL, [25.5–3074.0] vs. 192 pg mL, [33.6–4199.0]; P = 0.43; respectively).

Conclusion

In our RCT, rewarming from 33 °C at 0.25 °C/h, compared to 0.50 °C/h, did not decrease the serum IL6 level after shockable CA. Further RCTs are needed to better define the optimal TTM strategy for patients with CA.

Trial registration ClinicalTrials.gov, NCT02555254. Registered September 14, 2015.

Take-Home Message: Rewarming at a rate of 0.25 °C/h, compared to 0.50 °C, did not result in lower serum IL6 levels after achievement of hypothermia at 33 °C in patients who remained comatose after shockable cardiac arrest. No associations were found between the slower rewarming rate and day-90 functional outcomes or mortality.

140-character Tweet: Rewarming at 0.25 °C versus 0.50 °C did not decrease serum IL6 levels after hypothermia at 33 °C in patients comatose after shockable cardiac arrest.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13054-021-03842-9.

Integrons, a predictive biomarker for antibiotic resistance in acute sepsis: the IRIS study

BACKGROUND

Considering the increase in MDR Gram-negative bacteria (GNB), the choice of empirical antibiotic therapy is challenging. In parallel, use of broad-spectrum antibiotics should be avoided to decrease antibiotic selection pressure. Accordingly, clinicians need rapid diagnostic tools to narrow antibiotic therapy. Class 1-3 integrons, identified by intI1-3 genes, are genetic elements that play a major role in antibiotic resistance in GNB.

OBJECTIVES

The objective of the IRIS study was to evaluate the negative and positive predictive values (NPVs and PPVs, respectively) of intI1-3 as markers of antibiotic resistance.

METHODS

The IRIS study was an observational cross-sectional multicentre study that enrolled adult subjects with suspected urinary tract or intra-abdominal infections. intI1-3 were detected directly from routinely collected biological samples (blood, urine or intra-abdominal fluid) using real-time PCR. A patient was considered 'MDR positive' if at least one GNB, expressing acquired resistance to at least two antibiotic families among β-lactams, aminoglycosides, fluoroquinolones and/or co-trimoxazole, was isolated from at least one biological sample.

RESULTS

Over a 2 year period, 513 subjects were enrolled and 409 had GNB documentation, mostly Enterobacterales. intI1 and/or intI2 were detected in 31.8% of patients and 24.4% of patients were considered 'MDR positive'. The NPV of intI1 and/or intI2 as a marker of acquired antibiotic resistances was estimated at 92.8% (89.1%-95.5%). The NPVs for first-line antibiotics were all above 92%, notably >96% for resistance to third-generation cephalosporins.

CONCLUSIONS

The IRIS study strongly suggests that the absence of intI1 and intI2 in biological samples from patients with GNB-related infections is predictive of the absence of acquired resistances.

ADHD Symptomatology and Perceived Stress Among French College Students

Objective: The objective of this study was to examine the independent association between inattention and hyperactivity/impulsivity symptoms and perceived stress among French college students. Method: Participants (N = 6,951) completed self-report surveys assessing ADHD symptoms, perceived stress, and sociodemographic characteristics. Multinomial logistic regression models were used to evaluate the association between ADHD symptoms and perceived stress. Results: Participants had a mean age of 20.8 years, and 75.6% were female. We found significant associations between increasing levels of inattention and hyperactivity/impulsivity symptoms and high level of perceived stress after adjustment for confounding variables. The association was stronger for inattention (odds ratio [OR] = 4.58, 95% confidence interval [CI] = [4.02, 5.22]) than for hyperactivity/impulsivity symptoms (OR = 1.21, 95% CI = [1.05 to 1.39]). Conclusion: Higher levels of inattention and hyperactivity/impulsivity were independently associated with perceived stress in French college students. This association was mainly driven by inattention. Screenings to better detect ADHD symptoms should be implemented in universities.

Self-perceived attention deficit and hyperactivity symptom levels and risk of non-migraine and migraine headaches among university students: A cross-sectional study

OBJECTIVES

The aim was to evaluate the association of self-perceived levels of attention deficit and hyperactivity symptoms with non-migraine and migraine headaches among university students. We also evaluated their association with migraine aura.

METHODS

Study subjects were all participants in the internet-based Students Health Research Enterprise. Scores were built to evaluate global attention and hyperactivity symptom levels, self-perceived attention deficit levels and self-perceived hyperactivity symptom levels based on the Adult Attention Deficit and Hyperactivity Disorder Self-Report Scale (ASRS v1.1.). We used standardised questions to classify headache and group participants into "no headache," "non-migraine headache," "migraine without aura" or "migraine with aura".

RESULTS

A total of 4816 students were included (mean age 20.3 ± 2.8 years; 75.5% women). Compared with participants without headache, we found significant associations between global ADHD scores and migraine. Students in the highest quintile of global ASRS scores had adjusted odds ratio (aOR) of 1.95 (95% CI 1.56-2.45) when compared to the lowest. This association was mainly driven by an association between self-perceived hyperactivity and migraine with aura. The aOR for migraine with aura was 2.83 (95% CI 2.23-3.61) for students in the highest quintile of hyperactivity. No significant association was found for any attention and hyperactivity symptom level measure and non-migraine headache and between self-perceived levels of attention deficit and migraine.

CONCLUSIONS

Among students in higher education in France, self-perceived levels of attention deficit and hyperactivity symptoms were selectively associated with migraine. The association was strongest for the hyperactivity domain and migraine with aura.

Stress, attention deficit hyperactivity disorder (ADHD) symptoms and tobacco smoking: The i-Share study

BACKGROUND

The contribution of mental health to the risk of smoking is increasingly acknowledged but still insufficiently studied during the key period of student life. In particular, the simultaneous action of stress and Attention Deficit Hyperactivity Disorder (ADHD) symptoms on the risk of smoking remains poorly understood.

AIMS

To assess the effects of stress and ADHD symptoms on tobacco smoking.

METHOD

Multivariate modeling was conducted on the French i-Share study (n=8110, median age 20.3 years, 74.8% females, 32.9% regular/occasional smokers) to evaluate the associations between stress, ADHD symptoms and tobacco smoking, adjusting for potential family/socio-demographic confounders.

RESULTS

Students with high levels of stress were more likely to smoke>10 cigarettes/day (adjusted odds ratio (aOR): 1.48, 95% CI: 1.12-1.96) than those with low levels of stress. Students with high levels of ADHD symptoms were more likely to smoke>10 cigarettes/day (aOR: 2.08, 95% CI: 1.58-2.75) than those with low levels of ADHD symptoms.

CONCLUSIONS

Stress and ADHD contribute independently to the risk of smoking. Interventions targeting each condition are likely to reduce the burden of tobacco use in students.

Model cheese aroma perception is explained not only by in vivo aroma release but also by salivary composition and oral processing parameters

The aim of the present paper was to determine, from four model cheeses differing in fat content and firmness, the respective impacts ofin vivoaroma release, bolus rheology, chewing activity, mouth coating and salivary composition on dynamic aroma perception.

Screen time exposure and reporting of headaches in young adults: A cross-sectional study

Objective The objective of this article is to investigate whether excessive screen time exposure is associated with non-migraine headache and migraine in young adults. Background Increased levels of television time have been associated with increased risk of headache. However, time spent using newer electronic devices with a screen (smartphone, tablet) has not been examined yet. Methods We conducted a cross-sectional study among 4927 participants of the French i-Share cohort. Demographic characteristics, screen time exposure (computers, tablets, smartphones and television) as well as headache/migraine symptoms were recorded in a standardized questionnaire. Multinomial logistic regression models were used to evaluate the association between screen time exposure and headache status. Results Participants had a mean age of 20.8 years and 75.5% were female. The multivariable model showed that students in the highest screen time exposure quintile had an increased risk for migraine. The odds ratio (OR) (95% confidence interval (CI)) was 1.37 (1.14 to 1.66) for migraine when compared with students without headache and with low screen time exposure. This association was somewhat stronger for migraine without aura (OR = 1.50, 95% CI 1.19 to 1.89). We found no significant association between screen time exposure and non-migraine headache. Conclusion High levels of screen time exposure are associated with migraine in young adults. No significant association was found with non-migraine headache.

Association of screen time with self-perceived attention problems and hyperactivity levels in French students: a cross-sectional study

OBJECTIVE

To investigate whether high levels of screen time exposure are associated with self-perceived levels of attention problems and hyperactivity in higher education students.

DESIGN

Cross-sectional study among participants of the i-Share cohort.

SETTING

French-speaking students of universities and higher education institutions.

PARTICIPANTS

4816 graduate students who were at least 18 years old.

EXPOSURE

Screen time was assessed by self-report of the average time spent on five different screen activities on smartphone, television, computer and tablet and categorised into quartiles.

MAIN OUTCOME MEASURE

We used the Attention Deficit Hyperactivity Disorder Self-Report Scale (ASRS-v1.1) concerning students' behaviour over the past 6 months to measure self-perceived levels of attention problems and hyperactivity. Responses were summarised into a global score as well as scores for attention problems and hyperactivity.

RESULTS

The 4816 participants of this study had a mean age of 20.8 years and 75.5% were female. Multivariable ordinary regression models showed significant associations of screen time exposure with quintiles of the total score of self-perceived attention problems and hyperactivity levels as well as the individual domains. Compared to the lowest screen time exposure category, the ORs (95% CI) were 1.58 (1.37 to 1.82) for each increasing level of quintiles of the global score, 1.57 (1.36 to 1.81) for increasing quintiles of attention levels and 1.25 (1.09 to 1.44) for increasing quartiles of hyperactivity.

CONCLUSIONS

Results of this large cross-sectional study among French university and higher education students show dose-dependent associations between screen time and self-perceived levels of attention problems and hyperactivity. Further studies are warranted to evaluate whether interventions could positively influence these associations.

Salivary composition in obese vs normal-weight subjects: towards a role in postprandial lipid metabolism?

In the pathophysiological context of obesity, oral exposure to dietary fat can modulate lipid digestion and absorption, but underlying in-mouth mechanisms have not been clearly identified. Therefore, we tested the hypothesis that salivary components related to dietary fat sensitivity would differ according to body mass index (BMI) and postprandial lipid metabolism in young men. Saliva was collected from nine normal-weight (BMI=22.3±0.5 kg m(-2)) and nine non-morbid obese (BMI=31.7±0.3 kg m(-2)) men before an 8-h postprandial metabolic exploration test involving the consumption of a 40-g fat meal, in which obese subjects revealed a delayed postprandial lipid metabolism. Nine salivary characteristics (flow, protein content, lipolysis, amylase, proteolysis, total antioxidant status, lysozyme, lipocalin 1 and carbonic anhydrase-VI) were investigated. We show that, under fasting conditions, salivary lipolysis was lower in obese vs normal-weight subjects, whereas proteolysis and carbonic anhydrase VI were higher. We reveal through multivariate and Mann-Whitney analysis that differences in fasting salivary lipolysis and proteolysis between both groups are related to differences in postprandial lipid metabolism including exogenous fatty-acid absorption and β-oxidation. These results suggest a potential role of salivary composition on postprandial lipid metabolism and bring novel causal hypotheses on the links between salivary composition, sensitivity to dietary fat oral income and postprandial lipid metabolism according to BMI.

Effect of oxidoreduction potential on aroma biosynthesis by lactic acid bacteria in nonfat yogurt

The aim of this study was to investigate the effect of oxidoreduction potential (Eh) on the biosynthesis of aroma compounds by lactic acid bacteria in non-fat yogurt. The study was done with yogurts fermented by Lactobacillus bulgaricus and Streptococcus thermophilus. The Eh was modified by the application of different gaseous conditions (air, nitrogen, and nitrogen/hydrogen). Acetaldehyde, dimethyl sulfide, diacetyl, and pentane-2,3-dione, as the major endogenous odorant compounds of yogurt, were chosen as tracers for the biosynthesis of aroma compounds by lactic acid bacteria. Oxidative conditions favored the production of acetaldehyde, dimethyl sulfide, and diketones (diacetyl and pentane-2,3-dione). The Eh of the medium influences aroma production in yogurt by modifying the metabolic pathways of Lb. bulgaricus and Strep. thermophilus. The use of Eh as a control parameter during yogurt production could permit the control of aroma formation.

Sorption of aroma compounds in PET and PVC during the storage of a strawberry syrup

The sorption of 14 aroma compounds into PET and PVC was monitored during storage of a strawberry syrup for 1 year. Concentrations in the syrup and in the polymer were determined during storage and compared with previously published results obtained with glass bottles. Apparent partition coefficients between the polymer and the syrup (noted K app) were estimated from experimental kinetics without reaching equilibrium K app values and optimally identified from the kinetic data obtained between 30 and 90 days. They exhibited a similar behaviour for both polymers with values were between 2 x 10(-5) and 2 x 10(-3), 4 x 10(-5) and 3 x 10(-2), respectively, for PET and PVC. The variation of K app values in PET was mainly correlated to the polarity of tested compounds as assessed by their log P values. By contrast, the variations in K app values for PVC were mainly related to their chain lengths. Due to slightly higher partition coefficients and diffusion coefficients in PVC compared with PET, the amount of absorbed aroma was four times higher in PVC than in PET; however, the amount of absorbed aroma compounds was less than 0.1% of the initial amount present into the syrup, except for octyl butanoate. The variation in concentration in the syrup was interpreted as a combination of a degradation process and a transport process into the packaging material. Both effects were particularly noticeable for both PET and unstable aroma compounds.

Comparison of different methods: static and dynamic headspace and solid-phase microextraction for the measurement of interactions between milk proteins and flavor compounds with an application to emulsions

Interactions between 10 aroma compounds from different chemical classes and 5 mixtures of milk proteins have been studied using static or dynamic headspace gas chromatography and solid-phase microextraction (SPME). Static headspace analysis allows the quantification of the release of only the most abundant compounds. Dynamic headspace analysis does not allow the discrimination of flavor release from the different protein mixtures, probably due to a displacement of headspace equilibrium. By SPME analysis and quantification by GC-MS (SIM mode) all of the volatiles were quantified. This method was optimized to better discriminate aroma release from the different milk protein mixtures and then from oil/water emulsions made with these proteins. The highest difference between the release in different proteins was observed for ethyl hexanoate, which has a great affinity for beta-lactoglobulin. Ethyl hexanoate is thus less released from models and emulsions containing this protein.

Competitive binding of aroma compounds by beta-cyclodextrin

Retention of six aroma compounds has been studied after dehydration of ternary mixtures of aroma water and beta-cyclodextrin. A maximal retention of a mole of aroma per mole of beta-cyclodextrin has been observed for five of the aroma compounds, whereas retention of benzyl alcohol can be twice as high. Retention of a mixture of aroma compounds has also been studied. It has been noted that when volatile compounds compete for the same binding sites on beta-cyclodextrin, ethyl hexanoate, 2-methylbutyric acid, and benzyl alcohol are, respectively, better retained than ethyl propionate, hexanoic acid, and hexanol. Preferential retention observed with esters can be simply explained by their difference of physicochemical properties, but for the acids and alcohols a study at the molecular scale has been necessary. The better retention of 2-methylbutyric acid can be explained by differences in the nature of interaction between the acids and their carrier. At least selectivity of retention noted for the alcohol could be due to a difference in the location of the guest and also a difference in the number of aroma molecules that can be bound per polysaccharide molecule.

Influence of packaging on the aroma stability of strawberry syrup during shelf life

Different types of packaging (glass bottle, PVC, and PET) were compared for the preservation of aroma quality of a strawberry syrup during shelf life. Esters, alcohols, and aldehydes were analyzed by solid-phase micro-extraction (SPME) and solvent extraction. During storage, hydrolysis of esters in acids and alcohols led to a modification of the aroma profile which can be explained by the replacement of "fruity" and "fresh" notes by "dairy note" in the syrup. Aroma compounds that are responsible for fruity notes, such as methyl cinnamate, methyl anthranilate, and methyl dihydrojasmonate, were strongly reduced after 90 days. This could be explained by a selective interaction of these compounds with the polymer matrix (PET or PVC). After 330 days, a later and important decrease of the "fruity notes" occurred in both PETs; so PVC2 and the glass bottle were found to be able to maintain a balanced aroma for long-term storage.

Interactions between methyl ketones and beta-lactoglobulin: sensory analysis, headspace analysis, and mathematical modeling

Interaction of flavor compounds with proteins is known to have an influence on the release of flavor from food. Hydrophobic interactions were found between beta-lactoglobulin and methyl ketones; the affinity constant increases by increasing the hydrophobic chain. Addition of beta-lactoglobulin (0.5 and 1%) to aroma solutions (12.5, 50, and 100 microL L(-)(1)) of three methyl ketones induces a significant decrease in odor intensity. The chosen methyl ketones were 2-heptanone (K(b) = 330), 2-octanone (K(b) = 950), and 2-nonanone (K(b) = 2440). The release of these flavor compounds (50 microL L(-)(1)) was studied by static headspace in water solution (50 mM NaCl, pH 3) with different concentrations of beta-lactoglobulin (0, 0.5, 1, 2, 3, and 4%). Increasing the concentration of protein increases the retention of volatiles, and this effect is greatest for 2-nonanone, the compound with the highest affinity constant, and lowest for 2-heptanone. A mathematical model previously developed to describe flavor release from aqueous solutions containing flavor-binding polymers (Harrison, M.; Hills, B. P. J. Agric. Food Chem. 1997, 45, 1883-1890) was used to interpret the data. The model assumes that the polymer-flavor interaction is reversible and the rate-limiting step for release is the transfer of volatiles across the macroscopic gas-liquid interface. This model was used to predict the equilibrium partitioning properties and the rate of release of the three methyl ketones. Increasing the affinity constant leads to decreased release rates and a lower final headspace aroma concentration.

Flavor release from salad dressings: sensory and physicochemical approaches in relation with the structure

The effect of process and formulation on sensory perception and flavor release was investigated on salad dressing models. Oil/vinegar emulsions (phi = 0.5, droplet size > 10 microm) with thickeners and a whey protein concentrate were prepared with different fat droplet sizes and different distributions of fat droplet size. The effect of the amount of emulsifier was also tested. Sensory profile analysis was performed by a trained panel and flavor release quantified by dynamic headspace analysis. When the droplet size is increased, the lemon smell and citrus aroma significantly increase, whereas the egg note, mustard, and butter aroma significantly decrease. The concentrations of alcohols and acids significantly increase when droplet size increases, whereas those of other compounds such as limonene or benzaldehyde significantly decrease. The dispersion of the droplet size has a small effect on flavor perception, and the effect of the increase of the amount of emulsifier is noticed only by instrumental analysis.

Potent aroma compounds of two red wine vinegars

Gas chromatography olfactometry (GCO) was used to determine key aroma compounds of two red wine vinegars. Sensory analysis was performed to choose the best neutralization agent of acetic acid (NaOH or MgO) and to test representativeness of four extracts obtained by different methods (dichloromethane extraction, XAD-2, mixture of XAD-2 and XAD-7, and Extrelut resins extraction). Neutralization with NaOH followed by dichloromethane extraction was selected to extract volatile compounds of vinegars. Key odorant compounds were determined by GCO based on detection frequency with 13 people. In the two red wine vinegars, 13 odors were perceived by at least 70% of the panelists, and 8 compounds among the 13 were identified: acetic acid, 3-methylbutyric acid, 2-phenyl-1-ethanol, 2, 3-butanedione, butyric acid, 2-methylbutyric acid, mixture of 2- and 3-methyl-1-butanol, and two newly identified compounds in vinegar, 3-hydroxy-2-pentanone and 3-(methylthio)-1-propanal. Quantification of all the volatile compounds was performed by GC-FID, and 10 other compounds were identified for the first time in wine vinegar.

Measurement of interactions between polysaccharides and flavour compounds by exclusion size chromatography: advantages and limits

Interactions between flavour compounds and polysaccharides have been studied by exclusion size chromatography, the Hummel and Dreyer method. Hydrogen bonding was found between 2-acetyl thiazole and dextrines of different degrees of polymerisation. The number of binding sites and the affinity constant increase by increasing the degree of polymerisation. Hydrogen bonding was also responsible for the interactions between xanthane and 1-octen-3-ol or 2-acetyl pyrazine, with 1 mole of 1-octen-3-ol bound per pentasaccharide repeating unit. Unfortunately, the number of flavour compounds, which can be studied with this method, is limited due to their low water solubility and their low UV absorption.

Chirality of the gamma-lactones produced by Sporidiobolus salmonicolor grown in two different media

Sporidiobolus salmonicolor is an aroma-producing yeast which gives a peach-like smell to the culture media. The enantiomeric ratios of the five gamma-lactones produced by this yeast cultivated in two different media were determined by multidimensional gas chromatography (MDGC) on a fused silica capillary column coupled to a modified beta-cyclodextrin column. These ratios remain constant during growth and are not affected by the composition of the medium. The (R)-enantiomer is highly predominant (99%) for gamma-decalactone and predominant (68-88%) for gamma-octalactone, gamma-nonalactone, and (Z6)-gamma-dodecenolactone. A ratio close to racemic was found for gamma-dodecalactone. A discussion on the metabolic origin of these lactones is based on the analysis of the enantiomeric ratios obtained. With respect to consumers' preference for products considered as "natural," microbial lactone production may represent a valuable alternative to fruit flavors. The enantiomeric lactone ratios produced by Sporidiobolus salmonicolor are compared with those reported from some fruits.

[HBV-DNA assay by hybridization in solution. Value of low levels measured with the Abbott-Genostics device]

Quantitation of HBV-DNA is the most precise test for measuring viral replication. A commercial liquid phase hybridation test (Abbott) is now commonly used for diagnosis and monitoring of chronic hepatitis B. Interpretation of weak positive results obtained with this test are often difficult. Fifty-four sera with a concentration lower than 12 pg/ml with the Abbott HBV-DNA assay were tested with another commercial hybridation assay (Digene-Murex) and with an in-house PCR test. PCR is positive in 24 sera among the 35 HBs antigen positive sera, but is always negative in HBs Antigene negative sera. All the HBe Antigen positive sera were positive with the PCR test. A positive result was obtained with the Digene test in only 14 sera, 13 of them were confirmed by PCR. Ten sera among the remaining 11 PCR positive sera had a low HBV-DNA concentration but under the Digene cut-off level (10 pg/ml). The sensitivity could be greatly enforced with a lower cut-off level without any lack of specificity. The PCR test remains very helpful for sera with low concentration of HBV-DNA.

Hepatitis C: description of a highly sensitive method for clinical detection of viral RNA

To improve the sensitivity of hepatitis C virus RNA (HCV RNA) detection in serum by 'nested' polymerase chain reaction (PCR), primers belonging to 5' non-coding (5'NC) regions were used to compare the classical phenol/chloroform technique by using the proteinase K and silica gel technique with guanidinium thiocyanate. The silica gel techniques was found to be more efficient and sensitive for the extraction and purification of viral RNA from serum samples. The silica gel technique also avoids contact with hazardous volatile chemicals like phenol and chloroform and provides a better protection for viral RNA. Furthermore, the RNA detection sensitivity was greatly improved by modifying the buffer for reverse transcription and PCR. Using silica gel extraction, and the modified buffer, viral RNA was detected in 699 sera from anti-HCV second generation ELISA positive patients. These sera were distributed in second generation RIBA confirmed, indeterminate and non confirmed groups with PCR positive rates of 71.4%, 45.7% and 15.8%, respectively. Two out of 227 ELISA negative patients showed the presence of HCV RNA in serum. An association between the presence of antibodies against a determined viral peptide and viremia was not detected.

Chirality of the gamma-lactones formed by Fusarium poae INRA 45

A filamentous fungus, Fusarium poae INRA 45, was grown in two liquid Czapek-type media (a Czapek medium, and a yeast extract plus casaminoacids-enriched Czapek medium). Eight gamma-lactones, i.e., gamma-penta-, gamma-octa-, gamma-nona-, gamma-deca-, and gamma-dodecalactone, (6Z)-gamma- and (6E)-gamma-dodecenolactones, and a di-unsaturated gamma-dodecalactone, were tentatively, or conclusively, identified by capillary gas chromatography (GC) and coupled GC-MS, in the volatile fractions of the cultures. Kinetics of the formation of gamma-dodecalactone, (6Z)-gamma- and (6E)-gamma-dodecenolactones, (three major lactones), and gamma-dodecalactone (a minor lactone) were quantitatively studied by computerized GC integration. Variations of the (R/S) ratios of the lactone enantiomers were quantitatively studied by computerized multidimensional gas chromatography (MDGC) integration. The levels of the lactones were superior in the enriched Czapek-type medium to those of the Czapek medium, but the compositions of these media did not influence significantly the (R/S) ratios of these lactones. Formation of the enantiomers is discussed in terms of metabolism of potential precursors.