Co-Occurrence of Aflatoxin B1, Zearalenone and Ochratoxin A in Feed and Feed Materials in Central Italy from 2018 to 2022

Mycotoxin contamination of feed and feed materials represent a serious health hazard. This study details the occurrence of aflatoxin B1 (AFB1), zearalenone (ZEN) and ochratoxin A (OTA) in 826 feed and 617 feed material samples, collected in two Italian Regions (Umbria and Marche) from 2018 to 2022 analyzed using a UPLC-FLD platform. The developed method was validated and accredited (ISO/IEC 17025) with satisfactory accuracy and precision data obtained in repeatability and intralaboratory reproducibility conditions. Feed had a higher incidence of contaminated samples (26%) with respect to feed materials (6%). AFB1 was found up to 0.1045 mg/kg in cattle feeds and 0.1234 mg/kg in maize; ZEN was detected up to 6.420 mg/kg in sheep feed while OTA was rarely reported and in lower concentrations (up to 0.085 mg/kg). Co-contamination of at least two mycotoxins was reported in 0.8% of the analyzed samples. The incidence of above maximum content/guidance level samples was 2% for feed and feed materials while almost 3-fold-higher for maize (5.8%) suggesting how mycotoxin contamination can affect some matrices more than others. Obtained data can be useful to improve official monitoring plans and therefore further raise awareness of this issue between agriculture stakeholders, healthcare entities and non-professionals.

Isolation and Characterisation of Human-Derived blaKPC-3-Producing Salmonella enterica Serovar Rissen in 2018

In this study, we describe a Salmonella enterica serovar (S.) Rissen strain with a reduced susceptibility to meropenem, isolated from a urinary infection in an 89-year-old woman in 2018 during activity surveillance in Italy (Enter-Net Italia). The genomic characteristics, pathogenicity, and antimicrobial resistance mechanisms were investigated via a genomic approach. Antimicrobial susceptibility testing revealed a "susceptible, increased exposure" phenotype to meropenem in the S. Rissen strain (4_29_19). Whole-genome sequencing (WGS) was performed using both the NovaSeq 6000 S4 PE150 XP platform (Illumina, San Diego, CA, USA) and MinION (Oxford Nanopore). The S. Rissen 4_29_19 strain harboured two plasmids: a pKpQIL-like plasmid carrying the blaKPC-3 resistance gene in a Tn4401a transposon (pKPC_4_29_19), and a ColE-like plasmid (p4_4_29_19) without resistance genes, highly prevalent among Enterobacterales. Comparative analysis revealed that the pKPC_4_29_19 plasmid was highly related to the pKpQIL reference plasmid (GU595196), with 57% coverage and 99.96% identity, but lacking a region of about 30 kb, involving the FIIK2 replicon region and the entire transfer locus, causing the loss of its ability to conjugate. To our knowledge, this is the first time that a pKpQIL-like plasmid, carrying blaKPC-3, highly diffused in Klebsiella pneumoniae strains, has been identified in a Salmonella strain in our country. The acquisition of blaKPC genes by Salmonella spp. is extremely rare, and is reported only sporadically. In zoonotic bacteria isolated from humans, the presence of a carbapenem resistance gene carried by mobile genetic elements, usually described in healthcare-associated infection bacteria, represents an important concern for public health.

[Covid-19 emergency and telemedicine: multifamily psychoeducational intervention in a forensic setting.]

AIM

The aim is to describe remote multifamily psychoeducational intervention led by REMS "Castore" team (an Italian health care facility for offenders who suffer from mental disorders and socially dangerous) in ASL Roma 5, a local health authority, during covid-19 emergency.

METHODS

The applied theoretical models have been the integrated psychoeducational intervention by I. Falloon and the multifamily psychoeducational intervention based on problem solving by F. Veltro. The multifamily psychoeducational intervention was attempted by inpatients' relatives from June to August 2020 with 8 weekly meetings of 90' each led by two psychiatric rehabilitation therapists and healthcare experts. Six families were involved in the study and its members were assessed by questionnaire on family problems, Brief-COPE and general health questionnaire tests. Users were assessed by Level of Expressed Emotion Scale test for their expressed emotion.

RESULTS

Data analysis highlighted the general low level of subjective and objective burden for family members in association with a high perception of that support provided by REMS. Furthermore, the study has shown those coping approaches oriented to the research of practical solutions, acceptance of events and assertive communication.

DISCUSSION

The low subjective and objective burden may be attributed to implicit security conditions in REMS and the absence of tasks mainly carried out by experts. Those coping styles oriented to more practical than emotional approaches suggest an emotional hyper control or stigma perception leading to isolation and loneliness.

CONCLUSIONS

The multifamily psychoeducational intervention has allowed a trustworthy relationship with REMS. Considering that the families involved in the study have never benefited by other psychoeducational interventions before, their early involvement appears to be a potential tool for preventing and managing crisis as well as minimizing recidivism.

The Prevalence of PTSD in a Forensic Psychiatric Setting: The Impact of Traumatic Lifetime Experiences

Background

Several studies have identified traumatic history among forensic patients and its association with criminal behaviors and psychiatric diagnoses. Post-traumatic stress disorder (PTSD) is highly prevalent in forensic settings causing a serious deterioration of the primary psychiatric disorder.

Aims

Our study aims to evaluate the prevalence of PTSD and the role of traumatic experiences and abuse in the development of severe psychiatric disorders in a sample of psychiatric offenders.

Methods

Fifty-three patients admitted in Italian high intensity therapeutic facilities-the Residenze per l'Esecuzione delle Misure di Sicurezza (REMS)-were evaluated with the Trauma Experience Checklist (TEC) and the Millon Clinical Multiaxal Inventory (MCMI-III) to study lifetime traumatic memories and general psychopathology, respectively.

Results

Preliminary findings show that about 41% (N = 22) of psychiatric offenders were affected by PTSD, often not due to a single episode but to multiple lifetime traumas. Therefore, lifetime traumatic experiences and specifically sexual abuse are significant risk factors for the development of a personality disorder, which is present in the 38% (N = 20) of the sample.

Conclusions

The high PTSD prevalence and the strong association found between trauma and abuse with the development of a personality disorder emphasizes the importance of an early evaluation and intervention on traumatic experiences in this difficult population of psychiatric patients; in fact, the treatment of psychiatric offenders is actually vague and devoid of scientific evidence. Our results open up the perspective on the use of known and specific interventions for trauma, such as EMDR and Mindfulness.

Genetic Profiles and Antimicrobial Resistance Patterns of Salmonella Infantis Strains Isolated in Italy in the Food Chain of Broiler Meat Production

This work aimed to evaluate the antimicrobial susceptibility of 87 Salmonella Infantis strains isolated in Italy from 2016 to 2019 along the food chain of broiler meat production and in humans and to determine the genetic profiles of the strains in order to establish a possible correlation with the antimicrobial pattern. All isolates were tested by the disk diffusion method to evaluate antimicrobial susceptibility toward sixteen antimicrobials, and the broth microdilution method was used to confirm extended spectrum β-lactamase (ESBL) production. PCR and pulsed field gel electrophoresis (PFGE) were applied to characterize ESBL-encoding and AmpC β-lactamase genes and to analyze the S. Infantis strains genetic profiles respectively. S. Infantis isolates showed high prevalence of resistance, in particular toward nalidixic acid (97.7%), tetracycline (96.5%), sulphamethoxazole/trimethoprim (91%) and cefepime (72.4%). The 80.5% of isolates were ESBL, cefotaxime-resistant, carrying the bla_CTX-M1 gene. The most prevalent PFGE profile was XbaI.0126 (35.6%). The remaining strains had a genetic homology from 81% to 97% with the XbaI.0126 profile. The strains belonging to these profiles were isolated from different matrices collected along the broiler food chain independently on the year and from the region and there was no correlation between the PFGE profiles and resistance patterns. We found two ESBL-producing S. Infantis strains with the same XbaI.2621 profile isolated from humans and from poultry feces, not yet reported in Italy. Our findings confirmed the diffusion of ESBL-multi drug resistant (MDR) S. Infantis along the broiler food chain and in humans and underlined the importance of continuous monitoring to control and to reduce the prevalence of this bacterium, applying a global One Health approach.

Transport to the Slaughterhouse Affects the Salmonella Shedding and Modifies the Fecal Microbiota of Finishing Pigs

Contaminated pork is a significant source of foodborne Salmonellosis. Pork is contaminated at the slaughterhouse and the intestinal content is the predominant source of Salmonella for carcass contamination. The prevalence of Salmonella-positive pigs increases significantly when the time of transport to the slaughterhouse is longer than two hours. The hypothesis behind this study is that transport to the slaughterhouse increases the load of Salmonella in feces and determines a shift of the fecal microbiota in finishing pigs. Fecal samples were collected in a pig herd positive for Salmonella spp., the day before the transport and at the slaughterhouse. Salmonella loads were estimated by the most probable number (MPN) technique, according to the ISO/TS 6579-2:2012/A1. Moreover, the fecal bacteria composition was assessed by sequencing the V3-V4 hypervariable regions of the 16S rRNA gene. Our study showed that the load of Salmonella increases after transport, confirming that this phase of the production chain is a critical point for the control of Salmonella contamination. A lower richness and an increased beta-diversity characterized the fecal microbiota composition of Salmonella-positive animals after transport. In this stage, a natural Salmonella infection causes a disruption of the fecal microbiota as observed in challenge studies.

Bioadhesive Polymeric Films Based on Red Onion Skins Extract for Wound Treatment: An Innovative and Eco-Friendly Formulation

The onion non-edible outside layers represent a widely available waste material deriving from its processing and consumption. As onion is a vegetable showing many beneficial properties for human health, a study aiming to evaluate the use of extract deriving from the non-edible outside layers was planned. An eco-friendly extraction method was optimized using a hydroalcoholic solution as solvent. The obtained extract was deeply characterized by in vitro methods and then formulated in autoadhesive, biocompatible and pain-free hydrogel polymeric films. The extract, very soluble in water, showed antioxidant, radical scavenging, antibacterial and anti-inflammatory activities, suggesting a potential dermal application for wounds treatment. In vitro studies showed a sustained release of the extract from the hydrogel polymeric film suitable to reach concentrations necessary for both antibacterial and anti-inflammatory activities. Test performed on human keratinocytes showed that the formulation is safe suggesting that the projected formulation could be a valuable tool for wound treatment.

Nutritional quality, safety and sensory properties of smoked tench (Tinca tinca) pâté from Trasimeno Lake, Italy

The present study evaluated the safety, nutritional and sensory properties of fish pâtés made from smoked tench (Tinca tinca) pulp. Two formulations of tench pâté were produced, one of which included olive oil and the other contained mascarpone cheese. The prepared pâté jars were thermally treated according to the method applied in the canning industry. The inactivation of Clostridium botulinum during thermal treatment was determined through a challenge test study, demonstrating the complete depletion of targeted bacteria. Tench pâtés showed high nutritional properties, especially the formulation with olive oil, which was characterised by lower contents of cholesterol and saturated fatty acids and a high level of monounsaturated fatty acids. The two experimental formulations possessed a specific sensory profile, due to the ingredients incorporated into the products. Consumers’ evaluation established differences in the acceptance of the two products: the formulation with added olive oil was more appreciated by consumers, who displayed a higher purchase intent for this product. The study suggests that minced smoked tench is not only a promising ingredient for pâté production but that it also represents a value-added product able to contribute to freshwater food consumption.

Dialectical behaviour therapy (DBT) for forensic psychiatric patients: An Italian pilot study

BACKGROUND

Several previous randomised controlled trials of dialectical behaviour therapy (DBT) since Linehan's original have shown that it has an advantage over standard care or other psychological treatments, but focus is usually on suicide-related behaviours, and little is known about its effect with offender-patients.

AIMS

To evaluate DBT with a group of offender-patients in the Italian high intensity therapeutic facilities-the Residenze per l'Esecuzione delle Misure di Sicurezza (REMS), established under the Italian Law 81/2014.

METHODS

Twenty-one male forensic psychiatric in-patients with borderline personality disorder were enrolled and randomly assigned to 12 months of standard DBT together with all the usual REMS treatments (n = 10) or usual REMS treatments alone (n = 11). All participants completed the same pretreatment and posttreatment assessments, including the Barratt Impulsiveness Scale (BIS-11), Difficulties in Emotion Regulation Scale (DERS), and Toronto Alexithymia Scale 20 (TAS-20).

RESULTS

Men receiving DBT showed a significantly greater reduction in motor impulsiveness, as measured by the BIS-11, and emotional regulation, as reflected by the DERS total score, than the controls. There were no significant differences between groups in alexithymia scores.

CONCLUSIONS

Italy has innovative forensic psychiatric facilities with a new recovery-rehabilitation approach, but the ambitious goals behind these cannot be achieved by pharmacology alone. For the first time in clinical forensic settings in Italy, there has been limited access to DBT. This small pilot study suggests this is likely to help ameliorate traits associated with violent and antisocial behaviours, so a full-scale randomised controlled trial should follow.

Antimicrobial efficacy of a polyphenolic extract from olive oil by-product against "Fior di latte" cheese spoilage bacteria

This study aimed to evaluate a polyphenol extract from olive oil by-product, to improve the preservation of "Fior di latte" cheese during storage. Nine batches of "Fior di latte" cheese were manufactured in a local dairy production plant: three batches treated with 250 μg/mL of phenols from olive oil by-products in the governing liquid; three batches treated with 500 μg/mL of phenols in the governing liquid, and three untreated batches as the control group. The phenols effectively retarded the growth of Pseudomonas fluorescens and Enterobacteriaceae, acting mainly on the lag phase of the microorganisms, resulting in the prolongation of the time needed to reach the acceptable microbial limit. The delay in the growth of the spoilage bacteria was considered to indirectly influence the sensorial acceptability threshold, recorded through survival analysis. The combination of the two above-mentioned factors promotes the extension of "Fior di latte" cheese shelf life. by >2 and 4 days, for PA and PB respectively.

Molecular characterization and antimicrobial susceptibility of Pasteurella multocida strains isolated from hosts affected by various diseases in Italy

Pasteurella multocida is a widespread pathogen associated with major animal diseases of economic significance. Despite this, little is known about the capsular types, virulence gene pattern, and antimicrobial susceptibility of isolates from hosts affected by different diseases, and no data are available in Italy. One hundred eighty six isolates of P. multocida, were taken from different species in different states of health in several Italian regions, and were tested for genes encoding for capsular types (cap) and major virulence factors (tbpA, toxA, hgbB and pfhA). Antimicrobial susceptibility was investigated with the agar diffusion test. The majority of isolates was capA+. However, the distribution differed according to species and disease of origin, with a greater heterogeneity in isolates from rabbits; capE was never found, while capB was detected once. Only capA+ and capF+ strains tested positive for pfhA. Conversely, almost all capD+ isolates were hgbB+. In bovine respiratory disease, pfhA+/tbpA+/capA+ isolates predominated, while tbpA+/toxA+/capD+ isolates predominated in sheep. Overall, low levels of resistance were found, with full susceptibility to ceftiofur and florfenicol. Lower susceptibility to older antimicrobials was recorded, since only approximately 1/3 of the isolates showed susceptibility to tylosin and erythromycin, and resistance to tetracycline (7.5%), and trimethoprim - sulphametoxazole (4.8%) was also observed.

Thermal Inactivation and Growth Potential of Listeria Monocytogenes in Smoked Tench

An experimental study for the evaluation of Listeria monocytogenes inactivation during a hot smoking process in tench was performed using Listeria innocua strains. Furthermore, the survival of L. monocytogenes in smoked tench was determined after post-processing in contaminated samples, evaluating the growth potential during storage. L innocua was not detected after the smoking process. In the challenge test, the growth potential of L. monocytogenes was 5.68 log colony forming unit g-1. The results showed that hot smoking at an inner temperature around 72°C is able to eliminate the microorganism. Nevertheless, the product is able to support the growth of the pathogen if post-process contamination occurs, as the food is suitable for Listeria multiplication. Product recontamination should be prevented by means of appropriate application of hygiene measures.

Antimicrobial Activity of Olive Mill Wastewater Extract Against Pseudomonas Fluorescens Isolated from Mozzarella Cheese

Olive mill wastewater polyphenol extract was tested for antimicrobial activity against 64 strains of Pseudomonas fluorescens responsible for mozzarella discolouration. The extract showed a minimum inhibitory concentration (MIC)₅₀ value of 5 mg/mL and a MIC₉₀ value of 7 mg/mL. The MBC₅₀ and MBC₉₀ values corresponded to 6 and 8 mg/mL, respectively. The MIC concentration (7 mg/mL) was demonstrated to have a bacteriostatic effect while maintaining the bacterial concentration on the levels of the inoculum for 48 hours. The 3/2 MIC concentration was responsible for four logs CFU/mL depletion in colony count after 24 h. As the extract concentration decreased from MIC value, no inhibitory effects were recorded.

Behaviour of Listeria Monocytogenes in Artisanal Raw Milk Pecorino Umbro Cheese: A Microbiological Challenge Test

In the present study, a microbiological challenge test in artificially contaminated raw milk Pecorino Umbro cheese during cheese-making was carried out. Raw ewe milk was contaminated by a suspension of particular Listeria monocytogenes strains. The number of L. monocytogenes and L. monocytogenes dynamic growth were evaluated during cheese-making and storage. A significant decrease of the viable count of L. monocytogenes was observed during ripening and L. monocytogenes viable count was below the limit of quantification during storage. The results show that the product is unable to support the growth of the pathogen.

[Psychotropic-associated sexual dysfunctions: a survey of clinical pharmacology and medication-associated practice]

Epidemiological and clinical studies show that often persons affected by depression and schizophrenia can suffer of impairment of the sexual function. Most antidepressant and antipsychotic drugs have adverse sexual effects but it is difficult to identify if the impairment of the sexual function can be attributed to clinical picture or to the psychopharmacological treatments. Both antidepressants and novel and conventional antipsychotics are associated with significant sexual side effects and the presence of sexual side effects may affect compliance and adherence to treatment. In some specific clinical populations (e.g. youths), these specific side-effects turn out to be one of the most annoying and promote increased drop-out rates and poor adherence to treatment. Nevertheless, these clinical variables are often underestimated or not investigated in the course of follow-up of persons suffering from psychiatric disorders in treatment with psychotropic medications. Growing awareness of the adverse effects of psychotropic drugs has led to attempts to use adjuvants or substitute treatments to resolve sexual dysfunction. Effects on sexual function should be carefully diagnosed and treated; it should clearly discuss with patients in order to preserve an adequate quality of life, promote greater adherence to treatment and promote a good remission and recovery. The aim of this study is to review the most recent and significant literature data regarding association between sexual dysfunction and psychotropic medications, especially highlighting neurobiological and clinical data in order to improve the clinical pratice.

[Use of cannabis and psychopathological risk in onset psychosis]

AIM

The aim of the study is to assess the correlations between cannabis use and psychopathological features, disorder severity and global functioning in subjects with onset psychosis (schizophrenic and bipolar psychosis) and at risk mental state.

MATERIALS AND METHODS

Sixty-seven consecutive subjects with diagnosis of bipolar spectrum disorder (N=49), schizophrenic spectrum disorder (N=5) and at risk mental state (N=13) were recruited from the SMILE (Service for Monitoring and early Intervention Looking at the fight against the onset of mental Even psychological youths' suffering). All subjects were assessed with the Self Report Symptom Inventory-90 (SCL-90), the Global Assessment of Functioning scale (GAF) and Clinical Global Impressions-Severity (CGI-S). Moreover, they were assessed for the cannabis use in the last month.

RESULTS

The total sample was splitted in two groups: Group 1 of cannabis use subjects (N=30) and Group 2 of no cannabis use subjects (N=37). Group 1 subjects showed significant higher scores at psychoticism SCL-90 dimension and at CGI-S than Group 2 subjects. The higher scores at anger/hostility and psychoticism SCL-90 dimensions and at CGI-S seem to be discriminant features of Group 1 cannabis use subjects.

CONCLUSIONS

The data reported suggest that cannabis use assessment in onset psychosis (bipolar and schizophrenic onset) and at risk mental state could add clinical information to the psychopathological and diagnostic description. Such information should be ''incorporated'' in the treatment choice model and outcome prediction assessment.

Colonoscopic findings in coeliac disease on a gluten-free diet

BACKGROUND

to date, there are few data on colonoscopic findings in patients with celiac disease, and most of these obtained in patients with iron deficiency anaemia.

AIMS

we assessed colonoscopic findings in unselected patients with coeliac disease, since there are no studies available also considering morphological aspects, and there is literature suggestion of increased prevalence of colorectal tumours.

MATERIAL AND METHODS

colonoscopies with multiple biopsies were retrospectively analyzed in 42 coeliac disease patients on gluten-free diet above age 40; 16 had clinical or laboratory features of iron deficiency anaemia. Mucosal biopsies were evaluated for the presence of intraepithelial lymphocytes and of mucosal eosinophils, in addition to conventional histologic assessment, and compared with those obtained in 15 controls.

RESULTS

macroscopic abnormalities (polyps, diverticula, inflammatory changes) were found in 26% of patients. Microscopic abnormalities (lymphocytic colitis, melanosis coli, rectal histiocytosis) were found in 36% of patients. None of these findings was found in controls. Coeliac disease patients had significantly higher eosinophil score than controls in the right colon, whereas this was not significantly different between groups in the left colon.

CONCLUSIONS

colonoscopic findings in coeliac disease on gluten-free diet may reveal significant findings, even in patients without iron deficiency anaemia. There is the need of further studies in larger cohorts of patients to establish whether colonoscopy in these patients may be clinically useful.

Post-Traumatic and Psychiatric Symptoms among Young Earthquake Survivors in Primary Care Camp Hospital

Earthquakes have been found to be associated with increased prevalence of psychiatric disorders: Post-traumatic Stress Disorder (PTSD) with a diagnosis range of 1.5%-74%, depression, anxiety and sleep disorders and substance abuse. Risk factors are varied: exposure to the earthquake, closeness to the epicenter, disruption of social network, financial loss, female sex, low educational level, etc. PTSD diagnosis is difficult because people unconsciously neglect traumatic history and ignore consequences. Between April 6th 2009 and September 2009, 323 young survivors aged between 18 and 30 years were screened for PTSD symptoms at the S.M.I.L.E., a psychiatric service for young people at the L'Aquila Camp Hospital. The screening assessment consisted of: a socio-demographic schedule with questions about earthquake experience, the General Health Questionnaire-12 items (GHQ-12), Impact Event Scale-Revised (IES-R) and Semi-structured Clinical Interview Diagnosis II (SCID-II). Regarding psychiatric morbidity, 44.2% and 37.4% had respectively moderate and high stress levels. Female gender and unemployment were significantly correlated (p<.001) with stress level and Obsessive-Compulsive (OC) trait. After screening assessment, the 66.7% (N=215) of total sample showed a positive post-traumatic symptomatology with 13.8% of PTSD diagnosis. Obsessive-Compulsive trait, female gender, destruction of housing and high level of stress (GHQ ≥ 20) were significant predictors for a PTSD diagnosis when compared with subjects positive for PTSD symptomatology but without a PTSD diagnosis according to DSM-IV criteria. Personality features must be considered important risks for post-traumatic consequences: OC trait was significantly associated with a high score on the GHQ-12 (≥20) and is a significant predictor of PTSD symptoms (“re-experiencing” dimension). Houses destroyed, gender and unemployed were also important risk factors. Our study confirms that a natural disaster produces high levels of mental disorders with significant long-term risk of chronic impairment, such as the development of a PTSD diagnosis (13.8%) with enormously costly consequences for the mental health care system and society. This should be a high priority in a public health program.

Effect of the implementation of HACCP on the microbiological quality of meals at a university restaurant

A study was conducted to evaluate the microbiological quality, including total mesophilic counts and markers of bacteriological hygiene, as indicator of food safety of three categories of the most consumed meals in a university restaurant, before and after implementation of the HACCP system and personnel training. Cold gastronomy products, cooked warm-served products, and cooked cold-served products were tested for bacterial contamination. Throughout the experiment, 894 samples were examined for total counts of aerobic bacteria, counts of indicator organisms (coliform organisms and Escherichia coli) and pathogens (Staphylococcus aureus, Bacillus cereus, Salmonella spp., and Listeria monocytogenes). Implementation of the HACCP system, together with training in personnel hygiene, good manufacturing practices, and cleaning and sanitation procedures, resulted in lower aerobic plate counts and a lower incidence of S. aureus, coliform organisms, E. coli, and B. cereus, whereas Salmonella spp. and L. monocytogenes were not found in all samples studied. The microbial results of this study demonstrate that personnel training together with HACCP application contributed to improve the food safety of meals served in the restaurant studied.