Antibiotic-exposed patients with non-small-cell lung cancer preserve efficacy outcomes following first-line chemo-immunotherapy

BACKGROUND

Prior antibiotic therapy (pATB) is known to impair efficacy of single-agent immune checkpoint inhibitors (ICIs), potentially through the induction of gut dysbiosis. Whether ATB also affects outcomes to chemo-immunotherapy combinations is still unknown.

PATIENTS AND METHODS

In this international multicentre study, we evaluated the association between pATB, concurrent ATB (cATB) and overall survival (OS), progression-free survival (PFS) and objective response rate (ORR) in patients with non-small-cell lung cancer (NSCLC) treated with first-line chemo-immunotherapy at eight referral institutions.

RESULTS

Among 302 patients with stage IV NSCLC, 216 (71.5%) and 61 (20.2%) patients were former and current smokers, respectively. Programmed death-ligand 1 tumour expression in assessable patients (274, 90.7%) was ≥50% in 76 (25.2%), 1%-49% in 84 (27.9%) and <1% in 113 (37.5%). Multivariable analysis showed pATB-exposed patients to have similar OS {hazard ratio (HR) = 1.42 [95% confidence interval (CI): 0.91-2.22]; P = 0.1207} and PFS [HR = 1.12 (95% CI: 0.76-1.63); P = 0.5552], compared to unexposed patients, regardless of performance status. Similarly, no difference with respect to ORR was found across pATB exposure groups (42.6% versus 57.4%, P = 0.1794). No differential effect was found depending on pATB exposure duration (≥7 versus <7 days) and route of administration (intravenous versus oral). Similarly, cATB was not associated with OS [HR = 1.29 (95% CI: 0.91-1.84); P = 0.149] and PFS [HR = 1.20 (95% CI: 0.89-1.63); P = 0.222] when evaluated as time-varying covariate in multivariable analysis.

CONCLUSIONS

In contrast to what has been reported in patients receiving single-agent ICIs, pATB does not impair clinical outcomes to first-line chemo-immunotherapy of patients with NSCLC. pATB status should integrate currently available clinico-pathologic factors for guiding first-line treatment decisions, whilst there should be no concern in offering cATB during chemo-immunotherapy when needed.

Decoupling of the amygdala to other salience network regions in adolescent-onset recurrent major depressive disorder

BACKGROUND

Recent meta-analyses of resting-state networks in major depressive disorder (MDD) implicate network disruptions underlying cognitive and affective features of illness. Heterogeneity of findings to date may stem from the relative lack of data parsing clinical features of MDD such as phase of illness and the burden of multiple episodes.

METHOD

Resting-state functional magnetic resonance imaging data were collected from 17 active MDD and 34 remitted MDD patients, and 26 healthy controls (HCs) across two sites. Participants were medication-free and further subdivided into those with single v. multiple episodes to examine disease burden. Seed-based connectivity using the posterior cingulate cortex (PCC) seed to probe the default mode network as well as the amygdala and subgenual anterior cingulate cortex (sgACC) seeds to probe the salience network (SN) were conducted.

RESULTS

Young adults with remitted MDD demonstrated hyperconnectivity of the left PCC to the left inferior frontal gyrus and of the left sgACC to the right ventromedial prefrontal cortex (PFC) and left hippocampus compared with HCs. Episode-independent effects were observed between the left PCC and the right dorsolateral PFC, as well as between the left amygdala and right insula and caudate, whereas the burden of multiple episodes was associated with hypoconnectivity of the left PCC to multiple cognitive control regions as well as hypoconnectivity of the amygdala to large portions of the SN.

CONCLUSIONS

This is the first study of a homogeneous sample of unmedicated young adults with a history of adolescent-onset MDD illustrating brain-based episodic features of illness.

Therapeutic potential of nucleic acid-based drugs in coronary hyper- proliferative vascular diseases

The thickening of the vessel wall (intimal hyperplasia) is a pathological process which often follows revascularization approaches such as transluminal angioplasty and artery bypass graft, procedures used to re-vascularize stenotic artery. Despite the significant improvements in the treatment of intimal hyperplasia obtained in the last years, the problem has not completely solved. Nucleic acid based-drugs (NABDs) represent an emergent class of molecules with potential therapeutic value for the treatment of intimal hyperplasia. NABDs of interest in the field of intimal hyperplasia are: ribozymes, DNAzymes, antisense oligonucleotides, decoy oligonucleotides, small interfering RNAs and micro interfering RNAs. These molecules can recognize, in a sequencespecific fashion, a target which, depending on the different NABDs, can be represented by a nucleic acid or a protein. Upon binding, NABDs can down-modulate the functions of the target (mRNA/proteins) and thus they are used to impair the functions of disease-causing biological molecules.In spite of the great therapeutic potential demonstrated by NABDs in many experimental model of intima hyperplasia, their practical use is hindered by the necessity to identify optimal delivery systems to the vasculature. In the first part of this review a brief description of the clinical problem related to intima hyperplasia formation after revascularization procedures is reported. In the second part, the attention is focused on the experimental evidences of NABD therapeutic potential in the prevention of intimal hyperplasia. Finally, in the third part, we will describe the strategies developed to optimize NABD delivery to the diseased vessel.

Clinical characteristics and evaluation of LDL-cholesterol treatment of the Spanish Familial Hypercholesterolemia Longitudinal Cohort Study (SAFEHEART)

Aim

Familial hypercholesterolemia (FH) patients are at high risk for premature coronary heart disease (CHD). Despite the use of statins, most patients do not achieve an optimal LDL-cholesterol goal. The aims of this study are to describe baseline characteristics and to evaluate Lipid Lowering Therapy (LLT) in FH patients recruited in SAFEHEART.

Methods and Results

A cross-sectional analysis of cases recruited in the Spanish FH cohort at inclusion was performed. Demographic, lifestyle, medical and therapeutic data were collected by specific surveys. Blood samples for lipid profile and DNA were obtained. Genetic test for FH was performed through DNA-microarray. Data from 1852 subjects (47.5% males) over 19 years old were analyzed: 1262 (68.1%, mean age 45.6 years) had genetic diagnosis of FH and 590 (31.9%, mean age 41.3 years) were non-FH. Cardiovascular disease was present in 14% of FH and in 3.2% of non-FH subjects (P < 0.001), and was significantly higher in patients carrying a null mutation compared with those carrying a defective mutation (14.87% vs. 10.6%, respectively, P < 0.05). Prevalence of current smokers was 28.4% in FH subjects. Most FH cases were receiving LLT (84%). Although 51.5% were receiving treatment expected to reduce LDL-c levels at least 50%, only 13.6% were on maximum statin dose combined with ezetimibe. Mean LDL-c level in treated FH cases was 186.5 mg/dl (SD: 65.6) and only 3.4% of patients reached and LDL-c under 100 mg/dl. The best predictor for LDL-c goal attainment was the use of combined therapy with statin and ezetimibe.

Conclusion

Although most of this high risk population is receiving LLT, prevalence of cardiovascular disease and LDL-c levels are still high and far from the optimum LDL-c therapeutic goal. However, LDL-c levels could be reduced by using more intensive LLT such as combined therapy with maximum statin dose and ezetimibe.

Anaemia, iron and vitamin deficits in patients with peripheral arterial disease

INTRODUCTION

Anaemia can compromise muscle and organ function. Related iron and vitamin body stores have seldom been assessed in patients with peripheral arterial disease.

REPORT

We retrospectively analysed basal prevalence of anaemia, iron, B(12)-vitamin and folic acid deficits in 420 patients with claudication and 204 patients with critical limb ischaemia (CLI). The prevalence of the evaluated parameters was 9.8%, 6.7%, 6.7% and 2.9% among patients with claudication but 49.5%, 31.9%, 15.7% and 6.4% among CLI patients, respectively (p < 0.05 for all).

DISCUSSION

Anaemia, iron and vitamin deficits are uncommon among patients with ischemic claudication but very prevalent among patients with CLI.

Long-term cardiovascular outcome after elective abdominal aortic aneurysm open repair

BACKGROUND

We analyzed the incidence of late cardiovascular events and mortality after elective infra-/juxtarenal abdominal aortic aneurysm open repair (AAA-OR).

METHODS

We included patients who survived AAA-OR in our center in 1988-2006. We registered late cardiac, cerebrovascular, and peripheral vascular events, as well as all-cause and cardiovascular mortality. We calculated patient survival and freedom from cardiovascular events (Kaplan-Meier) and evaluated risk factors (multivariate analysis).

RESULTS

We studied 297 patients: 292 (98.3%) men, aged 67 +/- 7 (44-83) years, 143 (48.1%) bifurcated grafts. In a mean follow-up of 78.7 +/- 52.9 months, we registered 203 cardiovascular events in 123 (41.4%) patients, at a rate of 0.16 cardiovascular events/patient-year. Eleven (3.7%) patients suffered graft-related complications. Freedom from cardiovascular events was 94.2%, 67.2%, 45.7%, and 27.6% at 1, 5, 10, and 15 years, respectively. Survival was 96.6%, 74.7%, 50.7%, and 31.5%, respectively. The main cause of death was cardiovascular disease (n = 54, 18.2%), followed by cancer (n = 43, 14.5%). Only four (1.3%) deaths were graft-related. Coronary artery disease and chronic renal failure were predictive of cardiovascular mortality (p = 0.033 and 0.006).

CONCLUSION

Although long-term survival is similar to that in the general population, successful AAA-OR patients remain at increased risk of cardiovascular events throughout their lifetime. Graft-related complications are rare, confirming the durability of the procedure.

Bioavailability of insect growth regulator residues in citrus

The aim of this study was to increase the knowledge in the field of bioavailability of pollutants in agricultural food samples. Bioavailability of flufenoxuron, lufenuron, pyriproxyfen and fenoxycarb was studied in a common commodity as mandarin in vitro. Not only was it studied in fresh fruit but also in standards and canned mandarin to be able to establish matrix-related differences. Human gastric digestion, intestinal digestion and absorption were imitated. Porcine pepsin, porcine pancreatin, bile salts and semipermeable cellulose dialysis tubing were used. Dialysis values were lower than 15% and followed this order: standards > processed samples > fresh samples. The highest dialyzable values were observed for fenoxycarb and pyriproxyfen. The higher the digested amount of pesticide, the higher the dialysed amount.

Influence of several fungicides on the antioxidant activity of red wines (var. Monastrell)

The antioxidant activity of wines obtained from grapes treated with six fungicides (famoxadone, fenhexamid, fluquinconazole, kresoxim-methyl, quinoxyfen and trifloxystrobin) was investigated. Two field trials in triplicate were carried out for each formulation of the fungicide at the recommended dose of the manufacturer. The first trial was carried out under good agricultural practices (GAP), following the recommended pre-harvest interval, and the second one under critical agricultural practices (CAP) that involves treating the same field just before the harvest. The residue levels were determined by gas and liquid chromatography coupled to mass detectors (GC-MS and LC-MS). The antioxidant activity was determined in the wines obtained from the thirteen trials including one control, six from treated grapes obeying the pre-harvest interval, and six from grapes treated at the day of harvest or at most unfavorable conditions. Elimination of 40-100% of the initial fungicide residues present in grapes was observed during the wine-making process. It can be inferred from the results that the use of these fungicides did not produce any decrease of the antioxidant activity in the wines (7.19 +/- 0.22 mmol Trolox/L for the blank wine versus a range of 6.45 +/- 0.82 mmol Trolox/L to 10.06 +/- 0.59 mmol Trolox/L for the treated wines) at the pre-harvest interval and most unfavorable conditions. Nevertheless, the presence of famoxadone, kresoxim-methyl and quinoxyfen increased the antioxidant activity and this was directly related to their residue levels in the grapes. Also, the wine phenolic composition was altered in variable intensity by the presence of the fungicide residues.

Removal of pesticides from white wine by the use of fining agents and filtration

The effects of four clarification agents (bentonite, charcoal, PVPP and potassium caseinate) on the removal of residues of three fungicides (famoxadone, fluquinconazole and trifloxystrobin) applied directly to a racked white wine, elaborated from Airen variety grapes from the D.O. Region of Jumilla (Murcia, Spain) are studied. The clarified wines were filtered with 0.45 microm nylon filters to determine the influence of this winemaking process in the disappearance of fungicide residues. Hydro-alcoholic solutions with the three fungicides at concentrations of 1 and 2 ppm were then added through intense stirring to each of the containers. Two hours later, the corresponding clarifying agent was added with intense stirring for some minutes. The containers were then sealed and left to settle for five days. Once the clean wines had been racked, they were filtered through nylon 0.45 microm pore filters. All assays were performed three times. Analytical determination of fluquinconazole and trifloxystrobin was performed by gas chromatography with an electron captor detector (ECD), while that of famoxadone was made using an HPLC-DAD. For the three fungicides, the highest elimination is produced with the clarification by charcoal, reaching Levels of removal of 100% in all cases. For the four clarifying agents, the highest elimination is produced for the fluquinconazole residues. The fungicide which is retained most in the lees is famoxadone, since it has the lowest solubility of the three pesticides studied. The highest percentage of residues in the lees is obtained for the assay with charcoal. The filtration process of the clarified wines using the four agents studied is not effective, since the elimination percentage is generally lower than 10% of the initial residues in the non-clarified wines.

Bioavailability of insect growth regulators in citrus and stone fruits

The aim of this study was to offer data about the bioavailability of flufenoxuron, lufenuron, pyriproxyfen and fenoxycarb in common commodities like mandarin, apricot and peach. The in vitro bioavailability of the compounds was studied not only in fresh fruit but also in standards and canned food in order to establish possible differences according to the matrix. The gastric digestion was simulated with porcine pepsin at pH 2, for 2 h in a shaking water bath at 37 degrees C. The intestinal digestion was simulated with porcine pancreatin at pH 7, for 2 h in a shaking water bath at 37 degrees C. The intestinal absorption was simulated with cellulose dialysis tubing filled with a solution of sodium carbonate. No in vitro bioavailability was observed in mandarin, peach and apricot samples spiked at the concentrations generally found in the market for the raw and processed commodities. In standards, the dialysis started at the level of 0.25 mg/kg. This is an approximation to the pesticide digestion and absorption in humans.

Dissipation of insect growth regulators in fresh orange and orange juice

It was studied the dissipation rates of fenoxycarb, Lufenuron, flufenoxuron and pyriproxyfen from their application on navelina orange crops to the production of orange juice. Supervised trials were carried out for the phytosanitary treatments under two situations, one according to Good Agricultural Practices (GAP) and the other one with Critical Agricultural Practices (CAP). Samples of both situations were transformed into orange juice according to the current industrial process. The analytical methodology included acetone and dichloromethane/petroleum ether extraction and aminopropyl-based cleanup. Method validation followed SANCO Guidelines. The final objective was the determination of the exposure to the residues in raw and processed orange when good and critical agricultural conditions are used in the field.

Influence of fungicides on grape yeast content and its evolution in the fermentation

The influence of six fungicides (famoxadone, fenhexamid, fluquinconazole, kresoxim-methyl, quinoxyfen, trifloxystrobin) on the yeast content in harvested grapes has been studied along with their effect on it during the wine-making process. Two treatments were carried out with authorized formulates at the manufacturer doses. The first was carried out under good agricultural practices, obeying the security times, and the second one under critical conditions, applied on the day of harvesting. The grapes were harvested two hours after the application. During the wine-making process, samples were taken at 1, 5, 12 and 20 days after the start. The levels observed in the control sample (1.9 log CFU/cm2) were similar to previous studies. The counts in all treated samples were higher than the control sample, without adverse effect of the pesticides on the yeast count even in the grapes treated on the day of harvest. As with the observations on grapes, no effect of the pesticides on the fermentation count was observed. All counts on the treated samples were higher than the control sample. The treatment on the day of harvest did not have any effect on the fermentation count, with superior results being obtained for all the pesticides.

Growth Rate and Associated Factors in Small Abdominal Aortic Aneurysms

OBJECTIVE

To study the growth rate and factors influencing progression of small infrarenal abdominal aortic aneurysms (AAA).

DESIGN

Observational, longitudinal, prospective study.

PATIENTS AND METHODS

We followed patients with AAA <5 cm in diameter in two groups. Group I (AAA 3-3.9 cm, n = 246) underwent annual ultrasound scans. Group II (AAA 4-4.9 cm, n = 106) underwent 6-monthly CT scans.

RESULTS

We included 352 patients (333 men and 19 women) followed for a mean of 55.2+/-37.4 months (6.3-199.8). The mean growth rate was significantly greater in group II (4.72+/-5.93 vs. 2.07+/-3.23 mm/year; p<0.0001). Group II had a greater percentage of patients with rapid aneurysm expansion (>4 mm/year) (36.8 vs. 13.8%; p<0.0001). The classical cardiovascular risk factors did not influence the AAA growth rate in group I. Chronic limb ischemia was associated with slower expansion (< or = 4 mm/year) (OR 0.47; CI 95% 0.22-0.99; p = 0.045). Diabetic patients in group II had a significantly smaller mean AAA growth rate than non-diabetics (1.69+/-3.51 vs. 5.22+/-6.11 mm/year; p = 0.032).

CONCLUSIONS

The expansion rate of small AAA increases with the AAA size. AAA with a diameter of 3-3.9 cm expand slowly, and they are very unlikely to require surgical repair in 5 years. Many 4-4.9 cm AAA can be expected to reach a surgical size in the first 2 years of follow-up. Chronic limb ischemia and diabetes are associated with reduced aneurysm growth rates.

9 USE OF SEXED SEMEN FOR ARTIFICIAL INSEMINATION IN HOLSTEIN HEIFERS IN MEXICO: PRELIMINARY RESULTS

Nowadays, X- and Y- sperm can be sorted reliably by flow cytometry/cell sorting. However, this new technology is rarely being adopted by dairy farmers in Mexico and in developing countries, mainly due to the higher price of sexed semen straws and to a lack of information and knowledge of the results that can be obtained with its use under field conditions. In 2004, a field experiment started in a dairy farm in Tizayuca, State of Hidalgo, Mexico, aimed to examine fertility and sex ratios after artificial insemination (AI) in heifers under field conditions. Semen from two Holstein bulls was used for the experiment. The semen was sexed and frozen by XY Mexico (subsidiary of XY, Inc., Fort Collins, CO, USA). Only the X fraction of spermatozoa was sorted and frozen in 0.25 cc plastic straws with 2.0 � 106 spermatozoa/straw. Sixty Holstein heifers averaging 14 months of age were artificially inseminated 12 hours after naturally occurring standing heat, using one straw of sexed semen, from June to October 2004. Fertility data of all inseminations were collected by rectal palpation from Days 45 to 60 after AI. A total of 30 heifers were pregnant, indicating a fertility of 50% froma single service. Sex of the calves was confirmed after calving between March and July 2005. From a total of 30 calves born after normal pregnancy, 27 were females (90%) and 3 were males (10%). In contrast, the pregnancy rate obtained in 60 heifers inseminated with non-sexed semen from the same two bulls was 68% (41 pregnant). From this group of heifers, 20 female (49%) and 21 male (51%) calves were born. Chi-square analysis indicated that pregnancy rates and sex ratios between the two groups were significantly different (P < 0.05). This preliminary information indicates that there is an advantage in the sex ratio obtained when using sexed semen for AI in Holstein heifers. This is especially important at a time when importation of replacement heifers to Mexico from Canada and the USA is not an option. However, more experiments are needed to confirm the results obtained in this preliminary study. Sexed semen and Holstein heifers were provided by Rancho El Nacimiento, Establo 196, Tizayuca, State of Hidalgo, M�xico.

271 USE OF SEXED SEMEN FOR BOVINE IVF IN MEXICO: PRELIMINARY RESULTS

The use of sexed embryos in dairy cattle is useful for the genetic and economic improvement of production. The aim of this study was to determine differences in in vitro maturation (IVM), in vitro fertilization (IVF), and in vitro development (IVD) with the use of sexed and unsexed sperm. Semen from one Holstein bull was used for the experiment. The semen was sexed and frozen by X-Y, Mexico (subsidiary of X-Y Inc., Fort Collins, CO, USA). Only the X fraction of spermatozoa was sorted and frozen in 0.25-mL plastic straws with 2.0 � 106 spermatozoa/straw. A modified protocol for IVF was used. A total of 334 ovaries were obtained from a local slaughterhouse and transported to the laboratory in physiological saline (25�C). From these, 1019 cumulus-oocyte complexes (COCs) were obtained and used for the procedures of IVM, IVF, and IVD. The average number of follicles aspirated per ovary was 3.6, and an average of 3.05 COCs were recovered per ovary. The oocyte recovery rate was 85%. For IVM, COCs were incubated in TCM-199 supplemented with BSA, pyruvate, FSH, and LH for 24 h. All incubations were performed at 38.5�C in a humidified atmosphere of 5% CO2 in air. After this period, COCs were placed in fertilization medium (TALP supplemented with BSA, heparin, penicillamine, and hypotaurine). For IVF, oocytes were randomly assigned to two groups: sexed semen (Holstein) or treatment group (TG), and non-sexed semen (Brahman, used as control in our laboratory) or control group (CG). For insemination, frozen-thawed semen from the Holstein and Brahman bulls was washed by centrifugation in two concentration gradients of a silicone solution. In both groups, sperm concentration used for IVF was 1 � 106 spermatozoa/mL. After insemination, oocytes and semen were co-incubated for 18 h. For IVD, presumptive zygotes were incubated for 7 days in a modified IVD medium (Barc-1) supplemented with BSA. The degree of IVD was evaluated according to the number of divisions of the embryos produced, and the number of embryos that developed to the morula and blastocyst stages. Five replicates were made. The rates of IVM, IVF, and IVD were analyzed by logistic regression. The COCs produced 890 fertilized oocytes. Of these, 442 were from the TG and 448 from the CG. A total of 393 embryos from the TG and 372 from the CG developed in vitro; embryos were evaluated for development on Day 7. A total of 108 morulae (21%) were produced in the TG and 100 (19%) in the CG, whereas 99 (19%) blastocysts developed in the TG and 105 (20%) in the CG. There were no statistically significant differences between the two groups studied for embryo IVD (P > 0.05). It is concluded that IVM, IVF, and IVD procedures used for conventional non-sexed semen can be used for similar results with sperm sexed by flow cytometry. This is the first report of sexed semen use for bovine IVF in Mexico and is a precedent for future investigations on in vitro embryo production in Mexico. More experiments are needed to confirm these preliminary findings. Sexed semen was provided by Rancho El Nacimiento, Establo 196, Tizayuca, State of Hidalgo, M�xico. Funding for J. A. was provided by CONACYT and UNAM.

Disappearance of fenhexamid residues during wine-making process

The main objective of this work was the study the influence of different wine-making techniques on the pesticide residue elimination from grapes to wine. In order to that, the maceration time effect (6 and 15 days) was studied on the final fenhexamid residue content in wine. And also, the influence of a prefermentative maceration at low temperatures (5 and 15 degrees C during three days of the maceration period) on the residue disappearance was determined in both maceration times. Determination of the residues of fenhexamid was made by GC-ECD, following extraction by an on-line micro method, with a mixture of acetone/dichloromethane (50/50 V/V) as extractant. The maceration time does not produce significant differences in the final pesticide content in wine. However, if the prefermentative temperature increases, there is a high elimination of the fungicide residues. The highest fungicide elimination was obtained in wines with long maceration and a prefermentation at 5 degrees C.

Detection of Abdominal Aortic Aneurysm in Patients with Peripheral Artery Disease

OBJECTIVE

To describe the prevalence of abdominal aortic aneurysms (AAA) in patients with peripheral artery disease (PAD).

DESIGN

Observational, descriptive, transverse study.

PATIENTS AND METHODS

We performed an abdominal ultrasound in 1190 consecutive patients with lower limb chronic ischemia (1/99-12/04). We registered cardiovascular risk factors and clinical data for analysis.

RESULTS

The ultrasound was inconclusive in 24 (2%) patients; 1166 patients completed the study. They were mostly male (93.7%), with an age mean of 67+/-9.9 years (37.7-93.4). The main cardiovascular risk factors were: smoking (80.9%), hypertension (41.7%) and hypercholesterolemia (31.4%). The prevalence of AAA was 13% (n = 151). Only 1.5% (n = 17) of the patients had a large AAA (>5 cm). The AAA was clearly more prevalent in men (n = 148; 13.6%) than in women (n = 3; 4.1%) (RR 3.47; 95% CI 1.11-10.89; p = 0.02). The prevalence significantly increased with age, with a maximum of 17.1% in over 75-year-old men (p = 0.006). Patients with tibial disease had a significantly higher prevalence of AAA than aortoiliac or femoro-popliteal disease (p = 0.02).

CONCLUSIONS

The prevalence of AAA in patients with PAD is much higher than that reported in the general population. We recommend that an abdominal ultrasound be routinely included in the study of these patients. Over 75-year-old men are at particularly high-risk.

Effects of clarification and filtration processes on the removal of fungicide residues in red wines (var. Monastrell)

The effects of six clarification agents (egg albumin, blood albumin, bentonite plus gelatin, charcoal, PVPP, and silica gel) on the removal of residues of four fungicides (cyprodinil, fludioxonil, pyrimethanil, and quinoxyfen) applied directly to a racked red wine, elaborated from Monastrell variety grapes from the D.O. region of Jumilla (Murcia, Spain), are studied. The clarified wines were filtered with 0.45 microm nylon filters to determine the influence of this winemaking process in the disappearance of fungicide residues. Analytical determination of cyprodinil, fludioxonil and pyrimethanil was performed by gas chromatography with an alkaline thermoionic detector (NPD), whereas that of quinoxyfen using an electron captor detector (ECD). In general, and for all of the fungicides except quinoxyfen, blood albumin has proved to be the most effective clarifying agent in the removal of residues, whereas silica gel proved to be ineffective against all of the pesticides with the exception of fludioxonil. Quinoxyfen is the least persistent fungicide in the clarified wines and that which appears with highest frequency in the lees. In general, filtration is not an effective step in the elimination of wine residues. The greatest elimination after filtration is obtained in wines clarified with charcoal and the lowest in those clarified with PVPP.

Fungicide dissipation curves in winemaking processes with and without maceration step

The evolution of residual levels of four fungicides (cyprodinil, fludioxonil, pyrimethanil, and quinoxyfen) during the elaboration of three types of wine with maceration (traditional red wine, carbonic maceration red wine, and red wine of long maceration and prefermentation at low temperature) and two types of wine without maceration (rose and white) has been studied. The disappearance curves of each fungicide have been analyzed during the period of each winemaking process (21 days) and during the different enological steps involved in the elaborations. The residual levels of fludioxonil reduce most quickly during the winemaking processes without maceration, whereas the decrease in levels of pyrimethanil was the slowest in practically all cases (with and without maceration). During carbonic maceration winemaking, the decay constant of cyprodinil was greater than that of the other pesticides in all assays (time and steps).

HCH and DDT residues in human placentas in Murcia (Spain)

Organochlorinated insecticides are ubiquitous toxicants that are transplacentally transferred from mother to fetus and are reported to produce adverse health effects in pregnant woman and neonates. To investigate hexachlorocyclohexane (HCH) and 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT) exposure in pregnant woman, a total of 102 placentas were analyzed by a gas chromatograph equipped with electron capture detector. Organochlorine residues were found in 69.6% of the samples. Lindane was detected in 24.5%, alpha-HCH in 2.9%, beta-HCH in 6.9%, p,p'-DDE in 44.1%, p,p'-DDT in 14.7% and p,p'-DDD in 10.8% of the samples. The pattern of dispersal by these substances in Murcia is similar to that described by different authors in other countries. Therefore, the past use of DDT and the present employment of lindane seem to be reflected in body tissues of the residents of this area.

Lethal systemic dissemination from a cutaneous infection due to Curvularia lunata in a heart transplant recipient

A 69-year-old male heart transplant recipient, being treated with Cell Cept, FK 506 and methylprednisolone had multiple deep brown skin nodules and nodes, on the upper right arm. Skin biopsy and culture detected a strain of Curvularia lunata. The infection disseminated to the whole skin surface, oral mucosa, upper third of the oesophagus and to the lungs. Therapy with antibiotics and antifungal drugs was ineffective. The patient died of sepsis. We did not find any other case of systemic dissemination from a skin infection due to C. lunata among heart transplant recipients. We feel that heart transplant recipients need adequate education to prevent situations that would put them at risk for infection and to seek medical advice immediately for an early diagnosis and an effective therapy.

Lichen planopilaris: report of 30 cases and review of the literature

BACKGROUND

Lichen planopilaris (LPP) affects primarily the scalp, resulting in scaling, atrophy, and alopecia with scarring. The purpose of our study was to obtain original data on LPP and to evaluate the efficacy of topical therapy in comparison with systemic therapies.

METHODS

We examined 30 patients affected by LPP between 1996 and 2001, performing clinical, laboratory, histopathologic and direct immunofluorescence examinations. Twenty-one of the patients (70%) were women and nine (30%) were men. The average age at presentation was 51.5 years. The average duration of the disease was 13 months at the time of the diagnosis. All patients received topical steroids for a total of 12 weeks.

RESULTS

Resolution of the inflammatory process and blocking of the cicatricial progression were observed in 66% of cases, a mild reduction of fibrosis and cicatrization in 20% of patients, and no response in 13%.

CONCLUSIONS

We concluded that topical therapy may be a valid alternative to systemic therapies, especially in patients with lesions in the early phase.