Male genital lichen sclerosus associated with urological interventions and microincontinence: a case series of 21 patients.

BACKGROUND: Male genital lichen sclerosus (MGLSc) is an acquired, chronic, inflammatory cutaneous disease associated with significant morbidity and squamous cell carcinoma of the penis. Consideration of all of the evidence suggests that chronic exposure of susceptible epithelium to urinary occlusion by the foreskin is the most likely pathomechanism. MGLSc never occurs in men who were circumcised at birth, and has been associated with trauma, instrumentation and anatomical abnormalities, e.g. frank hypospadia that results in microincontinence. AIM: To describe 21 patients who developed MGLSc following urological diagnoses and procedures. METHODS: We conducted a retrospective review of patients with a diagnosis of MGLSc whose symptoms related to urological procedures who attended or saw one of the authors (CBB) privately during the period June-October 2018. RESULTS: In total, 21 patients (mean age 59 years) were identified. The referrals came from the local urology departments, primary care or extramural dermatology services. Most of the patients were uncircumcised men. All had developed symptoms and signs of MGLSc within 5 years following their urological procedure; on examination, 30% of the patients were found to have damp penile skin due to microincontinence. Of the 21 patients, 10 had undergone radical prostatectomy for prostate cancer, 4 had a diagnosis of Peyronie disease, 4 had undergone multiple cystoscopies and urethroscopies, 2 had undergone surgery on the bladder neck and 1 had undergone implantation of a penile prosthesis to treat erectile dysfunction. CONCLUSION: This case series further strengthens the urinary occlusion hypothesis for the causation of MGLSc. It is important to recognize that urological interventions can create incompetence of the naviculomeatal valve post voiding. In uncircumcised men, this creates a risk factor for MGLSc that was not previously present. Occlusion, the phenomenon of koebnerization and currently unelucidated epithelial susceptibility factors lead to inflammation, sclerosis and cancer. Patients and urologists should be aware of these possibilities and preventative measures instituted, e.g. adaptive voiding habits and barrier protection.

Cytomegalovirus pre-emptive therapy after hematopoietic stem cell transplantation in the era of real-time quantitative PCR: comparison with recipients of solid organ transplants.

BACKGROUND: Cytomegalovirus (CMV) continues to be an important complication of hematopoietic stem cell transplantation and solid organ transplantation. METHODS: In this study, 314 patients who underwent hematopoietic stem cell transplantation between January 2003 and October 2011 were tested serially for CMV DNA by real-time quantitative polymerase chain reaction (qPCR) for 90 days post transplantation. Patients with CMV viremia >3000 genomes/mL (equivalent to 2520 IU/mL) received pre-emptive therapy and were compared with previously published data from solid organ transplant (SOT) patients monitored and treated in exactly the same way. RESULTS: After stem cell transplant (SCT), 48% of patients developed at least 1 episode of viremia. The median duration of a viremic episode was 25 days and the peak viral load (VL) was 4784 genomes/mL whole blood (equivalent to 4019 IU/mL). The data demonstrated that recipients with positive CMV serostatus were at increased risk of developing viremia, with 0% of donor-negative/recipient-negative (D-R-), 3.7% of D+R-, 79.5% of D-R+, and 74.2% of D+R+ groups developing viremia over follow-up (adjusted hazard ratio for D+R- vs. D+R+ group 0.03; 95% confidence interval 0.004, 0.18; P = 0.0013). In contrast with SOT patients, where 58/74 (78%) D+R- patients had viremia, a low risk of CMV infection was seen after stem cell transplantation (1/27; 3.7%). CONCLUSION: As both groups of patients, the previously published SOT patients and the present hematopoietic SCT patients, were monitored using the same protocol and qPCR assay with pre-emptive therapy administered at the same VL cutoffs, the distinct differences seen cannot be explained by differences in testing or management and thus emphasize distinct aspects of the natural history of CMV infection post transplant in these 2 patient groups.

Selection of yeasts with multifunctional features for application as starters in natural black table olive processing.

Yeasts are unicellular eukaryotic microorganisms with a great importance in the elaboration on many foods and beverages. In the last years, researches have focused their attention to determine the favourable effects that these microorganisms could provide to table olive processing. In this context, the present study assesses, at laboratory scale, the potential technological (resistance to salt, lipase, esterase and ß-glucosidase activities) and probiotic (phytase activity, survival to gastric and pancreatic digestions) features of 12 yeast strains originally isolated from Greek natural black table olive fermentations. The multivariate classification analysis carried out with all information obtained (a total of 336 quantitative input data), revealed that the most promising strains (clearly discriminated from the rest of isolates) were Pichia guilliermondii Y16 (which showed overall the highest resistance to salt and simulated digestions) and Wickerhamomyces anomalus Y18 (with the overall highest technological enzymatic activities), while the rest of strains were grouped together in two clearly differentiated clusters. Thus, this work opens the possibility for the evaluation of these two selected yeasts as multifunctional starters, alone or in combination with lactic acid bacteria, in real table olive fermentations.

Efficacy of natamycin to control fungal growth in natural black olive fermentation.

The effect of natamycin as a fungal control agent in natural black olive fermentation according to the traditional anaerobic system was studied. Black Conservolea olives were subjected to spontaneous fermentation in 8% (w/v) NaCl brine solution (control treatment) or brine supplemented with 0.01% (w/v) natamycin (active compound) for an overall period of 60 days. The changes in the microbial association (lactic acid bacteria, yeasts, Enterobacteriaceae), pH, titratable acidity, organic acids, and volatile compounds were monitored throughout fermentation. The initial microbiota consisted of lactic acid bacteria, yeasts, and Enterobacteriaceae. The addition of natamycin in the brine inhibited the growth of yeasts, without affecting the population dynamics of bacteria, resulting in a more vigorous fermentation with higher titratable acidity compared to spontaneous control process. Moreover, the presence of natamycin inhibited mould spoilage caused by the development of fungal mycelium on the surface of the brine during the traditional anaerobic fermentation system employed widely in Greece in natural black olive processing. Natamycin could be an important component of a processing system to control fungal growth in natural black olive fermentation and at the same time it has the potential to enhance the process by favouring the growth of the indigenous population of lactic acid bacteria against other competing microorganisms.

A study on the implications of NaCl reduction in the fermentation profile of Conservolea natural black olives.

This study examined the impact of different mixtures of NaCl, KCl, and CaCl(2) on the fermentation profiles of Conservolea natural black olives. Five different combinations of chloride salts were investigated, namely (i) 8% NaCl (control treatment), (ii) 4% NaCl and 4% KCl, (iii) 4% NaCl and 4% CaCl(2), (iv) 4% KCl and 4% CaCl(2), and (v) 2.6% NaCl-2.6% KCl-2.6% CaCl(2). The changes in the microbial association (lactic acid bacteria, yeasts, Enterobacteriaceae), pH, titratable acidity, organic acids, volatile compounds, and mineral content in olive flesh were analyzed. Results demonstrated that all salt combinations led to vigorous lactic acid processes based on the obtained values of pH (3.9-4.2) and titratable acidity (0.70-0.86 g lactic acid per 100 ml brine). Organoleptic evaluation was a critical factor in the acceptability of the final product. Increasing concentrations of CaCl(2) or a combination of KCl and CaCl(2) rendered the product bitter with low acceptability by the taste panel. Only one combination of chloride salts (4% NaCl and 4% KCl) could finally produce olives with lower sodium content and good organoleptic attributes. The results of this study could be employed by the Greek table olive industry in an attempt to produce natural black olives with less sodium without affecting the traditional taste of fermented olives in order to meet consumers' demand for low sodium dietary intake.

Use of titanium dioxide (TiO2) photocatalysts as alternative means for Listeria monocytogenes biofilm disinfection in food processing.

The aim of this work was to study the photocatalytic activity of titanium dioxide (TiO(2)) against Listeria monocytogenes bacterial biofilm. Different TiO(2) nanostructured thin films were deposited on surfaces such as stainless steel and glass using the doctor-blade technique. All the surfaces were placed in test tubes containing Brain Heart (BH) broth and inoculated with L. monocytogenes. Test tubes were then incubated for 10 days at 16°C in order to allow biofilm development. After biofilm formation, the surfaces were illuminated by ultraviolet A light (UVA; wavelength of 315-400 nm). The quantification of biofilms was performed using the bead vortexing method, followed by agar plating and/or by conductance measurements (via the metabolic activity of biofilm cells). The presence of the TiO(2) nanoparticles resulted in a fastest log-reduction of bacterial biofilm compared to the control test. The biofilm of L. monocytogenes for the glass nanoparticle 1 (glass surface modified by 16% w/v TiO(2)) was found to have decreased by 3 log CFU/cm(2) after 90 min irradiation by UVA. The use of TiO(2) nanostructured photocatalysts as alternative means of disinfecting contaminated surfaces presents an intriguing case, which by further development may provide potent disinfecting solutions. Surface modification using nanostructured titania and UV irradiation is an innovative combination to enhance food safety and economizing time and money.

Yeast heterogeneity during spontaneous fermentation of black Conservolea olives in different brine solutions.

AIMS: To assess the yeast community structure and dynamics during Greek-style processing of natural black Conservolea olives in different brine solutions. METHODS AND RESULTS: Black olives were subjected to spontaneous fermentation in 6% (w/v) NaCl brine solution or brine supplemented with (i) 0.5% (w/v) glucose, (ii) 0.2% (v/v) lactic acid and (iii) both glucose and lactic acid. Yeast species diversity was evaluated at the early (2 days), middle (17 days) and final (35 days) stages of fermentation by restriction fragment length polymorphism and sequence analyses of the 5.8S internal transcribed spacer and the D1/D2 ribosomal DNA (rDNA) regions of isolates. Analysis revealed a relatively broad range of biodiversity composed of 10 genera and 17 species. In all treatments, yeasts were the main micro-organisms involved in fermentation together with lactic acid bacteria that coexisted throughout the processes. Metschnikowia pulcherrima was the dominant yeast species at the onset of fermentation, followed by Debaryomyces hansenii and Aureobasidium pullulans. Species heterogeneity changed as fermentations proceeded and Pichia membranifaciens along with Pichia anomala evolved as the main yeasts of olive elaboration, prevailing at 17 and 35 days of the process. Molecular techniques allowed for the identification of five yeast species, namely A. pullulans, Candida sp., Candida silvae, Cystofilobasidium capitatum and M. pulcherrima, which have not been reported previously in black olive fermentation. CONCLUSIONS: By using molecular techniques, a rich yeast community was identified from Conservolea black olive fermentations. Metschnikowia pulcherrima was reported for the first time to dominate in different brines at the onset of fermentation, whereas Pichia anomala and P. membranifaciens evolved during the course. The addition of glucose and/or lactic acid perturbed yeast succession and dominance during fermentation. SIGNIFICANCE AND IMPACT OF THE STUDY: Yeasts have an important role in black olive fermentation and contribute to the development of the organoleptic characteristics of the final product. At the same time, certain species can cause significant spoilage. The present study adds to a better knowledge of yeast communities residing in olive fermentations towards a well-controlled process with minimization of product's losses.

Effect of temperature and water activity on growth and ochratoxin A production boundaries of two Aspergillus carbonarius isolates on a simulated grape juice medium.

AIMS: To develop and validate a logistic regression model to predict the growth and ochratoxin A (OTA) production boundaries of two Aspergillus carbonarius isolates on a synthetic grape juice medium as a function of temperature and water activity (a(w)). METHODS AND RESULTS: A full factorial design was followed between the factors considered. The a(w) levels assayed were 0.850, 0.880, 0.900, 0.920, 0.940, 0.960, 0.980 and the incubation temperatures were 10, 15, 20, 25, 30, 35 and 40 degrees C. Growth and OTA production responses were evaluated for a period of 25 days. Regarding growth boundaries, the degree of agreement between predictions and observations was >99% concordant for both isolates. The erroneously predicted growth cases were 3.4-4.1% false-positives and 0.7-1.4% false-negatives. No growth was observed at 10 degrees C and 40 degrees C for all a(w) levels assayed, with the exception of 0.980 a(w)/40 degrees C, where weak growth was observed. Similarly, OTA production was correctly predicted with a concordance rate >98% for the two isolates with 0.7-1.4% accounting for false-positives and 2.0-2.7% false-negatives. No OTA production was detected at 10 degrees C or 40 degrees C regardless of a(w), and at 0.850 a(w) at all incubation temperatures. With respect to time, the OTA production boundary shifted to lower temperatures (15-20 degrees C) as opposed to the growth boundary that shifted to higher temperature levels (25-30 degrees C). Using two literature datasets for growth and OTA production of A. carbonarius on the same growth medium, the logistic model gave one false-positive and three false-negative predictions out of 68 growth cases and 13 false-positive predictions out of 45 OTA production cases. CONCLUSIONS: The results of this study suggest that the logistic regression model can be successfully used to predict growth and OTA production interfaces for A. carbonarius in relation to temperature and a(w). SIGNIFICANCE AND IMPACT OF THE STUDY: The proposed modelling approach helps the understanding of fungal-food ecosystem relations and it could be employed in risk analysis implementation plans to predict the risk of contamination of grapes and grape products by A. carbonarius.

Temperature-assisted high hydrostatic pressure inactivation of Staphylococcus aureus in a ham model system: evaluation in selective and nonselective medium.

AIMS: The purpose of this study was to investigate the inactivation kinetics of Staphylococcus aureus in a ham model system by high hydrostatic pressure at ambient (25 degrees C) and selected temperatures (45, 55 degrees C). Selective [Baird Parker (BP) agar] and nonselective [brain heart infusion (BHI) agar] growth media were used for enumeration in order to count viable and sublethally injured cells. METHODS AND RESULTS: The micro-organism was exposed to a range of pressures (450, 500, 550, 600 MPa) at ambient temperature (25 degrees C) for up to 45 min. Additionally, the behaviour of the micro-organism was evaluated at mild temperatures in combination with high pressure treatment, namely: (i) 350, 400 and 450 MPa at 45 degrees C; and (ii) 350 and 400 MPa at 55 degrees C, for up to 12 min. Inactivation kinetics were calculated in terms of D(p) and z(p) values. Survival curves of S. aureus at ambient temperature were mostly linear, whereas when temperature was applied, tailing was observed in most survival curves. The estimated D(p) values and therefore the number of surviving cells, were substantially higher on the selective BP agar in the whole range of pressures applied, indicating that S. aureus showed greater recovery in the selective BP agar than the nonselective BHI agar. Samples pressurized at ambient temperature needed higher pressures (over 500 MPa) to achieve a reduction of the population of the pathogen more than 5 log CFU ml(-1). The same level of inactivation was achieved at lower pressure levels when mild heating was simultaneously applied. Indeed, more than 6 log CFU ml(-1) reductions were obtained at 400 MPa and 55 degrees C within the first 7 min of the process in BHI medium. CONCLUSION: Elevated temperatures allowed lower pressure levels and shorter processing times of pathogen inactivation than at room temperature. Greater recovery of the pathogen was observed in the selective (BP agar) medium, regardless of pressure and temperature applied. SIGNIFICANCE AND IMPACT OF THE STUDY: The obtained kinetics could be employed by the industry in selecting optimum pressure/temperature processing conditions. Attention must be given to the selection of the enumeration medium, as the use of an inappropriate medium would lead to underestimation of the surviving cells, thus imposing a risk in the microbiological safety of the product.

Modelling fungal growth using radial basis function neural networks: the case of the ascomycetous fungus Monascus ruber van Tieghem.

A radial basis function (RBF) neural network was developed and evaluated against a quadratic response surface model to predict the maximum specific growth rate of the ascomycetous fungus Monascus ruber in relation to temperature (20-40 degrees C), water activity (0.937-0.970) and pH (3.5-5.0), based on the data of Panagou et al. [Panagou, E.Z., Skandamis, P.N., Nychas, G.-J.E., 2003. Modelling the combined effect of temperature, pH and aw on the growth rate of M. ruber, a heat-resistant fungus isolated from green table olives. J. Appl. Microbiol. 94, 146-156]. Both RBF network and polynomial model were compared against the experimental data using five statistical indices namely, coefficient of determination (R(2)), root mean square error (RMSE), standard error of prediction (SEP), bias (B(f)) and accuracy (A(f)) factors. Graphical plots were also used for model comparison. For training data set the RBF network predictions outperformed the classical statistical model, whereas in the case of test data set the network gave reasonably good predictions, considering its performance for unseen data. Sensitivity analysis showed that from the three environmental factors the most influential on fungal growth was temperature, followed by water activity and pH to a lesser extend. Neural networks offer an alternative and powerful technique to model microbial kinetic parameters and could thus become an additional tool in predictive mycology.

Physicochemical, microbiological, and organoleptic profiles of Greek table olives from retail outlets.

The physicochemical, microbiological, and organoleptic profile of different commercial table olive products from retail outlets was studied. Average pH values were 4.00, 3.96, and 4.31 for Spanish-style green, naturally black, and dry-salted olives, respectively, while salt content was 6.21, 7.34, and 8.00% for the same commercial products. Mean values for titratable acidity were 0.53 and 0.63% (wt/vol) for green and naturally black olives. In general, mean values for pH, titratable acidity, and salt content were in accordance with the requirements established by the International Olive Oil Council (IOOC) for the trade of table olives, although considerable variation was observed within individual olive samples. Salt content of dry-salted olives did not meet the minimum limit of 10% established by the IOOC. The dominant microbiota consisted of lactic acid bacteria and yeasts. Their population was less than 10(9) CFU ml(-1), as stipulated by the IOOC standard for fermented olives held in bulk in a covering liquid. These microorganisms come from the natural microbiota found in spontaneous fermentations and impose no risk to human health. No enterobacteria, pseudomonads, Bacillus cereus, or Clostridium perfringens were detected in any of the samples given the physicochemical characteristics found. The organoleptic profile varied greatly according to processing style and commercial preparation. Green olives had more uniform sensory characteristics than naturally black and dry-salted olives. The most important attributes that influenced the judgment of the panelists were salt content and crispness of the olives.

Analysis of thermal processing of table olives using computational fluid dynamics.

In the present work, the thermal processing of table olives in brine in a stationary metal can was studied through computational fluid dynamics (CFD). The flow patterns of the brine and the temperature evolution in the olives and brine during the heating and the cooling cycles of the process were calculated using the CFD code. Experimental temperature measurements at 3 points (2 inside model olive particles and 1 at a point in the brine) in a can (with dimensions of 75 mm × 105 mm) filled with 48 olives in 4% (w/v) brine, initially held at 20 °C, heated in water at 100 °C for 10 min, and thereafter cooled in water at about 20 °C for 10 min, validated model predictions. The distribution of temperature and F-values and the location of the slowest heating zone and the critical point within the product, as far as microbial destruction is concerned, were assessed for several cases. For the cases studied, the critical point was located at the interior of the olives at the 2nd, or between the 1st and the 2nd olive row from the bottom of the container, the exact location being affected by olive size, olive arrangement, and geometry of the container.

Effect of wine-based marinades on the behavior of Salmonella Typhimurium and background flora in beef fillets.

The aim of this study was to evaluate the wine-based marinades to control the survival of acid-adapted and non-adapted Salmonella Typhimurium and background flora of fresh beef stored aerobically or under modified atmosphere. Beef slices were inoculated with a 3-strain cocktail of acid-adapted or non-adapted Salmonella Typhimurium strains DT 193, 4/74 and DSM 554 and marinated by immersion in wine (W) or wine supplemented with 0.3% thyme essential oil (WEO), for 12h at 4°C. Marinated slices were then stored under air or modified atmosphere conditions at 5°C. S. Typhimurium and background flora were followed for a 19-day period of storage. S. Typhimurium individual strains were monitored by pulsed field gel electrophoresis. Marination with wine significantly (P<0.05) reduced the background flora compared to the control (non-marinated). Furthermore, immersion of fillets in W or WEO marinades for 12h significantly (P<0.05) reduced the levels of S. Typhimurium compared to the non-marinated (control) samples by 1.1 and 1.4logCFU/g or 2.0 and 1.9logCFU/g for acid-adapted and non-adapted cells, respectively. Acid-adapted cells were more susceptible (P<0.05) to the addition of thyme essential oil in the wine marinade. The epidemic multi-drug resistant DT 193, the 4/74 and DSM 554 strains survived marination (for both W and WEO) and were detected at about similar proportions as revealed by PFGE results. Present results indicate that wine-based marinades are efficient, from a safety and shelf life stand point, in reducing pathogen's levels as well as the background beef flora.

Modelling the effect of temperature and water activity on the growth of two ochratoxigenic strains of Aspergillus carbonarius from Greek wine grapes.

AIMS: To develop descriptive models for the combined effect of temperature (10-40 degrees C) and water activity (0.850-0.980) on the growth of two ochratoxin A producing strains of Aspergillus carbonarius from Greek wine grapes on a synthetic grape juice medium. METHODS AND RESULTS: Fungal growth was measured as changes in colony diameter on a daily basis. The maximum specific colony growth rates (mu(max)) were determined by fitting the primary model of Baranyi describing the change in colony diameter (mm) with respect to time (days). Secondary models, relating mu(max) with temperature and a(w) were developed and comparatively evaluated based on polynomial, Parra, Miles, Davey and Rosso equations. No growth was observed at 0.850 a(w) (water activity) regardless of temperature, as well as at marginal temperature levels assayed (10 and 40 degrees C) regardless of water activity. The data set was fitted successfully in all models as indicated by the values of regression coefficients and root mean square error. Models with biological interpretable parameters were highly rated compared with the polynomial model, providing realistic cardinal values for temperature and a(w). The optimum values for growth were found in the range 0.960-0.970 a(w) and 34-35 degrees C respectively for both strains. The developed models were validated on independently derived data from the literature and presented reasonably good predictions as inferred by graphical plots and statistical indices (bias and accuracy factors). CONCLUSIONS: The effect of temperature and a(w) on the growth of A. carbonarius strains could be satisfactorily predicted under the current experimental conditions, and the proposed models could serve as a tool for this purpose. SIGNIFICANCE AND IMPACT OF THE STUDY: The results could be successfully employed as an empirical approach in the development and prediction of risk models of contamination of grapes and grape products by A. carbonarius.

Modelling the effect of high pressure on the inactivation kinetics of a pressure-resistant strain of Pediococcus damnosus in phosphate buffer and gilt-head seabream (Sparus aurata).

AIMS: The aim of this research was to: (i) determine the inactivation pattern of a pressure-resistant strain of Pediococcus damnosus by high hydrostatic pressure in phosphate buffer (pH 6.7) and gilt-head seabream using the linear, biphasic and Weibull models; and (ii) validate the applicability of the Weibull model to predict survival curves at other experimental pressure levels. METHODS AND RESULTS: A pressure-resistant strain of P. damnosus was exposed to a range of pressures (500, 550, 600 and 650 MPa) in phosphate buffer (pH 6.7) and gilt-head seabream for up to 8 min at ambient temperature (23 degrees C). Inactivation kinetics were described by the linear, biphasic and Weibull models. Increasing the magnitude of the pressure applied resulted in increasing levels of inactivation. Pronounced tailing effect was observed at pressures over 600 MPa. The Weibull and biphasic models consistently produced better fit than the linear model as inferred by the values of the root mean squared error, coefficient of determination (R2) and accuracy factor (A(f)). The scale factor (b) of the Weibull model was linearly correlated with pressure (P) treatment in the whole pressure range. Substituting the b parameter in the initial Weibull function and calculating the shape factor (n) by linear interpolation, high pressure (P) was directly incorporated into the model providing reasonable predictions of the survival curves at 570 and 630 MPa. Comparison between the survival curves in phosphate buffer and gilt-head seabream showed a clear protective effect of the food matrix on the resistance of the micro-organism, especially at 500 and 550 MPa. CONCLUSIONS: The Weibull and biphasic models were more flexible to describe the survival curves of P. damnosus in the experimental pressure range, taking also into account the tailing effect that could not be included in the linear model. The Weibull model could also give reasonable predictions of the survival curves at other experimental pressures in both pressure menstrua. As the food matrix has a protective effect in microbial inactivation, the development of accurate mathematical models should be done directly on real food to avoid under- or over-processing times. SIGNIFICANCE AND IMPACT OF THE STUDY: The development of accurate models to describe the survival curves of micro-organisms under high hydrostatic pressure treatment would be very important to the food industry for process optimisation, food safety and extension of the applicability of high pressure processing.

Image analysis as a mean to model growth of Escherichia coli O157:H7 in gel cassettes.

AIMS: The potential of image analysis for rapid and quantitative determination of the effect of environmental parameters such as temperature and pH on the growth of colonies of Escherichia coli O157:H7 derived from immobilized cells in gel cassettes was investigated. METHODS AND RESULTS: The organism was grown in brain heart infusion agar contained within a cassette formed between sheets of PVC film. The medium was adjusted to pH 5, 6 or 7 and incubated at 10, 20, 30 or 40 degrees C. The primary model of Baranyi was used to fit the growth data obtained by conventional plate counting and changes in colony area (2-dimensional spread of colonies) by light microscopy to derive estimates of maximum specific growth rates (micromax and Area micromax) in both cases. Growth rate values from both measurements were correlated and a secondary quadratic model was developed to predict micromax obtained via image analysis in response to environmental factors (temperature and pH). A progressive decrease of micromax and Area micromax was observed at lower temperatures and pH values. Immobilized cells failed to initiate growth at a pH of 5.0 and 10 degrees C. There was high correlation between micromax values estimated by conventional plate counting and Area micromax values from microscopic observations in gel cassettes, regardless of temperature and pH. The values of micromax derived indirectly from the correlation with Area micromax values fitted well to the secondary model and gave realistic predictions of maximum specific growth rate values estimated by standard plate counting. CONCLUSIONS: The micromax of E. coli O157:H7 determined by plate counting was linearly correlated with Area micromax estimated by light microscopy, enabling indirect determination of micromax via the Area micromax. The estimates of micromax via the image analysis technique may be further modelled in response to environmental factors such as temperature and pH to predict the response of the organism in intermediate conditions. SIGNIFICANCE AND IMPACT OF THE STUDY: Image analysis in combination with gel cassettes could be a potential tool for rapid and convenient data collection and construction of accurate mathematical models as an alternative to conventional plate counting methods.

Use of gradient plates to study combined effects of temperature, pH, and NaCl concentration on growth of Monascus ruber van Tieghem, an Ascomycetes fungus isolated from green table olives.

The effect of temperature, pH, and sodium chloride concentration on the growth of the Ascomycetes fungus Monascus ruber van Tieghem, the main spoilage microorganism during storage of table olives, was studied by using the gradient plate technique. Gradients of NaCl (3 to 9%, wt/vol) at right angles to gradients of pH (2 to 6.8) were prepared for the plates, which were incubated at 25, 30, and 35 degrees C. Visible fungal growth, expressed in optical density units, was recorded by image analysis and graphically presented in the form of three-dimensional grids. Results obtained from the plates indicated that the fungus was salt and acid tolerant, being able to grow at NaCl concentrations of up to 9% (wt/vol) and pH values of as low as 2.2, depending on the incubation temperature. The inhibitory effect of NaCl increased as the pH decreased progressively at 25 and 30 degrees C but not at 35 degrees C. Growth was better at 30 and 25 degrees C as judged by the larger extent of the plates covered by mycelium compared with that at 35 degrees C, where no growth was observed at pHs below 3.7. Differentiation between vegetative (imperfect-stage) and reproductive (perfect-stage) growth was evident on all plates, providing useful information about the effect of environmental conditions on the form of fungal growth. When the growth/no-growth surface model was obtained by applying linear logistic regression, it was found that all factors (pH, NaCl, and temperature) and their interactions were significant. Plots of growth/no-growth interfaces for P values of 0.1, 0.5, and 0.9 described the results satisfactorily at 25 and 35 degrees C, whereas at 35 degrees C the model predicted lower minimum pH values for growth in the range of 7 to 10% NaCl than those observed on the plates. Overall, it is suggested that the fungus cannot be inhibited by any combination of pH and NaCl within the limits of the brine environment, so further processing is required to ensure product stability in the market.

Pharmacological therapy for portal hypertension: rationale and results.

Drug therapy for acute variceal bleeding should be viewed as an adjunct to emergency sclerotherapy. Its role in preventing very early rebleeding (within days) following sclerotherapy needs to be established. The best candidates for such a role are somatostatin and octreotide, but glypressin and vasopressin and nitroglycerin combinations have therapeutic effects in the short-term. Propranolol is the drug for long-term prevention of rebleeding and prevention of the first variceal bleed. For primary prophylaxis it significantly reduces the rate of bleeding, and there is a trend towards reducing mortality. It should be used in cirrhotic patients with large varices. For secondary prophylaxis, propranolol significantly reduces rebleeding but does not improve survival. The reduction in rebleeding is similar to long-term sclerotherapy when compared in randomized studies. There is no value in adding beta-blockers to sclerotherapy compared with sclerotherapy alone, but few studies have evaluated the effects after the eradication of varices. beta-Blockers can be used as the first-line therapy to prevent variceal rebleeding. They also have been shown to reduce the frequency of rebleeding from congestive gastropathy. Many patients do not have a portal pressure reduction with propranolol. The addition of isosorbide mononitrate converts many nonresponders to responders. Current clinical trials are evaluating if therapeutic efficacy is improved by these drug combinations.

Effectiveness of acid suppression in preventing gastroesophageal reflux disease (GERD) after successful treatment of Helicobacter pylori infection.

There is evidence that Helicobacter pylori eradication might predispose to gastroesophageal reflux disease (GERD). The aim of this prospective study was to examine the effectiveness of antisecretory treatment, after successful H. pylori eradication, in preventing GERD, since no data exist so far. Eighty initially H. pylori(+) patients, without GERD at the time of H. pylori eradication [50 peptic ulcer (PU) and 30 nonulcer (NU), 55 men, 25 women, median age 38 years, range 19-57], after successful H. pylori eradication were randomized to recieve either omeprazole 20 mg daily (group A) or no treatment (group B) for one year. All patients underwent upper gastrointestinal endoscopy at 0, 6, and 12 months or when GERD symptoms occurred. There were 40 patients in each group, and there were no statistically significant differences between the two groups in terms of sex, age, body weight, ulcer/no ulcer ratio, and other demographic data. Seven patients from group A and five patients from group B were lost to follow-up, and therefore there were 33 and 35 patients in groups A and B, respectively, who completed the study. One of 33 patients in group A (3%) and 10/35 (28.5%) in group B developed GERD symptoms during follow-up (P = 0.0022). The respective values for esophagitis were 0/33 (0%) and 6/35 (17.1%) (P = 0.0083). In conclusion, antisecretory treatment in H. pylori(+) patients, after successful eradication, is effective in preventing GERD.