Assessment of probiotic and technological properties of Bacillus spp. isolated from Burkinabe Soumbala.

BACKGROUND: Soumbala is a highly loved alkaline traditional fermented food condiment in Burkina Faso. It harbors various microbiota dominated by fermentative Bacillus spp. as functional microorganism with little confirmed health-promoting properties. METHODS: The present study aimed to evaluate six Bacillus strains previously isolated and identified from soumbala. These strains were selected as presumptively safe bacteria for probiotic and technological characteristics. These strains were assessed for in vitro probiotic criteria (tolerance to acidic pH, gastric juice, 0.3% (m/v) bile salts, intestinal juice and 0.4% (w/v) phenol, cell surface hydrophobicity, auto-aggregation capacity, antimicrobial activity against foodborne pathogens, antibiotic susceptibility and biofilm production) and technological properties, including protease, amylase, lipase, and tannase activity, as well as poly-γ-glutamic acid (PGA) production and thermo-tolerance. RESULTS: All tested Bacillus strains (B54, F20, F24, F21, F26 and F44) presented variable relevant probiotic properties (good tolerance to pH 2 and pH 4, gastric juice, bile salts, intestinal juice and phenol), with marked differences in hydrophobicity and auto-aggregation capacity ranging from 73.62-94.71% and 49.35-92.30%, respectively. They exhibited a broad spectrum of activity against foodborne pathogens depending on target pathogen, with the highest activity exhibited by strain F20 (29.52 mm) against B. cereus 39 (p < 0.001). They also showed good biofilm production as well as variable hydrolytic enzyme activities, including protease (43.00-60.67 mm), amylase (22.59-49.55 mm), lipase (20.02-24.57 mm), and tannase (0-10.67 mm). All tested Bacillus strains tolerated temperature up to 50 °C, while only strains F26 and F44 showed the best PGA production. CONCLUSION: Overall, the tested cultures exhibiting potential probiotic and technological characteristics; particularly B. cereus F20, B. benzoevorans F21, B. cabrialessi F26, and B. tequilensis F44 could be a source of probiotic-starters of commercial interest in the production of high-quality soumbala.

Menopausal symptoms in epithelial ovarian cancer survivors: a GINECO VIVROVAIRE2 study.

OBJECTIVE: We have previously shown that epithelial ovarian cancer (EOC) and its treatments have negative effects on long-term quality of life (QoL) and fatigue. The present multicenter study investigated the main menopausal symptoms and gynecological management of EOC survivors (EOCS). METHODS: 166 patients with relapse-free ≥3 years after the end of treatment attended a consultation with a gynecologist, including a questionnaire related to vasomotor symptoms (VMS) and sexuality, a clinical examination, a blood sample and an osteodensitometry. QoL, fatigue, insomnia and mood disorders were measured with validated questionnaires and correlated to VMS. VMS and QoL were assessed according to natural menopause (NM) or surgical menopause (SM). RESULTS: Mean age at the survey was 62 [21-83] years and stage III/IV (48%). Mean delay since the end of treatment was 6 years. Fifty-nine patients (36%) had SM. Half of patients reported VMS. Seventy-two percent of EOCS with SM had VMS compared to 41% with NM (P < .001). VMS were not associated with poor global QoL, fatigue, insomnia or mood disorders. Two-thirds of EOCS reported a decrease in libido. Patients with SM showed a greater decrease in libido than NM (P < .02). Fourteen percent of them had osteoporosis and 50% osteopenia. Among the 85 patients with VMS, 80 did not receive HRT after cancer treatment. At the time of the survey, only 7 (4%) patients were receiving hormone replacement therapy (HRT). CONCLUSIONS: VMS and sexual disorders are frequently reported by EOCS, particularly among patients with SM. Most EOCS with menopausal symptoms could benefit from HRT to improve these symptoms.

Long-term fatigue and quality of life among epithelial ovarian cancer survivors: a GINECO case/control VIVROVAIRE I study.

BACKGROUND: Few data are available on long-term fatigue (LTF) and quality of life (QoL) among epithelial ovarian cancer survivors (EOCS). In this case-control study, we compared LTF, symptoms and several QoL domains in EOCS relapse-free ≥3 years after first-line treatment and age-matched healthy women. PATIENTS AND METHODS: EOCS were recruited from 25 cooperative GINECO centers in France. Controls were randomly selected from the electoral rolls. All participants completed validated self-reported questionnaires: fatigue (FACIT-F), QoL (FACT-G/O), neurotoxicity (FACT-Ntx), anxiety/depression (HADS), sleep disturbance (ISI), and physical activity (IPAQ). Severe LTF (SLTF) was defined as a FACIT-F score <37/52. Univariate and multivariate logistic regressions were conducted to analyze SLTF and its influencing factors in EOCS. RESULTS: A total of 318 EOCS and 318 controls were included. EOCS were 63-year-old on average, with FIGO stage I/II (50%), III/IV (48%); 99% had received platinum and taxane chemotherapy, with an average 6-year follow-up. There were no differences between the two groups in socio-demographic characteristics and global QoL. EOCS had poorer FACIT-F scores (40 versus 45, P < 0.0001), lower functional well-being scores (18 versus 20, P = 0.0002), poorer FACT-O scores (31 versus 34 P < 0.0001), and poorer FACT-Ntx scores (35 versus 39, P < 0.0001). They also reported more SLTF (26% versus 13%, P = 0.0004), poorer sleep quality (63% versus 47%, P = 0.0003), and more depression (22% versus 13%, P = 0.01). Fewer than 20% of EOCS and controls exercised regularly. In multivariate analyses, EOCS with high levels of depression, neurotoxicity, and sleep disturbance had an increased risk of developing SLTF (P < 0.01). CONCLUSION: Compared with controls, EOCS presented similar QoL but persistent LTF, EOC-related symptoms, neurotoxicity, depression, and sleep disturbance. Depression, neuropathy, and sleep disturbance are the main conditions associated with severe LTF.

Impact of anxio-depressive symptoms and cognitive function on oral anticancer therapies adherence.

PURPOSE: Oral anticancer therapies have an important place in the therapeutic arsenal, but factors influencing adherence to oral treatment are poorly documented in oncology. The objective of this study was to assess the impact of anxio-depressive symptoms and cognitive functioning on oral medication adherence. METHODS: This prospective study included cancer patients initiating a first oral therapy. Before initiation of treatment, an assessment of depression, anxiety, and cognition was performed. Using self-report questionnaires, we collected information on socio-demographic conditions and the non-adherence at 1 (M1) and 3 months (M3) after the beginning of treatment. RESULTS: Among 129 patients enrolled, median age was 70 years and 81% of patients were treated for metastatic cancer. Before initiating treatment, 16% and 8% of patients presented respectively depression and anxiety symptoms. Global cognitive impairment was observed in 51% of patients. Ten percent of the patients were non-adherent at M1 and 13% at M3. Depression was strongly associated with non-adherence at M1 (P = 0.046) and M3 (P = 0.014), but not anxiety. Non-adherence was associated with lower working memory (P = 0.037) and digit memory (P = 0.018) at M1 and short-term memory (P = 0.04) at M3. Patients with more than eight co-medications were more often non-adherents (P = 0.055). CONCLUSIONS: Non-adherence to oral anticancer therapies was mainly associated to depression. Focusing on depressive symptoms before initiation of oral anticancer therapy could help to identify patient profiles more likely to fail self-management. Working memory, digit memory, and short-term memory also seem to play a role in non-adherence. Further studies should include a more specific population, especially according to age.

Chemotherapy (platinum and pemetrexed) in combination with erlotinib in non-small cell lung cancer induces major gastrointestinal toxicity: two case reports from the FLARE/GFPC 03-2013 study.

WHAT IS KNOWN AND OBJECTIVE: A randomized phase III study was designed to assess the efficacy and safety of second-line platinum-based chemotherapy with or without erlotinib in non-small cell lung cancer (NSCLC) with EGFR-activating mutation after secondary resistance to EGFR-TKIs (epidermal growth factor receptor tyrosine kinase inhibitors). CASE SUMMARY: We report herein two of the first three patients who presented with major gastrointestinal toxicities in the experimental arm of the trial. WHAT IS NEW AND CONCLUSION: Pending further data, it would seem safer to administer EGFR-TKIs and chemotherapy sequentially rather than concomitantly.

REBECA: a phase I study of bevacizumab and whole-brain radiation therapy for the treatment of brain metastasis from solid tumours.

BACKGROUND: Brain metastases (BMs) are associated with a poor prognosis. Standard treatment comprises whole-brain radiation therapy (WBRT). As neo-angiogenesis is crucial in BM growth, combining angiogenesis inhibitors such as bevacizumab with radiotherapy is of interest. We aimed to identify the optimal regimen of bevacizumab combined with WBRT for BM for phase II evaluation and provide preliminary efficacy data. PATIENTS AND METHODS: In this multicentre single-arm phase I study with a 3 + 3 dose-escalation design, patients with unresectable BM from solid tumours received three cycles of bevacizumab at escalating doses [5, 10 and 15 mg/kg every 2 weeks at dose levels (DL) 0, 1 and 2, respectively] and WBRT (30 Gy/15 fractions/3 weeks) administered from day 15. DL3 consisted of bevacizumab 15 mg/kg with WBRT from day 15 in 30 Gy/10 fractions/2 weeks. Safety was evaluated using NCI-CTCAE version 3. BM response (RECIST 1.1) was assessed by magnetic resonance imaging at 6 weeks and 3 months after WBRT. RESULTS: Nineteen patients were treated, of whom 13 had breast cancer. There were no DLTs. Grade 1-2 in-field and out-field toxicities occurred for five and nine patients across all DLs, respectively, including three and six patients (including one patient with both, so eight patients overall) of nine patients in DL3. One patient experienced BM progression during treatment (DL0). At the 3-month post-treatment assessment, 10 patients showed a BM response: one of three treated at DL0, one of three at DL1, two of three at DL2 and six of seven at DL3, including one complete response. BM progression occurred in five patients, resulting in two deaths. The remaining patient died from extracranial disease progression. CONCLUSION: Bevacizumab combined with WBRT appears to be a tolerable treatment of BM. DL3 warrants further efficacy evaluation based on the favourable safety/efficacy balance. ClinicalTrials.gov Identifier: NCT01332929.

Does allergic rhinitis exist in infancy? Findings from the PARIS birth cohort.

BACKGROUND: Early onset of allergic rhinitis (AR) is poorly described, and rhinitis symptoms are often attributed to infections. This study analyses the relations between AR-like symptoms and atopy in infancy in the PARIS (Pollution and Asthma Risk: an Infant Study) birth cohort. METHODS: Data on AR-like symptoms (runny nose, blocked nose, sneezing apart from a cold) were collected using a standardized questionnaire administered during the health examination at age 18 months included in the follow-up of the PARIS birth cohort. Parental history of allergy and children's atopy blood markers (blood eosinophilia ≥470 eosinophils/mm(3) , total immunoglobulin E ≥45 U/ml and presence of allergen-specific IgE) were assessed. Associations were studied using multivariate logistic regression models adjusted for potential confounders. RESULTS: Prevalence of AR-like symptoms in the past year was 9.1% of the 1850 toddlers of the study cohort. AR-like symptoms and dry cough apart from a cold were frequent comorbid conditions. Parental history of AR in both parents increased the risk of suffering from AR-like symptoms with an OR 2.09 (P=0.036). Significant associations were found with the presence of concurrent biological markers of atopy, especially blood eosinophilia and sensitization to house dust mite (OR 1.54, P=0.046 and OR 2.91, P=0.042) whereas there was no relation with sensitization to food. CONCLUSIONS: These results support the hypothesis that AR could begin as early as 18 months of life. Suspicion of AR should be reinforced in infants with parental history of AR or biological evidence of atopy, particularly blood eosinophilia and sensitization to inhalant allergens.

Lactones and quinones from the tubers of Sinningia aggregata.

Three new aromatic epsilon-lactones, aggregatins A (1), B (2), and C (3), a new naphthoquinone derivative, aggregatin D (4), and three known anthraquinones, 2-methylanthraquinone, 7-methoxy-2-methylanthraquinone, and 7-hydroxy-2-methylanthraquinone, were isolated from the tubers of Sinningia aggregata (Gesneriaceae). Compounds 1 and 4 and the anthraquinones showed marginal antimicrobial activity.

Evaluation of patients' needs to design and assess a patient education program in cancer pain.

Purpose: Patient education constitutes a relevant strategy to improve pain management. In the field of therapeutic patient education (TPE), we aimed 1) to assess pain impact in cancer patients, 2) to identify patients' educative needs in pain management, and 3) to refine research criteria for its future evaluation. Patients and methods: Pain intensity, relief and interference were assessed in 75 cancer patients with unbalanced background pain. Self-assessment questionnaire evaluated i) patients' pain management and ii) their knowledge and needs in TPE. Results: Most patients experienced pain for more than 6 months and 41.6% reported adequate pain relief. Understanding pain and pain management were major patients' preferences (>58%). Most patients declared they knew their pain treatments, but fewer than half of them were able to name them. However, education concerning pain treatment was considered as essential in <30% of patients. Almost all patients (97.1%) stated pain education as beneficial, with a preference for individualized sessions (41.2%). In addition, the assessment criteria for its future evaluation were refined. Conclusion: Targeted population mainly concerned patients with persistent pain. Only half of patients reported pain relief despite antalgics. Patient education was declared as beneficial for almost all participants. Practice implications: Tailoring a pain TPE on patients' needs has the potential to help them to optimally manage their pain daily.

[Epidemiology of allergic respiratory disorders in infants]. / Epidémiologie des allergies respiratoires chez le nourrisson.

INTRODUCTION: Allergic disorders of the respiratory tract have been the subject of many epidemiological studies, especially during infancy which is known to be a critical period for development of the immune system. This paper aims to describe the prevalence of allergic respiratory disorders in children below three years of age in the general population, despite the lack of shared definition of asthma and allergic rhinitis among studies. STATE OF ART: Doctor-diagnosed asthma occurs in 5% of children below two years of age. One third of children below three years of age experience wheeze during a lower respiratory tract infection, but only 7% of children wheeze apart from a respiratory infection. Asthma-like cough and bronchial obstruction symptoms are reported in respectively 15% and 9% of children below two years of age. Depending on the definition of allergic rhinitis used, its prevalence varies from 1 to 30% among two years old children. PERSPECTIVES: Definitions of allergic respiratory tract disorders in infants become more elaborate involving parental and personal history of allergy and medication; epidemiological research now attempts to identify, using biological evidence of atopy, infants at risk of persistent allergic disorders. CONCLUSIONS: A better definition of allergic respiratory disorders in infants may help epidemiological research and early care management.

Antifungal activity of drimane sesquiterpenes from Drimys brasiliensis using bioassay-guided fractionation.

PURPOSE: This study describes the antifungal effect of extracts and compounds isolated from Drimys brasiliensis acting against dermatophytes. METHODS: The activities were evaluated by using the microbroth dilution method. RESULTS: Bioassay-guided fractionation of the most active extract from the bark (CHCl3) led to the isolation of the sesquiterpene drimanes polygodial, 1-beta-(p-methoxycinnamoyl)-polygodial, drimanial and 1-beta-(p-cumaroyloxy)-polygodial, which were selectively active against Epidermophyton floccosum and Tricophyton rubrum. CONCLUSIONS: The selective antifungal activity reported in this paper for drimanes isolated from D. brasiliensis opens the possibility that they could be helpful for the developing of new antifungal agents for treating the difficult to eradicate dermatomycoses produced by E. floccosum.

[How to describe indoor environment in epidemiological studies dealing with respiratory diseases]. / Description de l'environnement domestique et études épidémiologiques sur les pathologies respiratoires.

BACKGROUND: Indoor environment can be partly responsible for respiratory health. The aim of this paper is to summarize epidemiological studies dealing with the relations between indoor pollutions and asthma or atopy, to analyze the ways of characterization of the dwellings and to expose health effects of the studied risk factors and results of the confrontation between data issued from questionnaires and from environmental measurements. METHODS: Thirty two papers were listed on Medline data base since 1990. These are mainly case-control studies and cross-sectional surveys and most often concern children. The health status is objectively evaluated by medical examinations or indirectly characterized by questionnaires on symptoms. All the studies use a questionnaire to describe indoor environment while some environmental measurements, mostly of biological pollutions, could be realized simultaneously. RESULTS: Some associations between different characteristics of the dwellings and respiratory symptoms are commonly found. Thus, exposure to allergens of the dwellings, environmental tobacco smoke, home dampness or characteristics and cleaning of the bedding increase the prevalence of respiratory symptoms. Residential exposure to chemical pollutants, due to the existence of recent paints are also related to different respiratory symptoms. By contrast, for other indoor risk factors, without standardized evaluation, the impact on respiratory health is inconstant. These factors are sociodemographic environment, heating and cooking installations, use of a humidifier, treatment air system or ventilation system, wall-to-wall carpets or pets at home. CONCLUSIONS: On examining this review literature, disparity in description of the indoor environment, depending on the studied pollutants, is pointed out. That is why we advice to use ever validated questionnaires to evaluate environmental tobacco smoke, home dampness and presence of pets, in association with environmental measurements to study indoor sources of allergens. Conversely, to evaluate the home exposure to chemical pollutions poorly studied today, some new questionnaires have to be elaborated and validated with regard to environmental measurements before being used in epidemiological studies.

Exclusive radiotherapy for stage T1-T2N0M0 lanryngeal cancer: retrospective study of 59 patients at CFB and CHU de Caen.

OBJECTIVE: Study of patients with stage T1N0M0 or T2N0M0 glottic cancer treated by exclusive radiotherapy and comparison of the survival and functional results of this series with those of the literature. METHOD: Retrospective study of stage T1N0M0 or T2N0M0 glottic cancers diagnosed between 1st January 2000 and 31st December 2010 and treated by exclusive radiotherapy. Evaluation of survival, recurrence and larynx preservation rates. STUDY CENTRES: CLCC François-Baclesse and CHU de Caen. PATIENTS: Fifty-nine patients (53 men and sixwomen) treated for glottic cancer (57 squamous cell carcinomas, two verrucous carcinomas) comprising 51 T1N0M0 and eight T2N0M0 tumours. Treatment with exclusive radiotherapy (mean dose of 70 Grays limited to the thyroid cartilage for 57 patients, with lymph node irradiation for two patients). RESULTS: In this series, five (9.8%) patients with stage T1N0M0 glottic cancer and three patients (37.5%) with stage T2N0M0 glottic cancer relapsed, corresponding to a global recurrence rate of 13.6%. Three of the eight recurrences involved lymph nodes exclusively (N), two patients relapsed exclusively at the primary tumour site (T) and three patients presented local and lymph node recurrence (T and N). Treatment consisted of salvage total laryngectomy with bilateral cervical lymph node dissection in three cases, bilateral cervical lymph node dissection and sensitized radiotherapy in two cases, exclusive chemotherapy in one case, cervical lymph node dissection and cervical radiotherapy in one case. The last patient with recurrence died prior to salvage therapy. The larynx preservation rate was 94.9%. CONCLUSION: In comparison with the literature, treatment of stage T1-T2N0M0 glottic cancer by exclusive radiotherapy gives very good results, with a larynx preservation rate of 95%.

Analysis of phosphorothionate pesticides using a chloroperoxidase pretreatment and acetylcholinesterase biosensor detection.

Acetylcholinesterase (AChE) is responsible for the hydrolysis of acetylcholine in the nervous system. It is inhibited by organophosphate and carbamate pesticides. However, this enzyme is only slightly inhibited by organophosphorothionates, which makes the detection of these pesticides analytically very difficult. A new enzymatic method for the activation and detection of phosphorothionates was developed with the capability to be used directly in food samples without the need of laborious solvent extraction steps. Chloroperoxidase (CPO) from Caldariomyces fumago was combined with tert-butyl hydroperoxide and two halides. Chlorpyrifos and triazophos were completely oxidized. Fenitrothion, methidathion and parathion methyl showed conversion rates between 54 and 61%. Furthermore, the oxidized solution was submitted to an AChE biosensor assay. Chlorpyrifos spiked in organic orange juice was oxidized, where its oxon product was detected in concentrations down to 5 microg/L (final concentration food sample: 25 microg/L). The complete duration of the method takes about 2 h.

Nitro derivatives from the Arctic ice bacterium Salegentibacter sp. isolate T436.

Twenty-five aromatic nitro, dinitro and trinitro compounds were isolated in low yields of less than 1 mg l(-1) from a Salegentibacter sp. strain T436 derived from Arctic pack ice. Their structures were elucidated by MS and NMR techniques. Seven of these compounds, namely, 2-hydroxy-3-(4'-hydroxy-3'-nitrophenyl)-propionic acid methyl ester (6), 2-chloro-3- (4'-hydroxy-3'-nitrophenyl)propionic acid methyl ester (7), 3-(4'-hydroxy-3',5'-dinitrophenyl)-propionic acid methyl ester (14), 4'-hydroxy-3',5'-dinitrophenylethylchloride (16), (4'-hydroxy-3',5'-dinitrophenyl)-2-chloropropionic acid methyl ester (17), N-acetyl-3',5'-dinitrotyramine (18) and 2,6-dinitro-4-(2'-nitroethenyl)phenol (19) are new, and five are reported in this study from a natural source for the first time.

The Paris prospective birth cohort study: which design and who participates?

The Paris prospective birth cohort study was implemented in 2003 to assess environmental/behavioural factors associated with respiratory and allergic disorder occurrence in early childhood. This paper describes the design and sociodemographic features of eligible/enrolled families. Full-term newborns without any medical problem at birth were recruited in five Paris maternity hospitals. They resided in the Paris area and had French speaking mothers. Sample size is at least 3500 infants, and children are followed-up until their sixth birthday. Data collection is based on regular medical and environmental self-administered questionnaires to parents. Information on dwellings is gathered by means of phone questionnaires, and standardized medical examinations are carried out at 18 months and 6 years. Exposure to traffic-related pollution is modelled. At inclusion, some information concerning refusals is gathered in order to describe sociodemographic features of participating families as compared with eligible children. 4115 (63%) out of the 6493 eligible infants are now participating in this study. Participation rate is higher in parents with a high SES (socioeconomic status), for French and European parents, and for > or =25-year-old mothers, but decreases with sibship size. Similar determinants are associated with the distribution of reasons for non-participation. The participation rate in the Paris study is comparable with other similar studies. Finally, giving detailed explanation of the study aims at inclusion, establishing regular mailed and phoned contacts with families, offering free complete medical examinations for the participant child and re-sent missing questionnaires are very important to improve participation at inclusion and during follow-up.

Indoor aldehydes: measurement of contamination levels and identification of their determinants in Paris dwellings.

The recent increased prevalence of childhood asthma and atopy has brought into question the impact of outdoor pollutants and indoor air quality. The contributory role of aldehydes to this problem and the fact that they are mainly derived from the domestic environment make them of particular interest. This study therefore measures six different aldehyde levels in Paris dwellings from potentially different sources and identifies their indoor determinants. The study was carried out in the three principal rooms of 61 flats with no previous history of complaint for olfactory nuisance or specific symptoms, two-thirds of the flats having been recently refurbished. Aldehydes were sampled in these rooms using passive samplers, and a questionnaire on potential aldehyde sources was filled out at the same time. A multiple linear regression model was used to investigate indoor aldehyde determinants. Our study revealed that propionaldehyde and benzaldehyde were of minor importance compared to formaldehyde, acetaldehyde, pentanal, and hexanal. We found that levels of these last four compounds depended on the age of wall or floor coverings (renovations less than 1 year old), smoking, and ambient parameters (carbon dioxide levels, temperature). These results could help in the assessment of indoor aldehyde emissions.