Study of volatile compounds in Greek pistachio (Pistacia vera L. 'Aegina' cultivar) oils using Soxhlet and ultrasound assisted extraction.

Headspace solid-phase microextraction followed by gas chromatography-mass spectrometry (HS-SPME/GC-MS) represents the most used solvent-free methodology for the characterization of the complex and heterogeneous mix of volatile compounds. The present study investigates the differences in volatile profile of pistachio oils 'Aegina' cultivar extracted with two different techniques, ultrasound assisted extraction (UAE) and Soxhlet. Differences were observed both in the pistachio oil yield and the composition of the volatile compounds among these two groups of samples, which were significantly influenced due to the different thermal conditions. In terms of pistachio oil yield, the Soxhlet extraction technique was proven more efficient (52.5-68.2% w/w) than the UAE type (28.2-42.6% w/w). A total of 34 and 30 volatile compounds were identified for UAE and Soxhlet, respectively. The main ones associated with UAE were α-pinene, octane and decane, while the volatiles formed as a consequence of Soxhlet extraction were decane, nonanal and (E)-2-decenal. Terpenes' concentrations were found decreased in Soxhlet's samples, but hydrocarbons and aldehydes were significantly increased in these samples. Numerous studies concluded in common results. However, this article is the first to explore the influence of different extraction types on the volatile profile of the unique flavour and odor pistachio oil 'Aegina' cultivar.

Diagnostic Accuracy of Multiple D-Dimer Cutoff Thresholds and Other Clinically Applicable Biomarkers for the Detection and Radiographic Evaluation of Pulmonary Embolism.

Background: Diagnostic work-up of pulmonary embolism (PE) remains a challenge. Methods: We retrospectively studied all patients referred for computed tomography pulmonary angiography (CTPA) with suspicion of PE during a 12-month period (2018). The diagnostic accuracy of different D-dimer (Dd) cutoff thresholds for ruling out PE was evaluated. Furthermore, the association of Dd and red cell distribution width (RDW) with embolus location, CTPA findings, and patient outcome was recorded. Results: One thousand seventeen (n = 1017) patients were finally analyzed (mean age: 64.6 years (SD = 11.8), males: 549 (54%)). PE incidence was 18.7%. Central and bilateral embolism was present in 44.7% and 59.5%, respectively. Sensitivity and specificity for conventional and age-adjusted Dd cutoff was 98.2%, 7.9%, and 98.2%, 13.1%, respectively. A cutoff threshold (2.1 mg/L) with the best (64.4%) specificity was identified based on Receiver Operating Characteristics analysis. Moreover, a novel proposed Dd cutoff (0.74 mg/L) emerged with increased specificity (20.5%) and equal sensitivity (97%) compared to 0.5 mg/L, characterized by concurrent reduction (17.2%) in the number of performed CTPAs. Consolidation/atelectasis and unilateral pleural effusion were significantly associated with PE (p < 0.05, respectively). Patients with consolidation/atelectasis or intrapulmonary nodule(s)/mass on CTPA exhibited significantly greater median Dd values compared to patients without the aforementioned findings (2.34, (IQR 1.29−4.22) vs. 1.59, (IQR 0.81−2.96), and 2.39, (IQR 1.45−4.45) vs. 1.66, (IQR 0.84−3.12), p < 0.001, respectively). RDW was significantly greater in patients who died during hospitalization (p = 0.012). Conclusions: Age-adjusted Dd increased diagnostic accuracy of Dd testing without significantly decreasing the need for imaging. The proposed Dd value (0.74 mg/L) showed promise towards reducing considerably the need of CTPA. Multiple radiographic findings have been associated with increased Dd values in our study.

Malignant Superior Vena Cava Syndrome: State of the Art.

Superior vena cava syndrome (SVCS) is a clinical entity characterized by signs and symptoms arising from the obstruction or occlusion of the thin-walled superior vena cava (SVC) and can result in significant morbidity and mortality. Despite the rise of benign cases of SVCS, as a thrombotic complication of intravascular devices, it is most commonly seen secondary to malignancy as a consequence of thrombosis, direct invasion of tumor cells inside the vessel, or external compression. SVCS can be the initial presentation of a previously undiagnosed tumor in up to 60% of cases. Lung cancer and non-Hodgkin lymphoma (NHL) are responsible for up to 85%-90% of malignancy-related SVCS, while metastatic cancers account for approximately 10%. Herein, we review the pathophysiology, etiology, clinical presentation, diagnosis, and management of malignancy-related SVCS.

Dried Figs Quality Improvement and Process Energy Savings by Combinatory Application of Osmotic Pretreatment and Conventional Air Drying.

This study concerns the implementation of osmotic dehydration (OD) as a pre-treatment of air-drying in fig halves, aiming at drying acceleration, energy savings and product quality improvement. The effect of solid/liquid mass ratio, process temperature (25-45 °C) and duration (up to 300 min) on water activity (aw) and transport phenomena during OD, was modelled. The effective diffusion coefficients, drying time and energy consumption, were also calculated during air-drying at 50-70 °C. At optimum OD conditions (90 min, 45 °C), the highest water loss and solid gain ratio were achieved, while the aw (equal to an initial value 0.986) was decreased to 0.929. Air-drying time of OD- and control samples was estimated at 12 and 21 h, at 60 °C, respectively, decreasing the required energy by up to 31.1%. Quality of dried figs was systematically monitored during storage. OD-assisted air-drying led to a product of improved quality and extended shelf-life.

Chest CT severity score and radiological patterns as predictors of disease severity, ICU admission, and viral positivity in COVID-19 patients.

BACKGROUND: Chest computed tomography (CT) is a useful tool for the diagnosis of coronavirus disease-2019 (COVID-19), although its exact value for predicting critical illness remains unclear. This study evaluated the efficacy of chest CT to predict disease progression, pulmonary complications, and viral positivity duration. METHODS: A single-center cohort study was conducted by consecutively including hospitalized patients with confirmed COVID-19. The chest CT patterns were described and a total severity score was calculated. The predictive accuracy of the severity score was evaluated using the receiver operating characteristic analysis, while a Cox proportional hazards regression model was implemented to identify the radiological features that are linked to prolonged duration of viral positivity. RESULTS: Overall, 42 patients were included with 10 of them requiring intensive care unit admission. The most common lesions were ground glass opacities (92.9%), consolidation (66.7%), and crazy-paving patterns (61.9%). The total severity score significantly correlated with inflammatory and respiratory distress markers, as well as with admission CURB-65 and PSI/PORT scores. It was estimated to predict critical illness with a sensitivity and specificity of 75% and 70%, respectively. Time-to-event analysis indicated that patients without ground-glass opacities presented significantly shorter median viral positivity (16 vs. 27 days). CONCLUSIONS: Chest CT severity score positively correlates with markers of COVID-19 severity and presents promising efficacy in predicting critical illness. It is suggested that ground-glass opacities are linked to prolonged viral positivity. Further studies should confirm the efficacy of the severity score and elucidate the long-term pulmonary effects of COVID-19.

Recent Advances in Ruthenium-Catalyzed Hydrogenation Reactions of Renewable Biomass-Derived Levulinic Acid in Aqueous Media.

Levulinic acid (LA) is classified as a key platform chemical for the development of future biorefineries, owing to its broad spectrum of potential applications and because it is simply available from lignocellulosic biomass through inexpensive and high-yield production routes. Catalytic hydrogenation reactions of LA into the pivotal intermediate compound γ-valerolactone (GVL), and beyond GVL to yield valeric acid (VA), 1,4-pentanediol (1,4-PDO), and 2-methyltetrahydrofuran (2-MTHF) have gained considerable attention in the last decade. Among the various transition metals used as catalysts in LA hydrogenation reactions, ruthenium-based catalytic systems have been the most extensively applied by far, due to the inherent ability of ruthenium under mild conditions to hydrogenate the keto functionality of LA selectively into an alcohol group to form 4-hydroxyvaleric acid intermediate, which yields GVL spontaneously after dehydration and cyclization. This review focuses on recent advances in the field of aqueous-phase ruthenium-catalyzed hydrogenation reactions of LA toward GVL, VA, 1,4-PDO, 2-MTHF, 2-pentanol, and 2-butanol. It employs heterogeneous catalysts on solid supports, and heterogeneous water-dispersible catalytic nanoparticles or homogeneous water-soluble catalytic complexes with biphasic catalyst separation, for the inter alia production of advanced biofuels such as valeric biofuels and other classes of liquid transportation biofuels, value-added fine chemicals, solvents, additives to gasoline, and to food as well. The significance of the aqueous solvent to carry out catalytic hydrogenations of LA has been highlighted because the presence of water combines several advantages: (i) it is highly polar and thus an ideal medium to convert polar and hydrophilic substrates such as LA; (ii) water is involved as a byproduct; (iii) the presence of the aqueous solvent has a beneficial effect and enormously boosts hydrogenation rates. In sharp contrast, the use of various organic solvents gives rise to a dramatic drop in catalytic activities. The promotional effect of water was proven by numerous experimental investigations and several theoretical studies employing various types of catalytic systems; (iv) the large heat capacity of water renders it an excellent medium to perform large scale exothermic hydrogenations more safely and selectively; and (v) water is a non-toxic, safe, non-inflammable, abundantly available, ubiquitous, inexpensive, and green/sustainable solvent.

Shelf Life Extension and Improvement of the Nutritional Value of Fish Fillets through Osmotic Treatment Based on the Sustainable Use of Rosa damascena Distillation By-Products.

The objective of this work is the comparative study of different osmotic treatments at 37 °C on the quality and shelf life of chilled sea bass fillets. Fish fillets were treated using osmotic solutions consisting of oligofructose (40%-50%-60%) and 5% NaCl with (BP/OT) and without (OT) former antioxidant enrichment by using Rosa damascena distillation by-products. Water activity decreased to approximately 0.95 after 330 minutes of osmotic treatment. Untreated and osmotically treated fish fillets (BP/OT) and (OT) were subsequently stored at 5 °C and their quality was evaluated based on microbial growth and lipid oxidation. Osmotic treatment extended significantly the shelf life of fish in terms of microbial growth; however, it also accelerated its lipid oxidation. The impregnation of Rosa damascena phenolics not only counterbalanced this negative effect, but led to a more than four-fold increase of the shelf life of sea bass, as compared to the untreated samples.

Treatment of Hepatic Hydatid Cyst in a 7-Year-Old Boy Using a New Type of Radiofrequency Ablation Electrode.

BACKGROUND Radiofrequency ablation has been established as a treatment method for malignancies and some particular cystic lesions, especially in adults. Experience with radiofrequency ablation in the treatment of hydatid cysts, especially in children, is limited. CASE REPORT Although echinococcosis is rare, especially in children, we describe a 7-year-old boy with lung and liver cystic echinococcosis. Diagnosis was established by clinical history and imaging findings and confirmed by positive antiechinococcal antibodies. After 6 months of chemotherapy with albendazole, the liver lesion remained and a radiofrequency ablation under computed tomography guidance was obtained. The procedure was performed with a new type of ablation electrode in order to minimize handling and procedure duration and to achieve the best clinical result in only 1 session. This type of electrode provides the ability to simultaneously drain and ablate the cyst and the ability to monitor the desired ablation temperature in real time. CONCLUSIONS Our patient is the first pediatric case with hepatic hydatid cyst treated successfully with the use of a new type of radiofrequency ablation electrode under computed tomography guidance.

Thermal Ablation in the Management of Adrenal Metastasis Originating from Non-small Cell Lung Cancer: A 5-year Single-center Experience.

BACKGROUND: Treatment of adrenal metastasis from lung carcinoma may prolong survival in the selected patients. However, not all patients can undergo surgery; thus, minimally invasive ablation procedures such as radiofrequency ablation (RFA) and microwave ablation (MWA) have gained acceptance as alternative treatment methods. This study summarized a 5-year single-center experience regarding the evaluation of safety and efficacy of computed tomography (CT)-guided thermal ablation in the management of adrenal metastasis originating from non-small cell lung cancer (NSCLC). METHODS: The data of NSCLC patients ablated for adrenal metastasis at the Department of Diagnostic Imaging and Interventional Radiology, General Hospital Sotiria, were retrospectively analyzed. Patients were divided into two groups: RFA group and MWA group according to the therapeutic approaches. Preprocedural blood tests included measurement of international normalized ratio, partial thromboplastin time, and platelet enumeration. A dual-phase contrast-enhanced spiral CT was performed immediately after the procedure to assess the immediate response after ablation and to screen for related complications. Follow-up was performed with CT or magnetic resonance imaging at 1, 3, 6 months and 1 year after ablation and every 6 months thereafter. RESULTS: A total of 99 ablation sessions in 71 patients with adrenal metastasis originating from NSCLC were included in the final analysis. Self-limited, postablation syndrome occurred in 16/99 (16.1%) of ablation sessions. All procedures were technically successful. Immediate postablation imaging showed no contrast enhancement of the ablated tumor in all patients. Follow-up imaging at 3 months revealed local tumor progression in 8 (22.8%) patients of the RFA group and 7 (19.4%) patients of MWA group, all of them underwent a second session successfully. The 1-year assessment revealed local recurrence of the ablated tumor in six patients (17.1%) of RFA group and seven patients (19.4%) of MWA group. Among these 71 patients, those with tumor size >3.5 cm had a higher local recurrence rate (65.2%, 15/23) than those with tumors ≤3.5 cm (16.7%, 8/48; P = 0.012). There was no significant difference in the median survival time between RFA (14.0 months) and MWA (14.6 months) groups (P > 0.05). CONCLUSIONS: RFA and MWA showed comparable efficacy and safety in adrenal metastasis treatment.

Rare case of pulmonary histoplasmosis complicated with bronchocentric granulomatosis in a non endemic area.

BACKGROUND: Pulmonary histoplasmosis is a fungal infection caused by histoplasma capsulatum, rarely diagnosed in non endemic areas and/or immunocompromised patients. Complication of pulmonary histoplasmosis with bronchocentric granulomatosis is extremely rare. CASE REPORT: A 48-year-old man with prolonged fever and nausea was admitted to our hospital. Clinical examination revealed pathological auscultatory sounds to the left lung. Computed tomography was performed and revealed a large solid mass of the left upper lobe, limited pleural and pericardial effusion and calcified lymphadenopathy of mediastinum. A computed tomography guided core biopsy of the lung lesion was performed and three samples were obtained. Culture and polymerase chain reaction (PCR) revealed Histoplasma capsulatum. Histological findings were compatible with bronchocentric granulomatosis. Extended laboratory investigation excluded immunosuppresion. Our patient although immunocompetent was diagnosed with chronic pulmonary histoplasmosis complicated with bronchocentric granulomatosis and treatment with antifungal medication and methylprednisoline started. CONCLUSION: Description of a rare case of chronic pulmonary histoplasmosis in a non endemic area like Greece, with atypical radiological findings, complicated with bronchocentric granulomatosis.

Percutaneous microwave ablation vs radiofrequency ablation in the treatment of hepatocellular carcinoma.

Hepatocellular cancer ranks fifth among cancers and is related to chronic viral hepatitis, alcohol abuse, steatohepatitis and liver autoimmunity. Surgical resection and orthotopic liver transplantation have curative potential, but fewer than 20% of patients are suitable candidates. Interventional treatments are offered to the vast majority of patients. Radiofrequency (RFA) and microwave ablation (MWA) are among the therapeutic modalities, with similar indications which include the presence of up to three lesions, smaller than 3 cm in size, and the absence of extrahepatic disease. The therapeutic effect of both methods relies on thermal injury, but MWA uses an electromagnetic field as opposed to electrical current used in RFA. Unlike MWA, the effect of RFA is partially limited by the heat-sink effect and increased impedance of the ablated tissue. Compared with RFA, MWA attains a more predictable ablation zone, permits simultaneous treatment of multiple lesions, and achieves larger coagulation volumes in a shorter procedural time. Major complications of both methods are comparable and infrequent (approximately 2%-3%), and they include haemorrhage, infection/abscess, visceral organ injury, liver failure, and pneumothorax. RFA may incur the additional complication of skin burns. Nevertheless, there is no compelling evidence for differences in clinical outcomes, including local recurrence rates and survival.