Application of some inorganic metal oxide nanoparticles to control E. coli in raw milk.

Background: Nanoparticles are regarded as magical bullets because of their exclusive features. Recently, the usage of nanoparticles has progressed in almost all aspects of science and technology due to its ability to revolutionize certain fields. In the field of food science and technology, the application of nanoparticles is being researched in many various areas thus provides the dairy industry with a variety of new attitudes for developing the quality, prolong shelf life, ensure the safety and healthiness of foods. Aim: This study aimed to focus on the application of some inorganic metal oxide nanoparticles (zinc oxide (ZnO), magnesium oxide (MgO), and calcium oxide (CaO)) to control E. coli in raw milk and ensure its safety. Methods: The antibacterial action of certain nanoparticles (ZnO, MgO, and CaO) with multiple concentrations (0.1, 0.05, 0.025, 0.0125, 0.006, and 0.003 mg/ml) was evaluated against E. coli strains in ultra heat treated (UHT) milk samples. Also, storage temperature and storage period effects were studied. Results: The findings of the current research revealed that inorganic metal oxide nanoparticles had a significant antibacterial role against E. coli, in the following order; ZnO, MgO, and CaO, respectively. The antibacterial effect of inorganic metal oxide nanoparticles is more noticeable at lower temperatures. Conclusion: Inorganic metal nanoparticles can be used in the food industry for the purpose of the control of E. coli, and extension of the shelf life of dairy products.

Assessment of some chemical residues in Egyptian raw milk and traditional cheese.

Background: The assessment of risks related to food safety is becoming a challenge in developing countries with its consequent health hazards. Chemical risk assessment in dairy products is important to maintain consumer health locally and internationally. Since milk and dairy products are essential foods for a wide range of customers, mostly children, patients, and pregnant women, it is very important to estimate the risks of some chemical residues, such as pesticides, some heavy metals, and aflatoxins. Aim: This work aims to determine the levels of chemical contamination in milk and traditional Egyptian cheese. Methods: Heavy metals were determined in samples by atomic absorption spectrometry. GC-mass spectrometry (MS)/MS and LC-MS/MS were also used for measuring pesticide residues. The Aflatoxin M1 was determined by enzyme-linked immune-sorbent assay. Results: Raw milk samples were tested and showed elevated concentrations of lead and cadmium, (46% and 4%, respectively). The heavy metals detected in the Egyptian cheese samples were variable depending on the type of cheese. Moreover, p.p.-DDE phenofose was present in 45% and 29% of raw milk and Ras cheese samples, respectively. For Aflatoxin M1, only 7% of milk samples and 2.9% of Ras cheese samples exceeded the acceptable limits. Conclusion: More surveying and risk assessment of chemical residues in milk and milk products are essential for controlling health risks to consumers.

Relationship between the Dynamics of Flavor Compounds and Microbial Succession in the Natural Fermentation of Zhalajiao, a Popular Traditional Chinese Fermented Chili Paste.

Zhalajiao, a traditional Chinese fermented food, is popular due to its unique flavor. Traditional Zhalajiao fermentation is closely related to flavor compounds production. However, the mechanisms underlying the formation of these crucial flavor components in Zhalajiao remain unclear. Here, we explored the dynamic changes in physical and chemical properties, microbial diversity, and flavor components of Zhalajiao at various fermentation times. In total, 6 organic acids, 17 amino acids, and 21 key volatile compounds were determined as flavor components. In Zhalajiao, Lactobacillus and Cyanobacterium were the main bacteria that were involved in the formation of crucial flavor compounds. Candida showed a significant correlation with 14 key flavor compounds during fermentation (p < 0.05) and was the main fungal genus associated with flavor formation in Zhalajiao. This research offers a theoretical foundation for the flavor regulation and quality assurance of Zhalajiao.

Safety assessment of Enterococcus lactis based on comparative genomics and phenotypic analysis.

Enterococcus faecium is sometimes used in food production; however, its acquisition of antibiotic resistance has become an alarming health concern. The E. lactis species is closely related to E. faecium and has good probiotic potential. This study aimed to investigate the antibiotic resistance of E. lactis. We analyzed the antibiotic resistance phenotype and whole-genome sequences of 60 E. lactis isolates (23, 29, and 8 isolates from dairy products, Rice wine Koji, and human feces, respectively). These isolates showed varying degree of resistance to 13 antibiotics, and were sensitive to ampicillin and linezolid. The E. lactis genomes carried only a subset of commonly reported antibiotic resistance genes (ARGs) in E. faecium. Five ARGs were detected across the investigated E. lactis, including two universally present genes (msrC and AAC(6')-Ii) and three rarely detected ARGs (tet(L), tetM, and efmA). To identify other undescribed antibiotic resistance-encoding genes, a genome-wide association study was performed, returning 160 potential resistance genes that were associated with six antibiotics, namely chloramphenicol, vancomycin, clindamycin, erythromycin, quinupristin-dalfopristin, and rifampicin. Only around one-third of these genes encode known biological functions, including cellular metabolism, membrane transport, and DNA synthesis. This work identified interesting targets for future study of antibiotic resistance in E. lactis. The fact that the lower number of ARGs present in E. lactis supports that it may be an alternative to E. faecalis for use in the food industry. Data generated in this work is of interest to the dairy industry.

Impact of Salting Techniques on the Physio-Chemical Characteristics, Sensory Properties, and Volatile Organic Compounds of Ras Cheese.

Ras cheese is the main Egyptian hard cheese that is well-known worldwide. Herein, we investigated how different salting techniques affect the physio-chemical properties, sensory properties, and volatile compounds of Ras cheese over a six-month ripening period. Five Ras cheese treatments were made from pasteurized cow's milk using various salting techniques: traditional salting of Ras cheese, salting by applying all of the salt to the curd after the entire whey drainage, salting by applying all of the salt to the curd after half to two-thirds of the whey drainage, salting in a brine solution for 24 h without dry salting, and salting in a brine solution for 12 h and then dry salting. The obtained results by GC-MS recorded that thirty-eight volatile compounds were identified in Ras cheese treatments after six months of ripening, and the development of volatile compounds was affected by the salting technique as well as the ripening period of the cheeses, which played a major role in the type and concentration of volatile compounds. Results revealed that there are six esters, 15 fatty acids, five ketones, two aldehydes, four alcohols, and eight other compounds identified in most treatments. Some physio-chemical characteristics and sensory properties were found to have high correlations with the storage period, while some others have low correlations during the ripening period.

Changes in Sensory Properties, Physico-Chemical Characteristics, and Aromas of Ras Cheese under Different Coating Techniques.

Ras cheese is one of the main hard cheeses in Egypt and is well-known worldwide. Herein, we investigated the potential effects of different coating techniques on the physico-chemical characteristics, sensory properties, and aroma-related volatile organic compounds (VOCs) of Ras cheese over a six-month ripening period. Four coating techniques were tested, including (I) uncoated Ras cheese (the benchmark control), (II) Ras cheese coated with paraffin wax (T1), (III) Ras cheese coated with a plastic film under a vacuum (PFUV; T2), and (IV) Ras cheese coated with a plastic film treated with natamycin (T3). Although none of the treatments significantly affected the salt content, Ras cheese coated with a plastic film treated with natamycin (T3) slightly reduced the moisture content over the ripening period. Moreover, our findings revealed that while T3 had the highest ash content, it showed the same positive correlation profiles of fat content, total nitrogen, and acidity % as the control cheese sample, indicating no significant effect on the physico-chemical characteristics of the coated cheese. Furthermore, there were significant differences in the composition of VOCs among all tested treatments. The control cheese sample had the lowest percentage of other VOCs. T1 cheese, coated with paraffin wax, had the highest percentage of other volatile compounds. T2 and T3 were quite similar in their VOC profiles. According to our GC-MS findings, thirty-five VOCs were identified in Ras cheese treatments after six months of ripening, including twenty-three fatty acids, six esters, three alcohols, and three other compounds identified in most treatments. T2 cheese had the highest fatty acid % and T3 cheese had the highest ester %. The development of volatile compounds was affected by the coating material and the ripening period of the cheeses, which played a major role in the quantity and quality of volatile compounds.

New curative approach using embolization followed by moderate-dose radiotherapy after surgical failure for large right heart metastasis.

PURPOSE: Cardiac metastasis is a rare fatal event. An intracavitary right tumor mainly in the ventricle is difficult to manage. Literature reports suggest that cardiac surgery in oligometastatic patients could offer median survival of 1 year. We investigated salvage treatment comprising transcoronary tumor embolization followed 15 days later by cardiac radiotherapy (40.5 Gy/15 fractions). CASES: We report two cases of severe right cardiac metastasis with a history of abdominal cancer managed by this salvage treatment following residual cardiac mass after previous cardiac surgery. CONCLUSION: Both symptomatic patients improved progressively and were locally controlled for at least 1 year without toxicity.

Arteriovenous fistulas thrombosis in hemodialysis patients with COVID-19.

BACKGROUND: The current Coronavirus disease 2019 (COVID-19) outbreak is associated with significant mortality, especially in patients suffering from end stage renal disease (ESRD) and hemodialysis patients. Several previous studies reported an over-risk of arterial and venous thrombosis, in particular pulmonary embolism and venous thrombosis of catheter in COVID19 patients in intensive care unit. However, arteriovenous fistula (AVF) thrombosis has rarely been reported yet in these patients. AVF thrombosis is a serious complication that impacts significantly patients outcome. Here, we aim to describe characteristics and prognosis of a cohort of COVID-19 hemodialysis (HD) patients presenting with AVF thrombosis. METHODS: In the Ile de France region (Paris area) during the March 11th-April 30th 2020 period, fistula thrombosis cases were collected among COVID-19 hemodialysis patients in seven dialysis units and in interventional vascular departments. These patients' characteristics were analyzed through a review of the patient's medical records. RESULTS: Seventeen patients were included in our study (median age 69 years). Ten patients (59%) were men. Ten patients (59%) were diabetic and 88% had a high blood pressure. The mortality rate in these patients was 47%. All thrombosis treated with a declotting procedures (64%) were successfully cleared, but with early relapse in 36%. CONCLUSION: Our study highlights AVF thrombosis as a severe complication in COVID-19 hemodialysis patients that contributed to the severity and accelerated death.

Ischemic Cholangiopathy Following Transcatheter Arterial Chemoembolization for Recurrent Hepatocellular Carcinoma After Hepatectomy: an Underestimated and Devastating Complication.

BACKGROUND: Ischemic cholangiopathy (IC) has a known poor prognosis. However, the risks and outcomes of this complication after transcatheter arterial chemoembolization (TACE) in hepatectomized patients are poorly documented. This study aimed to evaluate the incidence of and to identify the predictive factors for IC following TACE for recurrent hepatocellular carcinoma (HCC) after hepatectomy. METHOD: From a cohort with a total of 486 patients who underwent resection for HCC, we included all consecutive patients who were treated with TACE for recurrent HCC after hepatectomy between 2000 and 2017. IC was defined by the coexistence of biological cholestasis and morphological lesions. RESULTS: A total of 156 patients underwent TACE for the treatment of HCC recurrence after hepatectomy. Of them, eight (5.1%) developed IC. Their prognosis was poor compared with patients without IC (3-year survival 23.4% vs 76.2%; P = 0.008). Two factors, namely, time between hepatectomy and TACE (4.8 months vs. 16.0 months, P = 0.001) and TACE for a remnant liver mobilized during hepatectomy (P = 0.001), were associated with IC. Receiver operating characteristic (ROC) curve analysis showed that 7 months was the more discriminant cutoff for the time period. IC occurred in 33.3% of the patients with the two factors, in 5.0% of those with one factor, and 0% in the absence of any factors. CONCLUSION: TACE for treating HCC recurrence carries a high risk of IC when performed early after hepatectomy in a previously mobilized liver. Our results might aid in identifying candidates for TACE for recurrent HCC, considering the major effect on patient outcomes.

Physico-chemical, microstructural and rheological properties of camel-milk yogurt as enhanced by microbial transglutaminase.

Camel milk produces watery texture when it is processed to yogurt. Despite the extensive studies on microbial transglutaminase (MTGase) in dairy research, the effect of this enzyme on the properties of yogurt made from camel milk has not been studied. This study aims to investigate the impact of MTGase with and without bovine skimmed milk powder (SMP), whey protein concentrate (WPC),or ß-lactoglobulin (ß-lg) on physico-chemical, rheological, microstructural, and sensory properties of camel-milk yogurt during 15 days of storage period. MTGase treatment markedly reduced the fermentation time of unfortified and SMP-fortified camel milk. The fortification of camel milk without MTGase failed to give set-type yogurt. The treatment of unfortified milk with MTGase enormously improved the viscosity and the body of yogurt samples. Fortification of MTGase-treated milk impacted positively on the viscosity, the water holding capacity, and the density of the protein matrix in the gel microstructure, which were influenced by the type of dairy ingredients. All MTGase-treated yogurts differed from each other in hardness and adhesiveness values. Electrophoresis results showed that the susceptibility of the individual milk proteins to MTGase varied, and there were differences among the treatments toward the enzyme. SMP-fortified yogurt was the most accepted product. Generally, the addition of MTGase preparation at a concentration of 0.4%, simultaneously with starter culture, to fortified camel milk was considered an effective tool to solve the challenges of producing set-type yogurt from this milk.

Arterio-venous fistula for automated red blood cells exchange in patients with sickle cell disease: Complications and outcomes.

Erythrocytapheresis (ER) can improve outcome in patients with sickle cell disease (SCD). A good vascular access is required but frequently it can be difficult to obtain for sickle cell patients. Arterio-venous fistulas (AVFs) have been suggested for ER in SCD supported by limited evidence. We report the largest cohort of ER performed with AVFs from three French SCD reference centers. Data of SCD patients undergoing ER with AVFs in the French SCD reference center were retrospectively collected. The inclusion criteria were: SS or Sß-Thalassemia and AVF surgery for ER. SCD-related complications, transfusion history, details about AVF surgical procedure, echocardiographic data before and after AVF, AVF-related surgical and hemodynamical complications were collected. Twenty-six patients (mean age 20.5 years, mean follow-up 68 months [11-279]) were included. Twenty-three patients (88.5%) required central vascular access before AVF. Fifteen AVFs (58%) were created on the forearm and 11 (42%) on the arm. Nineteen patients (73%) had stenotic, thrombotic or infectious AVF complications. A total of 0.36 stenosis per 1,000 AVF days, 0.37 thrombosis per 1,000 AVF days and 0.078 infections per 1.000 AVF days were observed. The mean AVF lifespan was 51 months [13-218]. One patient with severe pulmonary hypertension worsened after AVF creation and died. We report the first series of SCD patients with AVF for ER, demonstrating that AVFs could be considered as a potential vascular access for ER. Patients with increased risk for hemodynamic intolerance of AVFs must be carefully identified, so that alternative vascular accesses can be considered. Am. J. Hematol. 92:136-140, 2017. © 2016 Wiley Periodicals, Inc.

Early tumour response as a survival predictor in previously- treated patients receiving triplet hepatic artery infusion and intravenous cetuximab for unresectable liver metastases from wild-type KRAS colorectal cancer.

BACKGROUND: Early tumour shrinkage has been associated with improved survival in patients receiving cetuximab-based systemic chemotherapy for liver metastases from colorectal cancer (LM-CRC). We tested this hypothesis for previously treated LM-CRC patients receiving cetuximab (500 mg/m2) and triplet hepatic artery infusion (HAI) within European trial OPTILIV. METHODS: Irinotecan (180 mg/m2), 5-fluorouracil (2800 mg/m2) and oxaliplatin (85 mg/m2) were given as chronomodulated or conventional delivery. Patients were retrospectively categorised as early responders (complete or partial RECIST response after three courses) or non-early responders (late or no response). Prognostic factors were determined using multivariate logistic or Cox regression models. RESULTS: Response was assessed in 57 of 64 registered patients (89%), who had previously received one to three prior systemic chemotherapy protocols. An early response occurred at 6 weeks in 16 patients (28%; 9 men, 7 women), aged 33-76 years, with a median of 12 liver metastases (LMs) (2-50), involving five segments (1-8). Ten patients had a late response, and 31 patients had no response. Grade 3-4 fatigue selectively occurred in the non-early responders (0% versus 26%; p = 0.024). Early tumour response was jointly predicted by chronomodulation-odds ratio (OR): 6.0 (1.2-29.8; p = 0.029)-and LM diameter ≤57 mm-OR: 5.3 (1.1-25.0; p = 0.033). Early tumour response predicted for both R0-R1 liver resection-OR: 11.8 (1.4-100.2; p = 0.024) and overall survival-hazard ratio: 0.39 (0.17-0.88; p = 0.023) in multivariate analyses. CONCLUSIONS: Early tumour response on triplet HAI and systemic cetuximab predicted for complete macroscopic liver resection and prolonged survival for LM-CRC patients within a multicenter conversion-to-resection medicosurgical strategy. Confirmation is warranted for early response on HAI to guide decision making. Protocol numbers: EUDRACT 2007-004632-24 NCT00852228.

Intention-to-treat analysis of percutaneous endovascular treatment of hepatic artery stenosis after orthotopic liver transplantation.

Hepatic artery stenosis (HAS) is a rare complication of orthotopic liver transplantation (LT). HAS could evolve into complete thrombosis and lead to graft loss, incurring significant morbidity and mortality. Even though endovascular management by percutaneous transluminal angioplasty ± stenting (PTA) is the primary treatment of HAS, its longterm impact on hepatic artery (HA) patency and graft survival remains unclear. This study aimed to evaluate longterm outcomes of PTA and to define the risk factors of treatment failure. From 2006 to 2012, 30 patients with critical HAS (>50% stenosis of HA) and treated by PTA were identified from 870 adult patients undergoing LT. Seventeen patients were diagnosed by post-LT screening, and 13 patients were symptomatic due to HAS. PTA was completed successfully in 27 (90%) patients with angioplasty plus stenting in 23 and angioplasty alone in 4. The immediate technical success rate was 90%. A major complication that was observed was arterial dissection (1 patient) which eventually necessitated retransplantation. Restenosis was observed in 10 (33%) patients. One-year, 3-year, and 5-year HA patency rates were 68%, 62.8%, and 62.8%, respectively. Overall patient survival was 93.3% at 3 years and 85.3% at 5 years. The 3-year and 5-year liver graft survival rates were 84.7% and 64.5%, respectively. No significant difference was observed in patient and graft survivals between asymptomatic and symptomatic patients after PTA. Similarly, no difference was observed between angioplasty alone and angioplasty plus stenting. In conclusion, endovascular therapy ensures a good 5-year graft survival (64.5%) and patient survival (85.3%) in patients with critical HAS by maintaining HA patency with a low risk of serious morbidity (3.3%). Liver Transplantation 22 923-933 2016 AASLD.

Rep-PCR characterization and biochemical selection of lactic acid bacteria isolated from the Delta area of Egypt.

Samples of raw milk and traditional dairy products were collected from different rural areas in the Delta region. 170 isolates from these products were identified using repetitive genomic element-PCR (Rep-PCR) fingerprinting. The identified isolates were tested for efficiency of biomass production and separation, acidifying activity, autolytic and aminopeptidase properties, antagonistic activities and exopolysaccharide production. The obtained results revealed that the Lactobacillus delbrueckii subsp. lactis, Lactobacillus fermentum, Enterococcus faecium Lactobacillus delbrueckii subsp. bulgaricus, Lactobacillus paracasei subsp. paracasei, Lactobacillus plantarum and Lactococcus lactis subsp. lactis were the predominant species in Egyptian dairy products. Two percent of Lactococcus, 10% of Lactobacillus and 1% of Enterococcus isolates showed fast acidifying activity. Aminopeptidase and autolytic properties were generally higher for most Lactobacillus strains when compared to other strains. Among these species, lactobacillus paracasei subsp. paracasei was the highest in Aminopeptidase activity and autolytic properties. Antagonistic activity was detected in 40% of Lactococcus, 70% of Lactobacillus and 50% of Enterococcus isolates. Some isolates produced exopolysaccharides in milk and dairy products.

Osteosarcoma of the hand: a rare case for radiographic appearance, location, and age.

OBJECTIVE: This case describes the history, process of correct diagnosis, and treatment of a patient with pain in her left fourth finger, later found to be an osteosarcoma. CLINICAL FEATURES: A 28-year-old woman presented with pain in her left fourth finger, which she also noticed had been "getting bigger." Moderate tenderness and decreased range of motion were noticed over the metacarpophalangeal joint of the involved finger. INTERVENTION AND OUTCOME: Initial radiographs indicated a benign tumor with a pathological fracture, and the patient was referred to a hand surgeon. After debridement of the area, the pathology report returned with a diagnosis of osteoblastic osteogenic osteosarcoma. The patient then underwent amputation of the fourth ray and chemotherapy. CONCLUSION: This case presents a rare bone tumor of the hand and highlights the importance of clinical decision-making to lead to appropriate patient care.