Characterization and nutritional valorization of agricultural waste corncobs from Italian maize landraces through the growth of medicinal mushrooms.

The research investigates the potential use of maize cobs (or corncobs) from five genotypes, including the B73 inbred line and four locally cultivated landraces from Northern Italy, as substrate for implementing Solid State fermentation processes with four Medicinal Mushrooms (MMs). The corncobs were characterized based on their proximate composition, lignin, phenolics content (both free and bound), and total antioxidant capacity. Among the MMs tested, Pleurotus ostreatus and Ganoderma annularis demonstrated the most robust performance. Their growth was parametrized using Image Analysis technique, and chemical composition of culture samples was characterized compared to that of corncobs alone. In all culture samples, the growth of MMs led to a significant reduction (averaging 40%) in the total phenolics contents compared to that measured in corncobs alone. However, the high content of free phenolics in the cobs negatively impacted the growth of P. ostreatus. The final MM-corncob matrix exhibited reduced levels of free sugars and starch (≤ 2.2% DW, as a sum) and increased levels of proteins (up to 5.9% DW) and soluble dietary fiber (up to 5.0% DW), with a notable trend toward higher levels of ß-glucan compared to corncobs alone. This research paves the way for the use of this matrix as an active ingredient to enhance the nutritional value of food preparations.

Descripción demográfica, clínica y anatomopatológica de las microcirugías de laringe: estudio retrospectivo en el Hospital Británico de Buenos Aires / Demographic, clinical, and anatomopathological description of larynx microsurgeries: Retrospective study at Hospital Británico de Buenos Aires / Descrição demográfica, clínica e anatomopatológica das microcirurgias de laringe: estudo retrospectivo no Hospital Britânico de Buenos Aires

Objetivo: la microcirugía laríngea es un procedimiento terapéutico en lesiones benignas de laringe, diagnóstico en pacientes con disfonías de evolución variable y en casos de sospecha de malignidad. El objetivo de este estudio es describir las características de los pacientes intervenidos por microcirugía laríngea y las lesiones observadas en un servicio de otorrinolaringología en Argentina. Metodología: estudio retrospectivo. Se realizó la revisión de protocolos quirúrgicos, historias clínicas, videoestroboscopias computarizadas y documentos de anatomía patológica. Análisis univariado descriptivo con utilización de la t de Student o la Chi- cuadrado, según las características de las variables (p <0.005 para significancia estadística). Resultados: el sexo masculino fue el más intervenido, con una edad media de 51.2 ± 6.6 años. El antecedente de tabaquismo fue el más frecuente. Las principales lesiones macroscópicas fueron premalignas y malignas, pólipos y quistes. En la anatomía patológica se encontraron pólipos, carcinomas y quistes. En ambos sexos la lesión más frecuente fue el pólipo (33% vs. 45%, p =0.03). En pacientes con antecedente de tabaquismo la lesión más común fue pólipo, en ambos géneros, en menores de 60 años (46% vs. 30%, p =0.02), mientras en mayores de 60 años fue el carcinoma (33% vs. 15%, p <0.001). Conclusiones: en población masculina en sexta década de la vida se encontró principalmente presencia de pólipos, quistes y carcinomas. En pacientes de este género, con antecedente de tabaquismo, se describe mayor presencia de carcinomas.

Objective: Laryngeal microsurgery is a procedure indicated in benign laryngeal lesions; it is also a diagnostic tool in patients with dysphonia or in cases where malignancy is suspected. Methodology: Retrospective study in which clinical records, surgical protocols, videoestroboscopies, and pathology documents of patients under laryngeal microsurgery between 2011 and 2016 were reviewed. Univariate analysis was performed using Chi squared test (p <0.05). Results: Mean age was 51.2 ± 6.6 years, males were the most frequently intervened. Smoking was the most common comorbidity. The main macroscopic lesions observed were premalignant and malignant, polyps and cysts; in the pathology, polyps, carcinomas, and cysts were found. Polyps were the most frequent lesions found in both genders (33% vs 45%, p = 0.03). In patients with a smoking comorbidity, polyps were the most common lesion in both women and men (46% vs. 30%, p = 0.02). A greater presence of carcinomas was described in males over 60 with a history of smoking (33% vs 15%, p = 0.0001). Conclusions: Polyps, cysts, and carcinomas were mainly found in males over 60. A greater presence of carcinomas was described in male patients with a history of smoking.

Objetivo: a microcirurgia laríngea é um procedimento terapêutico em lesões benignas de laringe, diagnóstico em pacientes com disfonias de evolução variável e em casos de suspeita de malignidade. O objetivo deste estudo é descrever as características dos pacientes intervindos por microcirurgia laríngea e as lesões observadas num serviço de otorrinolaringologia na Argentina. Metodologia: estudo retrospectivo. Se realizou a revisão de protocolos cirúrgicos, histórias clínicas, videoestroboscopias computorizadas e documentos de anatomia patológica. Análise univariado descritivo com utilização da t de Student ou a Chi- quadrado, segundo as características das variáveis (p <0.005 para significância estatística). Resultados: o sexo masculino foi o mais intervindo, com uma idade média de 51.2 ± 6.6 anos. O antecedente de tabaquismo foi o mais frequente. As principais lesões macroscópicas foram pré-malignas e malignas, pólipos e quistos. Na anatomia patológica se encontraram pólipos, carcinomas e quistos. Em ambos sexos a lesão mais frequente foi o pólipo (33% vs. 45%, p =0.03). Em pacientes com antecedente de tabaquismo a lesão mais comum foi pólipo, em ambos gêneros, em menores de 60 anos (46% vs. 30%, p =0.02), enquanto em maiores de 60 anos foi o carcinoma (33% vs. 15%, p <0.001). Conclusões: na população masculina na sexta década da vida se encontrou principalmente presença de pólipos, quistos e carcinomas. Em pacientes deste gênero, com antecedente de tabaquismo, se descreve maior presença de carcinomas.

Lactic acid bacteria with cholesterol-lowering properties for dairy applications: In vitro and in situ activity.

Cholesterol-lowering activity is one of the most promising properties of lactic acid bacteria with probiotic characteristics. In the present study, 58 potentially probiotic lactic acid bacteria were tested for their ability to survive in vitro digestion and reduce cholesterol in a medium containing cholesterol and bile acids. The best-performing strains (Lactobacillus casei VC199, Lactobacillus paracasei ssp. paracasei SE160 and VC213, Lactobacillus plantarum VS166 and VS513, Enterococcus faecium VC223, and Enterococcus lactis BT161) resulted in a 42 to 55% reduction of the cholesterol level in broth and were further tested in cheese manufacture. The cholesterol content in all the cheeses decreased with ripening. All the strains were present in the cheese at levels higher than 107 cfu/g until 60 d of ripening, the highest reductions (up to 23%) being obtained when Lb. paracasei ssp. paracasei VC213 and E. lactis BT161 were added during the cheese-making. The adjunct cultures had no negative effect on the sensory characteristics of the cheese. Thus, these strains with proven in vitro properties are good candidates for novel probiotic-containing formulations and could be used to functionalize foods such as dairy fermented products.

Phenylketonuric diet negatively impacts on butyrate production.

BACKGROUND AND AIMS: Phenylalanine (Phe) restricted diet, combined with Phe-free l-amino acid supplementation, is the mainstay of treatment for phenylketonuria (PKU). Being the diet a key factor modulating gut microbiota composition, the aim of the present paper was to compare dietary intakes, gut microbiota biodiversity and short chain fatty acids (SCFAs) production in children with PKU, on low-Phe diet, and in children with mild hyperphenylalaninemia (MHP), on unrestricted diet. METHODS AND RESULTS: We enrolled 21 PKU and 21 MHP children matched for gender, age and body mass index z-score. Dietary intakes, including glycemic index (GI) and glycemic load (GL), and fecal microbiota analyses, by means of denaturing gradient gel electrophoresis (DGGE) and Real-time PCR were assessed. Fecal SCFAs were quantified by gas chromatographic analysis. RESULTS: We observed an increased carbohydrate (% of total energy), fiber and vegetables intakes (g/day) in PKU compared with MHP children (p = 0.047), as well a higher daily GI and GL (maximum p < 0.001). Compared with MHP, PKU showed a lower degree of microbial diversity and a decrease in fecal butyrate content (p = 0.02). Accordingly, two of the most abundant butyrate-producing genera, Faecalibacterium spp. and Roseburia spp., were found significantly depleted in PKU children (p = 0.02 and p = 0.03, respectively). CONCLUSION: The low-Phe diet, characterized by a higher carbohydrate intake, increases GI and GL, resulting in a different quality of substrates for microbial fermentation. Further analyses, thoroughly evaluating microbial species altered by PKU diet are needed to better investigate gut microbiota in PKU children and to eventually pave the way for pre/probiotic supplementations.

Glycemic index and glycemic load of commercial Italian foods.

BACKGROUND AND AIM: The glycemic index (GI) and glycemic load (GL) are useful parameters in the nutritional classification of carbohydrate foods. Diets characterized by a low GI and/or a low GL have been repeatedly and independently associated with decreased risk of diabetes and other chronic diseases. The aim of this study is to report the GI and GL value of carbohydrate-rich foods available on the Italian market and mostly consumed in Italy. METHODS AND RESULTS: GI values were determined according to FAO/WHO (1997) and ISO (2010). Overall, the 141 commercial foods that were analyzed represent food categories that are the source of >80% carbohydrate intake in Italy. The food items chosen were based mainly on the market share of the brand within each food category and grouped into 13 food categories: 1) beverages: fermented milk drink, juice, smoothie, soft drink; 2) biscuits; 3) breads; 4) bread substitutes; 5) breakfast cereals; 6) cakes and snacks; 7) candy and confectionery; 8) cereals; 9) desserts and ice-creams; 10) marmalade and jam; 11) pasta; 12) pizza; 13) sugar and sweetener. CONCLUSION: This database of commercial Italian foods partly overcomes the lack of information on GI and GL of local foods, contributing to a better understanding of the association between GI/GL and health and providing a more informed choice to Italian consumers and health practitioners.

Characterisation of a track structure imaging detector.

The spatial distribution of radiation-induced ionisations in sub-cellular structures plays an important role in the initial formation of radiation damage to biological tissues. Using the nanodosimetry approach, physical characteristics of the track structure can be measured and correlated to DNA damage. In this work, a novel nanodosimeter is presented, which detects positive ions produced by radiation interacting with a gas-sensitive volume in order to obtain a high resolution image of the radiation track structure. The characterisation of the detector prototype was performed and different configurations of the device were tested by varying the detector cathode material and the working gas. Preliminary results show that the ionisation cluster size distribution can be obtained with this approach. Further work is planned to improve the detector efficiency in order to register the complete three-dimensional track structure of ionising radiation.

A DNA barcoding approach to identify plant species in multiflower honey.

The purpose of this study was to test the ability of DNA barcoding to identify the plant origins of processed honey. Four multifloral honeys produced at different sites in a floristically rich area in the northern Italian Alps were examined by using the rbcL and trnH-psbA plastid regions as barcode markers. An extensive reference database of barcode sequences was generated for the local flora to determine the taxonomic composition of honey. Thirty-nine plant species were identified in the four honey samples, each of which originated from a mix of common plants belonging to Castanea, Quercus, Fagus and several herbaceous taxa. Interestingly, at least one endemic plant was found in all four honey samples, providing a clear signature for the geographic identity of these products. DNA of the toxic plant Atropa belladonna was detected in one sample, illustrating the usefulness of DNA barcoding for evaluating the safety of honey.

Towards a better understanding of Apis mellifera and Varroa destructor microbiomes: introducing 'phyloh' as a novel phylogenetic diversity analysis tool.

The study of diversity in biological communities is an intriguing field. Huge amount of data are nowadays available (provided by the innovative DNA sequencing techniques), and management, analysis and display of results are not trivial. Here, we propose for the first time the use of phylogenetic entropy as a measure of bacterial diversity in studies of microbial community structure. We then compared our new method (i.e. the web tool phyloh) for partitioning phylogenetic diversity with the traditional approach in diversity analyses of bacteria communities. We tested phyloh to characterize microbiome in the honeybee (Apis mellifera, Insecta: Hymenoptera) and its parasitic mite varroa (Varroa destructor, Arachnida: Parasitiformes). The rationale is that the comparative analysis of honeybee and varroa microbiomes could open new perspectives concerning the role of the parasites on honeybee colonies health. Our results showed a dramatic change of the honeybee microbiome when varroa occurs, suggesting that this parasite is able to influence host microbiome. Among the different approaches used, only the entropy method, in conjunction with phylogenetic constraint as implemented in phyloh, was able to discriminate varroa microbiome from that of parasitized honeybees. In conclusion, we foresee that the use of phylogenetic entropy could become a new standard in the analyses of community structure, in particular to prove the contribution of each biological entity to the overall diversity.

Fecal water genotoxicity in healthy free-living young Italian people.

Dietary habit affects the composition of human feces thus determining intestinal environment and exposure of colon mucosa to risk factors. Fecal water (FW) citotoxicity and genotoxicity were investigated in 33 healthy young Italian people, as well as the relationship between genotoxicity and nutrient intake or microflora composition. Two fecal samples were collected at 2 weeks apart and 3-d dietary diary was recorded for each volunteer. Cytotoxicity was measured using the Trypan Blue Dye Exclusion assay and genotoxicity using the Comet Assay (alkaline single-cell electrophoresis). Fecal bifidobacteria, total microbial count and nutrient intakes were also assessed. High intra- and inter-variability in genotoxicity data and in bacteria counts were found. None of the FW samples were citotoxic, but 90% of FW samples were genotoxic. Seventy five percent indicated intermediate and 15% were highly genotoxic. There was a different sex-related distribution. Genotoxicity was positively correlated to the total lipid intake in females and to the bifidobacteria/total bacteria count ratio in male volunteers. These results demonstrate that the majority of FW samples isolated from free-living Italian people show intermediate level of genotoxicity and sustain a relation between this possible non-invasive marker of colorectal cancer risk with both dietary habits and colonic ecosystem.

Advantages and limitations of the 'worst case scenario' approach in IMPT treatment planning.

The 'worst case scenario' (also known as the minimax approach in optimization terms) is a common approach to model the effect of delivery uncertainties in proton treatment planning. Using the 'dose-error-bar distribution' previously reported by our group as an example, we have investigated in more detail one of the underlying assumptions of this method. That is, the dose distributions calculated for a limited number of worst case patient positioning scenarios (i.e. limited number of shifts sampled on a spherical surface) represent the worst dose distributions that can occur during the patient treatment under setup uncertainties. By uniformly sampling patient shifts from anywhere within a spherical error-space, a number of treatment scenarios have been simulated and dose deviations from the nominal dose distribution have been computed. The dose errors from these simulations (comprehensive approach) have then been compared to the dose-error-bar approach previously reported (surface approximation) using both point-by-point and dose- and error-volume-histogram analysis (DVH/EVHs). This comparison has been performed for two different clinical cases treated using intensity modulated proton therapy (IMPT): a skull-base and a spinal-axis tumor. Point-by-point evaluation shows that the surface approximation leads to a correct estimation (95% accuracy) of the potential dose errors for the 96% and 85% of the irradiated voxels, for the two investigated cases respectively. We also found that the voxels for which the surface approximation fails are generally localized close to sharp soft tissue-bone interfaces and air cavities. Moreover, analysis of EVHs and DVHs for the two cases shows that the percentage of voxels of a given volume of interest potentially affected by a certain maximum dose error is correctly estimated using the surface approximation and that this approach also accurately predicts the upper and lower bounds of the DVH curves that can occur under positioning uncertainties. In conclusion, the assumption that the larger the patient shift the worse the dose error does not always hold on a point-by-point basis. Nevertheless, when performing a volumetric analysis, a limited set of worst case error scenarios correctly represents the worst quality of the plan in presence of setup errors. As a consequence of these results, we believe that the worst case scenario approach can be used in the IMPT planning procedure for estimating plan robustness provided that the possible limitations of this approach are known.

Isoflavone supplementation reduces DNA oxidative damage and increases O-ß-N-acetyl-D-glucosaminidase activity in healthy women.

Phenolic compounds are believed to boost the human antioxidant defense system and health; therefore, the aim of this research was to investigate the hypothesis that soy isoflavones (IFs) provide antioxidant protection in healthy women by evaluating DNA resistance to oxidative damage and O-ß-N-acetyl-D-glucosaminidase (OGA) activity. An IF supplement (80 mg/d) was given to 9 postmenopausal women and 13 young women for 6 months and then stopped up to the 14th month. The women were allowed to consume their normal diet. Blood samples were collected at the beginning of the study after 2, 4, and 6 months and then at the 8th and 14th months. Plasma concentrations of genistein and daidzein, total antioxidant capacity, plasma vitamin status, markers of oxidative stress (red blood cell membrane fluidity, activity of the red blood cell cytosolic enzyme OGA and lymphocyte DNA susceptibility to oxidative stress), and serum lipid profile were analyzed. Analysis of variance for repeated measures was used for statistical analysis. Plasma concentrations of IFs rose significantly during the supplementation period, and plasma total antioxidant capacity increased in young women; membrane fluidity and OGA activity increased, and DNA oxidative damage decreased (P < .05) at 4 months, then returned to the basal level. There was a significant inverse correlation between DNA damage and plasma IF concentrations (P < .01). The results indicated a positive effect of IF supplementation on oxidative stress in women, thus suggesting that the healthful action ascribed to soy consumption may be partially related to the antioxidant potential of IFs.

Integrative taxonomy at work: DNA barcoding of taeniids harboured by wild and domestic cats.

In modern taxonomy, DNA barcoding is particularly useful where biometric parameters are difficult to determine or useless owing to the poor quality of samples. These situations are frequent in parasitology. Here, we present an integrated study, based on both DNA barcoding and morphological analysis, on cestodes belonging to the genus Taenia, for which biodiversity is still largely underestimated. In particular, we characterized cestodes from Italian wildcats (Felis silvestris silvestris), free-ranging domestic cats (Felis silvestris catus) and hybrids populations. Adult taeniids were collected by post-mortem examinations of the hosts and morphologically identified as Taenia taeniaeformis. We produced cox1 barcode sequences for all the analysed specimens, and we compared them with reference sequences of individuals belonging to the genus Taenia retrieved from GenBank. In order to evaluate the performance of a DNA barcoding approach to discriminate these parasites, the strength of correlation between species identification based on classical morphology and the molecular divergence of cox1 sequences was measured. Our study provides clear evidence that DNA barcoding is highly efficient to reveal the presence of cryptic lineages within already-described taeniid species. Indeed, we detected three well-defined molecular lineages within the whole panel of specimens morphologically identified as T. taeniaeformis. Two of these molecular groups were already identified by other authors and should be ranked at species level. The third molecular group encompasses only samples collected in Italy during this study, and it represents a third candidate species, still morphologically undescribed.

Experimental verification of IMPT treatment plans in an anthropomorphic phantom in the presence of delivery uncertainties.

Clinically relevant intensity modulated proton therapy (IMPT) treatment plans were measured in a newly developed anthropomorphic phantom (i) to assess plan accuracy in the presence of high heterogeneity and (ii) to measure plan robustness in the case of treatment uncertainties (range and spatial). The new phantom consists of five different tissue substitute materials simulating different tissue types and was cut into sagittal planes so as to facilitate the verification of co-planar proton fields. GafChromic films were positioned in the different planes of the phantom, and 3D-IMPT and distal edge tracking (DET) plans were delivered to a volume simulating a skull base chordoma. In addition, treatments planned on CTs of the phantom with HU units modified were delivered to simulate systematic range uncertainties (range-error treatments). Finally, plans were delivered with the phantom rotated to simulate spatial errors. Results show excellent agreement between the calculated and the measured dose distribution: >99% and 98% of points with a gamma value <1 (3%/3 mm) for the 3D-IMPT and the DET plan, respectively. For both range and spatial errors, the 3D-IMPT plan was more robust than the DET plan. Both plans were more robust to range than to the spatial uncertainties. Finally, for range error treatments, measured distributions were compared to a model for predicting delivery errors in the treatment planning system. Good agreement has been found between the model and the measurements for both types of IMPT plan.

Long-term outcomes of a pilot CT screening for lung cancer.

BACKGROUND: Low-dose computed tomography (CT) screening can detect early stage lung cancer in high-risk populations. However, no data on repeated annual screening over more than 5 years are available, and the impact of screening on lung cancer mortality is controversial. METHODS: We analysed outcomes in high-risk asymptomatic volunteers (smokers and former smokers, >50 years) enrolled in a pilot study over 1 year from June 2000, who received annual low-dose CT for 7 years. Cumulative lung cancer incidence and survival were represented by Kaplan-Meier curves. Standardized incidence and mortality ratios were used to estimate risks relative to the general Italian and US population. RESULTS: Compliance was 86% at the end of the seventh year in 1035 recruited volunteers (71% men, mean age 58 years). Lung cancer was diagnosed in 54 (5.3%); radical surgery was possible in 48/54 (87%); 39/54 (72%) had stage I disease. Five-year survival was 63% overall, 89% for stage I cases. During 6308 person-years of observation, 47 participants had died versus 75 expected in the Italian general population standardised for age and sex. Fourteen lung cancer deaths were registered versus 27 expected in a standardised US smoker population. CONCLUSIONS: Seventy percent of screening-diagnosed patients had stage I disease, and the survival of screen-detected cancer patients was high. Lung cancer mortality was favourable compared to age- and sex-matched population of US smokers, suggesting that mortality can be lowered by screening, although larger trials with longer follow-up are necessary to confirm these findings.

Ocular dirofilariosis by Dirofilaria immitis in a dog: first case report from Europe.

A five-year-old, entire female mixed-breed dog was presented with corneal oedema and episcleral hyperaemia in the left eye. The ophthalmological examination revealed the presence of a free-swimming nematode in the anterior chamber. Circulating microfilariae were not observed by a modified Knott test nor were adult antigens detected in serum by a commercial ELISA. The parasite was surgically removed from the dog's eye, but its anterior end was damaged during the surgery. Based on the morphology of the posterior end, the nematode was preliminarily identified as a male Dirofilaria immitis. The species identification was confirmed by PCR amplification and sequencing of the mitochondrial coxI and 12S rDNA genes, using a DNA barcoding approach. Although other cases of ocular dirofilariosis by D. immitis have been previously recorded in Australia and the United States, the case reported herein is the first in a dog from Europe.

Litomosa chiropterorum Ortlepp, 1932 (Nematoda: Filarioidea) from a South African miniopterid: redescription, Wolbachia screening and phylogenetic relationships with Litomosoides.

69 Miniopterus notalensis, type host of the onchocercid Litomosa chiropterorum, were collected in caves in the Western Province and Gauteng Province, South Africa. The prevalence of these filariae was about 50 %. The microfilaria is folded, as in other Litomosa and an area rugosa composed of cuticular bosses is present in the male posterior region. L. chiropterorum is close to the species parasitic in other Miniopterus spp. and some Rhinolophus spp. from Africa, Madagascar and Europe; it is unique with the expanded anterior extremity and the four cephalic submedian bosses. The molecular analysis of L. chiropterorum, the first done with Litomosa species from a bat, supports the hypothesis that Litomosa and Litomosoides, which have an exceptionally large buccal capsule in common, form a group in which Litomosa has a basal position. Interestingly, L. chiropterorum does not harbour Wolbachia, as proved with immunohistological staining and PCR screening using the 16S rDNA gene as target. This is contrary to L. westi from rodents and the majority of the Litomosoides species parasitic in bats or rodents. The absence of Wolbachia in a filarioid group considered ancient based on traditional and molecular approaches opens interesting scenarios on the evolution of the endosymbionts spread through filarial lineages.

Efficacy of HT 7 point acupressure stimulation in the treatment of insomnia in cancer patients and in patients suffering from disorders other than cancer.

AIM: The induction of sleep would depend on interaction between gabaergic system and the pineal gland through its main hormone melatonin. Until few years ago benzodiazepines were the only drugs effective in the treatment of insomnia. Recently, however, both melatonin and acupressure have appear to be active in sleep disorders. The aim of study was to evaluate the efficacy of HT 7 point acupressure in insomnia. METHODS: The study enrolled 25 patients affected by sleep disorders, 14 of whom had a neoplastic disease. They were treated by HT 7 stimulation for al least two consecutive weeks using a medical device named H7 Insomnia Control. RESULTS: An improvement in the quality of sleep was achieved in 15/25 (60%) patients, with a more evident efficacy in cancer patients (11/14 [79%]). CONCLUSION: This study confirms previous clinical data showing the efficacy of acupressure in the treatment of sleep disorders, particularly in cancer-related insomnia.

The nematoda Filarioidea: critical analysis linking molecular and traditional approaches.

The molecular analysis of the Filarioidea and the endobacteria Wolbachia is no more limited to the agents of human diseases and the diversified sampling permits a synthesis with the morphological and biological results. The validity of the genera with "uncoherent host range", such as Monsonella, Litomosoides and Cercopithifilaria, is confirmed and, consequently, their evolution by host-switchings. Dirofilaria and Onchocerca, types of two subfamilies, appear more closely related than with other onchocercids. Waltonellinae from anurans and Oswaldofilariinae from reptiles have a basal position. These filariae, and some others also considered primitive, do not harbour Wolbachia. Evidence for transversal transmission of the bacteria and a second acquisition event is given with the supergroup F, identified in Monsonella, in one of the Cercopithifilaria species and in arthropods.

Effectiveness of pegylated interferon/ribavirin combination in 'real world' patients with chronic hepatitis C virus infection.

BACKGROUND: Clinical trials have shown that the combination of pegylated interferon/ribavirin induces a sustained virological response in 54-63% of patients with chronic hepatitis C virus infection, but its effectiveness in day-to-day clinical practice is less clear. AIM: To verify if the efficacy of pegylated interferon/ribavirin combination in 'real world' patients is comparable to that observed in trials. Methods The medical records of 397 consecutive naïve patients with chronic hepatitis C virus infection treated with pegylated interferon/ribavirin combination in nontertiary hospital settings were reviewed in order to assess the response to anti-viral treatment. RESULTS: The sustained virological response rate achieved in this population was similar to that recorded in registration trials (total population: 64%; genotype 1: 46%; genotypes 2-3: 84%). Also, the premature discontinuation rate (15%) was similar to that observed in registration trials, but there were fewer dose reductions in one or both medications (26%). We confirmed the association between adherence and sustained virological response among the patients infected with hepatitis C virus genotype 1 who were treated for > or =80% of the planned duration of treatment. CONCLUSION: The effectiveness of pegylated interferon/ribavirin therapy and factors predicting an sustained virological response in everyday clinical practice mirror those reported in randomized-controlled studies.

Measuring the glycemic index of foods: interlaboratory study.

BACKGROUND: Many laboratories offer glycemic index (GI) services. OBJECTIVE: We assessed the performance of the method used to measure GI. DESIGN: The GI of cheese-puffs and fruit-leather (centrally provided) was measured in 28 laboratories (n=311 subjects) by using the FAO/WHO method. The laboratories reported the results of their calculations and sent the raw data for recalculation centrally. RESULTS: Values for the incremental area under the curve (AUC) reported by 54% of the laboratories differed from central calculations. Because of this and other differences in data analysis, 19% of reported food GI values differed by >5 units from those calculated centrally. GI values in individual subjects were unrelated to age, sex, ethnicity, body mass index, or AUC but were negatively related to within-individual variation (P=0.033) expressed as the CV of the AUC for repeated reference food tests (refCV). The between-laboratory GI values (mean+/-SD) for cheese-puffs and fruit-leather were 74.3+/-10.5 and 33.2+/-7.2, respectively. The mean laboratory GI was related to refCV (P=0.003) and the type of restrictions on alcohol consumption before the test (P=0.006, r2=0.509 for model). The within-laboratory SD of GI was related to refCV (P<0.001), the glucose analysis method (P=0.010), whether glucose measures were duplicated (P=0.008), and restrictions on dinner the night before (P=0.013, r2=0.810 for model). CONCLUSIONS: The between-laboratory SD of the GI values is approximately 9. Standardized data analysis and low within-subject variation (refCV<30%) are required for accuracy. The results suggest that common misconceptions exist about which factors do and do not need to be controlled to improve precision. Controlled studies and cost-benefit analyses are needed to optimize GI methodology. The trial was registered at clinicaltrials.gov as NCT00260858.