Review: Insects and former foodstuffs for upgrading food waste biomasses/streams to feed ingredients for farm animals.

The increasing global need to find alternative protein/energy sources has triggered research in the field of non-conventional feed ingredients, with insects and former foodstuffs being the most promising. Insects contain high level of protein and fat, whereas former foodstuffs contain high energy in the form of carbohydrates and fats; therefore, both should be considered as promising alternative feed ingredients for livestock production. In addition to the nutritional value, they also represent a way by which food waste biomasses/streams can be upgraded to valuable feed ingredients. This review outlines the main nutritional and safety issues of insects and former foodstuffs, and also considers the legal framework involved. The importance of the type of insect metamorphosis and tailored substrates that could lead to the production of a premium feed is also described. This is also the first time that a review discusses the nutritional quality of former foodstuffs. Energy and the main nutrient content of former foodstuff are compared with the composition of common cereals as the principal energy sources in animal feed. For both ingredients a critical review of the safety issues is provided. Based on the current data available, both insects and former foodstuffs have an excellent potential use as alternative feed ingredients for livestock production. When produced in line with the criteria set by major feed/food authorities, they are characterized by high quality and safety standards. This makes them comparable to other feed materials and ingredients currently available on the market, although their full nutritional, functional, safety and sustainability evaluation cannot be considered complete.

Nutritional evaluation of former food products (ex-food) intended for pig nutrition.

Ex-food or former food products (FFPs) have been proposed as one of the categories with great promise as alternative feed ingredients. FFPs' nutritional potential is not yet fully exploited. Therefore, the aim of this study was to perform a nutritional evaluation of selected FFPs. In particular, six samples of mixed FFPs, all based on bakery products, were analysed for moisture, crude protein, ether extract, crude fibre, neutral detergent fibre, acid detergent fibre, starch and ash. Nitrogen-free extractives and non-structural carbohydrate were also determined. Based on FFPs' composition data, estimation of digestible energy and metabolisable energy values for pigs were calculated. Further, the in vitro digestibility values of FFPs were investigated using a multi-step enzymatic technique. A wheat sample was included as a control feed ingredient in the study. All data were reported on dry matter basis. FFPs have shown a nutrient composition comparable with cereal grains. In the tested FFPs, the average protein content was 10.0% and the average starch content was 52.4%. Nitrogen-free extractive ranged from 61.2% to 74.7%, whereas non-structural carbohydrate ranged from 58.5% to 79.3%. Compared with wheat, FFPs were characterised by a relative high fat content, averaging about 10.1%. The relatively high nitrogen-free extractive/non-structural carbohydrate/starch and fat concentration designated FFPs as valuable energy sources. Digestible energy and metabolisable energy averages were 17.2 and 16.9 MJ kg-1, respectively. The average in vitro digestibility value of FFPs samples was 88.2% ± 5.8%, comparable with that of wheat (90.6% ± 1.6%). FFPs are a fat-fortified version of common cereals grains. The high energy content and digestibility values elect FFPs as promising non-traditional ingredients for swine.

Economic analyses on the use of positron emission tomography for the work-up of solitary pulmonary nodules and for staging patients with non-small-cell-lung-cancer in Italy.

AIM: Increasing ageing of the population and tumor incidence, along with worldwide rationing of the resources for public health systems, spur the use of economic analyses for the choice of strategies and technologies in the assessment and management of cancer patients. Incidence and clinical managing of tumors vary in different countries even if positron emission tomography (PET) with 2-deoxy-2-[18F]-fluoro-D-glucose (FDG) is becoming a routine clinical method for diagnosis, staging, treatment monitoring and follow-up in a variety of tumors. Available data indicate that PET can be considered a superior alternative or complementary tool to other well-established methods. However, in spite of the above and of the rapidly increasing number of PET centers in Europe, USA and Japan, only a few studies have dealt with some of the economic aspects raised by the clinical use of PET because of differences in values of reimbursements and health costs. The main aim of this study is to propose and discuss an economic model of analysis for PET applications in the field of detection and management of pulmonary tumors. METHODS: In this study 2 assessments were performed by decision tree analysis on the economic impact of the availability of PET on decision-making processes for 2 conditions: solitary pulmonary nodules assessment and non-small-cell lung cancer (NSCLC) staging. In order to define a methodology consistent with the system of reimbursement and the prevalent clinical views of the Italian National Health Service, data on costs, death probability, and life expectancy were gathered from the literature and from the Italian system of reimbursement (ROD-DRGs). RESULTS: The results of the cost minimization analysis demonstrate that the use of PET in the diagnostic path for the workup of patients with SPN reduces the overall diagnostic costs, by approximately 50 Euro per patient, by reducing inappropriate invasive diagnostic investigation and their complications. The results of the cost effectiveness analysis demonstrate that the use of PET in the diagnostic path for the staging of patients with NSCLC reduces the overall diagnostic costs by approximately 108 Euro for added year, by reducing inappropriate surgical interventions and their complications. CONCLUSION: Both analyses are based on standard methods used in the literature, so our conclusions can be compared with results and assessments of similar studies in different countries and health care systems. Also in the Italian case, the use of an economic assessment provides relevant information on the efficacy and effectiveness of PET.

Anatomical and biochemical investigation of primary brain tumours.

Cancerous transformation entails major biochemical changes including modifications of the energy metabolism of the cell, e.g. utilisation of glucose and other substrates, protein synthesis, and expression of receptors and antigens. Tumour growth also leads to heterogeneity in blood flow owing to focal necrosis, angiogenesis and metabolic demands, as well as disruption of transport mechanisms of substrates across cell membranes and other physiological boundaries such as the blood-brain barrier. All these biochemical, histological and anatomical changes can be assessed with emission tomography, X-ray computed tomography (CT), magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS). Whereas anatomical imaging is aimed at the diagnosis of brain tumours, biochemical imaging is better suited for tissue characterisation. The identification of a tumoural mass and the assessment of its size and vascularisation are best achieved with X-ray CT and MRI, while biochemical imaging can provide additional information that is crucial for tumour classification, differential diagnosis and follow-up. As the assessment of variables such as water content, appearance of cystic lesions and location of the tumour are largely irrelevant for tissue characterisation, a number of probes have been employed for the assessment of the biochemical features of tumours. Since biochemical changes may be related to the growth rate of cancer cells, they can be thought of as markers of tumour cell proliferation. Biochemical imaging with radionuclides of processes that occur at a cellular level provides information that complements findings obtained by anatomical imaging aimed at depicting structural, vascular and histological changes. This review focusses on the clinical application of anatomical brain imaging and biochemical assessment with positron emission tomography, single-photon emission tomography and MRS in the diagnosis of primary brain tumours, as well as in follow-up.

Cytokine gene expression in B-cell chronic lymphocytic leukemia: evidence of constitutive interleukin-8 (IL-8) mRNA expression and secretion of biologically active IL-8 protein.

To extent our knowledge on the cytokines possibly involved in the pathophysiology of B-cell chronic lymphocytic leukemia (B-CLL), the mRNA expression of a panel of 10 cytokines was investigated on purified B-CLL cells using a reverse-transcriptase polymerase chain reaction method. Whereas negative RT-PCR signals were recorded for interleukin-1 alpha (IL-1 alpha), IL-2, IL-3, IL-4, IL-5, IL-7, tumor necrosis factor beta (TNF beta), and granulocyte-macrophage colony-stimulating factor, we detected the expression of IL-1 beta, IL-6 and TNF alpha. Furthermore, the constitutive expression of IL-8 mRNA was observed in all 17 B-CLL samples analyzed. mRNA expression was associated with the capacity of the leukemic cells to release IL-8 both constitutively (4.6 +/- 8.1 SD ng/mL) and, to a further extent, after stimulation (14.5 +/- 19.4 ng/mL). The circulating levels of IL-8 were also evaluated in 12 untreated B-CLL sera samples and the overall mean level was significantly higher (P < .01) than in normal sera. In addition, supernatants of purified B-CLL cells cultured in the presence of 12-O-tetradecanoylphorbol-13-acetate showed chemotactic activity towards neutrophils; this activity was neutralized in the presence of an anti-IL-8 antiserum. The mRNA for IL-8 was absent in five B-cell preparations from hairy cell leukemia cases and in four B-cell lines. Normal tonsil CD5+ B cells showed a low expression of IL-8 mRNA only in two of the nine preparations tested and the overall quantity of IL-8 released by these cells after 3 days' incubation was significantly lower compared with that released by B-CLL cells (0.4 +/- 0.3 and 1.6 +/- 0.9 ng/mL under basal and stimulated conditions, respectively). These findings point to an involvement of a member of the proinflammatory chemokine supergene family in human CD5+ B lymphocytes. The different IL-8 behavior observed between B-CLL cells and their normal counterpart is likely to reflect an activation state of the leukemic population.

Autologous bone marrow transplantation followed by interleukin-2 in children with advanced leukemia: a pilot study.

In an attempt to prolong disease-free survival in children with acute leukemia, we tested the feasibility of interleukin-2 (IL-2) administration after an autologous bone marrow transplantation (ABMT). We report the clinical and biological data obtained in three children with acute myelocytic leukemia (AML) in second complete remission (CR) and in seven children with acute lymphocytic leukemia (ALL) in second or subsequent CR, who received IL-2 at a median interval of 78 days (range 38-125) from ABMT. Patients were treated with 1-2 cycles of IL-2 given by continuous infusion over a 5-day period using a daily escalating protocol, from 100 micrograms/m2 per day to the maximum tolerated dose, followed after 3 weeks by low-dose IL-2 for 5 days monthly over a 6-h infusion on an out-patient basis. Side effects greater than grade 2 (WHO system), consisting of thrombocytopenia, fever, cutaneous rash, nausea and vomiting, diarrhoea were common during the high-dose IL-2 cycles, but resolved 24-48 h after stopping IL-2. Only one patient developed liver toxicity (grade 3, WHO) on day +3 of the first cycle which prompted us to stop the administration of IL-2. An increase in lymphocytes and eosinophils was also observed. IL-2 treatment was followed by a normalization of NK function and by the generation of a high proportion of endogenous LAK cells. All seven ALL patients relapsed at a median of 5 months (range 1-23). Two AML patients relapsed at 1 and 11 months, while the other is still in continuous CR at 23 months after IL-2 treatment. Our IL-2 schedule for treatment of leukemia in children after ABMT is thus feasible but its efficacy requires further investigation.

Interleukin 2 (IL2) in the management of acute myeloid leukemia: clinical and biological findings.

In this paper we review some of the preclinical findings which have led us to believe that immunotherapy with interleukin 2 (IL2)/lymphokine activated killer (LAK) cells may be a feasible approach in the management of acute myeloid leukemia. The main clinical and biological results so far obtained with IL2 treatment, and the currently ongoing protocols and strategies are discussed.

Immunoglobulin and T-cell receptor gene analysis in lymphoproliferative disorders.

The analysis of the configuration of the immunoglobulin (Ig) and T-cell receptor (TCR) gene regions has been of great relevance in defining conclusively the nature of several lymphoproliferative disorders in man. Furthermore, this technological tool has also helped to dissect between a monoclonal and polyclonal pattern of proliferation. The major results obtained, the potential use of molecular studies for the detection of minimal residual disease and the relevance of these techniques in the understanding of the processes of leukemogenesis and lymphomagenesis are discussed.

Cytokines in B-Cell Chronic Lymphocytic Leukemia.

The pleomorphic action of different cytokines in regulating the growth and proliferation of normal B- and T-lymphocyte populations is becoming progressively more apparent. Thus, the possibility that some cytokines, either alone or in variable combination, may play a role in different lymphoproliferative disorders has been increasingly suggested and potential autocrine or paracrine loops hypothesized. Here, we shall discuss some of the known B-cell growth factors which have been postulated to be involved in the hematological progression, clinical course and complications in B-cell lymphocytic leukemia.