Update on celiac disease

Celiac disease is a chronic autoimmune process that is modulated by an environmental trigger, namely glladin; a part of gluten which is present in wheat, barley and rye, Celiac disease is clearly increasing in prevalence worldwide and with easier access to screening tools the notion that it is a disease of Western society is in increasingly being challenged, We have also seen a broader gamut of symptoms and disease conditions that are associated with celiac disease to the extent that the nomenclature of classic and non-classic manifestations seems redundant. The increased recognition in prevalence is poorly understood but seems to also reflect a true increase in incidence, These observations supported by constantly improving diagnostic techniques; including serologic, genetic testing and endoscopic moralities has frustratingly not been paralleled in any measure by any breakthrough in managementpeer-reviewe

New gastrointestinal diagnostic modalities : capsule endoscopy

With an approximate length of 15 feet, the small intestine presents a daunting challenge to the clinician faced with symptoms referable to this relatively inaccessible area. In the last decade, capsule endoscopy (CE) has established an increasingly broad niche in the diagnostic armamentarium of both paediatric and adult clinicians; it is now the established standard of care in the work up of obscure gastrointestinal hemorrhage, suspected Crohn's Disease, polyposis syndromes and arguably, chronic abdominal pain.peer-reviewe

Supercritical CO2 extraction of waxes as part of a holistic biorefinery

The scope of this project was to utilise supercritical carbon dioxide (scCO2) extraction technology as a pre-treatment step in a holistic C4 biorefinery in order to extract added value metabolites from C4 agro-residues. The lipid profile of three different types of C4 biomass agro-residues namely miscanthus, maize and sugarcane was studied. Wax extractions with organic solvents and scCO2 were conducted on different parts of the plant. A diverse range of hydrophobic molecules were identified including long-chain fatty acids, n-policosanols, fatty aldehydes, n-alkanes, wax esters, sterols, steroid ketones and triterpenoids. The extracts exhibited significant differences in melting temperatures, highlighting the possibility for utilisation in different applications. The advantages of scCO2 extraction over conventional organic extraction are clearly demonstrated in this work. Herein, the first reported fractionation of maize stover wax gave rise to three waxy fractions. Fraction A consisted of high molecular weight compounds while Fraction B was predominantly phytosterols. Fraction C had the lowest melting profile and the wax was tested as a renewable antifoaming agent. Fraction C successfully reduced foam and had no negative effects on the detergent performance. The extraction of wax from C4 biomass only utilises around 1% of the total biomass. In order to have a systemic view of a C4 biomass processing scenario where scCO2 extraction is integrated into a biorefinery, the effects of scCO2 extraction on the downstream processing of maize stover and miscanthus were studied. In fermentation of maize stover for surfactant production, results show that there was a higher glucose consumption (19%) and greater growth (18%) for the scCO2-extracted maize stover when compared to non-treated maize stover. In fermentation experiments for ethanol production a 40% increase in overall ethanol production for the scCO2-extracted maize stover was obtained. Saccharification results on miscanthus leaves showed a 22% increase in sugar release for scCO2 extracts. Finally, this work cannot be developed further unless an economic evaluation of the manufacturing process is done. This is the first time an economic assessment for the scCO2 extraction of waxes from biomass has been carried out. The cost for miscanthus and maize stover wax extraction was found to be €148/kg of wax and €88.19/kg of wax respectively. If the biomass was pelletised, leaves were solely taken into consideration (4 times the wax yield) and the biomass was combusted following the extraction, then the cost of the wax could be reduced to as much as €8.60/kg of wax for miscanthus and €1.97/kg of wax for maize

Clinical outcome of pediatric collagenous gastritis : case series and review of literature

Collagenous gastritis (CG) is characterized by patchy subepithelial collagen bands. Effective treatment and the clinical and histological outcome of CG in children are poorly defined. The aim of this study is to summarize the published literature on the clinical outcome and response to therapy of pediatric CG including two new cases. We performed a search in Pubmed, OVID for related terms; articles including management and clinical and/or endo-histologic follow up information were included and abstracted. Reported findings were pooled in a dedicated database including the corresponding data extracted from chart review in our patients with CG. Twenty-four patients were included (17 females) with a mean age of 11.7 years. The clinical presentation included iron deficiency anemia and dyspepsia. The reported duration of follow up (in 18 patients) ranged between 0.2-14 years. Despite most subjects presenting with anemia including one requiring blood transfusion, oral iron therapy was only documented in 12 patients. Other treatment modalities were antisecretory measures in 13 patients; proton pump inhibitors (12), or histamine-2 blockers (3), sucralfate (5), prednisolone (6), oral budesonide in 3 patients where one received it in fish oil and triple therapy (3). Three (13%) patients showed no clinical improvement despite therapy; conversely 19 out of 22 were reported with improved symptoms including 8 with complete symptom resolution. Spontaneous clinical resolution without antisecretory, anti-inflammatory or gastroprotective agents was noted in 5 patients (4 received only supplemental iron). Follow up endo-histopathologic data (17 patients) included persistent collagen band and stable Mononuclear cell infiltrate in 12 patients with histopathologic improvement in 5 patients. Neither collagen band thickness nor mono-nuclear cell infiltrate correlated with clinical course. Intestinal metaplasia and endocrine cell hyperplasia were reported (1) raising the concern of long term malignant transformation. In summary, CG in children is a chronic disease, typically with a variable clinical response and an indolent course that is distinct from the adult phenotype. Long term therapy usually inclused iron supplementation but cannot be standardized, given the chronicity of the disease, variability of response and potential for adverse events.peer-reviewe

Synthesis of cholesterol-reducing sterol esters by enzymatic catalysis in bio-based solvents or solvent-free

Enzymatic synthesis of a β-sitosterol ester in bio-based solvents was compared with conventional solvents. Limonene and p-cymene gave higher initial reaction rates than n-hexane, and comparable conversions after 24 hours (∼75%). Importantly, a solvent-free system yielded the highest conversion (88%)

Optimisation and economic evaluation of the supercritical carbon dioxide extraction of waxes from waste date palm (Phoenix dactylifera) leaves

Wax extraction has been achieved from an abundant and sustainable waste residue, date palm leaves (or leaflets). Supercritical carbon dioxide extraction was utilised as a clean and efficient extraction technology in this process. Extraction conditions including pressure and temperature have been optimised using response surface methodology (via a 2 × 2 factorial experimental design). The highest yield obtained was 3.49% at 400 bar and 100 °C, which is significantly higher than other reported agricultural residues. The wax obtained at optimum condition (400 bar, 100 °C) exhibited a comparable melting point (78 °C) to carnauba wax, making it a suitable alternative or replacement for this overexploited commercial plant wax. The supercritical process required significantly shorter extraction times (with a 97% isolated wax yield after 120 min), as compared to soxhlet systems which typically required extraction times of up to 5 h to obtain comparable yields. Supercritical carbon dioxide was utilised to tailor the extraction process and obtain waxes with different textural properties, chemical composition and melting profile (35–78 °C). An economic study for the date palm leaf wax extraction estimated a lowest cost of manufacture (COM) at €3.78 kg−1 wax. The low cost of the manufacturing, combined with high wax recovery, the thermal properties of the extract and abundance of this waste resource, makes date palm leaf an attractive feedstock for the natural wax industry

Supercritical extraction as an effective first-step in a maize stover biorefinery

Supercritical carbon dioxide (scCO2) has been investigated for the generation of valuable waxy compounds and as an added-value technology in a holistic maize stover biorefinery. ScCO2 extraction and fractionation was carried out prior to hydrolysis and fermentation of maize stover. Fractionation of the crude extracts by scCO2 resulted in wax extracts having different compositions and melting temperatures, enabling their utilisation in different applications. One such fraction demonstrated significant potential as a renewable defoaming agent in washing machine detergent formulations. Furthermore, scCO2 extraction has been shown to have a positive effect on the downstream processing of the maize stover. Fermentation of the scCO2 extracted maize stover hydrolysates exhibited a higher glucose consumption and greater potential growth for surfactant (in comparison with non-scCO2 treated stover) and ethanol production (a 40% increase in overall ethanol production after scCO2 pre-treatment). This work represents an important development in the extraction of high value components from low value wastes and demonstrates the benefits of using scCO2 extraction as a first-step in biomass processing, including enhancing downstream processing of the biomass for the production of 2nd generation biofuels as part of an integrated holistic biorefinery

Enhanced microwave assisted pyrolysis of waste rice straw through lipid extraction with supercritical carbon dioxide

A combination of supercritical carbon dioxide (scCO2) extraction and microwave-assisted pyrolysis (MAP) have been investigated for the valorisation of waste rice straw. ScCO2 extraction of rice straw led to a 0.7% dry weight yield of lipophilic molecules, at elevated temperatures of 65 °C and pressures of 400 bar. Lipid compositions (fatty acids, fatty alcohol, fatty aldehydes, steroid ketones, phytosterols, n-alkanes and wax esters) of the waxes obtained by scCO2 were comparable to those obtained Soxhlet extraction using the potentially toxic solvent n-hexane. ScCO2 extraction positively influenced the pyrolysis heating rate, with a rate of 420 K min−1 for particles of 500-2000 μm, compared to 240 K min−1 for the same particle size of untreated straw. Particle size significantly affected cellulose decomposition and the distribution of pyrolysis products (gaseous, liquid and char), highlighting the importance of selecting an adequate physical pre-treatment. TG and DTG of the original rice straw and resulting biochar produced indicated that cellulose was completely decomposed during the MAP. While a rapid pressure change occurred at ∼120 °C (size > 2000 μm) and ∼130 °C (size 500-2000 μm) during MAP and was associated with the production of incondensable gas during cellulose decomposition, this takes place at significantly lower temperatures than those observed with conventional pyrolysis, 320 °C. Wax removal by scCO2 influences the dielectric properties of the straw, enhancing microwave absorption with rapid heating rates and elevated final pyrolysis temperatures, illustrating the benefits of combining these sustainable technologies within a holistic rice straw biorefinery

Integrated biorefinery approach to valorise Saccharina latissima biomass : Combined sustainable processing to produce biologically active fucoxanthin, mannitol, fucoidans and alginates

The feasibility of European seaweed farming depends on the valorisation of algal biomass harvested. In the present work we have combined sequential extraction processes from Saccharina latissima to produce a range of products, focusing on the extraction of fucoxanthin using supercritical CO2 followed by different valorisation routes. We optimised the conditions the for extraction of fucoxanthin (40 MPa, temperature has little impact on extraction) and the extracts obtained were tested on cancer cell cultures to determine the antiproliferative effects of this pigment. We established that the supercritical CO2 extracts have an antiproliferative effect similar to that of commercial fucoxanthin (concentrations 0.1–0.4 mg/mL) and showed that the active compound in the extracts is fucoxanthin. In order to integrate this process with a holistic valorisation of the algal biomass, we explored the extraction of mannitol using a microwave-assisted protocol (4.15 wt % yield). We also evaluated the potential extraction of fucoidans and alginates from the solids remaining after supercritical CO2 extraction (67.27 to 69.38 % of alginates). A life cycle analysis of the supercritical CO2 extraction proposed shows that the drying process of algal biomass and the energy used to compress the CO2 are the elements with the highest environmental impact (over 90% of CO2 eq/g of extract) in this the process, indicating routes for reducing the environmental footprint. Combining supercritical CO2 extraction and microwave-assisted extraction methods would enable European seaweed producers to obtain multiple marketable products from algal biomass

Supercritical extraction as an effective first-step in a maize stover biorefinery

Supercritical carbon dioxide (scCO2) has been investigated for the generation of valuable waxy compounds and as an added-value technology in a holistic maize stover biorefinery. ScCO2 extraction and fractionation was carried out prior to hydrolysis and fermentation of maize stover. Fractionation of the crude extracts by scCO2 resulted in wax extracts having different compositions and melting temperatures, enabling their utilisation in different applications. One such fraction demonstrated significant potential as a renewable defoaming agent in washing machine detergent formulations. Furthermore, scCO2 extraction has been shown to have a positive effect on the downstream processing of the maize stover. Fermentation of the scCO2 extracted maize stover hydrolysates exhibited a higher glucose consumption and greater potential growth for surfactant (in comparison with non-scCO2 treated stover) and ethanol production (a 40% increase in overall ethanol production after scCO2 pre-treatment). This work represents an important development in the extraction of high value components from low value wastes and demonstrates the benefits of using scCO2 extraction as a first-step in biomass processing, including enhancing downstream processing of the biomass for the production of 2nd generation biofuels as part of an integrated holistic biorefinery