High-pressure processing (HPP) of raw and dry-cured ham from experimentally infected pigs as a potential tool for the risk control of Toxoplasma gondii

Raw and dry-cured meats have been identified as a potential source of Toxoplasma gondii infection for humans. The present study evaluated the efficacy of an alternative non-thermal food-processing treatment, high hydrostatic pressure, on the viability of T. gondii bradyzoites in raw and dry-cured ham. Meat of pigs experimentally exposed to 4000 oocysts of T. gondii VEG strain was vacuum-packaged and subjected to high pressure processing (HPP). Tap water (6 °C ± 1 °C) was used as the pressure-transmitting fluid, and its temperature during HPP increased 2.7 °C per 100 MPa. The effect was evaluated by bioassay in mice followed by qPCR. In raw ham, 100–400 MPa/1 min did not inactivate T. gondii, whereas 600 MPa/20 min was effective. In dry-cured ham, 600 MPa for 3 or 10 min were not effective and a 20-min treatment was required to render the bradyzoites non-infectious for mice. Our results point toward the potential use of HPP as a tool for risk control of T. gondii and as a food safety guarantee. Industrial relevance text: Under real production conditions, the usual HPP treatments applied by the food industry to control L. monocytogenes and other pathogenic bacteria are 600 MPa of pressure and holding times of 3–10 min. Our study demonstrated, however, that longer treatment times are required to inactivate the parasite and, thus, to guarantee the safety of raw and dry-cured meats in order to reduce the public health risk of toxoplasmosis. Further research is needed to evaluate other HPP conditions, including pulsed cycles, for the inactivation of T. gondii in foods of animal origin

Aphasia in a patient with acute hepatic encephalopathy associated with multifocal cortical brain lesions (Letter)

La encefalopatía hepática aguda (EHA) se caracteriza típicamente por una amplia gama de manifestaciones neuropsiquiátricas incluyendo alteraciones del comportamiento, estado de ánimo o cognitivas asociadas a asterixis y diferentes grados de alteración del nivel de consciencia que pueden progresar a estupor o coma en algunos casos1. Esta situación puede ser debida a una insuficiencia hepática aguda, cirrosis, hipertensión portal o la presencia de una derivación porto-sistémica2,3. La resonancia magnética (RM) cerebral en EHA puede mostrar alteraciones de se nal en diferentes áreas cerebrales debido a edema vasogénico y citotóxico relacionado con el efecto tóxico del amonio en el cerebro. Estas alteraciones pueden desaparecer después de la resolución de la encefalopatía o pueden progresar a necrosis laminar cortical en los casos con evolución desfavorable. Las presentaciones con manifestaciones focales son muy poco frecuentes en la EHA y pueden derivar en errores diagnósticos

Çédille, revista de estudios franceses

Presentació

Acute propranolol administration effectively decreases portal pressure in patients with TIPS dysfunction. Transjugular intrahepatic portosystemic shunt

Background and aims: Up to 60% of patients treated with transjugular intrahepatic portosystemic shunt (TIPS) require angioplasty or restenting during the first year of follow up because of TIPS dysfunction (stenosis of the intrahepatic shunt increasing the portal pressure gradient above the 12 mm Hg threshold). We hypothesised that in patients with TIPS stenosis, propranolol administration, by decreasing portal inflow, would markedly decrease portal pressure. Patients and methods: Eighteen patients with TIPS dysfunction were investigated by measuring portal pressure gradient before and after acute propranolol administration (0.2 mg/kg intravenously; n=18). Results: Propranolol markedly reduced the portal pressure gradient (from 16.6 (3.5) to 11.9 (4.8) mm Hg; p16 mm Hg) (8/10 v 1/8; p=0.015). Conclusions: Propranolol therapy may delay the increase in portal pressure and reduce the need for reintervention in patients with TIPS dysfunction

Acute propranolol administration effectively decreases portal pressure in patients with TIPS dysfunction. Transjugular intrahepatic portosystemic shunt

Background and aims: Up to 60% of patients treated with transjugular intrahepatic portosystemic shunt (TIPS) require angioplasty or restenting during the first year of follow up because of TIPS dysfunction (stenosis of the intrahepatic shunt increasing the portal pressure gradient above the 12 mm Hg threshold). We hypothesised that in patients with TIPS stenosis, propranolol administration, by decreasing portal inflow, would markedly decrease portal pressure. Patients and methods: Eighteen patients with TIPS dysfunction were investigated by measuring portal pressure gradient before and after acute propranolol administration (0.2 mg/kg intravenously; n=18). Results: Propranolol markedly reduced the portal pressure gradient (from 16.6 (3.5) to 11.9 (4.8) mm Hg; p16 mm Hg) (8/10 v 1/8; p=0.015). Conclusions: Propranolol therapy may delay the increase in portal pressure and reduce the need for reintervention in patients with TIPS dysfunction

Acute Appendicitis: Hispanics and the Hamburger Sign

Objective: To describe the presenting clinical findings of patients with acute appendicitis and compare them with those described in the medical literature. To corroborate a common medical myth among Hispanic physicians regarding the presentation of acute appendicitis. Methods: This was a retrospective multicenter chart review of patients diagnosed post-operatively with appendicitis after presenting to five different Emergency Departments in Southern Puerto Rico (PR). Results: A total of 1,540 patients with pathologically confirmed cases of appendicitis were enrolled in our study. Of the study population, 45% were female, and 55% were male, and 43% were over 21 years old. Reported symptoms in our study showed that 98% of the patients had abdominal pain, 47% had nausea, and only 17.6% presented with anorexia. Conclusion: It was our main objective to compare the presenting signs and symptoms of patients with acute appendicitis in our Hispanic population in southern PR with those found in primary medical textbooks and literature. We gathered information regarding signs and symptoms, as well as laboratory and radiographic data of patients with positive pathologic exams for appendicitis. Of the 1,540 patients with confirmed appendicitis, only 17.6% presented with anorexia. Our findings demonstrate that the rate of anorexia in the studied population is significantly lower when compared to current literature. The absence of anorexia, once considered a hallmark of appendicitis, must not lead the physician to rule out this diagnosis in the Hispanic population