Antagonistic effect of Trichoderma harzianum VSL291 on phytopathogenic fungi isolated from cocoa (Theobroma cacao L.) fruits

In this study we evaluated the antagonism in vitro of Trichoderma harzianum strain VSL291 against 18 pathogens of cocoa fruits in dual culture. T. harzianum VSL291 inhibited the growth of the phytopathogenic fungi tested between 10.54 and 85.43%. The mycoparasitism of Moniliophthora roreri by T. harzianum VSL291 was studied by light and scanning electron microscopy. T. harzianum VSL291 hyphae grew in parallel with the hyphae of M. roreri and in some places these were united with the hyphae of the cocoa pathogen through small structures like apresorious that tangled in the pathogenic fungus preventing its growth. T. harzianum VSL291 produced lytic enzymes: β-1,3-glucanases, chitinases, proteases, xylanases and lipases, when grown in minimal medium, with fungal cell walls as the sole carbon source. The highest proteolytic activities detected in T. harzianum VSL291 broth with M. roreri, Penicillium expansum and Byssochlamys spectabilis cell walls appear to be associated with increased activities of β-1,3 glucanases, chitinases, lipases, proteases and xylanases and biocontrol index derived from the experiments of confrontation. These results suggest that proteolytic enzymes according to their degree of induction could participate in the antagonistic effect of T. harzianum VSL291 against the fungi tested.Key words: Antagonism, Trichoderma harzianum, mycoparasitism, phytopathogenic fung

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified