Severe hepatotoxicity following ingestion of Herbalife nutritional supplements contaminated with Bacillus subtilis

BACKGROUND/AIMS: Nutritional supplements are widely used. Recently, liver injury after consumption of Herbalife preparations was reported but the underlying pathogenesis remained cryptic. METHODS: Two patients presented with cholestatic hepatitis and pruritus, and cirrhosis, respectively. Viral, alcoholic, metabolic, autoimmune, neoplastic, vascular liver diseases and synthetic drugs as the precipitating causes of liver injury were excluded. However, both patients reported long-term consumption of Herbalife products. All Herbalife products were tested for contamination with drugs, pesticides, heavy metals, and softeners, and examined for microbial contamination according to standard laboratory procedures. Bacteria isolated from the samples were identified as Bacillus subtilis by sequencing the 16S rRNA and gyrB genes. RESULTS: Causality between consumption of Herbalife products and disease according to CIOMS was scored "probable" in both cases. Histology showed cholestatic and lobular/portal hepatitis with cirrhosis in one patient, and biliary fibrosis with ductopenia in the other. No contamination with chemicals or heavy metals was detected, and immunological testing showed no drug hypersensitivity. However, samples of Herbalife products ingested by both patients showed growth of Bacillus subtilis of which culture supernatants showed dose- and time-dependent hepatotoxicity. CONCLUSIONS: Two novel incidents of severe hepatic injury following intake of Herbalife products contaminated with Bacillus subtilis emphasize its potential hepatotoxicity.

The STEREO/PLASTIC response to solar wind ions (Flight measurements and models)

The Plasma and Supra-Thermal Ion Composition (PLASTIC) instrument is one of four experiment packages on board of the two identical STEREO spacecraft A and B, which were successfully launched from Cape Canaveral on 26 October 2006. During the two years of the nominal STEREO mission, PLASTIC is providing us with the plasma characteristics of protons, alpha particles, and heavy ions. PLASTIC will also provide key diagnostic measurements in the form of the mass and charge state composition of heavy ions. Three measurements (E/qk, time of flight, ESSD) from the pulse height raw data are used to characterize the solar wind ions from the solar wind sector, and part of the suprathermal particles from the wide-angle partition with respect to mass, atomic number and charge state. In this paper, we present a new method for flight data analysis based on simulations of the PLASTIC response to solar wind ions. We present the response of the entrance system / energy analyzer in an analytical form. Based on stopping power theory, we use an analytical expression for the energy loss of the ions when they pass through a thin carbon foil. This allows us to model analytically the response of the time of flight mass spectrometer to solar wind ions. Thus we present a new version of the analytical response of the solid state detectors to solar wind ions. Various important parameters needed for our models were derived, based on calibration data and on the first flight measurements obtained from STEREO-A. We used information from each measured event that is registered in full resolution in the Pulse Height Analysis words and we derived a new algorithm for the analysis of both existing and future data sets of a similar nature which was tested and works well. This algorithm allows us to obtain, for each measured event, the mass, atomic number and charge state in the correct physical units. Finally, an important criterion was developed for filtering our Fe raw flight data set from the pulse height data without discriminating charge states.

From transient to steady state deformation and grain size: A thermodynamic approach using elasto-visco-plastic numerical modeling

Numerical simulation experiments give insight into the evolving energy partitioning during high-strain torsion experiments of calcite. Our numerical experiments are designed to derive a generic macroscopic grain size sensitive flow law capable of describing the full evolution from the transient regime to steady state. The transient regime is crucial for understanding the importance of micro structural processes that may lead to strain localization phenomena in deforming materials. This is particularly important in geological and geodynamic applications where the phenomenon of strain localization happens outside the time frame that can be observed under controlled laboratory conditions. Ourmethod is based on an extension of the paleowattmeter approach to the transient regime. We add an empirical hardening law using the Ramberg-Osgood approximation and assess the experiments by an evolution test function of stored over dissipated energy (lambda factor). Parameter studies of, strain hardening, dislocation creep parameter, strain rates, temperature, and lambda factor as well asmesh sensitivity are presented to explore the sensitivity of the newly derived transient/steady state flow law. Our analysis can be seen as one of the first steps in a hybrid computational-laboratory-field modeling workflow. The analysis could be improved through independent verifications by thermographic analysis in physical laboratory experiments to independently assess lambda factor evolution under laboratory conditions.

Effect of meal ingestion on liver stiffness in patients with cirrhosis and portal hypertension.

BACKGROUND AND AIMS Liver stiffness is increasingly used in the non-invasive evaluation of chronic liver diseases. Liver stiffness correlates with hepatic venous pressure gradient (HVPG) in patients with cirrhosis and holds prognostic value in this population. Hence, accuracy in its measurement is needed. Several factors independent of fibrosis influence liver stiffness, but there is insufficient information on whether meal ingestion modifies liver stiffness in cirrhosis. We investigated the changes in liver stiffness occurring after the ingestion of a liquid standard test meal in this population. METHODS In 19 patients with cirrhosis and esophageal varices (9 alcoholic, 9 HCV-related, 1 NASH; Child score 6.9±1.8), liver stiffness (transient elastography), portal blood flow (PBF) and hepatic artery blood flow (HABF) (Doppler-Ultrasound) were measured before and 30 minutes after receiving a standard mixed liquid meal. In 10 the HVPG changes were also measured. RESULTS Post-prandial hyperemia was accompanied by a marked increase in liver stiffness (+27±33%; p<0.0001). Changes in liver stiffness did not correlate with PBF changes, but directly correlated with HABF changes (r = 0.658; p = 0.002). After the meal, those patients showing a decrease in HABF (n = 13) had a less marked increase of liver stiffness as compared to patients in whom HABF increased (n = 6; +12±21% vs. +62±29%,p<0.0001). As expected, post-prandial hyperemia was associated with an increase in HVPG (n = 10; +26±13%, p = 0.003), but changes in liver stiffness did not correlate with HVPG changes. CONCLUSIONS Liver stiffness increases markedly after a liquid test meal in patients with cirrhosis, suggesting that its measurement should be performed in standardized fasting conditions. The hepatic artery buffer response appears an important factor modulating postprandial changes of liver stiffness. The post-prandial increase in HVPG cannot be predicted by changes in liver stiffness.

Voluntary ingestion of antiparasitic drugs emulsified in honey represents an alternative to gavage in mice

The oral route is the most frequently used method of drug intake in humans. Oral administration of drugs to laboratory animals such as mice typically is achieved through gavage, in which a feeding needle is introduced into the esophagus and the drug is delivered directly into the stomach. This method requires technical skill, is stressful for animals, and introduces risk of injury, pain and morbidity. Here we investigated another method of drug administration. The benzimidazole derivative albendazole was emulsified in commercially available honey and administered to mice by voluntary feeding or gavage. Mice that received albendazole by either gavage or honey ingestion had virtually identical levels of serum albendazole sulfoxide, indicating that uptake and metabolism of albendazole was similar for both administration techniques. In addition, dosing mice with the albendazole-honey mixture for 8 wk had antiparasitic activity comparable to earlier studies using gavage for drug administration. Compared with gavage, voluntary ingestion of a drug in honey is more rapid, less stressful to the animal, and less technically demanding for the administrator. Because of its low cost and ready availability, honey presents a viable vehicle for drug delivery.

Acute kidney injury in three dogs after ingestion of a descaling agent containing maleic acid

Maleic acid (MA) is a common component of descaling products and is widely used in daily life. Accidental ingestion in relevant amounts does not play a major role in human beings; however, it seems to be highly toxic for dogs. It has been commonly used experimentally to induce Fanconi syndrome in dogs or small rodents. Two dogs were presented for acute kidney injury (AKI) after accidental ingestion of a descaling agent containing MA at an estimated amount of 70 mg/kg each. The third dog involved was euthanased by the referring veterinarian, and postmortem pathological analysis revealed severe acute tubular necrosis consistent with toxic nephropathy. The other dogs received symptomatic therapy for AKI including treatment with haemodialysis and showed complete normalisation of serum creatinine at a follow-up after five months. Renal damage can be very severe, but seems to be at least partially reversible and an attempt to treatment is warranted.

Bone-added periodontal plastic surgery: a new approach in esthetic dentistry

This article proposes a combined technique including bone grafting, connective tissue graft, and coronally advanced flap to create some space for simultaneous bone regrowth and root coverage. A 23 year-old female was referred to our private clinic with a severe class II Miller recession and lack of attached gingiva. The suggested treatment plan comprised of root coverage combined with xenograft bone particles. The grafted area healed well and full coverage was achieved at 12-month follow-up visit. Bone-added periodontal plastic surgery can be considered as a practical procedure for management of deep gingival recession without buccal bone plate.

Maternal ingestion of radon-222 in drinking water and the absorbed radiation dose to the embryo

Maternal ingestion of high concentrations of radon-222 (Rn-222) in drinking during pregnancy may pose a significant radiation hazard to the developing embryo. The effects of ionizing radiation to the embryo and fetus have been the subject of research, analyses, and the development of a number of radiation dosimetric models for a variety of radionuclides. Currently, essentially all of the biokinetic and dosimetric models that have been developed by national and international radiation protection agencies and organizations recommend calculating the dose to the mother's uterus as a surrogate for estimating the dose to the embryo. Heretofore, the traditional radiation dosimetry models have neither considered the embryo a distinct and rapidly developing entity, the fact that it is implanted in the endometrial layer of the uterus, nor the physiological interchanges that take place between maternal and embryonic cells following the implantation of the blastocyst in the endometrium. The purpose of this research was to propose a new approach and mathematical model for calculating the absorbed radiation dose to the embryo by utilizing a semiclassical treatment of alpha particle decay and subsequent scattering of energy deposition in uterine and embryonic tissue. The new approach and model were compared and contrasted with the currently recommended biokinetic and dosimetric models for estimating the radiation dose to the embryo. The results obtained in this research demonstrate that the estimated absorbed dose for an embryo implanted in the endometrial layer of the uterus during the fifth week of embryonic development is greater than the estimated absorbed dose for an embryo implanted in the uterine muscle on the last day of the eighth week of gestation. This research provides compelling evidence that the recommended methodologies and dosimetric models of the Nuclear Regulatory Commission and International Commission on Radiological Protection employed for calculating the radiation dose to the embryo from maternal intakes of radionuclides, including maternal ingestion of Rn-222 in drinking water would result in an underestimation of dose. ^

Black Degradable Plastic Mulch Evaluation

Black polyethylene plastic mulch provides many benefits to fruit and vegetable producers. It increases earliness by increasing spring soil temperatures, conserves soil moisture, and reduces pesticide usage by decreasing weed and disease pressure. Furthermore, during seasons of high precipitation, it protects fertilizer from leaching below the root zone. Unfortunately, polyethylene mulches do not degrade and must be removed from the field and discarded each season. This is a labor-intensive process whether it is done mechanically or by hand. Several degradable plastic mulches have been developed that are designed to be incorporated into the soil profile, eliminating the need for removal, with no negative impact on soil quality or health. However, these degradable plastics often do not meet degradation expectations (either degrade too quickly or degrade incompletely and require manual removal). The objective of this project was to evaluate several degradable mulches for storage life, ease of use, and influence on tomato production.