ESTIMATION OF THE SUITABILITY OF METHODS FOR DETERMINING LACTIC ACID CONTENT IN DIFFUSION JUICE FOR APPLICATION IN CHEMICAL AND TECHNICAL CONTROL OF SUGAR PRODUCTION

Development of microbiological infection in the process of production of diffusion juice is one of the most important factors affecting the quality of diffusion juice and sucrose loss. In this regard, it is important to promptly monitor the microbiological contamination of mixture from water and beet chips in the diffusion apparatus. Lactic acid is used as an indicator of the degree of microbiological contamination of the diffusion juice. Traditionally, when calculating unaccounted sucrose losses on diffusion, the titrimetric method is used to determine the concentration of lactic acid with preliminary isolation of acid anions from the diffusion juice on ionite columns. However, this method is time-consuming and labor-intensive and is not suiTable for operational control. The article suggests using a simpler and less time-consuming spectrophotometric method for operational control, based on measuring the optical density of the colored product of the reaction of lactate ions with iron(III) chloride at a wavelength 400 nm. The results of evaluating the consistency of data on the content of lactic acid in diffusion juices obtained using the traditional and spectrophotometric methods are presented in article. The results of data analysis using the Bland-Altman descriptive statistics method confirm that the data obtained by various methods are in good agreement with each other, and therefore the spectrophotometric method for determining the concentration of lactate ions can be used in production control in the sugar industry.

Case report : Use of Phototherapy for Acrodermatitis Continua of Hallopeau in Childhood: Case Report and Review of the Literature

A 6-year-old girl presented to our attention with a 7-month history of erythema and pustules on the distal portion of her left first finger, which deeply affected the beginning of her scholar activity. On examination, her digit was swollen, markedly erythematous, and littered with several small pustules; nail was strikingly dysmorphic. The other digits showed variable degree of onychodystrophy (Fig. 1A). There were neither prior history of psoriatic lesions nor familiarity for psoriasis. Microscopic and cultural examination did not show any microbiological infection. Histological sample showed psoriasiform hyperplasia, with a collection of granulocytes in the context of parakeratosis as well as in the intraepithelial area (Munro-like microabscesses), and focal spongiosis with absent granular layer. The dermis showed increased vascularity within the dermal papillae. Ultrasonography highlighted cutaneous and sub-cutaneous thickness increase with intra-articular synovial effusion (Fig. 1C); at color Doppler, increase of vascularization was present in sub-cutaneous tissue (Fig. 1D). On the basis of these findings, a diagnosis of acrodermatitis continua of Hallopeau (ACH) was performed. Past treatment only consisted of topical steroids. A cycle of clobetasol 0.05% ointment under occlusion and narrow band UVB (310 -311 nm) was prescribed for 30 days. The improvement observed at follow-up visit (Fig. 1B), increased after the subsequent 2 months of therapy, without relapse. The young patient is still under treatment and no relapse was notead at 3.5 months follow-up.

Neutropenic Enterocolitis: Clinical Features and Outcomes

Background. Little attention has been given to patients with neutropenic enterocolitis (NEC or typhlitis). However, as significant advances have been made in both hematology, oncology and critical care management, updating outcome data on these patients is timely. Patients and methods. We conducted here a retrospective hospital-based cohort from patients admitted to the intensive care unit (ICU) from a cancer center that includes 10 wards of oncology and hematology (a 650-bed public hospital with 330 beds for treatment of malignancies). Patients with NEC were compared to patients with other digestive complications. We used the NEC definition suggested by Gorschlüter based on presence of neutropenia and at least one major criteria (bowel thickening and fever) with one or several minor criteria (abdominal aches, diarrhea, abdominal distension, abdominal cramps and low digestive bleedings), after exclusion of other intestinal affections listed above. Results. Among the 171 patients admitted for acute digestive complications over a 15-y study period (1997-2011), 54 (33%) presented with NEC. Median age was 48 years (IQR: 38-60y) and there were 34 men and 20 women. Hematological malignancies were more common (87% versus 13% solid tumors), mainly non hodgkin lymphoma (41%) and among them 5 undergoing autologous SCT. Abdominal pains were present in 74% of the patients. Vomiting, diarrhea and mucositis were present in 91%, 76% and 39%, respectively. All patients were treated with fasting, naso-gastric aspiration, hydroelectrolytic equilibration, large spectrum antibiotics and parenteral nutrition. Eight (15%) patients were operated. Vasopressive drugs were used for 31 patients (57%), mechanical ventilation for 22 (41%) and renal replacement for 14 (26%). Microbiological infection was documented for 32 patients: 1 fungal infection (Candida), 16 Escherichia coli, 7 Clostridium difficile (2 toxinogen), 6 Pseudomonas aeruginosae, 2 other enterobacteria. Twelve (22%) patients died. Compared to non-NEC patients, patients with NEC were sickest (median Simplified Acute Physiology II score was 54.5 (IQR 42.5-62.5) vs. 48 (IQR 35.5-61.5). Also, NEC was associated with more exposure to cytosine arabinoside (46% vs 20%, p=0.0008), anthracyclines (37% vs 13%, p=0.0008), vinca-alkaloids (28% vs 8%, p=0.002) and VP16 (24% vs 12%, p=0.0067). Steroids were not associated with incidence of NEC (19% vs 21%, p=0.84). Clinical symptoms that were significantly different in patients with NEC were vomiting (91% vs 70%, p=0.003), diarrhea (76% vs 53%, p=0.006) and mucositis (39% vs 17%, p=0.004). However, digestive bleedings were less common (11% vs 30%, p=0.01). CT findings helped to differentiate NEC and non-NEC patients with, colic (57% vs 33%, p=0.033) and small intestine (35% vs 14%, p=0.023) thickening, occlusive findings (51% vs 19%, p=0.002). Pneumatosis and pneumoperitoneum were not significantly different in the two groups (8% vs 4%, and 8% vs 12%, respectively). Need for surgery was non significantly higher in non-NEC patients (25% vs. 15%, p=0.22). However, mortality was significantly lower in NEC patients (22% vs 41%, p=0.023). Median time hospitalization in ICU was 7 days (IQR: 6.5-23.5d) vs 4d (IQR: 3-10d) for non-NEC patients. Conclusion: Neutropenic enterocolitis is a clinical entity that has its own clinical, radiological and management peculiarities that translate into different outcomes. Early recognition of the syndrome may help in setting prompt appropriate treatment and monitoring. Disclosures No relevant conflicts of interest to declare.