Dexmedetomidine decreases the inflammatory response to myocardial surgery under mini-cardiopulmonary bypass

Cardiopulmonary bypass (CPB) with extracorporeal circulation produces changes in the immune system accompanied by an increase in proinflammatory cytokines and a decrease in anti-inflammatory cytokines. We hypothesize that dexmedetomidine (DEX) as an anesthetic adjuvant modulates the inflammatory response after coronary artery bypass graft surgery with mini-CPB. In a prospective, randomized, blind study, 12 patients (4 females and 8 males, age range 42-72) were assigned to DEX group and compared with a conventional total intravenous anesthesia (TIVA) group of 11 patients (4 females and 7 males). The endpoints used to assess inflammatory and biochemical responses to mini-CPB were plasma interleukin (IL)-1, IL-6, IL-10, interferon (INF)-γ, tumor necrosis factor (TNF)-α, C-reactive protein, creatine phosphokinase, creatine phosphokinase-MB, cardiac troponin I, cortisol, and glucose levels. These variables were determined before anesthesia, 90 min after beginning CPB, 5 h after beginning CPB, and 24 h after the end of surgery. Endpoints of oxidative stress, including thiobarbituric acid reactive species and delta-aminolevulinate dehydratase activity in erythrocytes were also determined. DEX+TIVA use was associated with a significant reduction in IL-1, IL-6, TNF-α, and INF-γ (P<0.0001) levels compared with TIVA (two-way ANOVA). In contrast, the surgery-induced increase in thiobarbituric acid reactive species was higher in the DEX+TIVA group than in the TIVA group (P<0.01; two-way ANOVA). Delta-aminolevulinate dehydratase activity was decreased after CPB (P<0.001), but there was no difference between the two groups. DEX as an adjuvant in anesthesia reduced circulating IL-1, IL-6, TNF-α, and INF-γ levels after mini-CPB. These findings indicate an interesting anti-inflammatory effect of DEX, which should be studied in different types of surgical interventions.

Analysis of Brazilian consumer preference of filled chocolate

Chocolate is the most popular product made from cocoa. It is mainly consumed with fillings, such as fondant, hydrogenated fat or fruits. This work aimed at assessing the sensory acceptability of chocolate filled with strawberry, orange or passion fruit pulps, mixed in fondant, in a hydrogenated fat base and as truffles. Ninety four consumers participated in the test using a 10 cm hedonic scale to rate the overall liking of the samples. Two-way analysis of variance and the Internal Preference Mapping technique were used to analyze the data. Results showed a good overall liking for almost all samples, especially for strawberry and passion fruit truffles, which obtained 8.4 and 8.8 global means, respectively (p < 0.05), in liking ratings, followed by the hydrogenated fat and fondant fillings. The Internal Preference Map presented two dimensions explaining 72.5% of the variation found. Regarding the flavors, strawberry - traditional in chocolate and confectionary in Brazil - and passion fruit obtained better acceptance, unlike the orange fillings, which showed significantly lower ratings (p < 0.05). The orange fondant filling obtained a global mean of 6.5.