Impact of initial exposure to calcineurin inhibitors on kidney graft function of patients at high risk to develop delayed graft function

We conducted a retrospective analysis of the influence of full doses of calcineurin inhibitors [8-10 mg kg-1 day-1 cyclosporine (N = 80), or 0.2-0.3 mg kg-1 day-1 tacrolimus (N = 68)] administered from day 1 after transplantation on the transplant outcomes of a high-risk population. Induction therapy was used in 13% of the patients. Patients also received azathioprine (2 mg kg-1 day-1, N = 58) or mycophenolate mofetil (2 g/day, N = 90), and prednisone (0.5 mg kg-1 day-1, N = 148). Mean time on dialysis was 79 ± 41 months, 12% of the cases were re-transplants, and 21% had panel reactive antibodies >10%. In 43% of donors the cause of death was cerebrovascular disease and 27% showed creatinine above 1.5 mg/dL. The incidence of slow graft function (SGF) and delayed graft function (DGF) was 15 and 60%, respectively. Mean time to last dialysis and to nadir creatinine were 18 ± 15 and 34 ± 20 days, respectively. Mean creatinine at 1 year after transplantation was 1.48 ± 0.50 mg/dL (DGF 1.68 ± 0.65 vs SGF 1.67 ± 0.66 vs immediate graft function (IGF) 1.41 ± 0.40 mg/dL, P = 0.089). The incidence of biopsy-confirmed acute rejection was 22% (DGF 31%, SGF 10%, IGF 8%). One-year patient and graft survival was 92.6 and 78.4%, respectively. The incidence of cytomegalovirus disease, post-transplant diabetes mellitus and malignancies was 28, 8.1, and 0%, respectively. Compared to previous studies, the use of initial full doses of calcineurin inhibitors without antibody induction in patients with SGF or DGF had no negative impact on patient and graft survival.

Anti-tumor necrosis factor-a for the treatment of steroid-refractory acute graft-versus-host disease

Allogeneic stem cell transplantation has been increasingly performed for a variety of hematologic diseases. Clinically significant acute graft-versus-host disease (GVHD) occurs in 9 to 50% of patients who receive allogeneic grafts, resulting in high morbidity and mortality. There is no standard therapy for patients with acute GVHD who do not respond to steroids. Studies have shown a possible benefit of anti-TNF-a (infliximab)for the treatment of acute GVHD. We report here on the outcomes of 10 recipients of related or unrelated stem cell transplants who received 10 mg/kg infliximab, iv, once weekly for a median of 3.5 doses (range: 1-6) for the treatment of severe acute GVHD and who were not responsive to standard therapy. All patients had acute GVHD grades II to IV (II = 2, III = 3, IV = 5). Overall, 9 patients responded and 1 patient had progressive disease. Among the responders, 3 had complete responses and 6 partial responses. All patients with cutaneous or gastrointestinal involvement responded, while only 2 of 6 patients with liver disease showed any response. None of the 10 patients had any kind of immediate toxicity. Four patients died, all of them with sepsis. Six patients are still alive after a median follow-up time of 544 days (92-600) after transplantation. Considering the severity of the cases and the bad prognosis associated with advanced acute GVHD, we find our results encouraging. Anti-TNF-a seems to be a useful agent for the treatment of acute GVHD.

Proximal tubular dysfunction as an indicator of chronic graft dysfunction

New strategies are being devised to limit the impact of renal sclerosis on graft function. Individualization of immunosuppression, specifically the interruption of calcineurin-inhibitors has been tried in order to promote better graft survival once chronic graft dysfunction has been established. However, the long-term impact of these approaches is still not totally clear. Nevertheless, patients at higher risk for tubular atrophy and interstitial fibrosis (TA/IF) development should be carefully monitored for tubular function as well as glomerular performance. Since tubular-interstitial impairment is an early event in TA/IF pathogenesis and associated with graft function, it seems reasonable that strategies directed at assessing tubular structural integrity and function would yield important functional and prognostic data. The measurement of small proteins in urine such as α-1-microglobulin, N-acetyl-beta-D-glucosaminidase, alpha/pi S-glutathione transferases, β-2 microglobulin, and retinol binding protein is associated with proximal tubular cell dysfunction. Therefore, its straightforward assessment could provide a powerful tool in patient monitoring and ongoing clinical assessment of graft function, ultimately helping to facilitate longer patient and graft survival associated with good graft function.

Human umbilical cord blood cells in infarcted rats

Therapy with bone marrow-derived cells has been used in ischemic patients with reported success. The aim of this study was to determine the therapeutic efficacy of fresh and frozen human umbilical cord blood cells (hUCB) in Wistar rats submitted to permanent occlusion of the left coronary artery. Three hours after myocardial infarction, 2 x 10(7) hUCB cells or vehicle were administered by intramyocardial injection. The animals were divided into five groups: control (N = 10), sham operated (N = 10), infarcted that received vehicle (N = 9), infarcted treated with cryopreserved hUCB (N = 7), and infarcted treated with fresh hUCB (N = 5). Cardiac function was evaluated by electrocardiogram (ECG) and echocardiogram (ECHO) before cell therapy, and by ECG, ECHO, cardiopulmonary test, and left ventricular pressure measurements 3 weeks later. After 3 weeks, both groups treated with hUCB still had Q wave present in L1, âQRS >90° and reduced shortening fraction (less than 50%). In addition, cardiac indexes of left ventricular contractility and relaxation were 5484 ± 875 and -4032 ± 643 mmHg (cryopreserved hUCB) and 4585 ± 955 and -2862 ± 590 mmHg (fresh hUCB), respectively. These values were not statistically different from those of saline-treated animals. Cardiopulmonary exercise test profile was typical of infarcted hearts; exercise time was about 14 min and maximal VO2 was 24.77 ± 5.00 mL·kg-1·min-1. These data show that hUCB therapy did not improve the cardiac function of infarcted animals or prevent cardiac remodeling.

Decomposition of trimethylamine oxide related to the use of sulfites in shrimp

Currently, sulfites are employed on board to inhibit melanosis (blackspot) on crustaceans. However, when used in excess this chemical compound not only can cause adverse reactions in SO2-sensitive individuals, but also favors the decomposition of trimethylamine oxide (TMAO) into dimethylamine (DMA) and formaldehyde (FA), thus compromising the quality of the product, which can be observed mainly through the texture change of the meat after cooking. This study was conducted to verify the increase of the contents of DMA and FA by the excessive use of sodium metabisulfite in white shrimp (Penaeus schmitti). For laboratory trials, shrimp were beheaded, washed and immersed in a 2% sodium metabisulfite solution for 10 minutes. Specimens were stored either on ice and maintained for 48 hours in refrigeration, or stored in a freezer for 48 hours. Samples were collected at intervals of 0, 24 and 48 hours, and analyzed for residual SO2, TMAO, TMA, DMA and FA. The immersion of shrimp in a 2% sodium metabisulfite for 10 minutes favored the decomposition of TMAO which greatly increased the contents of DMA and FA. The FA and DMA measured in fresh shrimp was low. Moreover, the storage of shrimp tails on ice resulted in a significant reduction of the TMA, DMA, FA and residual SO2 contents compared to the specimens under frozen storage.

Quality evaluation of fresh-cut ‘Pérola’ pineapple stored in controlled atmosphere

The purpose of this research was to determine the best gas mixture in controlled atmosphere conditions to store fresh-cut ‘Pérola’ pineapple, particularly in relation to the maintenance of visual quality and reduction of microbial growth. After sanitation, fruit was manually peeled, sliced and dipped in 20 mg.L-1 NaOCl solution for 30 seconds. Then, the excess liquid was drained and the slices were placed in sealed glass jars connected to a flowboard installed in a cold room (5 ± 1 °C). Desired gas mixtures were supplied continuously for 12 days from cylinders connected to the flowboard. Controlled atmospheres of 2:5, 2:10, 2:15, 5:5, 5:10, 5:15, 8:5, 8:10 and 8:15 (O2:CO2, %) and air were used. The product was evaluated for pulp color, total and fecal coliforms, mesophilic and psychrotrophic aerobic, mold and yeast counts. Total and fecal coliforms were not detected. The fresh-cut ‘Pérola’ pineapple was not very sensitive to storage in controlled atmosphere, considering that the slices had little browning and were free of contamination, that would affect the food safety at the end of the storage period

Bacterial ecology of tilapia fresh fillets and some factors that can influence their microbial quality

The purpose of research was to investigate the bacterial ecology of tilapia (Oreochromis niloticus) fresh fillets and some factors that can influence its microbial quality. Samples of fish cultivation water (n = 20), tilapia tegument and gut (n = 20) and fresh fillets (n = 20) were collected in an experimental tilapia aquaculture located in the city of Lavras, Minas Gerais, Brazil. Staphylococcus spp., Aeromonas spp., Enterococcus spp. and Enterobacteriaceae were quantified using selective plating. For the enumeration of Pseudomonas spp., the most probable number technique (MPN) was utilized. Bacterial colonies (n = 198) were identified by Gram strain and biochemical tests. Aeromonas spp., Pseudomonas spp., Enterococcus spp. and Enterobacteriaceae were found in the cultivation water (water from a fishpond cultivation), tegument, gut, and fresh fillets. Staphylococcus spp. was not isolated in the cultivation water. Salmonella spp. was not detected. The count variable of 10 to 10³ CFU or MPN.(g or mL)-1. Associated to freshwater tilapia fillet processing, there is a large variety of microorganisms related to foodborne illnesses and fish products deterioration.

Volatile compounds profile of fresh-cut peki fruit stored under different temperatures

The objective of this work was to identify and verify the influence of time and temperature on the volatile compounds profile of fresh cut peki. Peki fruits were washed, sanitized, their kernels were extracted, and they were packaged and stored for 15 days at 0, 5, and 10 °C and 6 days at 22 °C. The volatiles compounds were analyzed by GC - MS. Ethyl hexanoate and ethyl octanoate were found in higher percentages, 63 and 16.3%, respectively. The determined volatiles were not influenced by the storage period. Hexanoic acid, ethyl 2-octenoate and ethyl decanoate were not influenced by the different temperatures. The temperatures 0, 5, and 10 °C did not influence ethyl hexanoate, ethyl 2-hexenoate and ethyl octanoate either. In addition, the temperatures 5, 10, and 22 °C did not influence ethyl hexanoate, cis-β-ocimene and ethyl octanoate. The temperature of 22 °C determined higher percentages of ethyl hexanoate and lower percentages of ethyl octanoate, in comparison to the temperature of 0 °C, and higher percentages of ethyl 2-hexenoate in comparison to the temperatures of 0, 5, and 10 °C. The temperature of 5 °C determined higher percentage of cis-β-ocimene when compared with the temperature of 0 °C. The storage temperatures of 0 and 5 °C were the most appropriate for the conservation.

Evaluation of temperatures in a refrigerated container for chilled and frozen food transport

The objective of this work was to monitor the operational conditions of the transport of chilled and frozen foods during delivery within cities and to evaluate the impact of the door openings on the alteration of the internal temperature of the refrigerated environment. Several temperature and pressure sensors were used in a refrigerated container with two compartments and they were installed in the refrigeration system unit and on the internal and external surfaces of the container. After the monitoring tests, it was verified that door openings during deliveries resulted in a disturbance that raised the internal temperature of the refrigerated container above values recommended for adequate conservation of the products transported. Moreover, increasing the number of door openings promoted a cumulative effect on the internal temperature, mainly in the chilled food compartment of the container. It was concluded that the refrigeration system unit presented serious limitations with regard to the maintenance of the container's internal temperature during the actual distribution routine, since it does not possess enough instantaneous capacity to restore the temperature set-point between deliveries.

Role of food safety in procedures adopted for the purchase of minimally processed and fresh vegetables by foodservices

This research was designed to analyze whether the procedures adopted by foodservice establishments for the purchase of minimally processed and fresh vegetables favor the acquisition of safe products. This research investigated the purchasing policies of such establishments, whether self-managed or administered by foodservice contractors, in the municipality of Campinas and its outlying districts. A random sample of thirty-nine establishments participated in the research. The instruments for data collection were pre-tested, and the actual interviews were conducted by trained personnel. Comparative analyses were made using various statistical tests. All of the participating establishments purchase fresh vegetables, although only six of them use minimally processed ones. For most of the establishments, price is at least one of the most important criteria for the selection of a supplier, and they do not normally monitor the safety of the fresh products purchased (51.3%), nor do they make regular technical visits to guarantee quality (46.2%); moreover, most do not carry out a supplier development program. It is suggested that routine technical visits to suppliers should be adopted, as well as the creation of courses, such as those dealing with the safety of vegetables and supplier development, to be offered to foodservices.

Microstructural changes of frozen strawberries submitted to pre-treatments with additives and vacuum impregnation

Strawberries were submitted to freezing after pre-treatments with hydrocolloid and calcium salts (pectin and calcium chloride) at different concentrations, in the attempt to establish a correlation of the effects of these substances and their processing, on the physical and microstructural characteristics of fruits after thawing. Strawberry halves were submitted to impregnation with controlled vacuum pressure of 84.4, 50.5 and 16.6 kPa; comprising pectin at concentrations of 0, 1.5 and 3%; with the addition of calcium chloride at concentrations of 0, 3 and 6%; and glucose at 20%, for 4 hours. Measurements were made of the total soluble solid contents, cellular fluid loss, texture and viscosity of the solution, before and after the freezing/thawing. Images of the tissue cuts during the freezing, in function of time, were taken in an optic microscope coupled to a cold-stage and controlled temperature system, where the reduction of the cellular area was quantified using an image analyzing software. The pectin concentration had an influence on and demonstrated a potential for protection of the frozen tissue samples. The photomicrographs showed that the loss of cellular fluid occurs during the growth of ice formed in the intercellular spaces and it is retarded through treatments with high pectin concentrations.

Sensory and microbiological evaluation of uncured fresh chicken sausage with reduced fat content

The purpose of this study was to evaluate the acceptability and the microbiological safety of uncured fresh chicken sausages with reduced fat content, considering the scientific evidence that correlated cancer and cardiovascular diseases to this diet. Two formulations of uncured fresh chicken sausage were processed using different concentrations of cochineal carmine pigment, rosemary extracts and synthetic antioxidants, which are used to give color, appearance and pleasant flavor to the products. Then, instrumental color (L*, a*, b*, C* and h*), microbial contamination and sensory tests (ranking and acceptance) were used to evaluate the quality of the uncured chicken sausages. The instrumental color (chroma and hue) and the sensory properties of the A and B uncured sausages were similar to the commercial cured sausage (C). However, the sensory color and appearance of samples A and B were statistically higher than those of the commercial uncured sausages D, which are prepared without the addition of nitrite or pigments. The results showed that it is possible to produce safe and high-quality uncured fresh chicken sausage with reduced fat content, using natural pigments and antioxidants.

Moisture sorption isotherms of fresh and blanched pumpkin (Cucurbita moschata)

Moisture desorption isotherms of fresh and heat blanched pumpkins (Cucurbita moschata) were determined at three temperatures (30, 50 and 70 °C), using the standard, static-gravimetric method. The GAB, Oswin, BET, Halsey, and Henderson models were tested and, with the exception of the Henderson model, showed satisfactory fits to the experimental data. The GAB model was used to analyze the fitting ability to describe the isotherm type. The shape of the desorption isotherms of fresh and blanched pumpkin at 30 and 50 °C was intermediate to types II and III, and at 70 °C it was of type II for the blanched pumpkin and close to type II for the fresh sample. The influence of blanching on the decrease in equilibrium moisture was very small compared to the fresh samples and it was related to the loss of soluble solids during the pre-treatment. The isosteric heat of sorption measures indicated that a larger amount of heat was required to remove the water from the fresh samples than from the blanched ones.

Volatile profile and physical, chemical, and biochemical changes in fresh cut watermelon during storage

Existing data about the aroma of fresh-cut watermelon and the metabolic changes that occur with minimal processing are scarce. Given the close relationship that exists between aroma, texture, and quality characteristics, it is necessary to investigate the changes in the volatile profile and texture of watermelon, a fruit extensively sold in supermarket chains throughout Brazil. The objective of this work was to analyze the volatile profile using solid phase microextraction (SPME) as well as texture changes in fresh-cut watermelon stored at 5 °C for ten days. Chromatography associated with sensory analysis (sniffing) led us to conclude that 9-carbon (C9) alcohols and aldehydes are the major responsible for the flavor and aroma of minimally processed watermelon stored at 5 ± 1 °C/90 ± 5% RH for ten days, and also that the aroma diminishes in intensity with storage, but it does not affect the final quality of the product. It was noted that the amount of drained liquid, soluble pectin, and weight loss increased during storage concurrently with a reduction in firmness and a structural breakdown of the cells. Pectin methyl esterase activity remained constant and polygalacturonase activity was not detected.

Estimate of respiration rate and physicochemical changes of fresh-cut apples stored under different temperatures

In this study, the influence of storage temperature and passive modified packaging (PMP) on the respiration rate and physicochemical properties of fresh-cut Gala apples (Malus domestica B.) was investigated. The samples were packed in flexible multilayer bags and stored at 2 °C, 5 °C, and 7 °C for eleven days. Respiration rate as a function of CO2 and O2 concentrations was determined using gas chromatography. The inhibition parameters were estimated using a mathematical model based on Michaelis-Menten equation. The following physicochemical properties were evaluated: total soluble solids, pH, titratable acidity, and reducing sugars. At 2 °C, the maximum respiration rate was observed after 150 hours. At 5 °C and 7 °C the maximum respiration rates were observed after 100 and 50 hours of storage, respectively. The inhibition model results obtained showed a clear effect of CO2 on O2 consumption. The soluble solids decreased, although not significantly, during storage at the three temperatures studied. Reducing sugars and titratable acidity decreased during storage and the pH increased. These results indicate that the respiration rate influenced the physicochemical properties.