Incidence of deep vein thrombosis and quality of venous thromboembolism prophylaxis

OBJECTIVE: to determine the incidence of deep vein thrombosis and prophylaxis quality in hospitalized patients undergoing vascular and orthopedic surgical procedures. METHODS: we evaluated 296 patients, whose incidence of deep venous thrombosis was studied by vascular ultrasonography. Risk factors for venous thrombosis were stratified according the Caprini model. To assess the quality of prophylaxis we compared the adopted measures with the prophylaxis guidelines of the American College of Chest Physicians. RESULTS: the overall incidence of deep venous thrombosis was 7.5%. As for the risk groups, 10.8% were considered low risk, 14.9%moderate risk, 24.3% high risk and 50.5% very high risk. Prophylaxis of deep venous thrombosis was correct in 57.7%. In groups of high and very high risk, adequate prophylaxis rates were 72.2% and 71.6%, respectively. Excessive use of chemoprophylaxis was seen in 68.7% and 61.4% in the low and moderate-risk groups, respectively. CONCLUSION: although most patients are deemed to be at high and very high risk for deep vein thrombosis, deficiency in the application of prophylaxis persists in medical practice.

Efficacy, safety, quality control, marketing and regulatory guidelines for herbal medicines (phytotherapeutic agents)

This review highlights the current advances in knowledge about the safety, efficacy, quality control, marketing and regulatory aspects of botanical medicines. Phytotherapeutic agents are standardized herbal preparations consisting of complex mixtures of one or more plants which contain as active ingredients plant parts or plant material in the crude or processed state. A marked growth in the worldwide phytotherapeutic market has occurred over the last 15 years. For the European and USA markets alone, this will reach about $7 billion and $5 billion per annum, respectively, in 1999, and has thus attracted the interest of most large pharmaceutical companies. Insufficient data exist for most plants to guarantee their quality, efficacy and safety. The idea that herbal drugs are safe and free from side effects is false. Plants contain hundreds of constituents and some of them are very toxic, such as the most cytotoxic anti-cancer plant-derived drugs, digitalis and the pyrrolizidine alkaloids, etc. However, the adverse effects of phytotherapeutic agents are less frequent compared with synthetic drugs, but well-controlled clinical trials have now confirmed that such effects really exist. Several regulatory models for herbal medicines are currently available including prescription drugs, over-the-counter substances, traditional medicines and dietary supplements. Harmonization and improvement in the processes of regulation is needed, and the general tendency is to perpetuate the German Commission E experience, which combines scientific studies and traditional knowledge (monographs). Finally, the trend in the domestication, production and biotechnological studies and genetic improvement of medicinal plants, instead of the use of plants harvested in the wild, will offer great advantages, since it will be possible to obtain uniform and high quality raw materials which are fundamental to the efficacy and safety of herbal drugs.

Salivary cortisol as a tool for physiological studies and diagnostic strategies

Salivary cortisol is an index of plasma free cortisol and is obtained by a noninvasive procedure. We have been using salivary cortisol as a tool for physiological and diagnostic studies, among them the emergence of circadian rhythm in preterm and term infants. The salivary cortisol circadian rhythm in term and premature infants was established between 8 and 12 postnatal weeks. In the preterm infants the emergence of circadian rhythm was parallel to the onset of sleep rhythm. We also studied the use of salivary cortisol for screening for Cushing's syndrome (CS) in control and obese outpatients based on circadian rhythm and the overnight 1 mg dexamethasone (DEX) suppression test. Salivary cortisol was suppressed to less than 100 ng/dl after 1 mg DEX in control and obese patients. A single salivary cortisol measurement at 23:00 h and again after 1 mg DEX above the 90th percentile of the obese group values had sensitivity and specificity of 93 and 93% (23:00 h), and 91 and 94% (after DEX), respectively. The sensitivity improved to 100% when we combined both parameters. We also studied 11 CS children and 21 age-matched primary obese children for whom salivary cortisol sensitivity and specificity were 100/95% (23:00 h), and 100/95% (1 mg DEX), respectively. Similar to adults, sensitivity and specificity of 100% were obtained by combining 23:00 h and 1 mg DEX. The measurement of salivary cortisol is a useful tool for physiological studies and for the diagnosis of CS in children and adults on an outpatient basis.

Restless leg syndrome, sleep quality and fatigue in multiple sclerosis patients

We have tested the hypothesis that restless leg syndrome (RLS) is related to quality of sleep, fatigue and clinical disability in multiple sclerosis (MS). The diagnosis of RLS used the four minimum criteria defined by the International Restless Legs Syndrome Study Group. Fatigue was assessed by the Fatigue Severity Scale (FSS >27), quality of sleep by the Pittsburgh Sleep Quality Index (PSQI >6), excessive daytime sleepiness by the Epworth Sleepiness Scale (ESS >10) and clinical disability by the Expanded Disability Status Scale (EDSS). Forty-four patients (32 women) aged 14 to 64 years (43 ± 14) with disease from 0.4 to 23 years (6.7 ± 5.9) were evaluated. Thirty-five were classified as relapsing-remitting, 5 as primary progressive and 4 as secondary progressive. EDSS varied from 0 to 8.0 (3.6 ± 2.0). RLS was detected in 12 cases (27%). Patients with RLS presented greater disability (P = 0.01), poorer sleep (P = 0.02) and greater levels of fatigue (P = 0.03). Impaired sleep was present in 23 (52%) and excessive daytime sleepiness in 3 cases (6.8%). Fatigue was present in 32 subjects (73%) and was associated with clinical disability (P = 0.000) and sleep quality (P = 0.002). Age, gender, disease duration, MS pattern, excessive daytime sleepiness and the presence of upper motor neuron signs were not associated with the presence of RLS. Fatigue was best explained by clinical disability and poor sleep quality. Awareness of RLS among health care professionals may contribute to improvement in MS management.

Influence of chitosan addition on quality properties of vacuum-packaged pork sausages

The aim of the study was to evaluate the influence of the chitosan addition on the quality of vacuum packaged pork sausages. A variant of the product was elaborated with 1% (w/w) of chitosan in lactic acid solution at 1% (v/v) and it was compared to a control. Sausages were mechanically stuffed and manually conformed and vacuum packaged. Sausages were stored at 4 °C and microbiological evaluations, pH measurements, texture profile analysis and sensorial evaluation were performed. The chitosan addition in the formulation of the sausages did not reduce the microbiological counts. The pH values obtained in all samples were similar, which suggests that the chitosan addition did not influence the pH values of sausages. The added chitosan did not affect significantly (p < 0.05) the results of the texture profile analysis and sensorial attributes and therefore, the overall acceptance of the sausages.

Sensory profile of 'Douradão' peaches cold stored under controlled atmosphere

The sensory quality of 'Douradão' peaches cold stored in three different conditions of controlled atmosphere (CA1, CA2, CA3 and Control) was studied. After 14, 21 and 28 days of cold storage, samples were withdrawn from CA and kept for 4 days in ambient air for ripening. The sensory profile of the peaches and the descriptive terminology were developed by methodology based on the Quantitative Descriptive Analysis (QDA). The panelists consensually defined the sensory descriptors, their respective reference materials and the descriptive evaluation ballot. Fourteen panelists were selected based on their discrimination capacity and reproducibility. Seven descriptors were generated showing similarities and differences between samples. The data were analyzed by ANOVA, Tukey test and Principal Component Analysis (PCA). Results showed significant differences in the sensory profiles of the peaches. The PCA showed that CA2 and CA3 treatments were more characterized by the fresh peach flavor, fresh peach appearance, juiciness and flesh firmness, and were effective in keeping the good quality of the 'Douradão' peaches during the 28 days of cold storage. The Control and CA1 treatments were characterized by the mealiness and were ineffective for quality maintenance of the fruits during cold storage.

Sensory evaluation of "dulce de leche" with coffee and whey using different affective data analysis methods

This study sought to evaluate the acceptance of "dulce de leche" with coffee and whey. The results were analyzed through response surface, ANOVA, test of averages, histograms, and preference map correlating the global impression data with results of physical, physiochemical and sensory analysis. The response surface methodology, by itself, was not enough to find the best formulation. For ANOVA, test of averages, and preference map it was observed that the consumers' favorite "dulce de leche" were those of formulation 1 (10% whey and 1% coffee) and 2 (30% whey and 1% coffee), followed by formulation 9 (20% whey and 1.25% coffee). The acceptance of samples 1 and 2 was influenced by the higher acceptability in relation to the flavor and for presenting higher pH, L*, and b* values. It was observed that samples 1 and 2 presented higher purchase approval score and higher percentages of responses for the 'ideal' category in terms of sweetness and coffee flavor. It was found that consumers preferred the samples with low concentrations of coffee independent of the concentration of whey thus enabling the use of whey and coffee in the manufacture of dulce de leche, obtaining a new product.

Adzuki beans (Vigna angularis) seed quality under several drying conditions

This study analyzed the drying process and the seed quality of adzuki beans (Vigna angularis). Grains of adzuki beans, with moisture content of 1.14 (decimal dry basis) at harvest and dried until the moisture content of 0.11 (decimal dry basis.) were used. Drying was done in an experimental drier maintened at controlled temperatures of 30, 40, 50, 60, and 70 ºC and relative humidity of 52.0, 28.0, 19.1, 13.1, and 6.8%, respectively. Physiological and technological seed quality was evaluated using the germination test, Index of Germination Velocity (IGV), electrical conductivity, and water absorption, respectively. Under the conditions tested in the present study, it can be concluded that drying time for adzuki beans decreases with the higher air temperatures of 60 and 70 ºC, and it affected the physiological and technological seed quality. Thus, to avoid compromising adzuki seeds quality, it is recommended to promote its drying up to 50 ºC.

Application of carnauba-based wax maintains postharvest quality of 'Ortanique' tangor

This study aimed at evaluating compositional changes in the quality of 'Ortanique' tangor after coating with the carnauba-based waxes Aruá Tropical® or Star Light®. The storage conditions studied simulated those of local marketing (22 ± 2 °C, 60 ± 5% RH). Non-destructive analysis, mass loss, peel color, and sensory evaluation, were performed upon coating and every three days up to the fifteenth day of storage. Destructive analysis, peel moisture content, chlorophyll of the peel, pulp color, juice content, soluble solids (SS), titratable acidity (TA), pH, and soluble solids to titratable acidity ratio, were performed upon coating and every four days up to the sixteenth day of storage. The assay was conducted using an entirely randomized design, with three replications (destructive analyses) or ten replications (non-destructive analyses), in a split plot scheme. Wax-coating, especially Aruá Tropical®, maintained fruit freshness by reducing mass loss and peel dehydration and retaining green color. Peel moisture content, chlorophyll content, and juice content had lower rates in the wax coated fruits. Puncture force, soluble solids, titratable acidity, pH, and soluble solids to titratable acidity ratio varied vary little over the course of storage. Sensory evaluation showed that the application of Aruá Tropical keeps 'Ortanique' tangor fresher for 6 days longer for commercialization.

Effect of whey protein concentrate on texture of fat-free desserts: sensory and instrumental measurements

It is important to understand how changes in the product formulation can modify its characteristics. Thus, the objective of this study was to investigate the effect of whey protein concentrate (WPC) on the texture of fat-free dairy desserts. The correlation between instrumental and sensory measurements was also investigated. Four formulations were prepared with different WPC concentrations (0, 1.5, 3.0, and 4.5 wt. (%)) and were evaluated using the texture profile analysis (TPA) and rheology. Thickness was evaluated by nine trained panelists. Formulations containing WPC showed higher firmness, elasticity, chewiness, and gumminess and clearly differed from the control as indicated by principal component analysis (PCA). Flow behavior was characterized as time-dependent and pseudoplastic. Formulation with 4.5% WPC at 10 °C showed the highest thixotropic behavior. Experimental data were fitted to Herschel-Bulkley model. The addition of WPC contributed to the texture of the fat-free dairy dessert. The yield stress, apparent viscosity, and perceived thickness in the dairy desserts increased with WPC concentration. The presence of WPC promotes the formation of a stronger gel structure as a result of protein-protein interactions. The correlation between instrumental parameters and thickness provided practical results for food industries.

Quality of deep frying oils and fats used in street-fairs in Goiânia, Brazil

Fried foods are widely consumed in Brazil and their quality depends on the oil or fat they are fried. Qualitative (physical chemistry indices) and quantitative measurements (fry-life oil or fat until disposal, oil turnover, type of oil or fat and amount and type of fried foods) and associations were performed. We applied a structured form and collected 60 mL of frying oil or fat in each of the 70 fried food stands of 15 street-fairs in Goiânia, Brazil. All samples were suitable in the quantity of free fat acids (<0.9% oleic acid), one was inadequate to peroxide value (>10 mEq/kg) and 1/3 was unsuitable to polar compounds (<25%). The majority (62%) use temperature up to the allowed (180 ºC). Approximately 250 units of products are fried in at least one day in 42% of the fried food stands. Soybean oil is used in the majority (94%) of fried food stands and the fry-life is of 6 hours (60%) or a day of work/sale. The nonconformity of the content of total polar compounds in fried foods had significant association with frying time and the conformity of acidity had significant relationship with frying time by a chi-square test. All other associations were not significant. A fry-life of oil or fat up to 6 hours can avoid the excess of polar compounds in the frying medium and protect the quality of fred foods.

Phisicochemical, sensory, and microbiological evaluation and development of symbiotic fermented drink

The goal of this study was to develop a symbiotic lacteous drink, evaluate its physicochemical and sensory characteristics, and verify the viability of Lactobacillus acidophilus in the drink. The milk serum-based drink consisted of 50% milk serum containing 10% saccharose, 25% powdered milk, 15% yacon pulp, and cultures of Lactobacillus acidophilus-La 5E and Bifidobacterium bifidum BB12. It was stored for up to 21 days under refrigeration. The milk serum-based drink was analyzed for protein, ether extract, total dietary fiber, total frutans, carbohydrate content, color, pH, acidity, and contamination by coliforms, and Salmonella sp. Coliforms and Salmonella sp were not detected, and L. acidophilus and B. bifidum provided satisfactory probiotic counts up to 21 days of storage under refrigeration. Lactobacillus acidophilus resistance to gastric acids and bile salts was detected only up to seven days of storage when evaluated in vitro. Sensory analysis and purchase viability were evaluated by consumers at 0, 7, 14, and 21 days of storage. Based on the analytical results and consumer evaluation, the drink was acceptable up to seven days of storage.

Use of simulated annealing in standardization and optimization of the acerola wine production

In this study, seven wine samples were prepared varying the amount of pulp of acerola fruits and the sugar content using the simulated annealing technique to obtain the optimal sensory qualities and cost for the wine produced. S. cerevisiae yeast was used in the fermentation process and the sensory attributes were evaluated using a hedonic scale. Acerola wines were classified as sweet, with 11°GL of alcohol concentration and with aroma, taste, and color characteristics of the acerola fruit. The simulated annealing experiments showed that the best conditions were found at mass ratio between 1/7.5-1/6 and total soluble solids between 28.6-29.0 °Brix, from which the sensory acceptance scores of 6.9, 6.8, and 8.8 were obtained for color, aroma, and flavor, respectively, with a production cost 43-45% lower than the cost of traditional wines commercialized in Brazil.

Bioactive compounds and acceptance of cookies made with Guava peel flour

The use of fruit industrial waste in the processing new foods represents an important new step for the food industry. This study aimed to develop cookie recipes using different amounts of guava peel flour (GPF) levels (30%, 50%, and 70%) to evaluate the proximate composition, and the phenolic compound, lycopene, and β-carotene levels in the cookies and flour and to evaluate the cookie sensory acceptance. The results demonstrated low moisture, lipid and carbohydrate contents in the flour and cookies. GPF was considered rich in fiber, ash, polyphenols, and β-carotene. The sensory analysis showed satisfactory acceptance of the cookies containing 30% GPF regarding the aroma, flavor, and texture attributes. The cookies containing 50% and 70% GPF received satisfactory acceptance regarding to aroma only. In conclusion, GPF can be used to partially replace wheat flour in the preparation of cookies to improve the nutritional quality without affecting the product sensory quality.

Evaluation of jumbo squid (Dosidicus gigas) byproduct hydrolysates obtained by acid-enzymatic hydrolysis and by autohydrolysis in practical diets for Pacific white shrimp (Litopenaeus vannamei)

The marine bioprocessing industry offers great potential to utilize byproducts for fish meal replacement in aquafeeds. Jumbo squid is an important fishery commodity in Mexico, but only the mantle is marketed. Head, fins, guts and tentacles are discarded in spite of being protein-rich byproducts. This study evaluated the use of two jumbo squid byproduct hydrolysates obtained by acid-enzymatic hydrolysis (AEH) and by autohydrolysis (AH) as ingredients in practical diets for shrimp. The hydrolysates were included at levels of 2.5 and 5.0% of the diet dry weight in four practical diets, including a control diet without hydrolysate. Shrimp growth and survival were not significantly affected by the dietary treatments. Postharvest quality of abdominal muscle was evaluated in terms of proximate composition and sensory evaluation. Significantly higher crude protein was observed in the muscle of shrimp fed the highest hydrolysate levels, AH 5% (204.8 g kg- 1) or AEH 5% (201.3 g kg- 1). Sensory analysis of cooked muscle showed significant differences for all variables evaluated: color, odor, flavor, and firmness. It was concluded that Jumbo squid byproducts can be successfully processed by autohydrolysis or acid-enzymatic hydrolysis, and that up to 5.0% of the hydrolysates can be incorporated into shrimp diets without affecting growth or survival.