Estimation of age- and stage-specific Catalan breast cancer survival functions using US and Catalan survival data

During the last part of the 1990s the chance of surviving breast cancer increased. Changes in survival functions reflect a mixture of effects. Both, the introduction of adjuvant treatments and early screening with mammography played a role in the decline in mortality. Evaluating the contribution of these interventions using mathematical models requires survival functions before and after their introduction. Furthermore, required survival functions may be different by age groups and are related to disease stage at diagnosis. Sometimes detailed information is not available, as was the case for the region of Catalonia (Spain). Then one may derive the functions using information from other geographical areas. This work presents the methodology used to estimate age- and stage-specific Catalan breast cancer survival functions from scarce Catalan survival data by adapting the age- and stage-specific US functions. Methods: Cubic splines were used to smooth data and obtain continuous hazard rate functions. After, we fitted a Poisson model to derive hazard ratios. The model included time as a covariate. Then the hazard ratios were applied to US survival functions detailed by age and stage to obtain Catalan estimations. Results: We started estimating the hazard ratios for Catalonia versus the USA before and after the introduction of screening. The hazard ratios were then multiplied by the age- and stage-specific breast cancer hazard rates from the USA to obtain the Catalan hazard rates. We also compared breast cancer survival in Catalonia and the USA in two time periods, before cancer control interventions (USA 1975–79, Catalonia 1980–89) and after (USA and Catalonia 1990–2001). Survival in Catalonia in the 1980–89 period was worse than in the USA during 1975–79, but the differences disappeared in 1990–2001. Conclusion: Our results suggest that access to better treatments and quality of care contributed to large improvements in survival in Catalonia. On the other hand, we obtained detailed breast cancer survival functions that will be used for modeling the effect of screening and adjuvant treatments in Catalonia

First-Line Chemotherapy with Anthracycline and Taxane Combination in Metastatic Breast Cancer. Detection of bone metastases with TRACP 5b

Background: In Finland, breast cancer (BC) is the most common cancer among women, and prostate cancer (PC) that among men. At the metastatic stage both cancers remain essentially incurable. The goals of therapy include palliation of symptoms, improvement or maintenance of quality of life (QoL), delay of disease progression, and prolongation of survival. Balancing between efficacy and toxicity is the major challenge. With increasing costs of new treatments, appropriate use of resources is paramount. When new treatment regimes are introduced into clinical practice a comprehensive assessment of clinical benefit, adverse effects and cost is necessary. Both BC and PC show a predilection to metastasize to bone. Bone metastases cause significant morbidity impairing the patients´ QoL. Diagnosis of bone metastases relies mainly on radiological methods, which however lack optimal sensitivity and specificity. New tools are needed for detection and follow-up of bone metastases. Aims: Anthracyclines and taxanes are effective chemotherapeutic agents in the treatment of metastatic breast cancer (MBC) with different mechanisms of action. Therefore, evaluation of the combination of anthracyclines with taxanes was a justifiable approach in the treatment of MBC patients. We assessed the efficacy, toxicity, cost of treatment and QoL of BC patients treated with first-line chemotherapy for metastatic disease with the combination epirubicin and docetaxel. We also evaluated the diagnostic potential of tartrate-resistant acid phosphatase 5b (TRACP 5b) and carboxyterminal telopeptides of type I collagen (ICTP) in the diagnosis of bone metastases in BC and TRACP 5b in PC patients. Results: The combination of epirubicin and docetaxel was effective in this phase II study, but required individual dose adjustment to avoid neutropenic infections, and the use of growth factors to maintain a feasible dose level. The response rate was 54 % (95 % CI 37-71) and the median overall survival (OS) was 26 months. Of the patients, 87 % were treated for infections. The treatment of adverse events required additional use of health resources mainly due to neutropenic infections, thereby raising direct treatment costs by 20 %. Despite adverse events, the global QoL was not significantly compromised during the treatment. Clinically evident acute cardiac toxicity was not observed. The combination of serum TRACP 5b and ICTP was at least equally sensitive and specific in detection of of bone metastases as commonly used total alkaline phosphatise (tALP) in BC patients. In contrast, TRACP 5b was less specific and sensitive than tALP as a marker of skeletal changes in PC patients. Conclusions: Treatment with epirubicin and docetaxel showed high efficacy in first-line chemotherapy of MBC. The relatively high incidence of neutropenic infections requiring hospitalization increased the treatment costs. Despite adverse events, the global QoL of the patients was not significantly compromised. The combination of TRACP 5b and ICTP showed similar activity as tALP in detecting bone metastases in MBC. In contrast, TRACP 5b was less specific and sensitive than tALP as a marker of skeletal changes in PC.

Integrated multivariate analysis to evaluate effects of pre-slaughter handling on pork quality

The aim of this study was to investigate the effect of pre-slaughter handling on the occurrence of PSE (Pale, Soft, and Exudative) meat in swine slaughtered at a commercial slaughterhouse located in the metropolitan region of Dourados, Mato Grosso do Sul, Brazil. Based on the database (n=1,832 carcasses), it was possible to apply the integrated multivariate analysis for the purpose of identifying, among the selected variables, those of greatest relevance to this study. Results of the Principal Component Analysis showed that the first five components explained 89.28% of total variance. In the Factor Analysis, the first factor represented the thermal stress and fatiguing conditions for swine during pre-slaughter handling. In general, this study indicated the importance of the pre-slaughter handling stages, evidencing those of greatest stress and threat to animal welfare and pork quality, which are transport time, resting period, lairage time before unloading, unloading time, and ambience.

Internet-based breast cancer patient’s pathway as an empowering patient educational tool

This three-phase study was conducted to examine the effect of the Breast Cancer Patient’s Pathway program (BCPP) on breast cancer patients’ empowering process from the viewpoint of the difference between knowledge expectations and perceptions of received knowledge, knowledge level, quality of life, anxiety and treatment-related side effects during the breast cancer treatment process. The BCPP is an Internet-based patient education tool describing a flow chart of the patient pathway during the breast treatment process, from breast cancer diagnostic tests to the follow-up after treatments. The ultimate goal of this study was to evaluate the effect of the BCPP to the breast cancer patient’s empowerment by using the patient pathway as a patient education tool. In phase I, a systematic literature review was carried out to chart the solutions and outcomes of Internet-based educational programs for breast cancer patients. In phase II, a Delphi study was conducted to evaluate the usability of web pages and adequacy of their content. In phase III, the BCPP program was piloted with 10 patients and patients were randomised to an intervention group (n=50) and control group (n=48). According to the results of this study, the Internet is an effective patient education tool for increasing knowledge, and BCPP can be used as a patient education method supporting other education methods. However, breast cancer patients’ perceptions of received knowledge were not fulfilled; their knowledge expectations exceed the perceived amount of received knowledge. Although control group patients’ knowledge expectations were met better with the knowledge they received in hospital compared to the patients in the intervention group, no statistical differences were found between the groups in terms of quality of life, anxiety and treatment-related side effects. However, anxiety decreased faster in the intervention group when looking at internal differences between the groups at different measurement times. In the intervention group the relationship between the difference between knowledge expectations and perceptions of received knowledge correlated significantly with quality of life and anxiety. Their knowledge level was also significant higher than in the control group. These results support the theory that the empowering process requires patient’s awareness of knowledge expectations and perceptions of received knowledge. There is a need to develop patient education to meet patients’ perceptions of received knowledge, including oral and written education and BCPP, to fulfil patient’s knowledge expectations and facilitate the empowering process. Further research is needed on the process of cognitive empowerment with breast cancer patients. There is a need for new patient education methods to increase breast cancer patients’ awareness of knowing.

Quality of radiotherapy care by development of e-feedback knowledge

The aim of this three phase study was to develop quality of radiotherapy care by the e-Feedback knowledge of radiotherapy -intervention (e-Re-Know). In Phase I, the purpose was to describe the quality of radiotherapy care and its deficits experienced by cancer patients. Based on the deficits in patient education in Phase II, the purpose was to describe cancer patients’ e-knowledge expectations in radiotherapy. In Phase III, the purpose was to develop and evaluate the outcomes of the e-Re-Know among breast cancer patients. The ultimate aim was to develop radiotherapy care to support patients’ empowerment with patient e-education. In Phase I (2004-2005), the descriptive design was used, and 134 radiotherapy patients evaluated their experiences by Good Nursing Care Scale for Patients (GNCS-P) in the middle of RT period. In Phase II (2006-2008), the descriptive longitudinal design was used and 100 radiotherapy patients’ e-knowledge expectations of RT were evaluated using open-ended questionnaire developed for this study before commencing first RT, in the middle of the treatment, and concluding RT period. In Phase III, firstly (2009-2010), the e-Re-Know intervention, i.e. knowledge test and feedback, was developed in terms of empowering knowledge and implemented with e-feedback approach based on literature and expert reviews. Secondly (2011-2014), the randomized controlled study was used to evaluate the e-Re-Know. Breast cancer patients randomized to either the intervention group (n=65) receiving the e-Re-Know by e-mail before commencing first RT and standard education or the control group (n=63) receiving standard education. The data were collected before commencing first RT, concluding last RT and 3 months after last RT using RT Knowledge Test, Spielberger’s State Trait Inventory (STAI) and Functional Assessment of Cancer Therapy - Breast (FACT-B) –instruments. Data were analyzed using statistical methods and content analysis. The study showed radiotherapy patients experienced quality of care high. However, there were deficits in patient education. Furthermore, radiotherapy patients’ multidimensional e-knowledge expectations through Internet covered mainly bio-physiological and functional knowledge. Thus, the e-Re-Know was developed and evaluated. The study showed when breast cancer patients’ carried out the e-Re-Know their knowledge of side effects self-care was significantly increased and quality of life (QOL) significantly improved in line with decrease in anxiety from time before radiotherapy period to three months after. In addition, the e-Re-Know has potential to have positive effects on anxiety and QOL, regardless of patient characteristics or knowledge level. The results support the theory of empowering patient education suggesting that empowerment can be supported by confirming patients’ understanding of own knowledge level. In summary, the e-Feedback knowledge of radiotherapy (e-Re-Know) intervention can be recommended in development of quality of radiotherapy care experienced by breast cancer patients. Further research is needed to assess and develop patient-centred quality of care by patient education among cancer patients.

Influence of secondary packing on the freezing time of chiken meat in air blast freezing tunnels

Freezing of poultry cuts in continuous convective air blast tunnels is normally performed with the products protected by Low Density Polyethylene (LDPE) as a primary packaging and using Corrugated Cardboard Boxes (CCB) as secondary packaging. The objective of this work was to investigate the influence of these secondary packaging on the freezing of poultry cuts in continuous convective air blast tunnels. The study was performed by replacing CCB with Perforated Metal Boxes (PMB) in order to remove the packaging thermal resistance. The assays, performed in a industrial plant, demonstrated that CCB used commercially for meat freezing have a high heat transfer resistance. Their replacement with PMB can lead to shorter freezing times and spatially homogeneous freezing. Reductions of up to 45% in the freezing times were observed using PMB. The plateau of the temperature curve, related to the freezing time of free water, was significantly reduced using PMB, which is accepted to lead to better product quality after thawing. As the products were protected by the LDPE films as primary packaging, their appearance were not affected. The results presented in this work indicate that replacing CBB with PMB can be an excellent alternative to reduce freezing time and improve freezing homogeneity in industrial air blast tunnels, which could also be applied to other products.

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.

Partial substitution of nitrite by chitosan and the effect on the quality properties of pork sausages

The aim of the study was to evaluate the influence of partial nitrite replacement by chitosan on the quality of Ham Visking (a type of pork sausages). Five Ham Visking formulations were elaborated modifying the sodium nitrite (0.011; 0.016 or 0.0212%) and chitosan concentrations (0.25 or 0.5%) in the products. Sausages were stored at 4 ºC and physicochemical, microbiological, and sensorial evaluations were performed in order to estimate their shelf life. Chitosan can be used in pork sausages without affecting ensory attributes such as color although the panelists detected textural differences among the samples with chitosan, which suggests that there is some influence of deacetylation degree of chitosan on the textural behavior of sausages which still needed to be explained for a successful application of chitosan in meat products. The reduction of residual sodium nitrite did not affect the color and flavor of such products, but the use of chitosan increasedsignificantly the shelf life of sausages.

Effect of genotype, finishing system, and sex on physiochemical characteristics of goat meat

Seventy-eight kids of both sexes and five genotypes were used: Alpine, ½ Boer + ½ Alpine (½ BA), ¾ Boer + ¼ Alpine, ½ Anglo-nubian + ½ Alpine and "tricross" (½ Anglo-nubian + ¼ Boer + ¼ Alpine) with initial average weight of 14.1 ± 2.5. The objective was to evaluate the effect of genotype, finishing system, and sex on the physiochemical characteristics of goat meat. Finishing systems were: ST1 - kid + dam in pasture and ST2 - weaned kid and feedlot. Kids in ST1 were kept in an area with Panicum maximum cv. Tanzania, and after grazing, water and mineral salt/mix were fed ad libitum to the animals. The animals in ST2 were confined in collective pens distributed according to genotypes and received diet with 16% CP and 73% TDN. The values of pH, a* (red content), Cooking Loss (CL), and Ether Extract (EE) percentage were influenced by genotype. Values for red content (a*) and L* (brightness), CL and percentages of moisture, protein, EE, and ash were influenced by the finishing system. Longissimus dorsi muscle from animals ½ BA exhibited better physiochemical characteristics. For greater tenderness and higher percentages of fat, consumers should choose female kid goat meat.

Rosemary extract and celery-based products used as natural quality enhancers for colonial type salami with different ripening times

This study aimed to evaluate the use of rosemary (Rosmarinus officinalis) extract (RE), celery (Apium graveolis), and low levels of NO3 and NO2 as natural agents to enhance the quality of colonial salami. Salami was produced according to three treatments: (A) Control: 0.1% curing salt; (B) Rosemary: 0.05% curing salt + 0.5% RE (rosemary extract); and (C) Rosemary+celery: 0.14% Veg 503 + 0.27% Veg 504 (sea salt plus celery) + 0.5% of RE (rosemary extract). There was no effect (P > 0.05) of the treatments on water activity, Na content, and residual NO3 and NO2. Fatty acids C18:2 and C20:4 were reduced (P < 0.05) during the ripening period in the Control treatment indicating possible oxidation. The use of celery resulted in lower pH values (P < 0.05) in the salami. Reduced addition of NO3 and NO2 resulted in salami lighter in color (higher L* values, P < 0.05) at the 12th day of ripening. In conclusion, celery-based products proved to be an effective source of NO2 and NO3 for color development, but the low pH of the product indicates the need for better evaluation of its use in fermented salami. The RE (rosemary extract) reduced fat oxidation in salami, but this needs further evaluation.

Influence of physical damage and freezing on histamine concentration and microbiological quality of yellowfin tuna during processing

Yellowfin tuna has a high level of free histidine in their muscle, which can lead to histamine formation by microorganisms if temperature abuse occurs during handling and further processing. The objective of this study was to measure levels of histamine in damaged and undamaged thawed muscle to determine the effect of physical damage on the microbial count and histamine formation during the initial steps of canning processing and to isolate and identify the main histamine-forming microorganisms present in the flesh of yellowfin tuna. Total mesophilic and psicrophilic microorganisms were determined using the standard plate method. The presence of histamine-forming microorganisms was determined in a modified Niven's agar. Strains were further identified using the API 20E kit for enterobacteriaceae and Gram-negative bacilli. Physically damaged tuna did not show higher microbiological contamination than that of undamaged muscle tuna. The most active histamine-forming microorganism present in tuna flesh was Morganella morganii. Other decarboxylating microorganisms present were Enterobacter agglomerans and Enterobacter cloacae. Physical damage of tune during catching and handling did not increase the level of histamine or the amount of microorganisms present in tuna meat during frozen transportation, but they showed a higher risk of histamine-forming microorganism growth during processing.

Okara, a soymilk industry by-product, as a non-meat protein source in reduced fat beef burgers

Okara is a by-product generated during the manufacture of soymilk and tofu. Wet okara was added to beef burgers at 0%, 20%, and 25%. The effects of okara on certain physicochemical, textural, and sensory properties of reduced fat beef burgers were investigated. The beef burgers formulated with okara (104.0-106.0 kcal/100 g) had 60% less calories than commercial beef burgers (268.8 kcal/100 g). The texture profile analysis showed that the addition of wet okara led to a significant increase in hardness (p < 0.05) and a concomitant reduction in the values of chewiness, springiness, and cohesiveness. Lower sensory scores (p < 0.05) of flavour were observed in the beef burgers containing 25% wet okara. However, the sensory evaluation results showed that juiciness, appearance, tenderness, and overall acceptability of beef burgers formulated with okara did not differ statistically from that of the control (0% okara). Wet okara (20%) can be used as a non-meat protein source in the production of reduced-fat beef burgers without changing their sensory quality.

Frog meat microbiota (Lithobates catesbeianus) used in infant food

Captive breeding of bullfrog (Lithobates catesbeianus) is of great economic potential, mainly for its thighs and leather. The nutritional quality of frog meat includes properly balanced amino acids with a protein profile of high biological value, low fat and low cholesterol, and high digestibility due to its short chain molecule structure. It is recommended by doctors and nutritionists, especially for protein restricted children or malnourished children. Aiming to aggregate value to the segment and offer a product with nutritional properties that meet the need of children aged six months and above, a meat product based on the composition of frog meat was developed experimentally. To ensure raw material quality after bleaching and deboning, the microbiota present in the frog meat was determined. The analyses were performed according to Brazilian laws. It was observed that the resident and transient microbiota met the standards set by regulations. The results found were: mesophyll 4.5 x 10(4) CFU/g; Staphylococcus coagulase positive 2.0 x 10² CFU/g; negative for Salmonella sp. and Aeromonas spp. The findings indicate that the raw material showed satisfactory sanitation even in terms of family industry.

Safety criteria for the acquisition of meat in Brazilian University restaurants

The present study's objective was to analyze the procedures aimed at guaranteeing sanitary conditions when acquiring meat. The study was conducted with university restaurants of the Federal Institutions of Higher Education (IFES) located in the five regions of Brazil. Data were collected using a questionnaire and an evaluation list, which was available online to restaurant professionals. The results showed that restaurants chose one or two types of meat, the most frequent of which were beef and chicken. In restaurants managed by the IFES, the acquisition of raw material occurred by bidding. For vendor selection, the restaurants required product registration with the Inspection Service and requested regulation of the supplier by the Health Surveillance. Monitoring was carried out through a technical visit to the supplier and a review of the past records of the supplier. A higher percentage of restaurants in the Southeast region met appropriate sanitary and hygienic criteria for the receipt of meat, followed by the South, Midwest, Northeast and North. We conclude that restaurants meet most of the safety criteria set in the legislation. However, some weaknesses are evident in the physical and functional structure, the system of transportation of raw material and the records of control measures at the place of reception.

Prevalence of Listeria monocytogenes in poultry meat

Abstract The objectives of this study were i) to isolate Listeria spp. and Listeria monocytogenes in broiler wing meat samples, ii) to confirm the isolates by PCR, based on prs and hly A gene sequences, iii) to determine the seasonal and monthly distribution of the isolates. A total of 120 broiler wing meat samples (60 packaged pieces wrapped using strech film in styrofoam plates and 60 unpackaged pieces) bought from different markets in Hatay province were analysed. Listeria spp. was isolated from 57 (47.5%) out of 120 samples. Fifty-four, out of 57 Listeria spp. isolates were identified as L. monocytogenes. L. monocytogenes was isolated from the samples collected during the spring, winter, summer, and autumn at the levels of 26.6%, 40%, 53.3%, 60%, respectively. In this study, the isolation rates were found to be the highest in autumn, while the isolation rates were found to be the lowest in spring. As a consequence, high prevalence of Listeria spp. and L. monocytogenes in poultry wing meat samples may pose a risk for human health. We consider that with obeying the rules of good hygiene practices (GHP), good manufacturing practices (GMP) and HACCP can minimize the contamination with Listeria spp.