Apple as sugar substitute in cake

The reduction of sugar in food is important for healthy eating without drastically changing eating habits. Fruits can contribute to sweetener the flavor and it can also improve the fiber content and the bioactive compounds, contributing to turn the product healthier. The aims of this study were to evaluate apple as sugar substitute in cake and to analyze nutritional and sensorial aspects. The nutritional composition was evaluated based on the Brazilian Food Composition Table. The sensory analysis was conducted with 9-point hedonic scale. Apples’ puree replacing sugar turned the cake healthier due to the reduction on TEV, lipid and carbohydrates content. It also increased the dietary fiber. There were differences on color, flavor and texture between cakes mean acceptance, but the overall quality means were not statistically different showing the possibility of sugar cane exclusion. Flavor, texture and overall quality of modified samples presented good acceptance by the tasters.     

A Case of Daptomycin-Induced Immune Thrombocytopenia

We report a case of severe daptomycin-induced immune thrombocytopenia in a patient treated for methicillin-resistant Staphylococcus epidermidis and ampicillin-resistant Enterococcus faecalis bacteremia acquired in an intensive care unit. Serum antibodies bound to platelets in the presence of daptomycin on flow cytometry. There was no evidence of other causes of thrombocytopenia. The patient died of brain herniation complicating extensive cerebral hemorrhage. To our knowledge, this is the first described case of daptomycin-induced thrombocytopenia.     

Cardiovascular adjustments to cold pressor test in postmenopausal women and the impact of α1-adrenergic blockade

Purpose

We investigate the impact of menopause on cardiovascular adjustments to the cold pressor test (CPT) and the role of the α1-adrenergic receptor.

Methods

Ten young women (YW) and nine postmenopausal women (MW) underwent 1 min of CPT in control and α1-blockade conditions (0.03 mg?kg^?1 of oral prazosin).

Results

CPT increased heart rate (HR) (YW: ?20?±?3 bpm; MW: ?13?±?2 bpm) and stroke volume (SV; YW: ?15?±?8 ml; MW: ?9?±?6 ml; p?=?0.01 for time) and evoked a greater increase in cardiac output (CO) in YW (YW: ?2.1?±?0.2 l?m^?1; MW: ?1.3?±?0.5 l?m^?1; p?=?0.01). α1-Blockade increased baseline HR and did not change HR, SV, and CO responses to CPT. MW presented an exaggerated systolic blood pressure (BP) response (YW: ?38?±?9 mmHg; MW: ?56?±?24 mmHg; p?=?0.03). The α1-blockade did not change baseline BP while blunting its response. Total vascular resistance (TVR) was similar between groups at baseline and increased during CPT only in MW (YW: ?2.3?±?1.4 mmHg?L^?1?min; MW:?6.8?±?5.9 mmHg?L^?1?min). Under α1-blockade, the TVR increase during CPT was attenuated in MW and abolished in YW (YW: ?0.3?±?1.2 mmHg?L^?1?min and MW: ?3.0?±?2.0 mmHg?L^?1?min). CPT did not change femoral vascular conductance (FVC) in either group before the blockade (YW: ??0.3?±?4.0 ml?min^?1?mmHg^?1; MW: ??0.2?±?0.8 ml?min^?1?mmHg^?1); however, FVC tended to increase in young women (YW: ?1.3?±?1.0 ml?min^?1?mmHg^?1; MW: ?0.1?±?1.5 ml?min^?1?mmHg^?1; p?=?0.06) after the α1-blockade.

Conclusion

In postmenopausal women, the cardiac ability to adjust to CPT is blunted and α1-adrenergic receptor stimulation is important for the increase in stroke volume. In addition, the peripheral effect of α1-adrenergic receptor stimulation seems to be increased in postmenopausal women.

     

Core cerebrospinal fluid biomarker profile in anti-LGI1 encephalitis

Journal of Neurology - To compare CSF biomarkers’ levels in patients suffering from anti-Leucine-rich Glioma-Inactivated 1 (LGI1) encephalitis to neurodegenerative [Alzheimer’s disease...     

An epidemiological perspective of personalized medicine: the Estonian experience

The Estonian Biobank and several other biobanks established over a decade ago are now starting to yield valuable longitudinal follow‐up data for large numbers of individuals. These samples have been used in hundreds of different genome‐wide association studies, resulting in the identification of reliable disease‐associated variants. The focus of genomic research has started to shift from identifying genetic and nongenetic risk factors associated with common complex diseases to understanding the underlying mechanisms of the diseases and suggesting novel targets for therapy. However, translation of findings from genomic research into medical practice is still lagging, mainly due to insufficient evidence of clinical validity and utility. In this review, we examine the different elements required for the implementation of personalized medicine based on genomic information. First, biobanks and genome centres are required and have been established for the high‐throughput genomic screening of large numbers of samples. Secondly, the combination of susceptibility alleles into polygenic risk scores has improved risk prediction of cardiovascular disease, breast cancer and several other diseases. Finally, national health information systems are being developed internationally, to combine data from electronic medical records from different sources, and also to gradually incorporate genomic information. We focus on the experience in Estonia, one of several countries with national goals towards more personalized health care based on genomic information, where the unique combination of elements required to accomplish this goal are already in place.     

Association analysis of juvenile idiopathic arthritis genetic susceptibility factors in Estonian patients

Clinical Rheumatology - Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic condition of childhood. Genetic association studies have revealed several JIA susceptibility loci...     

Fatigue failure load of an adhesively-cemented lithium disilicate glass-ceramic: Conventional ceramic etching vs etch & prime one-step primer

Objectives

To evaluate the effect of different glass-ceramic surface treatments and aging on the fatigue failure load of a lithium disilicate glass-ceramic adhesively cemented to a dentin analogue material.

Risk of post-traumatic stress symptoms in family members of intensive care unit patients

RATIONALE: Intensive care unit (ICU) admission of a relative is a stressful event that may cause symptoms of post-traumatic stress disorder (PTSD). OBJECTIVES: Factors associated with these symptoms need to be identified. METHODS: For patients admitted to 21 ICUs between March and November 2003, we studied the family member with the main potential decision-making role. MEASUREMENTS: Ninety days after ICU discharge or death, family members completed the Impact of Event Scale (which evaluates the severity of post-traumatic stress reactions), Hospital Anxiety and Depression Scale, and 36-item Short-Form General Health Survey during a telephone interview. Linear regression was used to identify factors associated with the risk of post-traumatic stress symptoms. MAIN RESULTS: Interviews were obtained for family members of 284 (62%) of the 459 eligible patients. Post-traumatic stress symptoms consistent with a moderate to major risk of PTSD were found in 94 (33.1%) family members. Higher rates were noted among family members who felt information was incomplete in the ICU (48.4%), who shared in decision making (47.8%), whose relative died in the ICU (50%), whose relative died after end-of-life decisions (60%), and who shared in end-of-life decisions (81.8%). Severe post-traumatic stress reaction was associated with increased rates of anxiety and depression and decreased quality of life. CONCLUSION: Post-traumatic stress reaction consistent with a high risk of PTSD is common in family members of ICU patients and is the rule among those who share in end-of-life decisions. Research is needed to investigate PTSD rates and to devise preventive and early-detection strategies.     

Quantification of eight new antidepressants and five of their active metabolites in whole blood by high-performance liquid chromatography-tandem mass spectrometry

A liquid chromatography-tandem mass spectrometry method is described for the blood determination of selective serotonin reuptake inhibitors (fluoxetine, paroxetine, sertraline, fluvoxamine, and citalopram), serotonin noradrenaline reuptake inhibitors (milnacipram and venlafaxine), a noradrenergic and specific serotoninergic antidepressant (mirtazapine) and five of their active metabolites (norfluoxetine, desmethylcitalopram, didesmethylcitalopram, desmethylvenlafaxine, and desmethylmirtazapine). After a liquid-liquid extraction from blood, the compounds and the internal standard (methylrisperidone) were eluted on a XTerra RP18 column with a gradient of acetonitrile/ammonium formate buffer 4 mmol/L pH 3.2. They were then detected by electrospray ionization mass spectrometry with multiple reaction monitoring mode. The calibration curves were linear over the range 5-500 ng/mL (20-2000 ng/mL for venlafaxine and desmethylvenlafaxine). The limit of quantification was set at 5 ng/mL for each compound (except for venlafaxine and desmethylvenlafaxine: 20 ng/mL). The bias were lower than 12%. Intraday and interday precisions, expressed as variation coefficient, were lower than 11%. The extraction recoveries were between 70 and 90% except for desmethylmirtazapine, desmethylvenlafaxine, milnacipram, and didesmethylcitalopram. This specific and sensitive method allows management of intoxication and is suitable for the routine determination of antidepressants in forensic investigations.