The Evolution of Polyphenols from Grapes to Wines

Polyphenols play an important role in the quality of wines, due to their contribution to the wine sensory properties: color, astringency and bitterness. They act as antioxidants, having positive role in human health. They can be divided into non-flavonoid (hydroxybenzoic and hydroxycinnamic acids and stilbenes) and flavonoid compounds (anthocyanins, flavan-3-ols and flavonols). Anthocyanins are responsible for the color of red grapes and wines, hydroxycinnamic and hydroxybenzoic acids act as copigments, stilbenes as antioxidants and the flavan-3-ols are mainly responsible for the astringency, bitterness and structure of wines, being involved also in the color stabilization during aging. This chapter will focus on the chemical structures of the main polyphenols, their identification and quantification in grapes and wines by advanced analytical techniques, highlighting also the maceration and aging impact on the polyphenols evolution. The factors influencing the phenolic accumulation in grapes are also reviewed, emphasizing as well the relationship between phenolic content in grapes versus wine. Polyphenolic changes during the wine making process are highlighted along with the main polyphenol extraction methods and analysis techniques. This research will contribute to the improvement in the knowledge of polyphenols: their presence in grapes, the relationship with wine quality and the influence of the external factors on their evolution

Alemtuzumab outcomes by age: Post hoc analysis from the randomized CARE-MS studies over 8 years

Alemtuzumab; Efficacy; SafetyAlemtuzumab; Eficacia; SeguridadAlemtuzumab; Eficàcia; SeguretatBackground Alemtuzumab significantly improved clinical and MRI outcomes vs. subcutaneous interferon beta-1a (SC IFNB-1a) in the CARE-MS trials (NCT00530348, NCT00548405), with sustained efficacy in 2 consecutive extensions (NCT00930553, NCT02255656 [TOPAZ]). Methods Post hoc analysis of 8-year alemtuzumab efficacy and safety in pooled CARE-MS patients (N=811) stratified by baseline age (≥18 to ≤25, >25 to ≤35, >35 to ≤45, >45 to ≤55 years). Results Compared with SC IFNB-1a over 2 years across age cohorts, alemtuzumab lowered annualized relapse rates (ARR; 0.22–0.24 vs. 0.38–0.51), improved or stabilized disability (freedom from 6-month confirmed disability worsening [CDW]: 85%–92% vs. 62%–88%; achievement of 6-month confirmed disability improvement [CDI]: 20%–31% vs. 13%–25%), increased proportions free of MRI disease activity (70%–86% vs. 42%–63% per year), and slowed brain volume loss (BVL; –0.45% to –0.87% vs. –0.50% to –1.39%). Through Year 2, the treatment effect with alemtuzumab did not significantly differ among age groups for ARR (p-interaction=0.6325), 6-month CDW-free (p-interaction=0.4959), 6-month CDI (p-interaction=0.9268), MRI disease activity-free (p-interaction=0.6512), and BVL (p-interaction=0.4970). Alemtuzumab remained effective on outcomes through Year 8 across age groups. Age-related increases in malignancies (≤45 years: 0.9%–2.2% vs. >45 years: 8.1%) and deaths (0%–1.7% vs. 7.0%) were observed. Serious infections also increased from the youngest (5.1%) to oldest (12.8%) age cohorts. Conclusions Alemtuzumab had greater efficacy than SC IFNB-1a over 2 years across comparable age groups, with no significant differences between alemtuzumab-treated age groups. Efficacy on relapse, disability, and MRI outcomes continued through Year 8 across age groups. Age-related increases in serious infections, malignancies, and deaths were observed.The study was supported by Sanofi and Bayer HealthCare Pharmaceuticals

The Role of Multiple Sclerosis as a Risk Factor for the Development of Osteoporosis

Background: Osteoporosis is the most common bone disease in the United States, and it is particularly common among women with multiple sclerosis (MS). However, despite this association, the temporal relationship between these two conditions has not been previously studied. Data from the Women’s Health Initiative provides a unique opportunity to examine the risk of developing osteoporosis over time in individuals diagnosed with MS. Objective: The purpose of this study is to refine the relationship between MS and osteoporosis, clarifying the impact of environmental and pharmacologic factors on each condition, as well as addressing treatment and preventative efforts for a patient population at a greater potential risk for osteoporosis. Methods: The study sample, derived from the Women’s Health Initiative, included 449 women who reported an MS diagnosis at baseline and 161,359 women without MS who comprised a control group. Baseline measures of self-reported osteoporosis, age, smoking status, steroid and anti-inflammatory use, and supplementary as well as dietary calcium and vitamin D were compared. MS patients reporting osteoporosis at baseline were removed, resulting in 355 women with MS to monitor for time to incident osteoporosis. Survival analyses were performed on follow-up data gathered annually between 1993 and 2005 to factor out significant associations of additional factors. Proportions of participants on osteoporosis-related medications as well as latency to use were compared between the multiple sclerosis and control cohorts. Results: At baseline, women with MS are nearly three times as likely to report osteoporosis (p Conclusions: A higher prevalence of osteoporosis at baseline suggests MS may significantly increase the risk of osteoporosis in premenopausal women. In contrast, environmental and pharmacologic variables appear to have a more significant role in the post-menopausal population. While osteoporosis was treated similarly between both groups, the point for intervention or prevention of osteoporosis in MS patients may be earlier in the disease course

CENÁRIO DA ARBORIZAÇÃO URBANA NAS MAIORES CIDADES DO ESTADO DO PARANÁ

Este artigo apresenta uma síntese sobre a situação da arborização urbana no Estado do Paraná obtida através de questionário respondido por profissionais responsáveis pelos setores relacionados à arborização urbana das cidades com mais de 60 mil habitantes. Das vinte e sete cidades paranaenses com mais de 60 mil habitantes apenas quatorze apresentam inventario parcial de arborização. Todas as prefeituras concordam que é importante o uso de espécies nativas, sendo que na maioria das cidades inventariadas a espécie nativa mais observada na arborização é Tabebuia chrysotricha. A espécie exótica invasora Ligustrum lucidum é a mais freqüente nas cidades inventariadas. Os principais problemas observados nas grandes cidades do Paraná são o vandalismo e a falta de conscientização sobre o valor da arborização urbana. A maior dificuldade é a falta de recursos financeiros para realização do manejo, para aquisição de sementes e para a produção de mudas. Todas as cidades investigadas apresentam na prefeitura um órgão responsável pela arborização urbana. A maioria dos profissionais que atuam nesses órgãos são agrônomos, engenheiros florestais, engenheiros ambientais, biólogos, técnicos (agrícolas, florestais, agropecuários), geógrafos e arquitetos ambientais

Sensorimotor Function in Progressive Multiple Sclerosis

Background: A sensitive test reflecting subtle sensorimotor changes throughout disease progression independent of mobility impairment is currently lacking in progressive multiple sclerosis. Objectives: We examined non-ambulatory measures of upper and lower extremity sensorimotor function that may reveal differences between relapsing–remitting and progressive forms of multiple sclerosis. Methods: Cutaneous sensitivity, proprioception, central motor function and mobility were assessed in 32 relapsing–remitting and 31 progressive multiple sclerosis patients and 30 non-multiple sclerosis controls. Results: Cutaneous sensation differed between relapsing–remitting and progressive multiple sclerosis at the foot and to a lesser extent the hand. Proprioception function in the upper but not the lower extremity differed between relapsing–remitting and progressive multiple sclerosis, but was different for both upper and lower extremities between multiple sclerosis patients and non-multiple sclerosis controls. Foot-tap but not hand-tap speed was slower in progressive compared to relapsing–remitting multiple sclerosis, suggestive of greater central motor function impairment in the lower extremity in progressive multiple sclerosis. In addition, the non-ambulatory sensorimotor measures were more sensitive in detecting differences between relapsing–remitting and progressive multiple sclerosis than mobility assessed with the 25-foot walk test. Conclusion: This study provides novel information about changes in sensorimotor function in progressive compared with relapsing–remitting forms of multiple sclerosis, and in particular the importance of assessing both upper and lower extremity function. Importantly, our findings showed loss of proprioceptive function in multiple sclerosis but also in progressive compared to relapsing–remitting multiple sclerosis

Whose Preferences Matter? A Patient-Centered Approach for Eliciting Treatment Goals

BACKGROUND: Patients facing a high-stakes clinical decision are often confronted with an overwhelming array of options. High-quality decisions about treatment should reflect patients\u27 preferences as well as their clinical characteristics. Preference-assessment instruments typically focus on pre-selected clinical outcomes and attributes chosen by the investigator. OBJECTIVE: We sought to develop a patient-centered approach to elicit and compare the treatment goals of patients with multiple sclerosis (MS) and healthcare providers (HCPs). METHODS: We conducted five nominal group technique (NGT) meetings to elicit and prioritize treatment goals from patients and HCPs. Five to nine participants in each group responded silently to one question about their treatment goals. Responses were shared, consolidated, and ranked to develop a prioritized list for each group. The ranked lists were combined. Goals were rated and sorted into categories. Multidimensional scaling and hierarchical cluster analysis were used to derive a visual representation, or cognitive map, of the data and to identify conceptual clusters, reflecting how frequently items were sorted into the same category. RESULTS: Five NGT groups yielded 34 unique patient-generated treatment goals and 31 unique HCP-generated goals. There were differences between patients and HCPs in the goals generated and how they were clustered. Patients\u27 goals tended to focus on the impact of specific symptoms on their day-to-day lives, whereas providers\u27 goals focused on slowing down the course of disease progression. CONCLUSIONS: Differences between the treatment goals of patients and HCPs underscore the limitations of using HCP- or investigator-identified goals. This new adaptation of cognitive mapping is a patient-centered approach that can be used to generate and organize the outcomes and attributes for values clarification exercises while minimizing investigator bias and maximizing relevance to patients

A rare presentation of hypertrophic olivary degeneration secondary to primary central nervous system lymphoma

Case report: A 71-year-old man presented with a 2-week history of nausea, vomiting, unsteady gait, and diplopia

Advances in the treatment of relapsing - Remitting multiple sclerosis

This article reviews and discusses the approved and emerging therapies for multiple sclerosis (MS). MS is a chronic and disabling immune-mediated disease of the central nervous system (CNS) that affects mainly young adults. MS imposes a huge economic burden on healthcare systems and the society. Although the last 20 years have brought a continuous expansion in therapeutic options, there are still unmet needs in MS management. Available MS drugs have varying degrees of efficacy in reducing relapse risk. The long-term term effects of these treatments are incompletely known. New therapies, along with variations of currently available treatments, may prove more effective and tolerable than the available drugs. Treatments for MS differ with respect to the mode of administration, tolerability and likelihood of treatment adherence, side effects, and risk of major toxicity. The armamentarium of approved disease-modifying therapies in MS and those in development include: (1) the first approved, moderately effective, injectable interferon-β and glatiramer acetate; (2) oral drugs (fingolimod, laquinimod, teriflunomide, dimethyl fumarate); (3) monoclonal antibodies (rituximab, ocrelizumab, ofatumumab, daclizumab, alemtuzumab); and (4) immunosuppressive agents (e.g. mitoxantrone). The place of each drug in the therapeutic algorithm is dependent on its specific risk-benefit profile. Patients' clinical and paraclinical phenotypes and biomarker profile may help to elucidate disease subtypes and response to therapy in the future, thus allowing treatment individualization

Eco-Friendly Alternative Disposal through the Pyrolysis Process of Meat and Bone Meal

The capitalization of agri-food waste is essential for the sustainability of a circular economy. This work focuses on a solution to eliminate such waste, meat and bone meal (MBM), which is produced in large quantities by the food industry and is prohibited for use as animal feed under the European directives. Therefore, with the focus of converting waste to energy, the catalytic pyrolysis of MBM in the presence of mesoporous silica nanocatalysts (SBA-3 and SBA-16 materials and metallic derivates) was investigated in a home-made reactor for the production of renewable energy. The mesoporous silica materials were synthesized using relatively simple methods and then characterized in order to determine their morpho-structural characteristics. The MBM pyrolysis behavior under different experimental conditions was examined in detail, both in the presence and absence of the new catalysts. The resulting MBM-based pyrolysis products, MBMPYOILs and MBMPYGASs, were also assessed as potential alternative fuels, highlighting comparable energy values to conventional fuels. The outcomes of this investigation offer a potential pathway to the clean production of gas and oil, thus promoting the high-grade utilization of MBM waste