Unele particularităţi ale mortalităţii prin tuberculoză în Republica Moldova în anul 2005

Din datele existente privind mortalitatea s-au analizat anumite particularităţi ale acesteia în anul 2005. Astfel, mortalitatea prin tuberculoză şi complicaţiile ei, сonstituind 19,10, a crescut în ultimii 20 de ani de 4,8 ori şi a atins nivelul anului 1965 (18,00). Mortalitatea determinată de localizarea respiratorie a tuberculozei este mult mai înaltă (98,0%) decât cea cauzată de localizările extrarespiratorii ale bolii şi de sechelele de tuberculoză (2,0%). Ponderea deceselor prin tuberculoză extrarespiratorie s-a redus în ultimii 10 ani de 3,1 ori. Majoritatea deceselor prin tuberculoză se produc în perioada de vârstă de 31-65 de ani (85,6%). Nivelul cel mai înalt al mortalităţii atât la bărbaţi, cât şi la femei s-a înregistrat la grupa de vârstă de 41-50 de ani. La 125 de decese(15,5%) tuberculoza drept cauză a decesului a fost depistată post-mortem, la 153 de decese (19,0%) ea a fost depistată tardiv (în termen de până la un an de evidenţă dispensarială). Frecvenţa depistării tuberculozei post- mortem şi tardiv a crescut în ultimii 10 ani respectiv de 2,4 ori şi 1,3 ori

Reducing the acid-forming potential of cheeses to improve their nutritional features : identification of biochemical levers and technological perspectives

Une caractéristique nutritionnelle peu connue des fromages est leur potentiel acidifiant, qui se révèle au cours du métabolisme et, à long terme, est susceptible d’induire des effets délétères sur la santé du consommateur. Malgré des conséquences physiopathologiques bien connues, très peu d’études se sont intéressées au potentiel acidifiant/alcalinisant des aliments et aucune à celui des fromages. L’objectif principal était d’évaluer d’une part le potentiel acidifiant des fromages et identifier ses déterminants au cours de la fabrication et d’autre part d’explorer des stratégies d’optimisation technologique permettant de réduire le potentiel acidifiant des fromages, tout en assurant leurs qualités gustatives. Le potentiel acidifiant a été évalué sur la base de l’indice PRAL (Potential Renal Acid Load, en tenant compte des teneurs en protéine, P, Cl, Na, K, Mg et Ca) et de la teneur en anions organiques (lactate et citrate). Dans un premier temps, l’étude du potentiel acidifiant de cinq types de fromages du commerce a permis d’établir un lien fort entre le type du fromage et son potentiel acidifiant. L’indice PRAL le plus faible est celui du fromage frais avec - 0,8 mEq/100 g, les indices les plus élevés atteignant 25,3 mEq/100 g pour le fromage à pâte pressée non-cuite (Cantal) et 28,0 mEq/100 g pour le fromage à pâte persillée (Fourme d’Ambert). Ce positionnement a ainsi permis de sélectionner un modèle fromage pour la suite des travaux : la Fourme d’Ambert. Dans une seconde phase, l’égouttage et le salage ont été identifiés comme les deux étapes technologiques déterminantes dans la génération du potentiel acidifiant du modèle fromage choisi, au cours de la transformation fromagère, suivie en milieu industriel. Ces études démontrent un déséquilibre important entre les éléments acidifiants (Cl, P, protéines) et les éléments alcalinisants majeurs (Na et Ca) du PRAL. En particulier, les Cl suivis par le P, ont exercé un très fort impact expliquant les indices élevés obtenus. Enfin, une substitution du NaCl par des sels organiques de calcium (lactate et citrate de Ca) a été testée en conditions industrielles pendant le salage à sec de la Fourme d’Ambert. Les deux sels ont montré un réel intérêt pour substituer partiellement le sel des fromages, sans affecter les propriétés sensorielles des produits finis et notamment les saveurs salée et amère. La substitution au lactate de Ca permettrait d’optimiser le potentiel acidifiant des fromages, en diminuant le PRAL et la teneur en Na et en augmentant la teneur en lactate. La substitution au citrate de Ca serait plutôt indiquée dans le cadre d’un enrichissement en Ca. En conclusion, ces études ont permis d’identifier les leviers à maîtriser pour réduire le potentiel acidifiant des fromages. L’approche adoptée a proposé la mise en application d’un concept connu principalement des nutritionnistes jusqu’ici dans les domaines de la biochimie et de la technologie alimentaires. Les perspectives d’innovation envisagées sont pertinentes avec les enjeux de santé publique actuels, en visant la réduction en Na dans les fromages et en participant à la limitation de l’acidose métabolique latente induite par les régimes occidentaux. Enfin, les retombées économiques de ces recherches sont prometteuses pour les filières fromagères.A disregarded nutritional feature of cheeses is their acid-forming potential when ingested, associated with deleterious effects for consumers’ health. Despite the well-known pathophysiological consequences, very few studies investigated the acidifying/alkalizing potential of foods and especially, none targeted cheeses. The research project aimed on the one hand to evaluate the acid-forming potential of cheeses and identify the main key steps of the manufacture involved in this phenomenon and on the other hand to explore technological optimization strategies to reduce the acid-forming potential of cheeses, without altering their sensory properties. The acid-forming potential was evaluated on the basis of their Potential Renal Acid Load (PRAL) index (considering protein, P, Cl, Na, K, Mg and Ca contents) and organic anions contents (lactate and citrate). Firstly, the study of the acid-forming potential of five commercial cheeses from different cheese-making technologies established a strong link between the type of cheese and their acid-forming potential. PRAL index ranged from - 0.8 mEq/100 g for fresh cheese to 25.3 mEq/100 g for hard cheese (Cantal) and 28.0 mEq/100 g for the blue-veined cheese Fourme d’Ambert. This positioning allowed to select Fourme d'Ambert as model cheese for next steps. Secondly, draining and salting were identified as the main key steps responsible for the generation of the acid-forming potential of the model cheese, by following an industrial cheese-making process. These studies emphasized a great imbalance between acidifying elements of PRAL calculation (Cl, P and proteins elements) and alkalinizing ones (Na and Ca). Particularly, Cl followed by P elements had a strong impact on the PRAL value. Finally, the salt substitution with organic calcium salts (calcium lactate and calcium citrate) was tested under industrial conditions during the dry salting of Fourme d'Ambert cheese. Both salts showed a real nutritional interest to partially replace salt in cheese, without affecting their sensory properties and especially the salty and the bitter flavors. The salt substitution by calcium lactate could reduce the acid-forming potential of cheeses, by decreasing the PRAL and the sodium content and by increasing the lactate content. The calcium citrate substitution would rather be recommended for Ca enrichment of cheeses. As a conclusion, these studies allowed to identify technological solutions to reduce the acid-forming potential of cheeses. The adopted approach proposed the implementation of a concept, known mainly by nutritionists so far, to the biochemistry and the food technology fields. The considered prospects for innovation are relevant with the current public health issues, targeting the reduction of Na in cheeses and participating in the limitation of the Western diets induced metabolic acidosis. Finally, the economic benefits of this research are promising for cheese-making producers

Réduire le potentiel acidifiant des fromages pour améliorer leurs fonctionnalités nutritionnelles : identification des leviers biochimiques et perspectives technologiques

A disregarded nutritional feature of cheeses is their acid-forming potential wheningested, associated with deleterious effects for consumers’ health. Despite the well-knownpathophysiological consequences, very few studies investigated the acidifying/alkalizingpotential of foods and especially, none targeted cheeses.The research project aimed on the one hand to evaluate the acid-forming potential ofcheeses and identify the main key steps of the manufacture involved in this phenomenon andon the other hand to explore technological optimization strategies to reduce the acid-formingpotential of cheeses, without altering their sensory properties. The acid-forming potential wasevaluated on the basis of their Potential Renal Acid Load (PRAL) index (considering protein,P, Cl, Na, K, Mg and Ca contents) and organic anions contents (lactate and citrate).Firstly, the study of the acid-forming potential of five commercial cheeses from differentcheese-making technologies established a strong link between the type of cheese and their acidformingpotential. PRAL index ranged from - 0.8 mEq/100 g for fresh cheese to 25.3 mEq/100 gfor hard cheese (Cantal) and 28.0 mEq/100 g for the blue-veined cheese Fourme d’Ambert.This positioning allowed to select Fourme d'Ambert as model cheese for next steps.Secondly, draining and salting were identified as the main key steps responsible for thegeneration of the acid-forming potential of the model cheese, by following an industrial cheesemakingprocess. These studies emphasized a great imbalance between acidifying elements ofPRAL calculation (Cl, P and proteins elements) and alkalinizing ones (Na and Ca). Particularly,Cl followed by P elements had a strong impact on the PRAL value.Finally, the salt substitution with organic calcium salts (calcium lactate and calciumcitrate) was tested under industrial conditions during the dry salting of Fourme d'Ambertcheese. Both salts showed a real nutritional interest to partially replace salt in cheese, withoutaffecting their sensory properties and especially the salty and the bitter flavors. The saltsubstitution by calcium lactate could reduce the acid-forming potential of cheeses, bydecreasing the PRAL and the sodium content and by increasing the lactate content. The calciumcitrate substitution would rather be recommended for Ca enrichment of cheeses.As a conclusion, these studies allowed to identify technological solutions to reduce theacid-forming potential of cheeses. The adopted approach proposed the implementation of aconcept, known mainly by nutritionists so far, to the biochemistry and the food technologyfields. The considered prospects for innovation are relevant with the current public healthissues, targeting the reduction of Na in cheeses and participating in the limitation of the Westerndiets induced metabolic acidosis. Finally, the economic benefits of this research are promisingfor cheese-making producers.Une caractéristique nutritionnelle peu connue des fromages est leur potentiel acidifiant,qui se révèle au cours du métabolisme et, à long terme, est susceptible d’induire des effetsdélétères sur la santé du consommateur. Malgré des conséquences physiopathologiques bienconnues, très peu d’études se sont intéressées au potentiel acidifiant/alcalinisant des aliments etaucune à celui des fromages.L’objectif principal était d’évaluer d’une part le potentiel acidifiant des fromages etidentifier ses déterminants au cours de la fabrication et d’autre part d’explorer des stratégiesd’optimisation technologique permettant de réduire le potentiel acidifiant des fromages, tout enassurant leurs qualités gustatives. Le potentiel acidifiant a été évalué sur la base de l’indicePRAL (Potential Renal Acid Load, en tenant compte des teneurs en protéine, P, Cl, Na, K, Mget Ca) et de la teneur en anions organiques (lactate et citrate).Dans un premier temps, l’étude du potentiel acidifiant de cinq types de fromages ducommerce a permis d’établir un lien fort entre le type du fromage et son potentiel acidifiant.L’indice PRAL le plus faible est celui du fromage frais avec - 0,8 mEq/100 g, les indices lesplus élevés atteignant 25,3 mEq/100 g pour le fromage à pâte pressée non-cuite (Cantal) et28,0 mEq/100 g pour le fromage à pâte persillée (Fourme d’Ambert). Ce positionnement a ainsipermis de sélectionner un modèle fromage pour la suite des travaux : la Fourme d’Ambert.Dans une seconde phase, l’égouttage et le salage ont été identifiés comme les deuxétapes technologiques déterminantes dans la génération du potentiel acidifiant du modèlefromage choisi, au cours de la transformation fromagère, suivie en milieu industriel. Ces étudesdémontrent un déséquilibre important entre les éléments acidifiants (Cl, P, protéines) et leséléments alcalinisants majeurs (Na et Ca) du PRAL. En particulier, les Cl suivis par le P, ontexercé un très fort impact expliquant les indices élevés obtenus.Enfin, une substitution du NaCl par des sels organiques de calcium (lactate et citrate deCa) a été testée en conditions industrielles pendant le salage à sec de la Fourme d’Ambert. Lesdeux sels ont montré un réel intérêt pour substituer partiellement le sel des fromages, sansaffecter les propriétés sensorielles des produits finis et notamment les saveurs salée et amère.La substitution au lactate de Ca permettrait d’optimiser le potentiel acidifiant des fromages, endiminuant le PRAL et la teneur en Na et en augmentant la teneur en lactate. La substitution aucitrate de Ca serait plutôt indiquée dans le cadre d’un enrichissement en Ca.En conclusion, ces études ont permis d’identifier les leviers à maîtriser pour réduire lepotentiel acidifiant des fromages. L’approche adoptée a proposé la mise en application d’unconcept connu principalement des nutritionnistes jusqu’ici dans les domaines de la biochimieet de la technologie alimentaires. Les perspectives d’innovation envisagées sont pertinentesavec les enjeux de santé publique actuels, en visant la réduction en Na dans les fromages et enparticipant à la limitation de l’acidose métabolique latente induite par les régimes occidentaux.Enfin, les retombées économiques de ces recherches sont prometteuses pour les filièresfromagères

Complementary approaches to understand the spreading behavior on skin of O/W emulsions containing different emollientss

International audienceThe human skin is a very complex living tissue, in a permanent evolution and self-renewing by constant lipids secretion. The characterization of this biological material is a major concern in dermo-cosmetic and pharmaceutics fields. Understanding the skin interaction with its environment, during application of skincare products, is consequently of genuine interest to better control the different phenomena occurring. In sensory language, the application of products on the skin is defined as the spreading behavior. Five O/W emulsions were formulated with different ratios of two emollients (isohexadecane and stearic acid). Complementary instrumental and sensory analysis of spreading behavior was carried out in vivo on human skin as well as in vitro on non-biological skin surface in order to investigate the impact of two emollients, and their mixtures in the spreadability and penetration of O/W emulsions. A first screening was made to link the physico-chemical properties (polarity, physical state and ratio) of emollients with the spreading behavior on human skin. Then, interesting parameters (the plateau value, its length and the increase of the friction value) from the tribological study on skin were considered to allow deepening the product/skin interactions after application of different emulsions and over time. In the last part of the study, an original method, using non-biological surfaces mimicking the human skin, was successfully tested with very good reproducibility of the spreading behavior. This original tool is of great interest to study the efficacy of new formulas on skin, but also for fundamental research and help performing standardized measurements as well as solving the logistic and safety problems of in vivo studies

Spreading behavior of cosmetic emulsions Impact of the oil phase

International audienceBackground Emollients are an important ingredient in personal care products, they are currently prescribed in skin disorders like eczema, which affects up to 30% of children in developed countries. Methods The aim of the study was to investigate the impact of two emollients (stearic acid and isohexadecane) and their mixtures in the spreadability and frictional effect on films obtained from oil-in-water emulsions. Rheological, textural, sensory and tribological analysis were performed on human skin and artificial substrates. Results The emollients ratio influences the spreading behavior of emulsions more isohexadecane in the oil phase easier to spread the product on the skin. Moreover, significant correlations were obtained for the spreading behavior obtained by textural measurements on artificial substrates and sensory analysis (Pearson coefficient = −0.871). The results obtained by frictiometer showed different developments over time after product application the friction values increase with the stearic acid concentration in emulsion. Discussion This study showed the importance to consider the emollient properties when one emollient is used in the emulsion, but especially their interactions, when several emollients are used, to better understand and anticipate their behavior. First, spreading was governed by the consistency of the emulsion, particularly impacted by the emollients ratio. But then, in a long-time spreading, when the emulsion broke down and residual film was formed, a particular interaction with skin influenced the spreadability. It appears that not only the physical state of the emollient but also its chemical nature, physical state, polarity, temperature might explain these phenomena. © 2018 Elsevier Lt

Draining and salting as responsible key steps in the generation of the acid-forming potential of cheese: Application to a soft blue-veined cheese

International audienceA disregarded nutritional feature of cheeses is their high acid-forming potential when ingested, associated with deleterious effects for consumers' health. This work aimed to characterize the generation of the acid-forming potential of a blue-veined cheese during manufacturing to identify the main key steps of the process involved in this phenomenon. Sampling was performed on 3 batches at 10 steps of the cheese-making process: reception of raw milk, pasteurization, maturation of milk, coagulation, stirring, draining of the curds and at 4 ripening stages: 21, 28, 42, and 56 d. Acid-forming potential of each sample was evaluated through (1) the calculation of the potential renal acid load (PRAL) index (considering protein, Cl, P, Na, K, Mg, and Ca contents) and (2) its organic anion content (lactate and citrate), considered as alkalinizing elements. Draining and salting were identified as the main key steps responsible for the generation of the acid-forming potential of cheese. The draining process induced an increase in the PRAL index from 1.2 mEq/100 g in milk to 10.4 mEq/100 g in drained curds due to the increase of the dry matter and the loss of alkaline minerals into the whey. The raise of PRAL value (20.3 mEq/100 g at d 56) following salting resulted from an imbalance between the strong acidogenic elements (Cl, P, and proteins) and the main alkalinizing ones (Na and Ca). Particularly, the Cl element had a major effect on the PRAL value. Regarding organic anions, draining induced a loss of 93% of the citrate content in initial milk. The lactate content increased as fermentation occurred (1,297.9 mg/100 g in drained curds), then decreased during ripening (519.3 mg/100 g at d 56). This lactate level probably contributes to moderate the acidifying potential of end products. Technological strategies aiming to limit the acid-forming potential of cheeses are proposed and would deserve further research to evaluate their nutritional relevance

Mécanisme de stabilisation et de structuration des interfaces par le xanthane Impact de la conformation du polymère

International audienc

Draining and salting as responsible key steps in the generation of the acid-forming potential of cheese: Application to a soft blue-veined cheese

International audienc

Calcium lactate as an attractive compound to partly replace salt in blue-veined cheese

International audienceIn addition to their high sodium content, cheeses are thought to induce an acid load to the body, which is associated with deleterious effects on consumers' health. Our objective was to explore the use of alkalinizing salts in partial substitution of NaCl to reduce both the sodium content and the acid-forming potential of cheese, without altering its sensory properties. Blue-veined cheeses were produced under industrial conditions, using brine salting followed by dry salting with a 4:1 (wt/ wt) mixture of calcium lactate: NaCl or calcium citrate: NaCl. Sodium chloride was used in 2 granulometries: coarse (control treatment) and fine, to obtain homogeneous mixtures with the organic salts. Cheeses were then ripened for 56 d. No major appearance defects were observed during ripening. Calcium lactate substitution decreased the Na content of the cheese core by 33%, and calcium citrate substitution increased the citrate content of the cheese core by 410%, respectively, compared with fine NaCl. This study highlighted the substantial role of salt granulometry in sodium content, with the use of the coarse salt reducing the sodium content by 21% compared with fine salt. Sensory profiles showed nonsignificant differences in bitter and salty perceptions of salt-substituted cheeses with calcium lactate and calcium citrate compared with control cheeses. The use of calcium lactate should be considered to reduce the sodium content and improve the nutritional quality of cheeses while maintaining the sensory quality of the products. Alkalinizing organic salts could replace the acidifying salts KCl or CaCl 2 , which are currently used in salt replacement and are not recommended for consumers with renal disease. The method described here should be considered by cheese-making producers to improve the nutritional quality of cheese. Additional nutritional optimization strategies are suggested

Exploratory study of acid-forming potential of commercial cheeses: impact of cheese type

International audienceDue to their composition, cheeses are suspected to induce an acid load to the body. To better understand this nutritional feature, the acid-forming potential of five cheeses from different cheese-making technologies and two milk was evaluated on the basis of their potential renal acid load (PRAL) index (considering protein, P, Cl, Na, K, Mg and Ca contents) and organic anions contents. PRAL index ranged from -0.8 mEq/100g edible portion for fresh cheese to 25.3 mEq/100g for hard cheese Cantal and 28 mEq/100g for blue-veined cheese Fourme d'Ambert. PRAL values were greatly subjected to interbatch fluctuations. This work emphasized a great imbalance between acidifying elements of PRAL calculation (Cl, P and proteins elements) and alkalinizing ones (Na and Ca). Particularly, Cl followed by P elements had a strong impact on the PRAL value. Hard cheeses were rich in lactate, thus, might be less acidifying than suspected by their PRAL values only