Identification and Management of Statin-Associated Symptoms in Clinical Practice : Extension of a Clinician Survey to 12 Further Countries

Statins are the first-choice pharmacological treatment for patients with hypercholesterolemia and at risk for cardiovascular disease; however, a minority of patients experience statin-associated symptoms (SAS) and are considered to have reduced statin tolerance. The objective of this study was to establish how patients with SAS are identified and managed in clinical practice in Austria, Belgium, Colombia, Croatia, the Czech Republic, Denmark, Portugal, Switzerland, Russia, Saudi Arabia, Turkey, and the United Arab Emirates. A cross-sectional survey was conducted (2015-2016) among clinicians (n = 60 per country; Croatia: n = 30) who are specialized/experienced in the treatment of hypercholesterolemia. Participants were asked about their experience of patients presenting with potential SAS and how such patients were identified and treated. Muscle-related symptoms were the most common presentation of potential SAS (average: 51%; range across countries [RAC] 17-74%); other signs/symptoms included persistent elevation in transaminases. To establish whether symptoms are due to statins, clinicians required rechallenge after discontinuation of statin treatment (average: 77%; RAC 40-90%); other requirements included trying at least one alternative statin. Clinicians reported that half of high-risk patients with confirmed SAS receive a lower-dose statin (average: 53%; RAC 43-72%), and that most receive another non-statin lipid-lowering therapy with or without a concomitant statin (average: 65%; RAC 52-83%). The specialists and GPs surveyed use stringent criteria to establish causality between statin use and signs or symptoms, and persevere with statin treatment where possible

Fats From Chemically Interesterified High-oleic Sunflower Oil And Fully Hydrogenated Palm Oil

Chemical interesterification of different lipid materials has considerable potential for the production of a wide variety of special fats with improved functional and nutritional properties. The present study aimed to evaluate the chemical interesterification of blends of high-oleic sunflower oil (HOSO) and fully hydrogenated palm oil (FHPO) in the ratios (% w/w) of 80:20, 70:30, 60:40 and 50:50. The blends were characterized in triacylglycerol composition, melting point, solid fat content and crystallization behavior, and some applications in food products were suggested. The interesterification altered the solid fat content, melting point and crystallization isotherm of the samples, after the levels of trisaturated triacylglycerols decreased and disaturated- monounsaturated and monosaturated-diunsaturated triacylglycerol contents increased, due to the randomization of fatty acids. The modification in the triacylglycerol composition promoted greater miscibility between the HOSO and FHPO fractions, creating new application possibilities for the food industry. © 2014 AOCS.915859866Sreenivasan, B., Interesterification of fats (1978) J Am Oil Chem Soc, 55, pp. 796-805. , 10.1007/BF02682651Konishi, H., Neff, W.E., Mounts, T.L., Chemical interesterification with regioselectivity for edible oils (1993) J Am Oil Chem Soc, 70, pp. 411-415. , 10.1007/BF02552716Wainwright, B., Specialty fats and oils (2000) Introduction to Fats and Oils Technology, pp. 505-511. , R.D. O'Brien W.E. Farr J. Wan (eds) AOCS Press ChampaignDijkstra, A.J., Edible oil processing, quo vadis (2004) Eur J Lipid Sci Tech, 106, pp. 77-78. , 10.1002/ejlt.200490011Scrimgeour, C.M., Harwood, J.L., Fatty acid and lipid structure (2007) The Lipid Handbook, pp. 1-36. , F.D. Gunstone J.L. Harwood A.J. Dijkstra (eds) Taylor & Francis Group Boca RatonNor Aini, I., Miskandar, M.S., Utilization of palm oil and palm products in shortenings and margarines (2007) Eur J Lipid Sci Tech, 109, pp. 422-432. , 10.1002/ejlt.200600232Mayamol, P.N., Balachandran, C., Samuel, T., Sundaresan, A., Arumughan, C., Zero trans shortening using rice bran oil, palm oil and palm stearin through interesterification at pilot scale (2009) Int J Food Sci Tech, 44, pp. 18-28. , 10.1111/j.1365-2621.2008.01627.xAshton, E.L., Best, J.D., Ball, M.J., Effects of monosaturated enriched sunflower oil on the CHD risk factors including LDL size and copper-induced LDL oxidation (2001) J Am Coll Nutr, 20, pp. 320-326. , 10.1080/07315724.2001.10719052Ahmadi, L., Marangoni, A.G., Functionality and physical properties of interesterified high oleic shortening structured with stearic acid (2009) Food Chem, 117, pp. 668-673. , 10.1016/j.foodchem.2009.04.072Dian, N., Sundram, K., Idris, N.A., Effect of chemical interesterification on triacylglycerol and solid fat contents of palm stearin, sunflower oil and palm kernel olein blends (2007) Eur J Lipid Sci Tech, 109, pp. 147-156. , 10.1002/ejlt.200600198Lida, H., Sundram, K., Siew, W.L., Aminah, A., Mamot, S., TAG composition and solid fat content of palm oil, sunflower oil, and palm kernel olein blends before and after chemical interesterification (2002) J Am Oil Chem Soc, 79, pp. 1137-1144. , 10.1007/s11746-002-0617-0Grimaldi, R., Gonçalves, L.A.G., Ando, M.Y., Optimization of chemical interesterification of palm oil - (in Portuguese) (2005) Quim Nova, 28, pp. 633-636. , 10.1590/S0100-40422005000400015(2009) Official Methods and Recommended Practices of the American Oil Chemists' Society, , AOCS AOCS ChampaignHartman, L., Lago, R.C., Rapid preparation of fatty acid methyl esters from lipids (1973) Lab Pract, 22, pp. 475-476Antoniosi Filho, N.R., Mendes, O.L., Lanças, F.M., Computer prediction of triacylglycerol composition of vegetable oils by HRGC (1995) Chromatographia, 40, pp. 557-562. , 10.1007/BF02290268Braipson-Danthine, S., Deroanne, C., Determination of solid fat content (SFC) of binary fat blends and use of these data to predict SFC of selected ternary fat blends containing low-erucic rapeseed oil (2006) J Am Oil Chem Soc, 83, pp. 571-581. , 10.1007/s11746-006-1242-7Ribeiro, A.P.B., Grimaldi, R., Gioielli, L.A., Gonçalves, L.A.G., Zero trans fats from soybean oil and fully hydrogenated soybean oil: Physico-chemical properties and food applications (2009) Food Res Int, 42, pp. 401-410. , 10.1016/j.foodres.2009.01.012Karabulut, I., Turan, S., Ergin, G., Effects of chemical interesterification on solid fat content and slip melting point of fat/oil blends (2004) Eur Food Res Tech, 218, pp. 224-229. , 10.1007/s00217-003-0847-4Ribeiro, A.P.B., Masuchi, M.H., Grimaldi, R., Gonçalves, L.A.G., Chemical interesterification of soybean oil and fully hydrogenated soybean oil: Influence of the reaction time - (in Portuguese) (2009) Quim Nova, 32, pp. 939-945. , 10.1590/S0100-40422009000400021Farmani, J., Hamedi, M., Safari, M., Madadlou, A., Trans-free Iranian vanaspati through enzymatic and chemical transesterification of triple blends of fully hydrogenated soybean, rapeseed and sunflower oils (2007) Food Chem, 102, pp. 827-833. , 10.1016/j.foodchem.2006.06.015Campos, R., Experimental methodology (2005) Fat Crystal Networks, pp. 267-349. , A.G. Marangoni (eds) Marcel Dekker New York(2005) Regulamento Técnico Para Fixação de Identidade e Qualidade de Óleos e Gorduras Vegetais, , Brazil National Health Surveillance Agency (ANVISA - Agência Nacional de Vigilância Sanitária) Ministério da Saúde. Resolução RDC n° 270, de 22 de Setembro de 2005. Diário Oficial da União, BrasíliaO'Brien, R.D., (2004) Fats and Oils - Formulating and Processing for Applications, , 2 CRC Press New YorkSilva, R.C., Soares, D.F., Lourenço, M.B., Soares, F., Silva, K.G., Gonçalves, M.I.A., Gioielli, L.A., Structured lipids obtained by chemical interesterification of olive oil and palm stearin (2010) Food Sci Tech, 43, pp. 752-758Timms, R.E., Phase behaviour of fats and their mixtures (1984) Prog Lipid Res, 23, pp. 1-38. , 10.1016/0163-7827(84)90004-3Rousseau, D., Marangoni, A.G., The effects of interesterification on the physical properties of fats (2002) Physical Properties of Lipids, pp. 479-565. , A.G. Marangoni S.S. Narine (eds) CRC Press Boca RatonMetin, S., Hartel, R.W., Crystallization of fats and oils (2005) Bailey's Industrial Oil and Fat Products, pp. 45-76. , F. Shahidi (eds) Wiley Interscience New YorkSaberi, A.H., Lai, O.M., Toro-Vázquez, J.F., Crystallization kinetics of palm oil in blends with palm-based diacylglycerol (2011) Food Res Int, 44, pp. 425-435. , 10.1016/j.foodres.2010.09.029Smith, K.W., Bhaggan, K., Talbot, G., Van Malssen, K.F., Crystallization of fats: Influence of minor components and additives (2011) J Am Oil Chem Soc, 88, pp. 1085-1101. , 10.1007/s11746-011-1819-7Petrauskaite, V., De Greyt, W., Kellens, M., Huyghebaert, A., Physical and chemical properties of trans-free fats produced by chemical interesterification of vegetable oil blends (1998) J Am Oil Chem Soc, 75, pp. 489-493. , 10.1007/s11746-998-0252-zDijkstra, A.J., Modification processes and food uses (2007) The Lipid Handbook, pp. 263-353. , F.D. Gunstone J.L. Harwood A.J. Dijkstra (eds) CRC Press Boca RatonGhotra, B.S., Dyal, S.D., Narine, S.S., Lipid shortenings: A review (2002) Food Res Int, 35, pp. 1015-1104. , 10.1016/S0963-9969(02)00163-

Influência do período de alimentação no consumo e ganho de peso do pirarucu Influence of feeding period on consumption and weight gain of pirarucu

O objetivo deste trabalho foi verificar o período preferencial de consumo alimentar do pirarucu, Arapaima gigas, e a influência de diferentes turnos de alimentação no consumo e ganho de peso dessa espécie. Foram testados três tratamentos: alimentação diurna (peixes alimentados às 9h e 15h), alimentação noturna (peixes alimentados às 21h e 3h) e alimentação contínua (peixes alimentados às 9h, 15h, 21h e 3h). Cada tratamento foi avaliado em triplicata, com cada unidade experimental formada por oito peixes, com peso médio de 313 g, estocados em tanques-redes de 1 m³ (1x1x1 m). Os nove tanques-redes foram alocados em um viveiro escavado de 120 m². O experimento durou 60 dias. A alimentação contínua promoveu maiores ganhos de peso e biomassa, taxa de crescimento específico e consumo total. Os tratamentos alimentação diurna e alimentação noturna apresentaram ganho de peso semelhante, porém, a alimentação diurna apresentou a melhor conversão alimentar. O período preferencial de alimentação do pirarucu foi o noturno, principalmente no começo da noite. Os dados deste estudo indicam que o horário de preferência alimentar não é o melhor horário de alimentação do pirarucu, em uma criação comercial. O período de alimentação mais indicado para a espécie, baseado na capacidade de conversão alimentar, é o diurno.<br>The objective of this study was to verify pirarucu Arapaima gigas preferential time of feeding, and the influence of different feeding periods on consumption and weight gain of this species. Three treatments were tested: diurnal feeding (fish fed at 9h and 15h), nocturnal feeding (fish fed at 21h and 3h), and continuous feeding (fish fed at 9h, 15h, 21h and 3h). Each treatment was evaluated in triplicate, and each trial unit had eight fishes with 313 g average weight, stoked into a 1 m³ (1x1x1 m) net cage. The nine net cages were located on a 120 m² earth pond. The trial lasted for 60 days. Continuous feeding promoted the highest weight and biomass gain, specific growth rate and feed consumption. Nocturnal and diurnal feeding treatments showed similar weight gain; however, diurnal feeding had the best feed conversion ratio. The preferred feeding time for pirarucu was the nocturnal period, mainly at the beginning of night. Data from this study indicated that the preferred feeding time is not the best one for feeding pirarucu on a commercial husbandry. The most indicated feeding period for this species, based on its feed conversion capacity, is diurnal period

Lisina digestível para frangos de corte machos entre 12 e 22 dias de idade

Avaliou-se nível de lisina digestível para 1050 frangos de corte dos 12 aos 22 dias de idade. O delineamento experimental foi inteiramente ao acaso, com cinco tratamentos, sete repetições e 30 aves por unidade experimental. Os tratamentos foram: 1,05; 1,10; 1,15; 1,20 e 1,25% de lisina digestível. Avaliaram-se ganho de peso, consumo de ração, conversão alimentar, composição e deposição de nutrientes corporais. Foram constatados efeitos quadráticos de lisina digestível no consumo de ração e resposta linear ascendente no peso da carcaça. Na composição química da carcaça, houve resposta quadrática do nível de lisina na concentração de proteína. As taxas de deposição proteica, deposição de água, da carcaça e do corpo total tiveram aumento linear em resposta ao acréscimo de lisina na dieta. O aumento da concentração de lisina, todavia, coincidiu com a redução da matéria mineral nas vísceras e sangue e no corpo total. Considerado o desempenho, o nível 1,1% de lisina digestível atendeu às necessidades do frango de corte entre o 12º e o 22º dia de idade. Consideradas a composição química e as taxas de deposição dos nutrientes corporais, a demanda pelo aminoácido digestível torna-se igual ou maior que 1,25

Listeria spp. no processamento de lingüiça frescal em frigoríficos de Pelotas, RS, Brasil Listeria spp. in the processing of fresh sausages in slaughterhou ses from Pelotas, RS, Brazil

Alimentos intensamente manipulados, como as lingüiças mistas do tipo frescal são freqüentemente responsáveis pela veiculação de enfermidades transmitidas por alimentos. Devido ao risco à saúde pública que a bactéria Listeria monocytogenes representa, este trabalho teve como objetivo estudar a presença de Listeria spp., em especial de L. monocytogenes, durante o processamento de lingüiças mistas do tipo frescal, em três frigoríficos com inspeção sanitária estadual, em Pelotas-RS. Para isso, analisou-se a matéria-prima utilizada no preparo da lingüiça, os equipamentos da linha de processamento e o produto final. Isolou-se Listeria spp. em 100% das 41 amostras analisadas, nos 3 estabelecimentos estudados. Dentre as diferentes espécies, L. innocua foi aquela isolada com maior freqüência, em 97,6% das amostras, seguida por L. monocytogenes em 29,3% e L. welshimeri em 24,4%. A presença destes microrganismos nas amostras analisadas, em especial no produto final, demonstra a necessidade de readequação nas práticas de limpeza e sanificação das plantas de processamento analisadas, bem como representa risco potencial de listeriose ao consumidor.<br>Food that is highly manipulated, such as fresh sausages, is frequently responsible for spreading food borne diseases. Due to the threat that the bacterium Listeria monocytogenes represents to public health, the aim of this work was to study the presence of Listeria spp., especially Listeria monocytogenes, during processing of fresh sausages, in three slaughterhouses with state food inspection, in the city of Pelotas, Brazil. The raw material used for the sausage elaboration, the equipment used in the processing and the end products were analyzed. The results showed Listeria spp. in 100% of the 41 samples analyzed. Among the different species, L. innocua was the most frequent, isolated from 97.6% of the samples, followed by the L. monocytogenes and L. welshimeri that were isolated from 29.3% and 24.4% of the samples, respectively. The presence of these microorganisms in the samples analyzed, especially in the end product, shows the need for adequateness of the cleaning and sanitation practices of the food processing plants analyzed. It also shows a potential risk of listeriosis to the consumer