Development, characterization, and stability of O/W pepper nanoemulsions produced by high-pressure homogenization

Interest in the utilization of bioactive plant compounds in foods has increased due to their biochemical activities (antioxidant, antimicrobial, etc.), and as alternatives in the reduction of the use of high concentrations of chemical substances. However, some of these additives are hydrophobic, thus being harder to disperse into the food matrix, which is generally water-based. A good alternative is the use of low concentrations of these compounds as nanoemulsions. The objective of the present study was to develop oil-in-water nanoemulsions containing dedo-de-moça pepper extract for food applications. Research in the development of these nanoemulsions was carried out using a high-speed homogenizer, followed by a high-pressure homogenizer. The influence of the following parameters was assessed: type and concentration of surfactants, hidrophilic-lipophilic balance, lipid/aqueous phase ratio, surfactant/oil ratio, pepper extract composition in nanoemulsion, and processing conditions. Nanoemulsions were evaluated by environmental (centrifugal and thermal) and storage stabilities, characterized by average droplet size and -potential measurements, color, interfacial tension, atomic force, and cryo-scanning electron microscopy. Those with average droplet size between 132 ± 2.0 and 145 ± 1.0 nm were developed depending on working pressure and number of cycles; -potential was around 36.71 ± 0.62 mV and the best nanoemulsion was stable to centrifugation and most of the thermal stresses. Droplets were characterized with cryo-scanning electron microscopy as being spherical, homogeneous, and stable, and remained stable when stored at 4 °C and room temperature for over 120 days. The pepper nanoemulsion, developed in the present study, has potential applications in the food industry.The first author gratefully acknowledges the CNPq and CAPES (National Council for Scientific and Technological Development, Program Science without Boarder) for the BSWE^ PhD (Process 236877/2012-1) fellowship, and CAPES for the national PhD fellowship. The last author acknowledges the São Paulo Research Foundation (FAPESP) Brazil, for the grant (CEPID-FoRC, 2013/07914-8).info:eu-repo/semantics/publishedVersio

The appropriate troponin T level associated with coronary occlusions in chronic kidney disease patients

Yuwares Sittichanbuncha,1 Pungkava Sricharoen,1 Panvilai Tangkulpanich,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, 2Department of Medicine, Faculty of Medicine, 3Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand Background: High-sensitivity troponin T (HS Trop T) plays an important role as a diagnostic marker for acute coronary syndrome. It is also related to cardiovascular outcomes. HS Trop T levels may be varied in individuals with renal dysfunction. This study aimed to find the appropriate HS Trop T cutoff points in chronic kidney disease (CKD) patients who had coronary artery occlusion. Patients and methods: The study was conducted at the Emergency Department, Ramathibodi Hospital, Mahidol University, Thailand. CKD patients stage 3–5 who had HS Trop T levels after 2 hours of chest pain and had coronary angiographic results were enrolled. Patients were divided into two groups: those who had significant occlusion of more than 70% of a coronary artery as the coronary artery disease (CAD) group and the non-CAD group. Results: In total, 210 patients met the study criteria. There were 132 patients (62.86%) who had significant stenosis of coronary arteries by coronary angiograms. The average age (standard deviation) of all patients was 71.02 (9.49) years. HS Trop T levels were significantly higher in all CKD patients with CAD than the non-CAD group (0.4973 versus 0.0384 ng/mL). Sex and HS Trop T levels were significantly associated with CAD by multivariate logistic regression analysis. The HS Trop T level of 0.041 ng/mL gave sensitivity and specificity of 65.91% and 75.65%, respectively, for CAD. Conclusion: The HS Trop T level of 0.041 ng/mL provided diagnostic properties for established coronary artery occlusion in CKD patients. Keywords: high-sensitivity troponin T, acute coronary syndrome, coronary artery occlusion, chronic kidney disease, sensitivity, specificity, coronary angiogra

Teaching emergency medicine with workshops improved medical student satisfaction in emergency medicine education

Pungkava Sricharoen,1 Chaiyaporn Yuksen,1 Yuwares Sittichanbuncha,1 Kittisak Sawanyawisuth2,3 1Department of Emergency Medicine, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand; 2Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand; 3The Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen, Thailand Background: There are different teaching methods; such as traditional lectures, bedside teaching, and workshops for clinical medical clerkships. Each method has advantages and disadvantages in different situations. Emergency Medicine (EM) focuses on emergency medical conditions and deals with several emergency procedures. This study aimed to compare traditional teaching methods with teaching methods involving workshops in the EM setting for medical students. Methods: Fifth year medical students (academic year of 2010) at Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand participated in the study. Half of students received traditional teaching, including lectures and bedside teaching, while the other half received traditional teaching plus three workshops, namely, airway workshop, trauma workshop, and emergency medical services workshop. Student evaluations at the end of the clerkship were recorded. The evaluation form included overall satisfaction, satisfaction in overall teaching methods, and satisfaction in each teaching method. Results: During the academic year 2010, there were 189 students who attended the EM rotation. Of those, 77 students (40.74%) were in the traditional EM curriculum, while 112 students were in the new EM curriculum. The average satisfaction score in teaching method of the new EM curriculum group was higher than the traditional EM curriculum group (4.54 versus 4.07, P-value <0.001). The top three highest average satisfaction scores in the new EM curriculum group were trauma workshop, bedside teaching, and emergency medical services workshop. The mean (standard deviation) satisfaction scores of those three teaching methods were 4.70 (0.50), 4.63 (0.58), and 4.60 (0.55), respectively. Conclusion: Teaching EM with workshops improved student satisfaction in EM education for medical students. Keywords: emergency medicine education, workshop, student satisfactio

Delirium after a traumatic brain injury: predictors and symptom patterns

Jutaporn Maneewong,1 Benchalak Maneeton,1 Narong Maneeton,1 Tanat Vaniyapong,2 Patrinee Traisathit,3 Natthanidnan Sricharoen,3 Manit Srisurapanont1 1Department of Psychiatry, 2Department of Surgery, Faculty of Medicine, 3Department of Statistics, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand Background: Delirium in traumatic brain injury (TBI) is common, may be predictable, and has a multifaceted symptom complex. This study aimed to examine: 1) the sum score of Glasgow Coma Scale (GCS) and if its component scores could predict delirium in TBI patients, and 2) the prominent symptoms and their courses over the first days after TBI. Methods: TBI patients were recruited from neurosurgical ward inpatients. All participants were hospitalized within 24 hours after their TBI. Apart from the sum score of GCS, which was obtained at the emergency department (ED), the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, diagnostic criteria for delirium were applied daily. The severity of delirium symptoms was assessed daily using the Delirium Rating Scale – Revised-98 (DRS-R-98). Results: The participants were 54 TBI patients with a mean GCS score of 12.7 (standard deviation [SD] =2.9). A total of 25 patients (46.3%) met the diagnosis of delirium and had a mean age of 36.7 years (SD =14.8). Compared with 29 non-delirious patients, 25 delirious patients had a significantly lower mean GCS score (P=0.04), especially a significantly lower verbal component score (P=0.03). Among 18 delirious patients, four symptoms of the DRS-R-98 cognitive domain (orientation, attention, long-term memory, and visuospatial ability) were moderate symptoms (score ≥2) at the first day of admission. After follow-up, three cognitive (orientation, attention, and visuospatial ability) and two noncognitive symptoms (lability of affect and motor agitation) rapidly resolved. Conclusion: Almost half of patients with mild to moderate head injuries may develop delirium in the first 4 days after TBI. Those having a low GCS score, especially the verbal component score, at the ED were likely to have delirium in this period. Most cognitive domains of delirium described in the DRS-R-98 were prominent within the first 4 days of TBI with delirium. Three cognitive and two noncognitive symptoms of delirium decreased significantly. Keywords: Delirium Rating Scale Revised-98, DRS-R-98, brain injuries, traumatic, noncognitive symptoms, cognitive symptoms, Glasgow Coma Scale scor

Screening of the most consumed beverages and spices for their bioactive non-nutrient contents

The present research emphasizes on the bioactive non-nutrient components of the frequently consumed food products daily. The most popular beverages (instant, filter and Turkish coffee, green, black, sage, apple, rosehip, linden and fennel tea infusions) and herbal spices (cinnamon thyme, cumin, mint, sweet pepper, chili pepper, sumac, black pepper and clove) were investigated to evaluate the antioxidant capacities of the samples. Amount of total biophenols (TB) and total flavonoids (TF) were measured by Folin-Ciocalteu and Aluminum chloride colorimetric methods, respectively. CUPRAC (The cupric ion reducing antioxidant capacity) assay and DPPH (, -diphenyl--picrylhydrazyl) free radical scavenging method were applied to determine the antioxidant activity (AA) of the products. Antimicrobial analyses of the samples were also conducted based on in vitro study. Furthermore, the main biophenol of each sample was identified through high performance liquid chromatography (HPLC). The outcome of the present study will be a useful guidance for the researchers looking for the health benefits of these daily consumed food products