Estimation of buffalo cheese yield by using the chemical-physical parameters of the milk

The aim of this study was to estimate cheese yield by using the chemical- physical parameters of the milk. Analysis were performed on 325 milk samples with 80-219 days in milk interval. Furthermore, buffaloes which showed a ratio between theoretical cheese yield (calculated by Altiero formula) and real cheese yield at 28 hours higher (Group A) or lower (Group B) than 0.983, were compared taking into account 5 hypothetical analytical potentialities of laboratories: 1) Fat percentage; 2) Protein and fat percentages; 3) Protein and fat percentages, pH and SH; 4) Protein and fat percentages, pH, SH, urea, protein percentage corrected per urea, lactose, solids-not-fat (SNF) and SCC; 5) Protein and fat percentages, pH, SH, urea, protein percentage corrected per urea, lactose, SNF, SCC, TAMF, milk DM percentage, ash percentage and casein percentage. Correlation and regression analyses with stepwise method were performed for curd quantity in relation to the physic-chemical ad microbiological milk composition by using SPSS 15.0. As expected, R2 value was such high as the number of variables included in the calculation. A higher R2 value was observed in those samples characterized by a ThCY/28CY ratio < 0.983. ThCY calculated according to Altiero et al (1989), underestimated 28CY of +1.8 g/litre in all samples, whereas a difference between –2.2 (Laboratory 2) and +1.0 (Laboratory 3) g/litre was registered if the actual formula is utilized. According to Altiero formula, 28CY was overestimated of 9.6 g/litre in Group A, whereas it was underestimated of 1.8 g/litre in Group B. According to our study, the estimation of 28CY showed a difference between –9.3 (Laboratory 2) and 9 (Laboratory 1) g/litre in Group A and – 3.5 (Laboratory 1) e 0.0 (Laboratory 5) g/litre

Correction of the ratio between real cheese yield at 28 hours and protein according to chemical composition of buffalo milk

The aim of this study was to verify the ratio between real cheese yield at 28 hours and proteins, after values correction according to the regression analysis. Milk characteristics of subjects characterized by a 28CY/protein ratio lower (Group A; n=212) or higher (Group B; n=108) than 56 were analysed by ANOVA in order to evaluate differences between the following milk characteristics: the lactodinamographic parameters (Formagraph, Foss, DN); the complete physic-chemical composition; fat (F), protein (P), casein, lactose, ash, urea, pH and SH; the somatic cells content (SCC) using (Milkoskan); the total aerobic mesophilic flora (TAMF) by the dilution method. Chemical composition of the curd was also determined (protein, fat and ash; ASPA, 1995). The milk protein content was adjusted for the non proteic N content determined in milk as urea (corrected P); the theoretic cheese yield (ThCY) was obtained by the following formula: cheese yield =milk x[-0.88 + 3.50 x P(%)+1.23 x F(%)] x 100 -1 (Altiero et al., 1989) and the ratio between ThCY/FCY and ThCY/28CY were calculated. Other calculated variables were: FCY/Corrected P, 28CY/Corrected P, CDM/Corrected P. Regression analysis was carried out between real cheese yield at 28 hours/proteins ratio and 28CY vs. all the parameters resulted different between the two groups of buffaloes. Real cheese yield at 28 hours/proteins ratio and 28CY were corrected and ANOVA was repeated on corrected data, in order to verify the modifications of the values. These correction reduced but did not eliminate the differences

Outcome of transcatheter aortic valve replacement in bicuspid aortic valve stenosis with new-generation devices

OBJECTIVES: To compare device success and paravalvular leak rates of 3 new-generation transcatheter aortic valve replacement devices in patients with bicuspid aortic valve stenosis and to test their biomechanical performance in a computer-based simulation model of aortic root with increasing ellipticity. METHODS: This retrospective multicentre study included 56 bicuspid aortic valve patients undergoing transcatheter aortic valve replacement with new-generation devices: Lotus/Lotus Edge (N = 15; 27%), Evolut-R (N = 20; 36%) and ACURATE neo (N = 21; 37%). Three virtual simulation models of aortic root with increasing index of eccentricity (0-0.25-0.5) were implemented. Stress distribution, stent-root contact area and paravalvular orifice area were computed. RESULTS: Device success was achieved in 43/56 patients (77%) with comparable rates among Lotus (87%), Evolut-R (60%) and ACURATE neo (86%; P = 0.085). Moderate paravalvular leak rate was significantly lower in the Lotus group as compared to Evolut-R group (0% vs 30%; P = 0.027) and comparable to the ACURATE neo group (0% vs 10%; P = 0.33). By index of eccentricity = 0.5, Lotus showed a uniform and symmetric pattern of stress distribution with absent paravalvular orifice area, ACURATE neo showed a mild asymmetry with small paravalvular orifice area (1.1 mm2), whereas a severely asymmetric pattern was evident with Evolut-R, resulting in a large paravalvular orifice area (12.0 mm2). CONCLUSIONS: Transcatheter aortic valve replacement in bicuspid aortic valve patients with new-generation devices showed comparable device success rates. Lotus showed moderate paravalvular leak rate comparable to that of ACURATE neo and significantly lower than Evolut-R. On simulation, Lotus and ACURATE neo showed optimal adaptability to elliptic anatomies as compared to Evolut-R

Prediction of mortality and heart failure hospitalisations in patients undergoing M-TEER: external validation of the COAPT risk score

Background: A risk score was recently derived from the Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation (COAPT) Trial. However, external validation of this score is still lacking. Aims: We aimed to validate the COAPT risk score in a large multicentre population undergoing mitral transcatheter edge-to-edge repair (M-TEER) for secondary mitral regurgitation (SMR). Methods: The Italian Society of Interventional Cardiology (GIse) Registry of Transcatheter Treatment of Mitral Valve RegurgitaTiOn (GIOTTO) population was stratified according to COAPT score quartiles. The performance of the COAPT score for 2-year all-cause death or heart failure (HF) hospitalisation was evaluated in the overall population and in patients with or without a COAPT-like profile. Results: Among the 1,659 patients included in the GIOTTO registry, 934 had SMR and complete data for a COAPT risk score calculation. Incidence of 2-year all-cause death or HF hospitalisation progressively increased through the COAPT score quartiles in the overall population (26.4% vs 44.5% vs 49.4% vs 59.7%; log-rank p<0.001) and COAPT-like patients (24.7% vs 32.4% vs 52.3% vs. 53.4%; log-rank p=0.004), but not in those with a non-COAPT-like profile. The COAPT risk score had poor discrimination and good calibration in the overall population, moderate discrimination and good calibration in COAPT-like patients and very poor discrimination and poor calibration in non-COAPT-like patients. Conclusions: The COAPT risk score has a poor performance in the prognostic stratification of real-world patients undergoing M-TEER. However, after application to patients with a COAPT-like profile, moderate discrimination and good calibration were observed

Transcatheter Aortic Valve Replacement for Degenerated Transcatheter Aortic Valves: The TRANSIT International Project

Background: Transcatheter aortic valve replacement (TAVR) has determined a paradigm shift in the treatment of patients with severe aortic stenosis. However, the durability of bioprostheses is still a matter of concern, and little is known about the management of degenerated TAV. We sought to evaluate the outcomes of patients with a degenerated TAV treated by means of a second TAVR. Methods: The TRANSIT is an international registry that included cases of degenerated TAVR from 28 centers. Among around 40 000 patients treated with TAVR in the participating centers, 172 underwent a second TAVR: 57 (33%) for a mainly stenotic degenerated TAV, 97 (56%) for a mainly regurgitant TAV, and 18 (11%) for a combined degeneration. Overall, the rate of New York Heart Association class III/IV at presentation was 73.5%. Results: Valve Academic Research Consortium 2 device success rate was 79%, as a consequence of residual gradient (14%) or regurgitation (7%). At 1 month, the overall mortality rate was 2.9%, while rates of new hospitalization and New York Heart Association class III/IV were 3.6% and 7%, respectively, without significant difference across the groups. At 1 year, the overall mortality rate was 10%, while rates of new hospitalization and New York Heart Association class III/IV were 7.6% and 5.8%, respectively, without significant difference across the groups. No cases of valve thrombosis were recorded. Conclusions: Selected patients with a degenerated TAV may be safely and successfully treated by means of a second TAVR. This finding is of crucial importance for the adoption of the TAVR technology in a lower risk and younger population