Physical, Chemical and Sensory Properties of Baked Products from Blends of Wheat and African Yam Bean (Sphenostylis stenocarpa) Water-Extractable Proteins

ABSTRACTBlends of wheat flour (WF) and African yam bean water-extractable proteins (AYBWEP) were processed into bread and cookies in the following ratios: 100: 0; 95: 5; 90: 10; 85: 15; 80: 20. The proximate composition, physical, chemical properties and sensory properties of bread and cookies samples from the blends were determined. Breads and cookies produced from the resultant blends were significantly higher (p<0.05) in protein (16.39% – 18.36%) than the control (11.80% – 12.58%). Carbohydrate content decreased from 60.74% with addition of AYBWEP to 52.81% following 20% substitution. The pH of bread samples prepared from whole wheat flour and blends of wheat flour and AYBWEP were significantly different (p<0.05) while bulk density and specific volume were not significantly different (p>0.05). The pH of bread samples and cookies decreased with increase in the proportion of the AYBWEP blend from 5% to 20%. The highest specific volume (3.70ml/g) was observed in bread samples prepared from the control 100: 0 blends while the 80:20 blends had the lowest specific volume (3.10ml/g). There was no significant difference (p>0.05) in the bulk density and thickness of the cookies. The cookies prepared using 80: 20 blends had the higher diameter (22.53cm) and spread factor (54.03cm) compared to the control. Generally, acceptability of the bread and cookies decreased with higher ratios of AYBWEP inclusion. The sensory acceptability scores showed the best AYBWEP substitution level for making bread and cookies was 5% and 10% of the AYBWEP respectively. The results are discussed in the context of the growing importance of promoting the processing and utilization of lesser known local crops in baked products.enrichment

Thrombogenicity and Reoperation of the St. Jude Medical Silzone (R) valve:A comparison with the conventional St. Jude medical valve

Background and aim of the study: The St. Jude Medical Silzone(R) valve was withdrawn from the market after an interim analysis of the AVERT study revealed a 2.76% incidence of paravalvar leakage leading to valve re-replacement, compared with only 1.02% in the control group. Additionally, an increased risk for thromboembolic complications was reported in different series of patients. Methods: To monitor the consistency of these reports, the incidence of thromboembolic complications and paravalvar leakage was investigated in 113 patients who received a Silzone valve at the authors' institution, compared with 101 patients who, immediately prior to the Silzone group, received a conventional valve. Results: No difference was found in the incidence of either thromboembolism or paravalvar leakage after either Silzone or conventional valve replacement. Conclusion: Differences between the AVERT study and the present study might reflect differences in operative technique or in patient groups, but this as yet is unknown. To clarify the prospects of the estimated 36,000 patients with Silzone valves world wide, further research should aim at identifying possible unique features of patient groups with a higher risk of paravalvar leakage leading to valve explantation. In brief, an increased rate of paravalvar leakage and/or thromboembolism does not apply to either valve replacement groups

Individual time within target range in patients treated with vitamin K antagonists:main determinant of quality of anticoagulation and predictor of clinical outcome. A retrospective study of 2300 consecutive patients with venous thromboembolism

The efficacy and safety of vitamin K antagonists (VKA) are related to the actual level of anticoagulation (given as the international normalized ratio, INR). It is often difficult to maintain an optimal INR over time. We assessed the clinical impact of the individual time spent within INR target range (ITTR) in 2304 consecutive patients with venous thromboembolism. Annual incidences of recurrent thromboembolism and major bleeding were 6.2% and 2.8% respectively. The relative risk (RR) of thromboembolism was 4.5 [95% confidence interval (CI) 3.1-6.6, P &lt;0.001] at INR &lt;2.0, for major bleeding it was 6.4 (2.5-16.1, P &lt;0.001) at INR &gt; 5.0, compared with INR 2.0-3.0. Patients with ITTR &lt;45% were at higher risk than those with ITTR &gt; 65% (RR 2.8, 1.9-4.3, P &lt;0.001), while no difference was demonstrated comparing ITTR 45-65% and ITTR &gt; 65% (RR 1.2, 0.7-1.8, P = 0.54). Annual incidences of recurrent thromboembolism were 16.0%, 4.9% and 4.6% at ITTR &lt;45%, 45-60% and &gt;65% respectively. For major bleeding these were 8.7%, 2.1% and 1.9% respectively. ITTR &lt;37% during the first 30 treatment days was highly predictive for the total treatment time ITTR &lt;45% (RR 24.2, 13.5-43.1, P &lt;0.001). In conclusion, ITTR can be used to identify patients on VKA at risk of recurrent thromboembolism or major bleeding. Since the 30-d ITTR is highly predictive for total treatment ITTR, these patients can be identified soon after start of treatment.</p

Individual time within target range in patients treated with vitamin K antagonists:main determinant of quality of anticoagulation and predictor of clinical outcome. A retrospective study of 2300 consecutive patients with venous thromboembolism

The efficacy and safety of vitamin K antagonists (VKA) are related to the actual level of anticoagulation (given as the international normalized ratio, INR). It is often difficult to maintain an optimal INR over time. We assessed the clinical impact of the individual time spent within INR target range (ITTR) in 2304 consecutive patients with venous thromboembolism. Annual incidences of recurrent thromboembolism and major bleeding were 6.2% and 2.8% respectively. The relative risk (RR) of thromboembolism was 4.5 [95% confidence interval (CI) 3.1-6.6, P 5.0, compared with INR 2.0-3.0. Patients with ITTR 65% (RR 2.8, 1.9-4.3, P 65% (RR 1.2, 0.7-1.8, P = 0.54). Annual incidences of recurrent thromboembolism were 16.0%, 4.9% and 4.6% at ITTR 65% respectively. For major bleeding these were 8.7%, 2.1% and 1.9% respectively. ITTR <37% during the first 30 treatment days was highly predictive for the total treatment time ITTR <45% (RR 24.2, 13.5-43.1, P <0.001). In conclusion, ITTR can be used to identify patients on VKA at risk of recurrent thromboembolism or major bleeding. Since the 30-d ITTR is highly predictive for total treatment ITTR, these patients can be identified soon after start of treatment

Exercise-induced ischemia after successful percutaneous coronary intervention is related to distal coronary endothelial dysfunction

Background: As endothelial dysfunction can be responsible for myocardial ischemia even in the absence of significant coronary lesions, we aimed to assess the correlation between endotheliumdependent vasomotor function and inducible ischemia late after successful coronary angioplasty. Methods: In 30 patients without angiographic restenosis or coronary disease progression, coronary endothelial function was determined by acetylcholine infusion 6 months after elective singlevessel stenting of the left coronary artery. Acetylcholine-induced diameter changes were assessed in the proximal and distal segments of both the stented and the contralateral vessels by means of quantitative coronary angiography. A maximal workload ergometric test was also performed prior to endothelial function testing. Results: Acetylcholine induced significant vasoconstrictive responses in the distal but not in the proximal segments of both the stented (-11 +/- 7% versus baseline; p <.01) and the contralateral vessels (-11 +/- 6%; p <.01), which were significantly correlated (R = .48; p <.05) and were completely reverted by nitroglycerine. Inducible ischemia was the only predictive factor for distal vasoconstriction in the stented vessel (p <.01) but not in the contralateral vessel (p = .06). Patients with minor signs of ischemia at the ergometric test showed a greater vasoconstriction than those with a completely normal test (-16 +/- 7% versus -7 +/- 6%; p <.01). Conclusions: Exercise-induced ischemia late after successful percutaneous coronary intervention is related to distal coronary endothelial dysfunction