The Risk of Undeclared Allergens on Food Labels for Pediatric Patients in the European Union

The dietary avoidance of allergens has been widely recognized as the key intervention in the management of food allergies, but the presence of undeclared allergens makes compliance difficult. The aim of this study was to analyze the presence of undeclared allergens in food labeling through RASFF notifications in the European Union, focusing on those allergens that frequently affect the pediatric population and the implicated products, so as to provide useful information for its risk evaluation and the development of educational materials for patients. The results showed milk (20.5%), gluten (14.8%), and nuts (10.9%) to be the pediatric allergens with higher presences. In 80% of the notifications concerning milk and milk derivatives, the specific compound present (lactose or lactoprotein) was not identified. They were mainly present in cereal and bakery products, prepared dishes and snacks, and cacao and confectionery products, all of which are frequently consumed by the pediatric population. The large quantity (7.6%) of undeclared allergens in “free-from-allergen” products was also remarkable, especially in regard to the supposedly not-present allergens. Undeclared allergens in food products pose an evident risk for allergic patients and knowledge of them should take a relevant role in a patient’s nutritional education. It is also necessary to raise awareness among manufacturers and safety authorities. © 2022 by the authors. Licensee MDPI, Basel, Switzerland

How batter formulation can modify fried tempura-battered zucchini chemical and sensory characteristics?

Tempura-fried vegetables are widely consumed and are greatly appreciated because of their characteristic dry and crispy crust, flavor and a golden–brown color. This study examined the effect of slice thickness, frying time and partial ingredient substitution in tempura batter with maltodextrin, ethanol, baking powder and cornflour on the rheological characteristics, moisture, oil uptake, color, texture and sensory characteristics of tempura-fried zucchini. The results showed an improved golden–brown coloring of the crust without affecting oil uptake when maltodextrin was included in the batter formulation. Moreover, dough viscosity and % pick-up lowered with maltodextrin addition. The partial substitution of water and wheat flour with ethanol, cornflour and baking powder resulted in a crispier and rougher crust that remained more stable over time but with less moisture and higher oil uptake. The substitution of certain tempura batter ingredients depending on the desired purpose could represent an interesting strategy to improve the quality of battered fried vegetables

Comparación de los índices PROFUND y PALIAR en pacientes pluripatológicos con enfermedad crónica no oncológica en fase avanzada

Background and objective: To compare the discrimination power of PROFUND and PALIAR indexes for predicting mortality in polypathological patients with advanced non-oncologic chronic disease. Material and methods: Prospective multicentre cohort study. We included polypathological patients with advanced non-oncologic chronic disease, who were admitted to internal medicine departments between July 1 st and December 31th, 2014. Data was collected from each patient on age, sex, categories of polypathology, advanced disease, comorbidity, functional and cognitive assessment, terminal illness symptoms, need for caregiver, hospitalisation in the past three and 12 months and number of drugs. We calculated the PROFUND and PALIAR indexes and conducted a 12-month follow-up. We assessed mortality with the Kaplan-Meier survival curves and the discrimination of indexes with the ROC curves. Results: We included 213 patients with a mean (standard deviation) age of 83.0 (7.0) years, 106 (49.8%) of whom were female. Mortality at six months was 40.4% and at 12 months 50.2%. Deceased patients scored higher scores on the PROFUND [11.2(4.2) vs 8.5(3.9); P <.001] and PALIAR [6.7 (4.6) vs 3.6(3.1); p < 0, 001] indexes. The discrimination of PALIAR index at six months (under the curve area 0.734 95%CI 0.665-0.803) was higher than of PROFUND, and there was no difference at 12 months. Conclusions: In polypathological patients with advanced non-oncologic chronic disease, the PALIAR index had better discrimination power than PROFUND index at 66 months and there were no differences at 12 months

Differences in the pressures of canal anal and rectal sensitivity in patients with fecal incontinence, chronic constipation and healthy subjects Diferencias en las presiones del canal anal y la sensibilidad rectal en pacientes con incontinencia anal, estreñimiento crónico y sujetos sanos

Introduction: There exist a great variability in the manometric findings between patients with anal incontinence (AI) and healthy subjects. The correlation between the pressures of the anal canal and the AI is not exact by the wide rank of normal values. Objectives: Prospective study to evaluate differences in the pressures of the anal canal and in rectal sensitivity in patients with AI, chronic constipation (CC) and healthy subjects. Material and methods: Ninety four patients with AI, 36 patients with CC and 15 healthy subjects were included. The following data were obtained: age, sex, resting pressure, anal canal length (ACL), squeeze maximum pressure (SMP), squeeze pressure duration (SPD), first sensation, urge and maximum tolerated volume (MTV). Statistical study: test of Kruskal-Wallis, test of Mann-Whitney, and multinomial logistic regression test. Results: There were significant differences in the resting pressure (p Introducción: Existe gran variabilidad en los hallazgos manométricos entre pacientes con incontinencia anal (IA) y sujetos sanos. La correlación entre las presiones del canal anal y la IA no es exacta por el amplio rango de valores normales. Objetivos: Estudio prospectivo para evaluar diferencias en las presiones del canal anal y en la sensibilidad rectal en pacientes con IA, estreñimiento crónico (EC) y sujetos sanos. Material y métodos: Noventa y cuatro pacientes con IA, 36 pacientes con EC y 15 sujetos sanos. Se obtuvieron: edad, sexo, presión de reposo, longitud del canal anal (LCA), presión de máxima contracción voluntaria (PMCV), duración de la contracción voluntaria, primera sensación, sensación de urgencia y máximo volumen tolerado (MVT). Estudio estadístico: test de Kruskal-Wallis, test de Mann-Whitney, regresión logística multinomial. Resultados: Se encontraron diferencias significativas en la edad (p < 0,001), la presión de reposo (p < 0,001), la LCA (p < 0,001) y la PMCV (p < 0,01) en el grupo de IA con respecto a los otros dos grupos. El volumen para la primera sensación fue significativamente más bajo en los sujetos sanos que en los otros dos grupos (p < 0,05). El volumen de urgencia y el MVT fueron menores en el grupo con IA con respecto a los otros dos grupos (p < 0,001). En el análisis multivariante la edad, la presión de reposo y el volumen de la primera sensación y de la urgencia aumentan el riesgo relativo de IA. Conclusiones: La mayor edad, la disminución presión basal del canal anal y la alteración del umbral sensorial rectal aumentan el riesgo de IA

Protocolo de enfermería en la atención al paciente y familia al ingreso en la unidad coronaria

Introducción: El ingreso de un paciente en la Unidad Coronaria, supone un choque emocional inevitable, generando una situación de gran estrés. La elaboración de este protocolo surge de la necesidad de dar una respuesta adecuada a esta situación. Objetivo: Paliar los efectos negativos que producen el miedo, la ansiedad, y el estrés en el paciente y familia al ingreso en nuestra unidad, estableciendo unos criterios, y un marco de actuación de la Enfermería con identidad propia, que garantice la calidad en la asistencia, aumentando el desarrollo y la satisfacción del personal sanitario. Material y métodos: 1. Estudio descriptivo. Se incluyeron 562 pacientes entre Septiembre 2001 y Noviembre 2002. 2. Cuestionarios anónimos. 3. Programas informáticos. 4. Bibliografía. Resultados: Al aplicar el protocolo, observamos una reducción significativa en todas las variables que generan estrés al ingreso del paciente en nuestra unidad. Cabe destacar la disminución en un 57% de la inseguridad que manifiesta el enfermo, y la disminución en un 34.2% de su incomodidad. La disminución del estrés muy alto y alto fue del 40% y 33.3% respectivamente. La variable miedo fue la que menos se consiguió reducir (19.1%), probablemente por las connotaciones negativas asociadas a la palabra Infarto, cateterismo, etc. Este aspecto se trabajó durante el ingreso mediante un programa de Educación Sanitaria. Conclusiones: Con la implantación del protocolo, hemos disminuido el impacto emocional que genera al paciente y a su familia el ingreso en la Unidad Coronaria, creando un ambiente tranquilo, agradable, y aportando seguridad y confianza en la actuación de los profesionales de enfermería