Utjecaj dodatka srebrne pokožice zrna kave na in-vitro preživljavanje kefirne kulture tijekom skladištenja

Probiotic dairy products must contain a certain level of live probiotic microorganisms at the time of consumption. The number of live microorganisms in kefir culture, which is a mixture of different microorganisms, may change during storage due to various factors. In this study, the effects of adding a novel ingredient coffee bean membrane (CSS-coffee silverskin), on the viability of microorganisms contained in kefir culture were investigated. For this purpose, CSS obtained from 2 different coffee varieties (Arabica and Robusta) was added to kefir samples at 3 different concentrations (0.5, 0.75 and 1.0 %) at the beginning of fermentation. It was observed that especially the addition of CSS belonging to the Robusta variety significantly increased the viability of lactic acid bacteria (lactobacilli and lactococci) which accounted for 88-94.10 % and 82.37-92.44 % respectively. During the storage period of 28 days at 4 °C; it could be observed that kefir enrichment with CSS of both coffee varieties increased the viability of lactobacilli and lactococci after in-vitro digestion, depending on the rate of supplementation. Number of yeasts was decreased during the storage.Probiotički mliječni proizvodi moraju u trenutku konzumacije sadržavati određenu količinu živih probitičkih bakterija. Kefirna kultura sadrži različite vrste mikroorganizama čiji se broj, ovisno o brojnim čimbenicima, može mijenjati tijekom skladištenja. U ovom je istraživanju ispitivan utjecaj dodatka novog tipa funkcionalnog sastojka - srebrne pokožice zrna kave (eng. CSS, coffee silverskin) na raspoloživost mikroorganizama koji čine kefirnu kulturu. U tu svrhu je CSS dobiven iz dvije vrste kave (Arabica i Robusta) dodavan uzorcima kefira u tri različite koncentracije (0,5, 0,75 i 1,0 %) na početku procesa fermentacije. Utvrđeno je kako je prije svega dodatak CSS dobivenog od Robusta vrste značajno utjecao na preživljavanje bakterija mliječne kiseline (laktobacila i laktokoka) koja je iznosila 88,00-94.10 %, odnosno 82,37-92,44 %. Tijekom 28 dana skladištenja na 4 °C utvrđeno je kako obogaćivanje kefira s CSS dobivenim iz obje vrste kave povećava preživljavanje laktobacila i laktokoka u uvjetima in vitro probave, što je uvjetovano količinom dodatka. Također, broj plijesni padao je tijekom skladištenja

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

In vitro evaluation of the bioaccessibility of antioxidative properties in commercially baby foods

Fruit-vegetable based products are essential for infants as they widely used the first complementary solid foods. This study aimed to investigate the physicochemical properties, the antioxidant capacities, total phenolic content, and bioaccessibility of 24 different commercially fruit-vegetable based complementary foods. To determination of bioaccessibility, samples were processed by an in vitro digestive enzymatic extraction that mimics the conditions in the gastrointestinal tract. Total polyphenol content was analyzed using Folin-Ciocalteu assay, and antioxidant capacities were assessed by CUPRAC and ABTS methods. The total phenol content of the samples ranges from 892.21 to 1729.13 mg GAE mg/100 g. While the antioxidant capacity of the samples averages 256.26 mu mol TE mg/100 g according to the ABTS method, they were found 2417.79 mu mol TE mg/100 g for CUPRAC method. Also, the bioaccessibility of total phenol content determined 62.72-98.48% of all samples. As a result, antioxidant properties and bioaccessibility of the samples were changed according to the sample content and chemical composition. The use of fruit or fruit juice in the preparation of commercial baby food has improved antioxidant capacity and bioaccessibility, thus increasing the beneficial health effect and nutraceutical properties of the baby meal.Scientific and Technological Research Council of Turkey (TUBITAK)Turkiye Bilimsel ve Teknolojik Arastirma Kurumu (TUBITAK) [115Z128]The authors would like to thank the Scientific and Technological Research Council of Turkey (TUBITAK) for financial support this research project (Project No: 115Z128). This study is a part of a master thesis of the first author and presenter at the III International Conference on Food Chemistry and Technology (FCT 2017), 2-4 November 2017, in Baltimore, USA.WOS:0005246327000022-s2.0-85083374164PubMed: 3271396

Evaluation of Children with Congenital Heart Disease Hospitalized with the Diagnosis of Lower Respiratory Tract Infection

WOS: 000429850300006Aim: Lower respiratory tract infections are an important reason for mortality and morbidity in children with congenital heart disease. This study aimed to evaluate 50 children who had congenital heart disease and were hospitalized with lower respiratory tract infection in the Ege University Faculty of Medicine Pediatrics Hospital. Materials and Methods: Fifty pediatric patients were taken into the study. Their clinical symptoms, acute phase reactants, chest X-rays, bacterial culture of transtracheal aspirate, respiratory virus panel (with multiplex polimerase chain reaction) from nasopharyngeal swab were examined. The groups were evaluated in terms of age, gender, enviromental smoke exposure, living with school-aged siblings, Respiratory Syncytial virus (RSV) prophylaxis, hospitalization time, causative pathogen, additional risk factors. Results: Of the 50 cases, 12 (24%) were cyanotic, 38 (76%) were acyanotic. There were 26 boys and 24 girls. The most common diagnosis in the acyanotic group was hemodynamically significant VSD (isolated or with other diagnoses) with 20 cases. The average age of the cyanotic group was 23.88 +/- 28.81, and the acyanotic group was 12.25 +/- 15.45 months old. Hospitalizations most frequently occured in winter. The most frequent viral agent was RSV, which was not seen in the cyanotic group. All of the RSV infected patients were under 12 months old. In 16.7% of cyanotic and 52.6% of acyanotic patients there were extra risk factors such as immune deficiency, Down syndrome, prematurity, Di George syndrome, cerebral palsy, postoperative early period. Three cases lost their lives due to severe respiratory failure. There was no statistically significant difference between the two groups when compared for demografic variables, risk factors, causative pathogens, hospitalization times. Conclusion: Lower respiratory tract infections and especifically RSV pneumonia are important causes of mortality and morbidity in patients diagnosed with congenital heart disease. To prevent risk factors, more studies must be done

Vitreous Humor Diffusion Changes in Behcet's Disease and Multiple Sclerosis

INAL, MIKAIL/0000-0003-0642-7913WOS: 000448798800010Objective: The aim of this study is to examine the diffusional changes in the vitreous humor in multiple sclerosis and Behcet's disease. Materials and Methods: Apparent diffusion coefficient values were investigated in diffusion magnetic resonance imaging scans of a total 111 vitreous, 31 of which were Behcet's disease patients, 40 had multiple sclerosis and 40 were healthy volunteers. Then, multiple sclerosis and Behcet's disease group were statistically compared with healthy volunteers and their apparent diffusion coefficient values amongst themselves. Results: There was no significant difference in terms of age and sex distribution among the three study groups (p>0.05). While there was no significant difference between multiple sclerosis and control groups (p>0.05), apparent diffusion coefficient values of Behcet's patients were significantly lower than multiple sclerosis and control groups (p<0.001). There was no significant difference between the patients with uveitis and those without uveitis in Behcet's disease. The apparent diffusion coefficient value of 2934,3(x10(-6) mm(2)/s) had a very high sensitivity and specificity (72.42-92.5%) for the Behcet's group, and by the use of ROC curve analysis, the detected cut off value for Behcet's disease was <= 2934,3(x10(-6) mm(2)/s). Conclusion: Our study showed that diffusion values in the vitreous humor were found to be decreased in patients with Behcet's disease, in comparison with the multiple sclerosis and the control groups. To the best of our knowledge, this has not been reported before

Lymphadenitis and Fever: First Presentation of Kawasaki Disease

WOS: 000406930000006Kawasaki disease is a vasculitis of infant and childhood period. Diagnosis of Kawasaki disease is based on clinical criteria including cervical lymphadenopathy. Here we reported a 3.5-year-old boy presenting with Kawasaki disease mimicking bacterial lymphadenitis and fever. If a child presents with lymphadenopathy only which is unresponsive to antibiotics, Kawasaki disease should be considered

A rare complication of chronic granulomatous disease in a child: constrictive aspergillus pericarditis

WOS: 000418480800015PubMed ID: 28990950A 3-year-old girl with the diagnosis of chronic granulomatous disease (CGD) was hospitalized for bron-chopneumonia and congestive heart failure. Her medical history included methylprednisolone medication for autoimmune gastric outlet obstruction. Computed tomography revealed pneumonic infiltrations and pericardial thickening. A pulsed-wave Doppler recording revealed E/A > 1. During a pericardiectomy, multiple islands of thick, firm-walled, fibrinous exudate-containing, small abscess formations were observed. Histopathological evaluation of pericardial tissue revealed granulomatous inflammation. Aspergillus fumigatus was cultured from the abscess. In conclusion, development of constrictive aspergillus pericarditis should be considered in patients with CGD because immediate initiation of antifungal management with aggressive surgical treatment is life-saving

A Retrospective Survey Comparing Suture Techniques Regarding the Risk of Permanent Epicardial Pacemaker Implantation After Ventricular Septal Defect Closure

WOS: 000447269900006PubMed ID: 30184030Objective: The aim of this study is to compare the continuous and combined suturing techniques in regards to the needing epicardial pacing at the time of weaning from cardiopulmonary bypass (EP-CPB) and to evaluate permanent epicardial pacemaker (PEP) implantation in patients who had undergone surgical ventricular septal defect (VSD) closure. Methods: This single-centre retrospective survey includes 365 patients who had consecutively undergone VSD closure between January 2006 and October 2015. Results: The median age and weight of the patients were 15 months (range 27 days - 56.9 years) and 10 kg (range 3.5 - 100 kg), respectively. Continuous and combined suturing techniques were utilised in 302 (82.7%) and 63 (17.3%) patients, respectively. While 25 (6.8%) patients required EP-CPB, PEP was implanted in eight (2.2%) patients. Comparison of the continuous and combined suturing techniques regarding the need for EP-CPB (72% vs. 28%, P=0.231) and PEP implantation (87.5% vs. 12.5%, P=1.0) were not statistically significant. The rate of PEP implantation in patients with perimembraneous VSD without extension and perimembraneous VSD with inlet extension did not reveal significant difference between the suture techniques (P=1.0 and P=0.16, respectively). In both univariate and multivariate analyses, large VSD (P=0.001; OR 8.63; P=0.011) and perimembraneous VSD with inlet extension (P<0.001; OR 9.02; P=0.005) had a significant influence on PEP implantation. Conclusion: Both suturing techniques were comparable regarding the need for EP-CPB or PEP implantation. Caution should be exercised when closing a large perimembraneous VSD with inlet extension

Necrotizing Liver Granuloma/Abscess and Constrictive Aspergillosis Pericarditis with Central Nervous System Involvement: Different Remarkable Phenotypes in Different Chronic Granulomatous Disease Genotypes

Chronic granulomatous disease (CGD) is a primary immune deficiency causing predisposition to infections with specific microorganisms, Aspergillus species and Staphylococcus aureus being the most common ones. A 16-year-old boy with a mutation in CYBB gene coding gp91phox protein (X-linked disease) developed a liver abscess due to Staphylococcus aureus. In addition to medical therapy, surgical treatment was necessary for the management of the disease. A 30-month-old girl with an autosomal recessive form of chronic granulomatous disease (CYBA gene mutation affecting p22phox protein) had invasive aspergillosis causing pericarditis, pulmonary abscess, and central nervous system involvement. The devastating course of disease regardless of the mutation emphasizes the importance of early diagnosis and intervention of hematopoietic stem cell transplantation as soon as possible in children with CGD