Functional Vegetable-Based Sausages for Consumption by Children

The dislike food preferences that children registered regarding vegetables and fish compromise the exposure to those iodine sources and may contribute to cause a nutritional deficiency in this micronutrient, causing serious damage of the brain and the central nervous system. Functional foods are becoming well-established in the market, focused on by an adult consumer more interested in healthy eating habits but without the motivation to optimize natural food preparation or to promote a wide variety of food in their diet. This article presents evidence of a new functional product concept, 100% vegetable, fermented soya based and salted by a red algae, that was approved by 900 parents who chose the sensorial features: distinctive aroma (57.9%), soft texture (38.4%), sausage shape (21%) and attractive color (77.9%). Three different varieties were developed: carrot (50% w/w), sugar-beet (50% w/w) and tomato (40% w/w) mini sausages, with tofu (20% w/w) and 0.8 % (w/w) of seaweed, reflecting trends that the younger consumer demands. The sensorial tests performed, after quality control assays, received very satisfactory acceptance by the potential buyer.

Exosomal glypican-1 is elevated in pancreatic cancer precursors and can signal genetic predisposition in the absence of endoscopic ultrasound abnormalities

BACKGROUND Individuals within specific risk groups for pancreatic ductal adenocarcinoma(PDAC)[mucinous cystic lesions(MCLs),hereditary risk(HR),and new-late onset diabetes mellitus(NLOD)]represent an opportunity for early cancer detection.Endoscopic ultrasound(EUS)is a premium image modality for PDAC screening and precursor lesion characterization.While no specific biomarker is currently clinically available for this purpose,glypican-1(GPC1)is overexpressed in the circulating exosomes(crExos)of patients with PDAC compared with healthy subjects or those harboring benign pancreatic diseases.AIM To evaluate the capacity of GPC1+crExos to identify individuals at higher risk within these specific groups,all characterized by EUS.METHODS This cross-sectional study with a prospective unicentric cohort included 88 subjects:40 patients with MCL,20 individuals with HR,and 20 patients with NLOD.A control group(CG)was submitted to EUS for other reasons than pancreatic pathology,with normal pancreas and absence of hereditary risk factors(n=8).The inclusion period was between October 2016 and January 2019,and the study was approved by the Ethics Committee of Centro Hospitalar Universitário de São João,Porto,Portugal.All patients provided written informed consent.EUS and blood tests for quantification of GPC1+crExos by flow cytometry and carbohydrate antigen 19-9(CA 19-9)levels by ELISA were performed in all subjects.EUS-guided tissue acquisition was done whenever necessary.For statistical analysis,SPSS®27.0(IBM Corp.,Armonk,NY,United States)version was used.All graphs were created using GraphPad Prism 7.00(GraphPad Software,San Diego,CA,United States).RESULTS Half of MCLs harbored worrisome features(WF)or high-risk stigmata(HRS).Pancreatic abnormalities were detected by EUS in 10.0%and 35.0%in HR and NLOD individuals,respectively,all considered non-malignant and“harmless.”Median levels of GPC1+crExos were statistically different:MCL[99.4%,interquartile range(IQR):94.9%-99.8%],HR(82.0%,IQR:28.9%-98.2%),NLOD(12.6%,IQR:5.2%-63.4%),and CG(16.2%,IQR:6.6%-20.1%)(P<0.0001).Median levels of CA 19-9 were within the normal range in all groups(standard clinical cut-off of 37 U/mL).Within HR,individuals with a positive history of cancer had higher median levels of GPC1+crExos(97.9%;IQR:61.7%-99.5%),compared to those without(59.7%;IQR:26.3%-96.4%),despite no statistical significance(P=0.21).Pancreatic cysts with WF/HRS were statistically associated with higher median levels of GPC1+crExos(99.6%;IQR:97.6%-99.8%)compared to those without(96.5%;IQR:81.3%-99.5%)(P=0.011),presenting an area under the receiver operating characteristic curve value of 0.723(sensitivity 75.0%and specificity 67.7%,using a cutoff of 98.5%;P=0.012).CONCLUSION GPC1+crExos may act as biomarker to support the diagnosis and stratification of PDAC precursor lesions,and in signaling individuals with genetic predisposition in the absence of EUS abnormalities.

Septic shock 3.0 criteria application in severe COVID-19 patients:An unattended sepsis population with high mortality risk

BACKGROUND Coronavirus disease 2019(COVID-19)can be associated with life-threatening organ dysfunction due to septic shock,frequently requiring intensive care unit(ICU)admission,respi-ratory and vasopressor support.There-fore,clear clinical criteria are pivotal for early recognition of patients more likely to need prompt organ support.Although most patients with severe COVID-19 meet the Sepsis-3.0 criteria for septic shock,it has been increasingly recognized that hyperlactatemia is frequently absent,possibly leading to an underestimation of illness severity and mortality risk.AIM To identify the proportion of severe COVID-19 patients with vasopressor support requirements,with and without hyperlactatemia,and describe their clinical outcomes and mortality METHODS We performed a single-center prospective cohort study.All adult patients admitted to the ICU with COVID-19 were included in the analysis and were further divided into three groups:Sepsis group,without both criteria;Vasoplegic Shock group,with persistent hypotension and vasopressor support without hyperlactatemia;and Septic Shock 3.0 group,with both criteria.COVID-19 was diagnosed using clinical and radiologic criteria with a severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)positive RT-PCR test.RESULTS 118 patients(mean age 63 years,87%males)were included in the analysis(n=51 Sepsis group,n=26 Vasoplegic Shock group,and n=41 Septic Shock 3.0 group).SOFA score at ICU admission and ICU length of stay were different between the groups(P<0.001).Mortality was significantly higher in the Vasoplegic Shock and Septic Shock 3.0 groups when compared with the Sepsis group(P<0.001)without a significant difference between the former two groups(P=0.713).The log rank tests of Kaplan-Meier survival curves were also different(P=0.007).Ventilator-free days and vasopressor-free days were different between the Sepsis vs Vasoplegic Shock and Septic Shock 3.0 groups(both P<0.001),and similar in the last two groups(P=0.128 and P=0.133,respectively).Logistic regression identified the maximum dose of vasopressor therapy used(AOR 1.046;95%CI:1.012-1.082,P=0.008)and serum lactate level(AOR 1.542;95%CI:1.055-2.255,P=0.02)as the major explanatory variables of mortality rates(R20.79).CONCLUSION In severe COVID-19 patients,the Sepsis 3.0 criteria of septic shock may exclude approximately one third of patients with a similarly high risk of a poor outcome and mortality rate,which should be equally addressed.