RESUMO
Ricotta cream though an emerging product sold in Brazil, by 2021 it has no fixed quality standards, a condition that can result in products with variable composition and properties. Additionally, there are no methods of sampling or analysis for its official control. In this context, this study investigated the physicochemical quality of five Brazilian ricotta cream brands to verify the extent of differences in the composition of this product, emphasizing the characterization and classification according to the Brazilian legislation and the Codex Alimentarius standards. Significant differences between brands concerning pH, titratable acidity, moisture, ash, fat, and fat in dry matter (FDM) were observed (P < 0.05), which were probably a result of their heterogeneous ingredient composition. According to Brazilian regulatory standards, all samples fit the "very high moisture" definition, and the brands A, B, D and E achieved the classification of "high-fat cheeses" since they contained at least 60.0% of FDM. Brand C was the only product that could be classified as a "medium fat cheese" due to having FDM values between 25.0% and 44.9%. All samples fit the Brazilian and Codex Alimentarius classification for "cream cheeses" based on their moisture, dry matter content, moisture on a fat-free basis and FDM. The results reinforce the need for regulatory standards regarding the physicochemical quality and composition of this cheese variety, to guarantee more transparency for the consumers and that they have access to more homogeneous products.
RESUMO
The authors present 2 cases of fatal cardiac tamponade associated with the insertion of a central venous catheter. The first case occurred soon after the insertion of the catheter (early complication), and the second case, 4 days after (late complication). In both cases, the post-catheter insertion check chest x-ray film showed the tip of the catheter located within the heart silhouette. The diagnosis of cardiac tamponade was made only during the cadaverous examination. In the first case, the catheter was found to be in the right internal jugular vein at autopsy. The postmortem examination showed a clear liquid inside the pericardial cavity and the inferior vena cava injury. In the second case, the catheter had been inserted via the right subclavian vein puncture and there was a perforation of the right atrium at autopsy. The child was using total parenteral nutrition, and the intrapericardial liquid was milky. The incorrect placement of the catheter tip and unrecognized complications led the 2 children to death.