Hybrid Palliation for Hypoplastic Left Heart Syndrome: Role of Echocardiography.

Hypoplastic left heart syndrome is a spectrum of complex congenital cardiac defects. Although in borderline cases, biventricular repair is a viable option, in the majority of cases, univentricular palliation is the treatment of choice. Hybrid palliation can be a valid alternative to classic Norwood operation in the neonatal period, especially in selected cases such as high-risk patients or borderline left ventricles. Echocardiography is the main diagnostic modality in this pediatric population, from the fetal diagnosis to the subsequent surgical steps of palliative treatment. Hybrid palliation is performed after birth and is characterized by surgical banding of the pulmonary arteries along with transcatheter stenting of the ductus arteriosus. There are some peculiar aspects of cardiac imaging that characterize this type of palliation, and that should be considered in the different phases before and after the procedure. We aimed to review the current literature about the role of echocardiography in the management of patients with hypoplastic left heart undergoing hybrid palliation.

Plant-Based Alternatives to Cheese Formulated Using Blends of Zein and Chickpea Protein Ingredients.

In this study, zein protein isolate (ZPI) and chickpea protein concentrate (CPC) ingredients were used to formulate five plant-based cheese alternatives. Ingredient ratios based on protein contributions of 0:100, 25:75, 50:50, 75:25 and 100:0 from ZPI and CPC, respectively, were used. Formulations were developed at pH ~4.5, with a moisture target of 59%. Shea butter was used to target 15% fat, while tapioca starch was added to target the same carbohydrate content for all samples. Microstructural analysis showed differences among samples, with samples containing ZPI displaying a protein-rich layer surrounding the fat globules. Schreiber meltability and dynamic low amplitude oscillatory shear rheological analyses showed that increasing the proportion of ZPI was associated with increasing meltability and greater ability to flow at high temperatures. In addition, the sample containing only CPC showed the highest adhesiveness, springiness and cohesiveness values from the texture profile analysis, while the sample containing only ZPI exhibited the highest hardness. Furthermore, stretchability increased with increasing ZPI proportions. This work will help understanding of the role and potential of promising plant-protein-ingredient blends in formulating plant-based alternatives to cheese with desirable functional properties.

Chickpea protein ingredients: A review of composition, functionality, and applications.

Chickpea (Cicer arietinum L.) is a pulse consumed all over the world, representing a good source of protein, as well as fat, fiber, and other carbohydrates. As a result of the growing global population the demand for the protein component of this pulse is increasing and various approaches have been proposed and developed to extract same. In this review the composition, functionality, and applications of chickpea protein ingredients are described. Moreover, methods to enhance protein quality have been identified, as well as applications of the coproducts resulting from protein extraction and processing. The principal dry and wet protein enrichment approaches, resulting in protein concentrates and isolates, include air classification, alkaline/acid extraction, salt extraction, isoelectric precipitation, and membrane filtration. Chickpea proteins exhibit good functional properties such as solubility, water and oil absorption capacity, emulsifying, foaming, and gelling. During protein enrichment, the functionality of protein can be enhanced in addition to primary processing (e.g., germination and dehulling, fermentation, enzymatic treatments). Different applications of chickpea protein ingredients, and their coproducts, have been identified in research, highlighting the potential of these ingredients for novel product development and improvement of the nutritional profile of existing food products. Formulations to meet consumer needs in terms of healthy and sustainable foods have been investigated in the literature and can be further explored. Future research may be useful to improve applications of the specific coproducts that result from the extraction of chickpea proteins, thereby leading to more sustainable processes.

Composition, Physicochemical and Sensorial Properties of Commercial Plant-Based Yogurts.

The aim of this study was to determine the key physicochemical, sensory and quality attributes of plant-based yogurts made from soy, coconut, cashew, almond and hemp, including a dairy benchmark yogurt. The soy, coconut and cashew-based yogurts showed textural parameters comparable to the dairy yogurt, with firmness values of 0.46, 0.44, 0.51 and 0.36 N, respectively. Rheological analysis showed that one of the soy-based yogurts was similar to the dairy yogurt in terms of apparent viscosity, in addition to water-holding capacity (82.8% and 75.7%, respectively). Other plant-based yogurts, e.g., hemp, showed different rheological and textural parameters to the other plant-based products, relating this to the agar and rice starch components of the hemp formulation. The sensory analysis demonstrated that some plant-based yogurts were similarly appreciated to dairy-based products. This was due mainly to the presence of specific hydrocolloids, sweeteners and flavours in the formulations; for example, the acceptability of the soy- and dairy-based yogurts were identical (5.95). The results obtained in this study allowed identification of key quality attributes of plant-based yogurt products and highlighted relationships between such attributes and formulation, which can be exploited in future product development.

An unexpected difficult intubation in a patient with myasthenia gravis undergoing video-assisted transcervical thymectomy.

Although there are different methods to evaluate predictive parameters of difficult intubation in apparently normal patients, sometimes this event is unpredictable.We herein report a clinical case of difficult intubation during anaesthesia for video-assisted thymectomy in non-thymomatous myasthenia gravis.