Gluten-Free Bread Enriched with Artichoke Leaf Extract In Vitro Exerted Antioxidant and Anti-Inflammatory Properties.

Due to its high nutritional value and broad beneficial effects, the artichoke plant (Cynara cardunculus L.) is an excellent healthy food candidate. Additionally, the artichoke by-products are usually discarded even though they still contain a huge concentration of dietary fibers, phenolic acids, and other micronutrients. The present work aimed to characterize a laboratory-made gluten-free bread (B) using rice flour supplemented with a powdered extract from artichoke leaves (AEs). The AE, accounting for the 5% of titratable chlorogenic acid, was added to the experimental gluten-free bread. Accounting for different combinations, four different bread batches were prepared. To evaluate the differences, a gluten-free type-II sourdough (tII-SD) was added in two doughs (SB and SB-AE), while the related controls (YB and YB-AE) did not contain the tII-SD. Profiling the digested bread samples, SB showed the lowest glycemic index, while SB-AE showed the highest antioxidant properties. The digested samples were also fermented in fecal batches containing viable cells from fecal microbiota samples obtained from healthy donors. Based on plate counts, no clear tendencies emerged concerning the analyzed microbial patterns; by contrast, when profiling volatile organic compounds, significant differences were observed in SB-AE, exhibiting the highest scores of hydrocinnamic and cyclohexanecarboxylic acids. The fecal fermented supernatants were recovered and assayed for healthy properties on human keratinocyte cell lines against oxidative stress and for effectiveness in modulating the expression of proinflammatory cytokines in Caco-2 cells. While the first assay emphasized the contribution of AE to protect against stressor agents, the latter enlightened how the combination of SB with AE decreased the cellular TNF-α and IL1-ß expression. In conclusion, this preliminary study suggests that the combination of AE with sourdough biotechnology could be a promising tool to increase the nutritional and healthy features of gluten-free bread.

Osteosarcoma in Children: Not Only Chemotherapy.

Osteosarcoma (OS) is the most severe bone malignant tumor, responsible for altered osteoid deposition and with a high rate of metastasis. It is characterized by heterogeneity, chemoresistance and its interaction with bone microenvironment. The 5-year survival rate is about 67% for patients with localized OS, while it remains at 20% in case of metastases. The standard therapy for OS patients is represented by neoadjuvant chemotherapy, surgical resection, and adjuvant chemotherapy. The most used chemotherapy regimen for children is the combination of high-dose methotrexate, doxorubicin, and cisplatin. Considered that the necessary administration of high-dose chemotherapy is responsible for a lot of acute and chronic side effects, the identification of novel therapeutic strategies to ameliorate OS outcome and the patients' life expectancy is necessary. In this review we provide an overview on new possible innovative therapeutic strategies in OS.

A Novel Capacitive Step Sensor to Trigger Stimulation on Functional Electrical Stimulators Devices for Drop Foot.

Drop foot is a typical clinical condition associated with stroke. According to the World Health Organization, fifteen million people suffer a stroke per year, and one of three people's survival gets drop foot. Functional Electrical Stimulation systems are applied over the peroneal motor nerve to achieve the drop foot problem's dorsiflexion. An accurate and reliable way to identify in real-time the gait phases to trigger and finish the stimulation is needed. This paper proposes a new step sensor with a custom capacitive pressure sensors array located under the heel to detect a gait pattern in real-time to synchronize the stimulation with the user gait. The step sensor uses a capacitive pressure sensors array and hardware, which acquire the signals, execute an algorithm to detect the start and finish of the swing phase in real-time, and send the synchronization signal wirelessly. The step sensor was tested in two ways: 10 meters walk test and walking in a treadmill for 2 minutes. These two tests were performed with two different walk velocities and with thirteen healthy volunteers. Thus, all the 1342 steps were correctly detected. Compared to an inertial sensor located in the lower-back, the proposed step sensor achieves a mean error of 27.60±0.03 [ms] for the detection of the start of the swing phase and a mean error of 20.86±0.02 [ms] for the detection of the end of the swing phase. The results show an improvement in time error (respect to others pressure step sensors), sensibility and specificity (both 100%), and comfortability.

Efficacy of Postbiotics in a PRP-Like Cosmetic Product for the Treatment of Alopecia Area Celsi: A Randomized Double-Blinded Parallel-Group Study.

INTRODUCTION: Alopecia areata (AA), also known as 'area Celsi', is the second most common form of hair loss affecting the scalp. Newly proposed treatments for AA include low-level light therapy, biologics such as Janus kinase inhibitors and autologous platelet-rich plasma (PRP), which is a well-known "elixir" for hair growth. Bioactive peptides developed through biotechnological applications have been used to overcome the limitations of PRP. More recently, the involvement of microbiota in hair growth disorders, in AA in particular, has been reported, and the usefulness of microbial metabolites, i.e. postbiotics, has been suggested. METHODS: This study was a randomized double-blinded parallel-group study in which 160 persons of both sexes affected by AA and aged between 18 and 60 years were enrolled. The subjects were randomly assigned to a treatment group (group 1), receiving the TR-PRP plus-Celsi cosmetic product, and a placebo group (group 2). The SALT (Severity of Alopecia Tool) score was determined in both groups at baseline and after 2 and 3 months of treatment, and the results compared between groups. RESULTS: The subjects in group 1 showed a significant change from baseline in SALT score at 2 months of treatment (61.04% ± 3.45%; p < 0.0001), with a further improvement at the end of treatment (3 months) (69.56% ± 4.32%; p < 0.0001). No significant changes from baseline were reported for the subjects in group 2 (T1: 26.45% ± 3.64%; T3: 27.63% ± 7.61%). CONCLUSIONS: The results of this study provide further proof of the efficacy of bioactive peptides that mimick the growth factors present in PRP in subjects affected by AA. They also add to our knowledge of the link between microbiota and hair growth disorders, emphasizing the importance of studies on the microbial community and microbial metabolites as a novel therapeutic approach.

Characterization of ethyl acetate and n-butanol extracts of Cymbopogon schoenanthus and Helianthemum lippii and their effect on the smooth muscle of the rat distal colon.

ETHNOPHARMACOLOGY RELEVANCE: Cymbopogon schoenanthus (C. schoenanthus) and Helianthemum lippii (H. lippii) are Saharan species found in the South West of Algeria, in the region of Bechar. Both plants are used in traditional medicine to treat gastrointestinal disorders. OBJECTIVE: The aim of our study was to characterize the composition of the ethyl acetate (EtOAc) and n-Butanol (n-BuOH) extracts of C. schoenanthus and H. lippii, and to elucidate and compare their effect on the reactivity of the rat distal colon. MAIN METHODS: The plants were macerated in a hydroalcoholic solution. After concentration, the aqueous solutions of the residues were submitted to liquid-liquid extractions to obtain EtOAc and n-BuOH extracts. The phenolic and flavonoid content of the extracts was determined by high performance liquid chromatography coupled with mass spectrometry with a time of flight analyzer (HPLC-TOF/MS). The effect of the extracts was tested on the rat distal colon, namely on the basal tone and on KCl- and Ach-induced precontracted preparations. RESULTS: HPLC-TOF/MS identified 32 phenols and flavonoids in the extracts. The four extracts relaxed the rat distal colon, the effect being noticed on the basal tone and on the KCl- and Ach-induced precontractions. The EtOAc and the n-BuOH extracts of H. lippii decreased the basal tone of the rat distal colon more markedly than the correspondent extracts of C. schoenanthus. Moreover, the n-BuOH extract of C. schoenanthus decreased the basal tone more markedly than the EtOAc extract of this plant but there was no difference between extracts of H. lippii. The EtOAc extracts of both C. schoenanthus and H. lippii totally reverted both the KCl- and the Ach-induced precontraction of the rat distal colon. However, the n-BuOH extracts of the two plants reverted the Ach-precontracted colon but not the colon that has been precontracted with KCl. CONCLUSION: Extracts of H. lippii contain a higher level of phenols compared to the extracts of C. schoenanthus. All extracts of C. schoenanthus and H. lippii caused marked relaxation of the isolated rat distal colon, either when applied directly or when tested over KCl- and Ach-induced precontraction. These results give support to the use of C. shoenanthus and H. lippii in traditional medicine, namely for gastrointestinal diseases.

Segurança na aplicação da eletroestimulação neuromuscular no doente crítico: estudo piloto / Safety in application of neuromuscular electrical stimulation in critically ill patients: pilot study

INTRODUÇÃO: A Neuromuscular Electrical Stimulation (NMES) é um importante aliado do paciente crítico, favorecendo contrações ativas mesmo em estado que requer imobilidade. OBJETIVO: Verificar a segurança da aplicação da NMES em Unidades de Terapia Intensiva (UTIs) de um hospital público da cidade de Salvador. MÉTODO: Trata-se de estudo piloto, de intervenção. Os dados foram coletados no período de fevereiro a junho de 2018, com amostra por conveniência em uma população de pacientes críticos intubados e em uso de vasopressores. Foi aplicada uma única sessão de 45 minutos de NMES em ambos os quadríceps (músculo reto femoral e vasto lateral), sendo coletados os seguintes dados hemodinâmicos 5 minutos antes da aplicação e logo após a terapêutica: frequência cardíaca, pressão arterial sistólica, diastólica e média; e frequência respiratória. Estes dados foram avaliados seguindo recomendações de segurança já descritas previamente. Para análise estatística, as variáveis foram descritas através de médias e desvio-padrão, mediana e intervalo interquartílico e percentuais obtidos nas variáveis do estudo. A distribuição dos dados foi avaliada pelo teste Shapiro-Wilk, e os testes Mann Whitney e T de student foram utilizados. RESULTADOS: A amostra foi composta por 8 pacientes sendo 1 excluído. Destes, 85,7% era do sexo feminino, sendo o diagnóstico clínico de Sepse evoluindo para choque em 85,7%, média da idade de 61±9,5 anos e APACHE II de 29±5,5. Não foram evidenciadas diferenças estatísticas em relação aos dados hemodinâmicos coletados pré e pós eletroestimulação. Estes dados são semelhantes aos resultados encontrados por outros autores em populações sem uso de vasopressores. CONCLUSÃO: É possível sugerir que a aplicação da NMES no doente crítico em uso de vasopressores é uma técnica segura e viável desde que respeitando os limites estabelecidos e parâmetros corretos baseados em evidências

INTRODUCTION: Neuromuscular Electrical Stimulation (NMES) is an important ally of the critically ill patient, favoring active contractions even when in a state that requires immobility. OBJECTIVE: The objective of this study was to verify the safety of NMES application in Intensive Care Units (ICUs) of a public hospital in the city of Salvador. MATERIAL AND METHODS: This is a pilot, study of intervention. Data were collected from February to June 2018, having as population critically ill intubated patients using vasopressors. A single 45-minute NMES session was applied to both quadriceps (rectus femoris and vastus lateralis), and the following hemodynamic data were collected 5 minutes before application and soon after therapy: cardiac frequency, systolic, diastolic and medium blood pressure and respiratory frequency. Data were collected following security recommandations, described earlier. For statistical analysis, the variables were described by mean and standard deviation, median and interquartile interval and percentages obtained for the variables of the study. The distribution of data was evaluated by the Shapiro-Wilk test and Mann Whitney test and t test were used. RESULTS: The sample consisted of 8 patients, being 1 excluded. Of these, 85.7% were female, with a clinical diagnosis of Sepsis in 85.7%, mean age of 61±9.5 years and APACHE II of 29±5.5. No statistical differences were observed in relation to hemodynamic data collected before and after electrostimulation. These data are similar to those found by other authors in populations without vasopressors usage. CONCLUSION: It is possible to suggest that the application of NMES in critically ill patients using vasopressors is a safe and viable technique as long as respecting the established limits and correct evidence-based parameters.

Lactic acid fermentation as a tool to enhance the antioxidant properties of Myrtus communis berries.

BACKGROUND: Myrtle (Myrtus communis L.) is a medicinal and aromatic plant belonging to Myrtaceae family, which is largely diffused in the Mediterranean areas and mainly cultivated in Tunisia and Italy. To the best of our knowledge, no studies have already considered the use of the lactic acid fermentation to enhance the functional features of M. communis. This study aimed at using a selected lactic acid bacterium for increasing the antioxidant features of myrtle berries, with the perspective of producing a functional ingredient, dietary supplement or pharmaceutical preparation. The antioxidant activity was preliminarily evaluated through in vitro assays, further confirmed through ex vivo analysis on murine fibroblasts, and the profile of phenol compounds was characterized. RESULTS: Myrtle berries homogenate, containing yeast extract (0.4%, wt/vol), was fermented with Lactobacillus plantarum C2, previously selected from plant matrix. Chemically acidified homogenate, without bacterial inoculum and incubated under the same conditions, was used as the control. Compared to the control, fermented myrtle homogenate exhibited a marked antioxidant activity in vitro. The radical scavenging activity towards DPPH increased by 30%, and the inhibition of linoleic acid peroxidation was twice. The increased antioxidant activity was confirmed using Balb 3 T3 mouse fibroblasts, after inducing oxidative stress, and determining cell viability and radical scavenging activity through MTT and DCFH-DA assays, respectively. The lactic acid fermentation allowed increased concentrations of total phenols, flavonoids and anthocyanins, which were 5-10 times higher than those found for the non-fermented and chemically acidified control. As shown by HPLC analysis, the main increases were found for gallic and ellagic acids, and flavonols (myricetin and quercetin). The release of these antioxidant compounds would be strictly related to the esterase activities of L. plantarum. CONCLUSIONS: The lactic acid fermentation of myrtle berries is a suitable tool for novel applications as functional food dietary supplements or pharmaceutical preparations.

Lactic acid fermentation as a tool to enhance the functional features of Echinacea spp.

BACKGROUND: Extracts and products (roots and/or aerial parts) from Echinacea ssp. represent a profitable market sector for herbal medicines thanks to different functional features. Alkamides and polyacetylenes, phenols like caffeic acid and its derivatives, polysaccharides and glycoproteins are the main bioactive compounds of Echinacea spp. This study aimed at investigating the capacity of selected lactic acid bacteria to enhance the antimicrobial, antioxidant and immune-modulatory features of E. purpurea with the prospect of its application as functional food, dietary supplement or pharmaceutical preparation. RESULTS: Echinacea purpurea suspension (5%, wt/vol) in distilled water, containing 0.4% (wt/vol) yeast extract, was fermented with Lactobacillus plantarum POM1, 1MR20 or C2, previously selected from plant materials. Chemically acidified suspension, without bacterial inoculum, was used as the control to investigate functional features. Echinacea suspension fermented with Lb. plantarum C2 exhibited a marked antimicrobial activity towards Gram-positive and -negative bacteria. Compared to control, the water-soluble extract from Echinacea suspension fermented with Lactobacillus plantarum 1MR20 showed twice time higher radical scavenging activity on DPPH. Almost the same was found for the inhibition of oleic acid peroxidation. The methanol extract from Echinacea suspension had inherent antioxidant features but the activity of extract from the sample fermented with strain 1MR20 was the highest. The antioxidant activities were confirmed on Balb 3T3 mouse fibroblasts. Lactobacillus plantarum C2 and 1MR20 were used in association to ferment Echinacea suspension, and the water-soluble extract was subjected to ultra-filtration and purification through RP-FPLC. The antioxidant activity was distributed in a large number of fractions and proportional to the peptide concentration. The antimicrobial activity was detected only in one fraction, further subjected to nano-LC-ESI-MS/MS. A mixture of eight peptides was identified, corresponding to fragments of plantaricins PlnH or PlnG. Treatments with fermented Echinacea suspension exerted immune-modulatory effects on Caco-2 cells. The fermentation with Lb. plantarum 1MR20 or with the association between strains C2 and 1MR20 had the highest effect on the expression of TNF-α gene. CONCLUSIONS: E. purpurea subjected to lactic acid fermentation could be suitable for novel applications as functional food dietary supplements or pharmaceutical preparations.

Vitamin A and infancy. Biochemical, functional, and clinical aspects.

Vitamin A is a very intriguing natural compound. The molecule not only has a complex array of physiological functions, but also represents the precursor of promising and powerful new pharmacological agents. Although several aspects of human retinol metabolism, including absorption and tissue delivery, have been clarified, the type and amounts of vitamin A derivatives that are intracellularly produced remain quite elusive. In addition, their precise function and targets still need to be identified. Retinoic acids, undoubtedly, play a major role in explaining activities of retinol, but, recently, a large number of physiological functions have been attributed to different retinoids and to vitamin A itself. One of the primary roles this vitamin plays is in embryogenesis. Almost all steps in organogenesis are controlled by retinoic acids, thus suggesting that retinol is necessary for proper development of embryonic tissues. These considerations point to the dramatic importance of a sufficient intake of vitamin A and explain the consequences if intake of retinol is deficient. However, hypervitaminosis A also has a number of remarkable negative consequences, which, in same cases, could be fatal. Thus, the use of large doses of retinol in the treatment of some human diseases and the use of megavitamin therapy for certain chronic disorders as well as the growing tendency toward vitamin faddism should alert physicians to the possibility of vitamin overdose.