Improving the Extraction of Polyphenols from Cocoa Bean Shells by Ultrasound and Microwaves: A Comparative Study.

The extraction of bioactive compounds from food by-products is one of the most important research areas for the nutraceutical, pharmaceutical, and food industries. This research aimed to evaluate the efficiency of Ultrasound-Assisted Extraction (UAE) and Microwave-Assisted Extraction (MAE), either alone or in combination, of phenolic compounds from cocoa bean shells (CBSs). These extraction techniques were compared with conventional methods, such as under simple magnetic stirring and the Soxhlet apparatus. After the preliminary characterization of the gross composition of CBSs, the total polyphenol content and radical scavenging of extracts obtained from both raw and defatted cocoa bean shells were investigated. Quantification of the main polyphenolic compounds was then performed by RP-HPLC-DAD, identifying flavonoids and phenolic acids, as well as clovamide. The application of MAE and UAE resulted in a similar or superior extraction of polyphenols when compared with traditional methods; the concentration of individual polyphenols was variously influenced by the extraction methods employed. Combining MAE and UAE at 90 °C yielded the highest antiradical activity of the extract. Spectrophotometric analysis confirmed the presence of high-molecular-weight melanoidins, which were present in higher concentrations in the extracts obtained using MAE and UAE, especially starting from raw material. In conclusion, these results emphasize the efficiency of MAE and UAE techniques in obtaining polyphenol-rich extracts from CBS and confirm this cocoa by-product as a valuable biomass for the recovery of antioxidant compounds, with a view to possible industrial scale-up.

Long-term Outcome of Children Born to Women with Autoimmune Rheumatic Diseases: A Multicentre, Nationwide Study on 299 Randomly Selected Individuals.

The concern about the offspring's health is one of the reasons for a reduced family size of women with rheumatic diseases (RD). Increased risk of autoimmune diseases (AD) and neurodevelopmental disorders (ND) has been reported in children born to patients with RD. Within a nationwide survey about reproductive issues of women with RD, we aimed at exploring the long-term outcome of their children. By surveying 398 patients who received their diagnosis of RD during childbearing age (before the age of 45), information about the offspring were obtained from 230 women who declared to have had children. A total of 148 (64.3%) patients were affected by connective tissue diseases (CTD) and 82 (35.7%) by chronic arthritis. Data on 299 children (156 males, 52.1%; mean age at the time of interview 17.1 ± 9.7 years) were collected. Twelve children (4.0%), who were born to patients with CTD in 75% of the cases, were affected by AD (8 cases of celiac disease). Eleven children had a certified diagnosis of ND (3.6%; 6 cases of learning disabilities); 9 of them were born to mothers with CTD (5 after maternal diagnosis). No association was found between ND and prenatal exposure to either maternal autoantibodies or anti-rheumatic drugs. Absolute numbers of offspring affected by AD and ND were low in a multicentre cohort of Italian women with RD. This information can be helpful for the counselling about reproductive issues, as the health outcomes of the offspring might not be an issue which discourage women with RD from having children.

"Disease knowledge index" and perspectives on reproductive issues: A nationwide study on 398 women with autoimmune rheumatic diseases.

OBJECTIVE: The reproductive choices of women affected by rheumatic diseases (RD) can be influenced by several factors, including the quality of physician-patient communication. We conducted a survey on reproductive issues aiming at exploring the unmet needs of women with RD during childbearing age. METHODS: We administered 65 multiple-choice and 12 open-answer questions about pregnancy counselling, contraception, use of drugs during pregnancy and other women reproductive issues to 477 consecutive women with RD aged 18-55 years followed-up in 24 rheumatology centres in Italy. Analysis was restricted to 398 patients who received their diagnosis of RD before the age of 45. According to the RD diagnosis, patients were subdivided into 2 groups: connective tissue diseases (n = 249) and chronic arthritis (n = 149). RESULTS: At the time of interview, women in both groups had a mean age of 40 years. Nearly one third of patients in each group declared not to have received any counselling about either pregnancy desire nor contraception. A smaller family size than desired was reported by nearly 37% of patients, because of concerns related to maternal disease in one fourth of the cases. A "Disease Knowledge Index" (DKI) was created to investigate the degree of patients' information about the implications of their RD on reproductive issues. Having received counselling was associated with higher DKI values and with a positive impact on family planning. CONCLUSION: Italian women of childbearing age affected by RD reported several unmet needs in their knowledge about reproductive issues. Strategies are needed to implement and facilitate physician-patient communication.