Anonna crassiflora suppresses colonic carcinogenesis through its antioxidant effects, bioactive amines, and phenol content in rats.

Marolo (Annona crassiflora) is an underutilized Brazilian Cerrado fruit with few reports in the literature about its bioactive compounds and functional properties. In this context, the chemoprevention against the carcinogen 1,2-dimethylhydrazine (DMH)-induced pre-neoplastic lesions in Wistar rat colon was investigated and correlated with marolo's antioxidant activity and the contents of phenolic compounds and bioactive amines. Total phenolic compounds (TPC) and total flavonoids compounds (TFC) were determined in the marolo pulp extract by spectrophotometric and Ultra-Performance Liquid Chromatography and diode array detection (UPLC-DAD) analysis. Free bioactive amines were determined by High Performance Liquid Chromatography and fluorescence detection (HPLC-FLD) after post column derivatization with o-phthalaldehyde. In addition, the in vitro antioxidant activity was determined by DPPH, and ABTS. Wistar rats were treated orally with marolo pulp at 0.7, 1.4 and 2.8 g/kg body weight (bw)/day added to a standard ration. Four subcutaneous injections of DMH (40 mg/kg bw) were used to induce a pre-neoplastic lesion that was assessed by the aberrant crypt foci (ACF) assay. The marolo pulp (fresh weigh) showed high content of total phenolic compounds (9.16 mg GAE/g), with predominance of chlorogenic acid (1.86 µg/g) and epicatechin (0.99 µg/g), and total flavonoids (7.26 mg CE/g), ∼85 % of the TPC. The marolo pulp had significant contents of tyramine (31.97 mg/kg), putrescine (20.65 mg/kg), and spermidine (6.32 mg/kg). The marolo pulp inhibited (p < 0.05) pre-neoplastic lesions induced by DMH administration at the all concentrations tested. These findings indicate that marolo pulp has a colon carcinogenesis chemopreventive effect, which could be due to, at least in parts, its antioxidant action associated with its phenolics and flavonoids content as well of spermidine.

Dissecção espontânea da artéria coronária, uma doença multifatorial: perspectivas da experiência de um centro / Spontaneous coronary artery dissection, a multifactorial disease: insights from a center experience

Introdução: Embora seja uma doença pouco conhecida, a dissecção espontânea da artéria coronária é uma causa importante e frequentemente subdiagnosticada da síndrome coronariana aguda não aterosclerótica, principalmente em mulheres. O objetivo deste estudo foi caracterizar uma amostra consecutiva de pacientes diagnosticados com dissecção espontânea da artéria coronária quanto a fatores predisponentes e desencadeadores; quadro clínico e angiográfico; abordagem terapêutica; ocorrência de eventos cardíacos adversos; recorrência e dissecção espontânea de artéria coronária de novo. Métodos: Estudo retrospectivo observacional longitudinal, unicêntrico, que incluiu pacientes diagnosticados com dissecção espontânea da artéria coronária (n=60) admitidos entre janeiro de 2010 e dezembro de 2020. Resultados: A mediana da idade foi de 55 anos, e 83% eram mulheres. A maioria dos pacientes (60%) não apresentava nenhum ou tinha apenas um fator de risco cardiovascular. O infarto agudo do miocárdio sem supradesnivelamento do segmento ST foi o quadro clínico em 67% dos casos. A artéria coronária mais frequentemente envolvida foi a descendente anterior (47%). A maioria das lesões (77%) aparecia na angiografia como dissecção espontânea da artéria coronária tipo 2. O tratamento conservador foi selecionado como abordagem inicial na maioria dos pacientes (72%). A incidência geral de dissecção espontânea da artéria coronária de novo não foi significativamente diferente entre os pacientes tratados primeiramente com revascularização, em comparação com os que receberam tratamento conservador (p=0,953). No entanto, a recidiva da dissecção espontânea da artéria coronária ocorreu no vaso originalmente envolvido em 3 dos 15 pacientes tratados com revascularização, em comparação com apenas um entre os 43 pacientes que foram tratados de forma conservadora (p<0,05). Conclusão: A dissecção espontânea da artéria coronária é mais frequente em mulheres jovens. O infarto agudo do miocárdio sem supradesnivelamento do segmento ST foi o quadro clínico mais observado, envolvendo principalmente a artéria descendente anterior. A revascularização não protegeu da recorrência.

Background: Although it is a poorly known disease, spontaneous coronary artery dissection is an important and frequently underdiagnosed cause of non-atherosclerotic acute coronary syndrome, particularly in women. The objective of this study was to characterize a consecutive sample of patients diagnosed with spontaneous coronary artery dissection with respect to predisposing and precipitating factors; clinical and angiographic presentation; management; occurrence of adverse cardiac events; recurrence; and de novo spontaneous coronary artery dissection. Methods: Longitudinal, observational, retrospective, single-centre study, including patients diagnosed with spontaneous coronary artery dissection (n=60) admitted between January 2010 and December 2020. Results: Median age was 55 years, and 83% were women. Most patients (60%) presented without any or just one cardiovascular risk factor. Non-ST-segment elevation acute myocardial infarction accounted for 67% of clinical presentations. The most frequently affected coronary artery was the left anterior descending (47%). Most lesions (77%) appeared on angiography as type 2 spontaneous coronary artery dissection. Conservative management was chosen as the initial approach in most patients (72%). The overall incidence of de novo spontaneous coronary artery dissection was not significantly different among patients initially managed with revascularization as compared to conservative treatment (p=0.953). However, spontaneous coronary artery dissection recurrence occurred in the originally involved vessel in 3 of 15 patients initially managed with revascularization, as compared to only one among 43 patients treated conservatively (p<0.05). Conclusion: Spontaneous coronary artery dissection occurs more often in young women. Non- ST-segment elevation acute myocardial infarction was the most frequent clinical presentation involving mainly the left anterior descending artery. Revascularization did not protect from recurrence.

Triple-Valve Infective Endocarditis: A Case with Unusual Features.

Infective endocarditis is a condition associated with high morbidity and mortality, usually with univalvular involvement. We describe the case of a 76-year-old woman with triple-valve endocarditis due to Streptococcus gallolyticus, complicated by perivalvular suppurative lesions, acute heart failure and acute kidney injury. Unfortunately, the patient died despite antibiotic therapy and emergent surgery. This case highlights uncommon triple-valve involvement in the absence of risk factors, posing a diagnostic and therapeutic challenge. LEARNING POINTS: Native triple-valve endocarditis is extremely rare, especially in the absence of predisposing conditions.Streptococcus gallolyticus has been associated with endocarditis as well colonic and hepatobiliary pathology, so gastrointestinal endoscopy is important as bacteraemia frequently precedes gastrointestinal symptoms, allowing prompt diagnosis.In multivalvular involvement, early surgery is often required, and timely recognition and treatment before complications develop may be decisive for prognosis.

Pasteurization of passion fruit Passiflora setacea pulp to optimize bioactive compounds retention.

Passiflora setacea is a wild species of passion fruit with interesting functional properties. Fruit seasonality demands conservation methods to enable its consumption throughout the year. We evaluated High Temperature Short Time (HTST) and Low Temperature Long Time (LTLT) binomials on physical, chemical, antioxidant and sensory characteristics of Passiflora setacea pulps. In natura (IN) and pasteurized pulps were analysed for DPPH, FRAP, ORAC, total phenolic content (TPC), vitamin C, bioactive amines, flavonoids, color, remaining enzymatic activity (REA), microbiological analyzes, sensory evaluation and physical stability. All binomials reached microbiological standards. Binomials 82 °C/20 s and 82 °C/40 s were selected for providing higher total antioxidant activity (TAA), TPC and lower REA. The highest levels of antioxidant activity, flavonoids, vitamin C were kept by 82 °C/20 s, without difference from IN pulp. LTLT binomial showed higher retention of bioactive amines, but also higher REA. Sensory acceptance was not affected by the binomials but pasteurized-cooked flavor was more checked for 82 °C 40 s than IN pulp.

Influence of spontaneous fermentation of manipueira on bioactive amine and carotenoid profiles during tucupi production.

Tucupi is a kind of broth that is common to the Amazonian region of Brazil, which is produced after the spontaneous fermentation and boiling of manipueira, a liquid by-product extracted from cassava roots during cassava flour production. The bioactive amines formation and their alterations during tucupi processing were investigated for the first time. In addition, the physicochemical changes, instrumental color parameters and carotenoid profile were monitored during tucupi production. Regarding the changes on the profile of carotenoids, all-trans-ß-carotene was the major carotenoid, followed by its 9- and 13-cis isomers, and this profile was not altered throughout the process. Spermidine (polyamine), putrescine, tyramine and histamine (biogenic amines) were the bioactive amines identified during the tucupi production process, but at low levels (0.76-7.24 mg/L). Principal Component Analysis suggested three distinct stages during tucupi production: the first stage was characterized by the manipueira up to 12 h of fermentation with the highest values of pH, total and reducing sugars, and total starch; the second stage refers to the end of the fermentation process (16 to 24 h), in which biogenic amines (histamine and tyramine) were produced; and the third stage was characterized by the final product (tucupi), with the highest values of total acidity, soluble solids, polyamines and tyramine. Therefore, the results suggest the need of an accurate control of the fermentation of the manipueira to avoid or minimize the formation of biogenic amines.

Spontaneous coronary artery dissection: A single-center case series and literature review.

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an unusual cause of acute coronary syndrome (ACS). Better recognition and diagnosis has raised awareness of this condition. However, the pathophysiology of SCAD and its prognosis are still little understood. We aimed to investigate the characteristics and prognosis of patients with SCAD, and subsequently performed a review of literature. METHODS: Single-center, retrospective study performed in patients hospitalized from January 2010 to December 2016 with suspected ACS (n=5002) whose final diagnosis was SCAD (n=27; 0.5%). RESULTS: Patients with SCAD were mainly female (81.5%; n=22), with median age of 56. Predisposing factors were identified in 12 (44%) patients and precipitating factors in three (11.1%). Non-ST elevation myocardial infarction (NSTEMI) was the main form of presentation (51.9%). The left anterior descending artery (LAD) territory was the most commonly involved (n=12, 44.4%). Type 2 dissection was the most prevalent angiographic pattern (n=17, 63%). The majority of patients (n=15; 55.6%) were managed medically and the remaining patients underwent percutaneous coronary intervention (PCI) with drug-eluting stents. Seven patients re-infarcted while in the hospital. Over the median follow-up period of 20 months, 7.4% of patients (n=2) had symptoms of heart failure (HF) and 14.8% developed ACS (in three patients the event occurred in a coronary territory other than that of the index case, and in one patient it occurred in the previously affected territory). There were no deaths. CONCLUSION: In the studied population, SCAD was more prevalent in middle-aged women. Despite the high prevalence of in-hospital re-infarction or during follow-up, the prognosis was good overall.

Modified shock index: A bedside clinical index for risk assessment of ST-segment elevation myocardial infarction at presentation.

INTRODUCTION: Prompt identification of higher-risk patients presenting with ST-segment elevation myocardial infarction (STEMI) is crucial to pursue a more aggressive approach. OBJECTIVE: We aimed to assess whether the modified shock index (MSI), the ratio of heart rate to mean arterial pressure, could predict six-month mortality among patients admitted with STEMI. METHODS: A retrospective observational cohort study was performed in a single center including 1158 patients diagnosed with STEMI, without cardiogenic shock on admission, between July 2009 and December 2014. They were divided into two groups: group 1 - patients with MSI<0.93 (72%); group 2 - patients with MSI≥0.93 (28%). The primary endpoint was six-month all-cause mortality. RESULTS: MSI≥0.93 identified patients who were more likely to have signs of heart failure (p=0.002), anemia (p<0.001), renal insufficiency (p=0.014) and left ventricular systolic dysfunction (p=0.045). They more often required inotropic support (p<0.001), intra-aortic balloon pump (p<0.001) and mechanical ventilation (p<0.001). Regarding in-hospital adverse events, they had a higher prevalence of malignant arrhythmias (p=0.01) and mechanical complications (p=0.027). MSI≥0.93 was an independent predictor of overall six-month mortality (adjusted HR 2.00, 95% CI 1.20-3.34, p=0.008). CONCLUSION: MSI was shown to be a valuable bedside tool which can rapidly identify high-risk STEMI patients at presentation.

Multivessel vs. culprit-only revascularization in patients with non-ST-elevation acute coronary syndromes and multivessel coronary disease. / Revascularização multivaso versus revascularização da artéria culprit em pacientes com síndrome coronária aguda sem supradesnivelamento do segmento ST e doença coronária multivaso.

INTRODUCTION: There have been no prospective randomized trials that enable the best strategy and timing to be determined for revascularization in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel coronary artery disease (CAD). OBJECTIVES: To compare short- and long-term adverse events following multivessel vs. culprit-only revascularization in patients with NSTE-ACS and multivessel CAD. METHODS: This was a retrospective observational study that included all patients diagnosed with NSTE-ACS and multivessel CAD who underwent percutaneous coronary intervention (PCI) between January 2010 and June 2013 (n=232). After exclusion of patients with previous coronary artery bypass grafting (n=30), a multivessel revascularization strategy was adopted in 35.1% of patients (n=71); in the others (n=131, 64.9%), only the culprit artery was revascularized. After propensity score matching (PSM), two groups of 66 patients were obtained, matched according to revascularization strategy. RESULTS: During follow-up (1543±545 days), after PSM, patients undergoing multivessel revascularization had lower rates of reinfarction (4.5% vs. 16.7%; log-rank p=0.018), unplanned revascularization (6.1% vs. 16.7%; log-rank p=0.048), unplanned PCI (3.0% vs. 13.6%; log-rank p=0.023) and the combined endpoint of death, reinfarction and unplanned revascularization (16.7 vs. 31.8%; log-rank p=0.046). CONCLUSIONS: In real-world patients presenting with NSTE-ACS and multivessel CAD, a multivessel revascularization strategy was associated with lower rates of reinfarction, unplanned revascularization and unplanned PCI, as well as a reduction in the combined endpoint of death, reinfarction and unplanned revascularization.

Consumption effect of a synbiotic beverage made from soy and yacon extracts containing Bifidobacterium animalis ssp. lactis BB-12 on the intestinal polyamine concentrations in elderly individuals.

This study aimed to investigate the effect of a synbiotic beverage made from soy and yacon (Smallanthus sonchifolius) extracts containing Bifidobacterium animalis ssp. lactis BB-12 on healthy elderly individuals' intestinal polyamine concentrations. A randomized, double-blinded, placebo-controlled trial has been conducted with twenty-nine volunteers (over 65years of age) who either had a daily intake of 150mL of synbiotic (synbiotic group - S) or placebo (placebo group - P) beverages. Both had the same nutrient composition, except that a probiotic culture was added to the synbiotic beverage. Total experiment time was 8weeks, which was divided into 3 consecutive phases: a prefeeding period (2weeks), followed by a feeding period (4weeks) and a postfeeding period (2weeks). Stool samples were collected at 3 time periods. Fecal concentrations of polyamines, putrescine (PUT), cadaverine (CAD) and spermidine (SPD) that were obtained during the synbiotic and placebo consumption period were significantly higher (p<0.05) than those found during the pre-consumption baseline level period. No significant differences in the number of bifidobacteria, clostridia, or enterobacteria were observed in any of the two groups at the three time periods. Similarly, no significant effect on the production of proinflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6) and anti-inflammatory interleukin-10 (IL-10) was induced by the synbiotic or placebo beverages consumption. The results herein indicate that both the synbiotic and the placebo beverage consumption have increased polyamines levels, which are often reduced in elderly individuals, without influencing inflammatory responses. In addition, both placebo and synbiotic beverages seems to contribute by maintaining increased polyamines levels.

Bioactive amines and phenolic compounds in cocoa beans are affected by fermentation.

Cocoa is the target of increased scientific research as it is one of the richest source of bioactive compounds. The formation of bioactive amines and their changes in cocoa beans during seven days of traditional fermentation was investigated for the first time. In addition, total phenolic compounds, anthocyanins contents and the scavenging capacity against ABTS radical were determined to monitor the fermentation process. Only two biogenic amines (tryptamine and tyramine) and two polyamines (spermidine and spermine) were detected in cocoa beans during fermentation. Fermentation was characterized by three stages: i) high levels of tryptamine, phenolics, and scavenging capacity; ii) high contents of spermine, total biogenic amines and total polyamines; and iii) the highest spermidine levels and total acidity, but the lowest total phenolic compounds and anthocyanins contents. The scavenging capacity of cocoa beans during fermentation correlated with total phenolic compounds and anthocyanins contents.

Multiclass method for pesticides quantification in honey by means of modified QuEChERS and UHPLC-MS/MS.

Bee products can be produced in an environment contaminated by pesticides that can be transported by honey bees to the hive and incorporated into the honey. Therefore, rapid and modern methods to determine pesticide residues in honey samples are essential to guarantee consumers' health. In this study, a simple multiresidue method for the quantification of 116 pesticides in honey is proposed. It involves the use of a modified QuEChERS procedure followed by UHPLC-MS/MS analysis. The method was validated according to the European Union SANCO/12571/2013 guidelines. Acceptable values were obtained for the following parameters: linearity, limit of detection (0.005mg/kg) and limit of quantification (0.010 and 0.025mg/kg), trueness (for the four tested levels the recovery assays values were between 70 and 120%), intermediate precision (RSD<20.0%) and measurement uncertainty tests (<50.0%). The validated method was applied for determination of 100 honey samples from five states of Brazil.

Pesticides in honey: A review on chromatographic analytical methods.

Honey is a product of high consumption due to its nutritional and antimicrobial properties. However, residues of pesticides, used in plagues' treatment in the hive or in crop fields in the neighborhoods, can compromise its quality. Therefore, determination of these contaminants in honey is essential, since the use of pesticides has increased significantly in recent decades because of the growing demand for food production. Furthermore, pesticides in honey can be an indicator of environmental contamination. As the concentration of these compounds in honey is usually at trace levels and several pesticides can be found simultaneously, the use of highly sensitive and selective techniques is required. In this context, miniaturized sample preparation approaches and liquid or gas chromatography coupled to mass spectrometry became the most important analytical techniques. In this review we present and discuss recent studies dealing with pesticide determination in honey, focusing on sample preparation and separation/detection methods as well as application of the developed methods worldwide. Furthermore, trends and future perspectives are presented.