Hospitalization-related economic impact of patients with cardiogenic shock in a high-complexity reference centre.

AIMS: Cardiogenic shock (CS) is associated with high mortality. Current guidelines strongly recommend centralizing the care of these patients in high-complexity centres. We described the hospitalization-related economic cost and its main determinants in patients with CS in a high-complexity reference centre. METHODS AND RESULTS: This is a single-centre, retrospective study. All patients with CS (2015-17) were included. Hospitalization-related cost per patient was calculated by analytical accountability method, including hospital stay-related expenditures, interventions, and consumption of devices. Expenditure was expressed in 2018 euros. All-cause mortality during follow-up was registered. Ratio of cost per life-year gained (LYG) was also calculated. A total of 230 patients were included, with mean age of 63 years. In-hospital mortality was 88/230 (38.3%). Hospital stay was longer in patients surviving after the admission (21.7 vs. 7.5 days, P < 0.001). Total economic cost for the overall cohort was 3 947 118€ (mean/patient 17 161€). Most of this cost was attributable to hospital stay (81.1%). The rest of the expenditure was due to in-hospital procedures (13.1%) and the use of devices (5.8%). Most of hospital stay-related costs (79.8%) were due to Critical Care Unit stay. Mean follow-up was 651 days. Total LYG was 409.77 years for the whole series. The observed ratio of cost per LYG was 9632.52 €/LYG. CONCLUSIONS: Management of CS in a reference centre is associated to a significant economic cost, but with a low ratio of cost per LYG. Most of this cost is attributable to hospital stay, specifically in critical care units.

Viability of sous vide, microwave and high pressure processing techniques on quality changes during shelf life of fresh cowpea puree.

An innovative cowpea puree containing 78.8% of fresh cowpea seeds was developed. Microwave treatment (8 kW/35 s), high hydrostatic pressure (550 MPa/10 min/23 ℃) or sous vide treatment (80 ℃, 3 min) were assayed as processing techniques. Blended fresh cowpea samples were used as control. Quality changes during 21 days at 5 ℃ were studied. Sous vide samples showed a relevant loss during storage of viscoelastic parameters, like elastic modulus (G') and viscous modulus (G″), which was also perceived in the sensory evaluation. On the contrary, high hydrostatic pressure and microwave treatments were able to preserve consistency, texture and taste. However, physicochemical properties, mainly colour, were greatly influenced by thermal treatments, although high hydrostatic pressure treatment preserved greenness. Total phenolic content and total antioxidant capacity were more affected by high hydrostatic pressure than by microwave treatments. In conclusion, microwave and high hydrostatic pressure processing treatments seem to be quite interesting techniques to develop legume-based products.

UV-C pretreatment of fresh-cut faba beans (Vicia faba) for shelf life extension: Effects of domestic microwaving for consumption.

Faba beans have a short shelf life which is even reduced after fresh-cut processing mainly due to browning and dehydration. In that sense, the effects of a UV-C treatment (3 kJ m-2), compared with non-exposed beans (CTRL), were studied on the sensory and microbial quality, and bioactive and anti-nutritional content of fresh-cut faba beans (cv. Muchamiel) during storage at 5 ℃. The effect of a domestic microwaving (3 min, 900 W) on bioactive and anti-nutritional compounds of fresh seeds prior to consumption at each sampling time was also studied. UV-C treatment extended the fresh-cut faba bean shelf life from 7 to 10 days with browning score (the main sensory parameter adversely affected) of 8 and 1 log unit lower than CTRL at day 10. UV-C did not negatively affect the total antioxidant capacity of samples during storage. The phytic acid and raffinose contents decreased by 30/40%, respectively, after 10 days, without influence of the UV-C treatment. Microwaving reduced the phytic acid and condensed tannins contents by 30% in those samples stored for up to six days, with low microwaving effect in the last storage days. Nevertheless, UV-C improved the condensed tannins reductions through storage (≈30%) compared with non-irradiated samples.

Effect of stevia supplementation of kale juice spheres on their quality changes during refrigerated shelf life.

BACKGROUND: Kale is a vegetable that contains a high proportion of health-promoting compounds although its consumption as a beverage is very limited due to its bitter flavor. Nonetheless, the bitter flavor of Brassica may be masked by sweetening. The effects were studied of different stevia extracts (CTRL, S0.5 (g L-1 ), S1.25 and S2.5) added to a kale beverage on the quality of kale juice spheres over a period of 7 days at 5 °C. Kale juice spheres were produced with a double-spherification technique, which allowed hydrogel spheres to be produced with high mechanical resistance. RESULTS: The addition of the stevia extracts did not affect the physicochemical quality of spheres. In particular, S2.5 spheres showed the least color changes after 7 days. All spheres showed good microbiological quality throughout storage, with loads < 7 log CFU g-1 , regardless of the stevia concentration. The sulforaphane content of kale spheres was not affected by the stevia supplementation over the 7-day period. CONCLUSION: The addition of stevia to the kale juice spheres led to a better flavor without altering product quality during refrigerated storage. © 2018 Society of Chemical Industry.

Immature pea seeds: effect of storage under modified atmosphere packaging and sanitation with acidified sodium chlorite.

BACKGROUND: Appropriate sanitation is a priority for extending the shelf life and promoting the consumption of immature pea seeds, as processing accelerates quality deterioration and microbial growth. RESULTS: The combined effect of disinfection with acidified sodium chlorite (ASC) or sodium hypochlorite (SH) and packaging under a passive modified atmosphere (MAP) at 1 or 4 °C on quality was analysed. After 14 days, greenness and vitamin C had decreased, especially in the SH-disinfected samples. Total phenols and antioxidant capacity were not affected by disinfection. Proteins levels fell by around 27%, regardless of the sanitizer and storage temperature. Compared with the initial microbial load, samples stored at 1 °C showed an increase of 1 log CFU g-1 in psychrophiles when treated with SH, whereas no increase of note occurred with ASC. In general, microbial counts were always below 3 log CFU g-1 for all the treatments. CONCLUSION: Immature pea seeds could be stored for 14 days at 1-4 °C under MAP with only minor quality changes. Disinfection with ASC resulted in better sensory quality, higher content of vitamin C and lower psychrophile counts. More research is needed to analyse the effect of these treatments on other quality parameters. © 2017 Society of Chemical Industry.

Improving quality of an innovative pea puree by high hydrostatic pressure.

BACKGROUND: The food industry is continuously innovating to fulfill consumer demand for new, healthy, ready-to-eat products. Pea purees could satisfy this trend by increasing the intake of legumes, which are an important source of nutrients. Moreover, sensorial properties like viscosity could be improved by high hydrostatic pressure (HHP). In this study the effect of a boiling treatment (10 min) followed by HHP at 550 kPa (0, 5 or 10 min) on the rheological properties, associated with enzymatic activity and particle size, as well as on the microbial and sensory quality of a pea-based puree stored for 36 days at 5 °C, has been assessed. RESULTS: The particle size of pea puree decreased after all processing treatments, but increased during storage in HHP-treated samples. Conversely, boiling treatment showed an increase in polygalacturonase activity at the end of the storage period, with a decrease in particle size, viscosity and stability. However, 5 min of 550 kPa HHP showed the highest mean particle size, mean surface diameter and viscosity regarding the remaining treatments. The microbial load remained low during storage. CONCLUSIONS: HHP treatment can be used by the food industry to improve the rheological properties, viscosity and stability of pea purees. © 2017 Society of Chemical Industry.