Betalains and their applications in food: The current state of processing, stability and future opportunities in the industry.

Betalains are water-soluble nitrogenous pigments with coloring properties and antioxidant activities, which is why they have been incorporated into several foods. However, their use is limited by their instability in response to different factors, such as, pH, oxygen, water activity, light, metals, among others. In this work, a review of up-to-date and relevant information is presented on the primary natural sources of betalains. Additionally, the advantages and disadvantages of the primary betalain extraction techniques are discussed and compared. The results of these studies were focused on the stability of betalains when incorporated into foods, either in pure or encapsulated form, and they are discussed through different technologies. Lastly, the most relevant information related to their stability and a projection of their promising future applications within the food industry is presented.

Thermal properties and volatile compounds profile of commercial dark-chocolates from different genotypes of cocoa beans (Theobroma cacao L.) from Latin America.

There is a growing interest in the identification of chemometric markers that allow the distinction and authentication of dark-chocolates according to their cocoa geographical origin and/or genotype. However, samples derived from Latin American cocoa, including specimens from North and South America, have not been studied in this context. An exploration of the melting behavior, fat composition, bioactive content, and volatile profile of commercial darkchocolates was conducted to identify possible patterns related to the genotype and/or origin of cocoa from Latin America. The melting properties were evaluated by DSC and related to fat content and fatty acids profile. Total polyphenol, anthocyanin, methylxanthine, and catechin content were analyzed. Finally, the volatile compounds were extracted and identified by HS-SPME/GC-MS and were analyzed through Principal Component Analysis (PCA) and the Hierarchical Cluster Analysis Heatmap (HCA Heatmap). The fatty acids profile showed a relationship with the melting properties of dark chocolate. The samples exhibited two glass-transition temperatures (Tg) at ≈19 °C and ≈25.5 °C, possibly related to traces of unstable polymorphic forms of monounsaturated triacylglycerides. The analysis of bioactive compounds demonstrated great variability among samples independent of the cocoa origin, genotype, and content. The PCA and HCA Heatmaps allowed discriminating against the chocolates in relation to the cocoa origin and genotype. Compounds like tetramethylpyrazine, trimethylpyrazine, benzaldehyde, and furfural could be considered as dark-chocolate aroma markers derived from Latin American cocoas (North American region). The 2-phenylethyl alcohol, 2-methylpropanoic acid, 2,3-butanediol, 2-nonanone, and limonene for derived from South America. And the 2-phenylethyl acetate, 3-methyl-butanal, and cinnamaldehyde could allow to distinguishing between regional genotypes.

Multicenter Study of the Real-World Use of Ceftaroline versus Vancomycin for Acute Bacterial Skin and Skin Structure Infections.

The objective of this study was to determine if real-world ceftaroline treatment in adults hospitalized for acute bacterial skin and skin structure infections (ABSSSI) is associated with decreased infection-related length of stay (LOSinf) compared to that with vancomycin. This was a retrospective, multicenter, cohort study from 2012 to 2017. Cox proportional hazard regression, propensity score matching, and inverse probability of treatment weighting (IPTW) were used to determine the independent effect of treatment group on LOSinf The patients were adults hospitalized with ABSSSI and treated with ceftaroline or vancomycin for ≥72 h within 120 h of diagnosis at four academic medical centers and two community hospitals in Arizona, Florida, Michigan, and West Virginia. A total of 724 patients were included (325 ceftaroline treated and 399 vancomycin treated). In general, ceftaroline-treated patients had characteristics consistent with a higher risk of poor outcomes. The unadjusted median LOSinf values were 5 (interquartile range [IQR], 3 to 7) days and 6 (IQR, 4 to 8) days in the vancomycin and ceftaroline groups, respectively (hazard ratio [HR], 0.866; 95% confidence interval [CI], 0.747 to 1.002). The Cox proportional hazard model (adjusted HR [aHR], 0.891; 95% CI, 0.748 to 1.060), propensity score-matched (aHR, 0.955; 95% CI, 0.786 to 1.159), and IPTW (aHR, 0.918; 95% CI, 0.793 to 1.063) analyses demonstrated no significant difference in LOSinf between groups. Patients treated with ceftaroline were significantly more likely to meet criteria for discharge readiness at day 3 in unadjusted and adjusted analyses. Although discharge readiness at day 3 was higher in ceftaroline-treated patients, LOSinf values were similar between treatment groups. Clinical and nonclinical factors were associated with LOSinf.

Impact of rapid, culture-independent diagnosis of candidaemia and invasive candidiasis in a community health system.

Background: Delay in treatment of candidaemia and invasive candidiasis remains a cause of significant morbidity and mortality in high-risk patients. Widespread empirical utilization of antifungal therapy often occurs in an effort to minimize this risk. Objectives: This study assessed the impact of the T2Candida Panel in a multi-hospital community health system on time to initiation of antifungal therapy in candidaemic patients as well as the utilization of micafungin. Methods: Outcomes were compared between those patients with candidaemia prior to T2Candida implementation and those after implementation. Micafungin utilization for patients with suspected candidaemia/invasive candidiasis was compared with that for patients with a negative T2Candida Panel post-implementation. Results: There was a significant decrease in time to appropriate therapy in the post-T2Candida group (34 versus 6 h, P = 0.0147). Empirical antifungal therapy was avoided in 58.4% of T2Candida-negative patients. Conclusions: These results support the implementation of T2Candida to improve time to appropriate therapy for candidaemic patients while simultaneously expanding antimicrobial stewardship efforts to appropriately utilize antifungals.

Treatment of methicillin-sensitive Staphylococcus aureus bacteremia secondary to septic phlebitis using dalbavancin.

WHAT IS KNOWN AND OBJECTIVE: Treatment of bacteremia due to Staphylococcus aureus often requires prolonged therapy leading to increased hospital lengths of stay and associated costs. For certain patients, referral to an outpatient parenteral antimicrobial therapy (OPAT) programme serves as an alternative to increased inpatient length of stay. We report an alternative to OPAT using dalbavancin for the treatment of methicillin-sensitive Staphylococcus aureus (MSSA). CASE SUMMARY: A 54-year-old Caucasian man was brought to the emergency department from a rehabilitation centre with altered mental status and possible seizure. A peripheral intravenous catheter was placed in the left forearm, and the patient was transferred to the intensive care unit (ICU) for management of his acute psychosis, possible seizure and hyponatremia. Seven days into admission, the patient became febrile thought to be secondary to septic phlebitis of the forearm. Blood cultures were taken and organism identification using Nanosphere Verigene® BC-GP rapid diagnostic testing resulted in MSSA. The patient received treatment with cefazolin with a planned treatment duration of 14 days but because of the patient's history of alcohol abuse, psychosis requiring hospitalization via the Baker Act, and history of non-compliance to follow-up appointments, the patient was deemed ineligible for OPAT. Due to the limited treatment options, therapy for MSSA bacteremia was changed on day 6 of cefazolin therapy to dalbavancin to complete the 14-day treatment duration. Blood cultures were negative at the end of treatment and no relapse of infection occurred. WHAT IS NEW AND CONCLUSION: To our knowledge, this is the first case report using dalbavancin in clinical practice for the treatment of MSSA bacteremia secondary to septic phlebitis. This report highlights the potential role of the newer lipoglycopeptides, such as dalbavancin, in treating patients who require long-term parenteral antimicrobial therapy and are ineligible for treatment via OPAT.