Bioavailability of Bioactive Compounds from Reconstituted Grapefruit Juice as Affected by the Obtention Process.

Much attention has been paid to the health benefits of including fruits and vegetables in the diet. However, for the compounds responsible for this beneficial effect to be effective at the level of the human organism, they must be available for absorption after digestion. In this sense, in vivo studies are needed to demonstrate the bioavailability of these compounds and their physiological activity. In order to provide information in this regard, this study collects data on the levels of vitamin C (VC) and naringenin (NAG) in the blood serum of the 11 volunteer participants in this trial, before and after consuming two different grapefruit juices. The juices were prepared by rehydrating the grapefruit powder obtained by freeze-drying (FD) the fruit puree or by spray-drying (SD) the liquefied grapefruit. No significant differences (p > 0.05) neither by juice nor by participant were observed in any case. The mean relative increase of VC, NAG and the radical scavenging ability (RSA) in blood serum due to grapefruit juices intake was 12%, 28% and 26%, respectively. Just VC showed a positive and significant Pearson's correlation with RSA. The mean bioavailability of VC was quantified as 1.529 ± 0.002 mg VC/L serum per 100 mg of VC ingested.

Composition of Powdered Freeze-Dried Orange Juice Co-Product as Related to Glucose Absorption In Vitro.

The reuse of food by-products is crucial for the well-being of the planet. Considering the high content of nutrients and other bioactive compounds in many of them, investigating their suitability for use as human food ingredients is an interesting challenge. In this study, in addition to the proximate composition, phenol content and antioxidant activity (AOA = 3.2 mmol Trolox equivalent (TE)/100 g, db) of orange juice powder by-product (CoP), different in vitro properties related to carbohydrate metabolism have been characterised. Specifically, the glycaemic index (GI), the glycaemic load (GL), the glucose dialysis retardation index (GDRI = 13.6%), the glucose adsorption capacity (GAC = 22.5 mM) and the inhibition capacity of α-amylase (α-A = 46.9%) and α-glucosidase (α-G = 93.3%) of powdered orange juice waste have been determined and related to fibre and phenolics composition. Taking advantage of the high fibre content of the by-product (36.67%), its GL was calculated for a CoP dose that allows labelling the food to which it is added as a source of fibre. The low GI value (24.4%) and the low GL (0.918 g available carbohydrates per serving) allowed us to conclude that the product studied could be an interesting opportunity for the food industry to offer it as a healthy food ingredient to be included in the diet, especially for those suffering from type 2 diabetes mellitus. Of the total phenolic compounds (TP = 509 mg equivalent of gallic acid (GAE)/100 g, db), 68% were found in free fraction (FP), and their contribution to the total AOA was 40.6%, while this was 54.9% for the 32% of phenols bound to plant tissues (BP).

In Vitro Bioaccessibility of Bioactive Compounds of Freeze-Dried Orange Juice Co-Product Formulated with Gum Arabic and Modified Starch.

The large amount of waste generated by the orange juice industry has sparked the interest of many researchers in incorporating recycling systems and following a much more sustainable circular economy model. This work proposes the valorization of the co-product generated in the orange juice extraction industry after freeze-drying for its subsequent reuse as a natural ingredient in the food industry. In addition, the possible protective effect of gum Arabic and corn starch esterified with octenyl succinic groups, in proportions optimised in previous studies 0.25 and 0.45 g/g orange co-product dry solutes, on the main bioactive compounds of orange peel during the freeze-drying process has been studied. The samples were characterised for their content of vitamin C (ascorbic and dehydroascorbic acids), flavonoids (hesperidin and narirutin), total phenols and total carotenoids, as well as their antioxidant capacity (DPPH and FRAP assays). In addition, samples were digested, mimicking the human enzymatic oral gastro-intestinal digestion process, and the bioaccessibility of the bioactive compounds was evaluated. It was observed that the addition of both biopolymers improved the stability of the hydrophilic compounds during freeze-drying. This conservative effect was more remarkable for higher biopolymer concentrations. However, no protective effect on carotenoid compounds was observed. This trend was reflected in the antioxidant activity of the different samples. In addition, the incorporation of biopolymers improved the bioaccessibility of the bioactive compounds studied. In conclusion, the results supported the feasibility of the freeze-dried orange juice co-product as a natural, sustainable source of health-promoting compounds.

Free and Bound Phenolic Compounds Present in Orange Juice By-Product Powder and Their Contribution to Antioxidant Activity.

Interest in fruit/vegetable consumption is not always linked to a particular diet but rather derives from their high antioxidant activity (AOA), with potential health benefits provided, in part, by polyphenols. Although phenols can be found in free form (FP) or bound to plant tissues (BP), the experimental methodology most frequently used for the quantification of total phenols (TP) is based on the extraction of a portion of FP, which may justify the lack of correlation often found between them and AOA. In this context, four successive extractions were performed to obtain FP and BP of powdered orange juice by-product, and their contribution to the AOA was studied. The first extract (MeOH, 30 °C) can be assumed to be one of the conventional methods for the quantification of TP. Re-extraction with MeOH (60 °C) afforded the FP. Two subsequent basic and acidic extractions yielded the BP. Although the FPs were the most abundant, the AOA (DPPH method) of the last fraction of BP was of the same order found in the first fraction of FP. This highlights the interest in extracting the BP from the by-product of orange juice if its antioxidant capacity is to be exploited.

Characterization of the Orange Juice Powder Co-Product for Its Valorization as a Food Ingredient.

The citrus juice industry produces a large amount of fiber-rich waste and other bioactive compounds of great interest for their potential health benefits. This study focuses on the valorization of the co-product resulting from the extraction of orange juice to offer it as a versatile, healthy, high-quality, and stable natural food ingredient in powder form. To this end, the vitamin C (VC) content (ascorbic and dehydroascorbic acid, AA and DHAA), major flavonoids (hesperidin and narirutin, HES and NAT), and techno-functional properties (angle of repose, AoR; hygroscopicity and wettability; density and porosity; mean particle size, MPS; water retention capacity, WRC; oil holding capacity, ORC; emulsifying and foaming capacity, EC and FC; and emulsion and foam stability, ES and FS) have been characterized. In addition, considering that dehydrated foods with high sugar content require the incorporation of high molecular weight biopolymers for their physical stabilization, the influence of starch modified with octenyl succinic acid (OSA) and gum Arabic (GA) on these properties has been studied. The results obtained confirm the high quality of this co-product to be offered as a powdered food ingredient with nutraceutical potential. The addition of the studied biopolymers is recommended as it does not modify the flowability of the powder and favors both the encapsulation of the bioactive compounds, especially in the presence of GA, and the rehydration capacity.

Protective capacity of gum Arabic, maltodextrin, different starches, and fibers on the bioactive compounds and antioxidant activity of an orange puree (Citrus sinensis (L.) Osbeck) against freeze-drying and in vitro digestion.

Dehydrated fruit puree may be a convenient way to promote the healthy consumption of fruit based foods. Drying carriers, highly used by the food industry to stabilize dried fruit products, may show a potential encapsulating capacity of the biocompounds, that could also limit their bioaccesibility. This study analyzed the impact of gum Arabic (GA), bamboo fiber (BF), native corn starch, starch substituted with octenylsuccinic groups, pea fiber, and maltodextrin on the in vitro bioaccessibility of vitamin C (VC), total phenols (TP), and ß-carotene, as well as on the antioxidant capacity during the freeze-drying and in vitro digestion of an orange puree. Amongst the formulations studied, GA + BF was the most effective for phytochemicals protection of the freeze-dried orange puree during the intestinal stage of digestion, resulting in a higher TP and VC bioaccessibility (59% and 36%, respectively).

Insights into the development of grapefruit nutraceutical powder by spray drying: physical characterization, chemical composition and 3D intestinal permeability.

BACKGROUND: The development of functional and nutraceutical foods comes from a greater awareness of the relationship between food and health by consumers. In recent years, the idea of purifying and encapsulating bioactive compounds through techniques such as spray drying has been well received by the food industry. The development and characterization of a grapefruit (Citrus paradisi) nutraceutical powder obtained by spray drying is of great interest owing to the different bioactive compounds and the potential health effects. RESULTS: The grapefruit powder was characterized by a low water amount (1.5 g water per 100 g powder) and a high porosity (75%). The color parameters were L* = 80.0 ± 1.8, hab * = 61.7 ± 0.4 and Cab * = 11.4 ± 0.6. The IC50 values determined for the freeze-dried oxalic acid extract (FDOA) and the freeze-dried methanol-water extract (FDMW) were 0.48 and 0.72 mg mL-1 respectively, while the total phenolic content (TPC) ranged between 1274 and 1294 mg gallic acid equivalent (GAE) per 100 g dry basis (d.b.). Regarding total flavonoid content (TFC), FDOA presented the highest amount (6592 mg quercetin equivalent (QE) per 100 g d.b.). For both extracts, the cell viability in Caco-2 and HT29-MTX was above 90% at 100 µg mL-1 . The bioavailability of the bioactive compounds was analyzed through a 3D intestinal model. Delphenidin-3-glucoside and hesperitin-7-O-glucoside presented a permeation higher than 50%, followed by hesperidin which was close to 30%. CONCLUSION: This work allows to establish that the formulation of grapefruit powder has great potential as a nutraceutical food, with spray drying being a good alternative technique in the food industry. © 2019 Society of Chemical Industry.

Equipo multidisciplinar de atención al paciente crítico: ¿qué aporta la integración del farmacéutico? / Multidisciplinary team of critically ill patient care: What is the contribution of the pharmacist?

Antecedentes y objetivo: La gravedad e inestabilidad de los pacientes, junto con el alto grado de complejidad de la medicación, hacen de las unidades de cuidados intensivos (UCI) un área crítica de problemas relacionados con la medicación. El objetivo de nuestro estudio fue analizar y evaluar la actividad clínica realizada por el farmacéutico clínico integrado en una UCI y conocer la opinión del personal. Material y método: Estudio descriptivo, prospectivo, de 42 meses de duración. El farmacéutico se integró en la actividad diaria del equipo multidisciplinar de una UCI de 12 camas perteneciente al Servicio de Anestesiología y Reanimación. Se registraron todas las intervenciones farmacoterapéuticas (IF) realizadas, el grado de aceptación, el método de comunicación y destinatario de la intervención, así como la evaluación clínica de las intervenciones aceptadas. Posteriormente, se realizó una encuesta al personal de la unidad sobre la seguridad del paciente y la influencia de la integración del farmacéutico en la unidad. Resultados: Se realizaron un total de 2399 IF con un 97,0% de aceptación. De estas, las mayoritarias fueron las relacionadas con la posología (37,8%) y las consultas al farmacéutico (25,7%). De las IF aceptadas, el 53,7% influyeron sobre la eficacia del tratamiento farmacológico y el 35,1% sobre la tolerancia. En la encuesta realizada al personal de la unidad para valorar la percepción de la integración del farmacéutico se obtuvo una valoración global de de 8,58 ± 1,40 sobre 10. Conclusiones: El farmacéutico hospitalario integrado en el equipo multidisciplinar de UCI puede aportar un valor añadido al proceso farmacoterapéutico del paciente crítico

Background and objective: The severity and instability of the patients, together with the high degree of complexity of the medication, make the intensive care units (ICU) a critical area of problems related to medication. The aim of our study was to analyze and assess the activity performed by the clinical pharmacist integrated in an ICU and to know the opinion of the staff about it. Material and method: A 42 month descriptive and prospective study was conducted. The pharmacist was integrated into the daily activity of the multidisciplinary team of a 12-bed ICU belonging to the Anaesthesiology and Resuscitation Department. Every pharmacotherapeutic intervention (PI) carried out, the degree of acceptance, the method of communication and the receiver of the intervention, as well as the clinical evaluation of the accepted interventions were recorded. Subsequently, a survey was carried out to the staff of the unit on the patient's safety and the influence of the integration of the pharmacist in the unit. Results: A total of 2399 PIs were carried out with a 97.0% of acceptance. Of these, most were those related to posology (37.8%) and consultations with the pharmacist (25.7%). Among the accepted PIs, 53.7% had an influence on the efficacy of drug therapy, and 35.1% on treatment tolerance. In the survey to the unit's staff in order to assess the perception of the pharmacist's integration, an overall assessment of 8.58 ± 1.40 out of 10 was obtained. Conclusions: The hospital pharmacist integrated in the ICU multidisciplinary team can add value to the pharmacotherapeutic process of the critical patient

Antioxidant and anti-inflammatory activities of freeze-dried grapefruit phenolics as affected by gum arabic and bamboo fibre addition and microwave pretreatment.

BACKGROUND: Recent epidemiological studies have suggested that phenolic compounds present in grapefruit play an important role in the bioactive properties of this fruit. However, the consumption of fresh grapefruit is low. Freeze-dried powdered grapefruit can be an alternative to promote this fruit consumption. To improve the quality and stability of the powdered fruit, encapsulating and anticaking agents can be added. In the present study, different grapefruit powders obtained by freeze-drying with the addition of gum arabic (1.27 g per 100 g) and bamboo fibre (0.76 g per 100 g) with and without a pre-drying microwave treatment were compared with the fresh and freeze-dried fruit with no carriers added, aiming to evaluate the effect of these preservation processes on phenolics content and on its antioxidant [1,1-diphenyl-2-picrylhydrazyl (DPPH), 2,2'-azinobis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) and ferric reducing ability of plasma (FRAP)] and anti-inflamatory (evaluated in RAW 264.7 macrophages) capacities. RESULTS: Freeze-drying and gum arabic and bamboo fibre addition significantly increased total phenolics, as well as the antioxidant and anti-inflammatory activities (by inhibiting nitric oxide production of lipopolysaccharide activated RAW 264.7 macrophages), of grapefruit. An additional increase in these parameters was obtained with microwave pretreatment before freeze-drying. CONCLUSIONS: The combined addition of gum arabic and bamboo fibre to grapefruit puree and the application of a microwave pretreatment improve the functional properties of the fruit without showing cytotoxicity in vitro. © 2017 Society of Chemical Industry.

Cefepime Associated With Phenytoin Induced Stevens-Johnson Syndrome.

We describe a recent case of Stevens-Johnson Syndrome. A 49-year-old man was admitted to the Intensive Care Unit of an Anaesthesia and Resuscitation Department because of a Fournier gangrene that derived in a sepsis, ventilator-associated pneumonia, and renal failure. He was under treatment with cefepime and suffered a generalized status epilepticus, so started treatment with phenytoin. The next day he developed a "maculous cutaneous eruption in trunk and lower limbs" compatible with a Stevens-Johnson Syndrome. Stevens-Johnson Syndrome is a very severe and potentially fatal multiorganic disease, especially when present in critically ill patients, with a strong drug-related etiology, especially with antiepileptic drugs.

Tocilizumab-induced psoriasiform rash in rheumatoid arthritis.

Tocilizumab (TCZ) is a humanized monoclonal antibody against the interleukin-6 (IL-6) receptor and has been approved for the treatment of rheumatoid arthritis (RA) patients who have had an inadequate response to previous biological therapies. Psoriasiform skin lesions, especially palmoplantar pustulosis lesions, are well described following anti-tumour necrosis factor therapy. We describe a 79-year-old woman with rheumatoid factor-positive, anti-citrullinated protein antibody-positive erosive RA, who developed a psoriasiform palmoplantar pustulosis reaction following treatment with TCZ therapy (IL-6 receptor). The rash showed histological features compatible with psoriasis and disappeared following discontinuation of TCZ.

Osteomielitis Crónica en Rodilla por Actinomicosis / Chronic Osteomyelitis Knee for Actinomycosis

Actinomicosis, causada por Actinomyces spp bacilo gram positivo, inmóvil, sin cápsula, anaerobio o anaerobio facultativo, forma parte de la flora nativa de la boca, ubicado en amígdalas, encías o boca de casi todas las personas. Generalmente se manifiesta después de un traumatismo, cirugía dental o proceso infeccioso. Las formas clínicas más frecuentemente observadas son: cérvico-facial, torácica y abdominal y rara vez en otras regiones. En el presente caso, se reporta a un paciente con cuadro clínico de aproximadamente un año de evolución, presentando dolor, inflamación y secreción amarillenta a nivel de rodilla izquierda. Al realizarse los estudios pertinentes, se identificó la presencia de infección por Actinomyces, ante la gravedad del caso el tratamiento se realizó con abordaje quirúrgico y antibióticoterapia prolongada (beta-lactámicos).

Actinomicosis caused by Actinomyces spp Bacillus gram positive, immobile, without capsule, anaerobic or anaerobic physician, part of the native flora of the mouth, located in tonsils, gums or mouth of almost all the persons. Generally it shows after a traumatism, dental surgery or infectious process. The clinical forms more frequently observed are: cérvico-facial, thoracic and abdominal and rarely in other regions. In the present case, it's reported a patient with approximately a year of evolution, with pain, inflammation and yellowish secretion of left knee. On the medical studies, the presence of infection by Actinomyces was identified, because of bad evolution the treatment was: surgical boarding and antibiotic terapy (Beta - lactamics).

Mitochondria and calcium flux as targets of neuroprotection caused by minocycline in cerebellar granule cells.

Minocycline, an antibiotic of the tetracycline family, has attracted considerable interest for its theoretical therapeutic applications in neurodegenerative diseases. However, the mechanism of action underlying its effect remains elusive. Here we have studied the effect of minocycline under excitotoxic conditions. Fluorescence and bioluminescence imaging studies in rat cerebellar granular neuron cultures using fura2/AM and mitochondria-targeted aequorin revealed that minocycline, at concentrations higher than those shown to block inflammation and inflammation-induced neuronal death, inhibited NMDA-induced cytosolic and mitochondrial rises in Ca(2+) concentrations in a reversible manner. Moreover, minocycline added in the course of NMDA stimulation decreased Ca(2+) intracellular levels, but not when induced by depolarization with a high K(+) medium. We also found that minocycline, at the same concentrations, partially depolarized mitochondria by about 5-30 mV, prevented mitochondrial Ca(2+) uptake under conditions of environmental stress, and abrogated NMDA-induced reactive oxygen species (ROS) formation. Consistently, minocycline also abrogates the rise in ROS induced by 75 microM Ca(2+) in isolated brain mitochondria. In search for the mechanism of mitochondrial depolarization, we found that minocycline markedly inhibited state 3 respiration of rat brain mitochondria, although distinctly increased oxygen uptake in state 4. Minocycline inhibited NADH-cytochrome c reductase and cytochrome c oxidase activities, whereas the activity of succinate-cytochrome c reductase was not modified, suggesting selective inhibition of complexes I and IV. Finally, minocycline affected activity of voltage-dependent anion channel (VDAC) as determined in the reconstituted system. Taken together, our results indicate that mitochondria are a critical factor in minocycline-mediated neuroprotection.