Analysis of microbiota structure in cooked ham as influenced by chemical composition and processing treatments: Identification of spoilage bacteria and elucidation on contamination route.

Spoilage in cooked ham is one of the main challenges where microbial contamination can play a fundamental role. This study aimed to characterize pork-cooked ham's microbial community changes among different food production conditions (formulation and processing) using 16S rRNA sequencing and also to investigate the spoilage bacteria in order to elucidate their contamination route. Samples of three pork-cooked ham references with and without post-pasteurization treatment and in contact with the slicing-packaging conveyor belt and slicer and packager surfaces were performed by 16S rRNA gene sequencing. In order to clarify the contamination route, surfaces were sampled by conventional microbiological methods. Results showed that Leuconostoc spp. was the principal genera in spoiled cooked ham and had no relation neither to formulation nor contact with the slicing-packaging conveyor belt. The contamination route found for Leuconostoc spp. was associated with the storage and packaging zone. In addition, the calculated shelf-life decreased to 57.5% independently of the environment interaction minimization when ham casing permeability was changed and linked to contamination of spoilage bacteria during the slicing and packaging process. This research illustrates how the combined approach provides complementary results to implement suggestions in the facility to reduce the cross-contamination with spoilage bacteria. It also generates tools to comprehend and propose transference models understanding the environmental and intrinsic factors related to microbial transfer rate.

Towards a phenomenological based model for predicting the hardness of a processed meat product.

This study aims to build a model for predicting the hardness of meat products by considering their protein fractions and protein structural changes during production. Protein solubility is considered an indicator of protein structural changes. The obtained model results show that structural changes of sarcoplasmic and myofibrillar proteins occur during production. The gelling capacity is formed by the effect of the three protein fractions, namely myofibrillar, sarcoplasmic and stromal. The obtained model allows the prediction of the hardness of meat products based on their protein fraction contents with error below 5%, thus reaching a significant adjustment between real process data and the simulated model.

Substitution of saturated fat in processed meat products: a review.

The food industry is increasingly directing its efforts to produce and commercialize functional foods where the reduction or even elimination of saturated fat is an important goal. This situation arises from the concern of many institutions and individuals worldwide on the growth of non-transmissible diseases, particularly cardiovascular ones. This article presents a revision of the most important research carried out on processed meat products production and looks at the topic from two principal points of view: the nutritional and technological function of fat and the way in which it is gradually being replaced in the above-mentioned products. Many ingredients have been used to substitute fat but while the results concerning the nutritional composition of the final products are generally acceptable, the sensory aspects are not completely solved. This review emphasizes the use of plastic fats because they allow the highest fat substitution levels during its process and consumption without affecting the product behavior.

Influence of trial registration on reporting quality of randomized trials: study from highest ranked journals.

OBJECTIVE: To evaluate the reporting quality of key methodological items of randomized control trials (RCTs) in 55 of the highest ranked journals. STUDY DESIGN AND SETTING: A list of the highest top ranked journals was identified, and a search for detecting RCTs in those journals was made. Two hundred sixty four journals were screened and 55 of them were identified having at least one RCT. Three RCTs were randomly selected a priori from each journal; 148 RCTs were finally included. RCTs were assessed by two reviewers using the Consolidated Standards of Reporting Trials (CONSORT) statement. RESULTS: Only 11 (8%) RCTs had all items adequately reported. In addition, 36% of RCTs reported that the study was registered in any trial registry. We found a significant difference in the quality of reporting for baseline characteristics, recruitment, participant's flow, and randomization implementation between those studies having reported the registration of their RCT in a trial registry and those that have not. Adherence to key methodological items of the CONSORT statement was as follows: sample size determination (60%), sequence generation (49%), allocation concealment (40%), and blinding (25%). CONCLUSIONS: Reporting of varied CONSORT items remains suboptimal. Registration in a trial registry was associated with improved reporting. Further efforts to enhance RCT registration could contribute to this improvement.

Development of combinations of chemically modified vegetable oils as pork backfat substitutes in sausages formulation.

Today's consumers look for foods which provide nutrition and pleasure, while safeguarding their health, the result of which is that they increasingly avoid foods containing cholesterol and saturated and trans fatty acids. Chemically modified vegetable oils can help tailor meat products to meet this growing need and at the same time fulfil the technological needs of the meat processing industry. In this study, 16 backfat samples were characterised for their solid fat content (SFC) and melting point and these characteristics were used to design a mixture of chemically modified vegetable oils for use as a pork fat substitute for elaborating sausages. The mixtures were prepared with different vegetable oils bearing in mind with stearic acid content due to its close correlation with the SFC. The backfat was characterised as a function of its SFC and some modified vegetable oil mixtures were proposed, which led to a 10-20% diminution in saturated fatty acids and with a melting point similar to those observed in the backfat. The fatty acid profile pointed to a polyunsaturated/saturated fatty acids ratio higher than 0.4, and an n-6/n-3 fatty acid ratio of less than 4 in both modified vegetable oil mixtures proposed.

Palliative endobronchial brachytherapy for non-small cell lung cancer.

BACKGROUND: Non-small cell lung cancers (NSCLC) constitutes about 80% of all lung cancer cases. Although surgery is the only curative treatment of NSCLC, fewer than 20% of tumors can be radically resected. Radiotherapy is one of the main treatment modalities in lung cancer, contributing to both its cure and palliation. Endobronchial brachytherapy (EBB) has been used as one approach to improve local control either alone or in combination with other treatments. OBJECTIVES: To assess the effectiveness of palliative EBB in increasing survival and to control thoracic symptoms in patients with advanced NSCLC compared with external beam radiation therapy (EBRT) or other alternative endoluminal treatments. SEARCH STRATEGY: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and other databases were searched, as were reference lists and handsearching of selected journals and conference proceedings. SELECTION CRITERIA: Randomized controlled trials (RCTs) comparing different regimens of palliative EBB with EBRT or other endobronchial interventions in patients with advanced NSCLC. DATA COLLECTION AND ANALYSIS: Thirteen RCTs were included. There were important differences in the doses of radiotherapy investigated, patient characteristics and the outcomes measured. Because of this heterogeneity no meta-analysis was attempted. MAIN RESULTS: We found trials comparing EBB to EBRT alone, EBB plus EBRT to EBRT alone, EBB plus chemotherapy to EBB alone, EBB to Nd-YAG laser and comparisons between diverse fractionation schedules of high dose rate EBB. From the heterogeneous information obtained from several small RCTs, we concluded that EBRT alone is more effective for palliation of NSCLC symptoms than EBB alone. Our findings did not provide conclusive evidence to recommend EBB plus EBRT to relieve symptoms compared to EBRT alone. Overall, for the primary endpoint of survival there was no evidence of benefit for EBB compared to EBRT and Nd-YAG laser or for the combination of EBB with chemotherapy. Additionally, findings from one trial suggested that twice 7.4 Gy was superior to the four times per week 3.8 Gy schedule for mean time of local control and fatal haemoptysis. No significant differences were found for fatal haemoptysis as an adverse event of EBB. AUTHORS' CONCLUSIONS: The evidence did not provide conclusive results that EBB plus EBRT improved symptom relief over EBRT alone. We were not able to provide conclusive evidence to recommend EBB with EBRT, chemotherapy or Nd-YAG laser. For patients previously treated by EBRT who are symptomatic from recurrent endobronchial central obstruction, EBB may be considered in selected cases.

Antibiotics for acute laryngitis in adults.

BACKGROUND: Acute laryngitis is a common illness worldwide. Diagnosis is often made by case history alone and treatment is often directed towards controlling symptoms. OBJECTIVES: The aim of this review was to assess the effectiveness of different antibiotic therapies in adults suffering acute laryngitis. A secondary objective was to report the rates of adverse events associated with these treatments. SEARCH STRATEGY: We systematically screened the following electronic databases: the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2006); MEDLINE (January 1966 to December Week 2 2006); and EMBASE (1974 to June 2006), LILACS (from 1982 to December 2006 ) and BIOSIS (1980 to June 2002). Other strategies included hand searching relevant journals, searching ongoing trial databases and general databases such as Google scholar. SELECTION CRITERIA: Randomized controlled trials comparing any antibiotic therapy with placebo in acute laryngitis. The main outcome measurement was objective voice scores. DATA COLLECTION AND ANALYSIS: Data were independently extracted by two review authors and then descriptively synthesized. MAIN RESULTS: Only two trials met study inclusion criteria after extensive literature searches. One hundred participants were randomly selected to receive either penicillin V (800 mg twice a day for five days), or an identical placebo, in a study of penicillin V in acute laryngitis in adults. A tape recording of each patient reading a standardized text was obtained during the first visit, subsequently during re-examination after one and two weeks, and at follow up after two to six months. No significant differences were found between the groups. The trial also measured symptoms reported by participants and found no significant differences. The second trial investigated erythromycin for treating acute laryngitis in 106 adults. The mean objective voice scores measured at the first visit, at re-examination after one and two weeks, and at follow up after two to six months did not significantly differ between control and intervention groups. At one week there were significant beneficial differences in the severity of reported vocal symptoms as judged by the participants (P = 0.042). Comparing the erythromycin and placebo groups on subjective voice scores the a priori relative risk (RR) was 0.7 (95% confidence interval (CI) 0.51 to 0.96, P = 0.034) and the number needed to treat (NNT) was 4.5. AUTHORS' CONCLUSIONS: Antibiotics appear to have no benefit in treating acute laryngitis. Erythromycin could reduce voice disturbance at one week and cough at two weeks when measured subjectively. We consider that these outcomes are not relevant in clinical practice. The implications for practice are that prescribing antibiotics should not be done in the first instance as they will not objectively improve symptoms.

Antibiotics for acute laryngitis in adults.

BACKGROUND: Acute laryngitis is a common illness worldwide. Diagnosis is often made by case history alone and treatment is often directed towards controlling symptoms. OBJECTIVES: The aim of this review was to assess the effectiveness of different antibiotic therapies in adults suffering acute laryngitis. A secondary objective was to report the rates of adverse events associated with these treatments. SEARCH STRATEGY: We systematically screened the following electronic databases: the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2004); MEDLINE (January 1966 to June Week 3 2004); and EMBASE (1974 to June 2004), LILACS (from 1982 to the 40th edition) and BIOSIS (1980 to June 2002). Other strategies included hand searching relevant journals, searching ongoing trial databases and general databases such as Alta Vista. SELECTION CRITERIA: Randomized controlled trials comparing any antibiotic therapy with placebo in acute laryngitis. The main outcome measurement was objective voice scores. DATA COLLECTION AND ANALYSIS: Data were independently extracted by two people and then descriptively synthesised. MAIN RESULTS: Only two trials met study inclusion criteria after extensive literature searches. One hundred patients were randomly selected to receive either penicillin V (800 mg twice a day for five days), or an identical placebo, in a study of penicillin V in acute laryngitis in adults. A tape recording of each patient reading a standardised text was obtained during the first visit, subsequently during re-examination after one and two weeks, and at follow up after two to six months. No significant differences were found between the groups. The trial also measured symptoms reported by patients and found no significant differences. The second trial investigated erythromycin for treating acute laryngitis in 106 adults. The mean objective voice scores measured at the first visit, at re-examination after one and two weeks, and at follow up after two to six months did not significantly differ between control and intervention groups. At one week there were significant beneficial differences in the severity of reported vocal symptoms as judged by the patients (p = 0.042). Comparing the erythromycin and placebo groups on subjective voice scores the a priori relative risk (RR) was 0.7 (95% confidence interval (CI) 0.51 to 0.96, p = 0.034) and the number needed to treat (NNT) was 4.5. AUTHORS' CONCLUSIONS: Antibiotics appear to have no benefit in treating acute laryngitis. Erythromycin could reduce voice disturbance at one week and cough at two weeks when measured subjectively. We consider that these outcomes are not relevant in clinical practice. The implications for practice are that prescribing antibiotics should not be done in the first instance as they will not objectively improve symptoms.

Registro latinoamericano de experimentos clínicos en curso (latin-rec) / Latin-American registration of clinical experiments under way (latin-rec)

Es bien conocido que tanto los experimentos clínicos aleatorizados así como las revisiones sistemáticas de la literatura y los meta análisis bien conducidos, ofrecen la evidencia más confiable y de mejor calidad, sobre el efecto de las intervenciones en salud. Los autores de revisiones sistemáticas, así como de otros estudios integrativos entre los que se encuentran guías de práctica clínica basadas en evidencia, y análisis económicos, deben tratar de encontrar toda la evidencia relevante en un intento para minimizar el riesgo del sesgo de publicación, que corresponde al hecho que los resultados negativos, es decir aquellos que no encuentran diferencias entre los grupos de intervención, es menos probable que lleguen a la publicación, tardan más tiempo en ser publicados cuando lo hacen y tienden a publicarse más frecuentemente en el idioma nativo del autor cuando no es el inglés; todo esto podría conducir a una distorsión de la evidencia disponible para la toma de decisiones en la práctica clínica. Adicionalmente, algunos resultados de experimentos no son fácilmente recuperados en búsquedas de la literatura porque nunca han sido publicados o lo han hecho en revistas biomédicas no indexadas en las grandes bases de datos1 y 3. Desde mucho tiempo atrás se ha reconocido la importancia de registrar de manera sistemática y prospectiva los experimentos clínicos aleatorizados. Sin embargo, existen varias barreras que han impedido el desarrollo de un registro comprehensivo para los experimentos clínicos a saber: resistencia de la industria farmacéutica y tecnológica, recursos insuficientes para hacer sostenible la empresa del registro a largo plazo, dificultades para forzar a los investigadores a registrar su ensayo y carencia de conocimiento acerca de los problemas de no registrar los experimentos4...

[Effectiveness of flunarizine in the prophylaxis of migraine: a meta-analytical review of the literature]. / Eficacia de flunaricina en la profilaxis de migraña: revisión metaanalítica de la bibliografía.

BACKGROUND: Migraine is a common and disabling health problem among young and middle aged adults. Flunarizine have been used as a prophylactic medication in its management for more than two decades. OBJECTIVE: The aim of the study is to systematically review the evidence obtained from randomized controlled trials about the efficacy and security of flunarizine versus placebo for the prevention of migraine in adults. MATERIALS AND METHODS: Electronic search were performed using the databases MEDLINE, EMBASE, Biosis, the Cochrane Library, Lilacs and others. Reference lists of retrieved studies, reviews and conference abstracts were used to found another articles. Additionally, the authors performed a handsearched in recognized journals related to migraine and neurological topics. Randomized, placebo controlled, double blind trials assessing the efficacy of flunarizine for preventing migraine were included. We evaluated the frequency of the attacks by comparing the mean frequency before and after the intervention for each group of treatment and then the two groups were compared. To evaluate the security of flunarizine we used included and excluded studies and open trials. RESULTS: Nine studies were obtained but only four met the inclusion criteria. The fixed effects model reported a reduction in the frequency of attacks by using flunarizine. The monthly difference was 0.55 attacks (CI 95%= 0.215 0.895; p= 0.002). Somnolence was the most frequent adverse effect in 20.5% of the subjects (n= 1,987). CONCLUSIONS: Based on a small number of trials, flunarizine, at a daily dose of 10 mg lightly reduces the frequency of migraine attacks.

Aeromedical certification of a pilot with bi-lateral prosthetic hands--a case report.

This case report involved a 47-yr-old male pilot, with 20,000 h of total flight time, who was involved in an auto accident and suffered a traumatic amputation of both of his hands, as well as head injuries with temporary cognitive deficits. He underwent rehabilitation and was fitted with Otto Bock myoelectrically-controlled upper extremity (right and left) prostheses. In the past, the FAA had medically certified a total of 17 pilots (3 Second-Class and 14 Third-Class) with unilateral amputated hands (8-left and 9-right). This was the first case involving a bilateral hand amputee. This report describes the aeromedical certification procedure used to determine this pilot's fitness for the issuance of a Third Class Medical Certificate.