Long-Term Effect on Bioactive Components and Antioxidant Activity of Thermal and High-Pressure Pasteurization of Orange Juice.

The long-term effect of thermal pasteurization (TP) and high-pressure processing (HPP) of orange juices stored under refrigeration, on the bioactive components and antioxidant activity, was compared. Total phenolic content (TPC), flavonoid, anthocyanin, and carotenoid contents, the individual content of major phenolic components, and the antioxidant activity, were evaluated in TP- and HPP-treated juices over a 36-day period. At day 0, no significant differences in TPC, and a decrease in carotenoid content after both treatments, were observed. TP caused a decrease of flavonoid and anthocyanin contents, while HPP increased flavonoid content. Three major phenolic components were identified: apigenin-6,8-di-C-glucoside, naringenin-7-O-rutinoside, and hesperetin-7-O-rutinoside, the latter increasing ca. 45% immediately after HPP. During storage, a decrease in TPC, and in the anthocyanin and carotenoid contents of both treated juices was observed, with higher anthocyanin and phenolic contents in HPP juices. A significant increase of hesperetin-7-O-rutinoside content was observed in HPP juice. Both treatments caused a decrease (26% and 13%, respectively) of antioxidant activity. Most of the kinetic profiles followed zero-order patterns, with HPP juices showing a considerably higher half-life than TP ones. These results clearly demonstrate the advantages of HPP for orange juice preservation allowing, also, their nutritional benefits to be enhanced by increasing the content of some bioactive components.

Predicting outcome after cardiopulmonary arrest in therapeutic hypothermia patients: clinical, electrophysiological and imaging prognosticators.

INTRODUCTION: Predicting outcome in comatose survivors of cardiac arrest is based on data validated by guidelines that were established before the era of therapeutic hypothermia. We sought to evaluate the predictive value of clinical, electrophysiological and imaging data on patients submitted to therapeutic hypothermia. MATERIALS AND METHODS: A retrospective analysis of consecutive patients receiving therapeutic hypothermia during years 2010 and 2011 was made. Neurological examination, somatosensory evoked potentials, auditory evoked potentials, electroencephalography and brain magnetic resonance imaging were obtained during the first 72 hours. Glasgow Outcome Scale at 6 months, dichotomized into bad outcome (grades 1 and 2) and good outcome (grades 3, 4 and 5), was defined as the primary outcome. RESULTS: A total of 26 patients were studied. Absent pupillary light reflex, absent corneal and oculocephalic reflexes, absent N20 responses on evoked potentials and myoclonic status epilepticus showed no false-positives in predicting bad outcome. A malignant electroencephalographic pattern was also associated with a bad outcome (p = 0.05), with no false-positives. Two patients with a good outcome showed motor responses no better than extension (false-positive rate of 25%, p = 0.008) within 72 hours, both of them requiring prolonged sedation. Imaging findings of brain ischemia did not correlate with outcome. DISCUSSION: Absent pupillary, corneal and oculocephalic reflexes, absent N20 responses and a malignant electroencephalographic pattern all remain accurate predictors of poor outcome in cardiac arrest patients submitted to therapeutic hypothermia. CONCLUSION: Prolonged sedation beyond the hypothermia period may confound prediction strength of motor responses.

Introdução: A determinação do prognóstico em sobreviventes comatosos de paragem cárdio-respiratória baseia-se em evidência adquirida sobretudo antes do advento da hipotermia terapêutica. O nosso objectivo é avaliar a capacidade preditiva de dados clínicos, electrofisiológicos e imagiológicos após a hipotermia terapêutica. Materiais e Métodos: Análise retrospectiva e consecutiva de doentes que foram tratados com hipotermia durante os anos de 2010 e 2011. Foram obtidos dados relativamente ao exame neurológico, potenciais evocados somatossensitivos e auditivos, electroencefalograma e ressonância magnética crânio-encefálica, nas primeiras 72 horas após o evento. O outcome definido foi a escala Glasgow Outcome Scale dicotomizada em mau prognóstico (pontuações 1 e 2) e bom prognóstico (pontuações 3, 4 e 5). Resultados: Estudados no total 26 doentes. Reflexos pupilares, corneanos e oculocefálicos abolidos, ausência de respostas N20 nos potenciais evocados somatossensitivos, estado de mal mioclónico e um padrão 'maligno' na electroencefalografia relacionaram-se com mau prognóstico, sem falsos-positivos (p = 0,05). Dois doentes classificados com bom outcome demonstraram respostas motoras ausentes ou em extensão nas primeiras 72 horas, originando uma taxa de falsos-positivos de 25% para este parâmetro (p = 0,008). Ambos requereram sedação até às 72 horas. A presença de isquémia na ressonância não teve relação significativa com o outcome. Discussão: A abolição dos reflexos pupilares, corneanos e oculocefálicos, a ausência de respostas N20 nos potenciais evocados, estado de mal mioclónico e um padrão electroencefalográfico 'maligno' mantêm-se parâmetros de mau prognóstico válidos em doentes submetidos a hipotermia terapêutica. Conclusão: A necessidade de sedação nestes doentes pode diminuir a capacidade prognóstica das respostas motoras.