Microencapsulation of Phenolic Extracts from Cocoa Shells to Enrich Chocolate Bars.

Cocoa bean shells were subjected to green extraction technologies, based on the absence of toxic organic solvents, to recover polyphenols; the extract was then encapsulated using a spray dryer and maltodextrin as coating agent. The best conditions observed in the spray drying tests (core-to-coating ratio 1:5; inlet temperature 150 °C; flow rate 6 ml min-1) were applied to produce the microcapsules used to enrich the same cocoa mass as the shells and processed for the preparation of the chocolate bars. Sensory analysis showed no significant differences between enriched chocolate bar and the unenriched reference one, except for the appearance. Both samples were then subjected to accelerated storage tests, at the end of which the polyphenols in the control chocolate bar (0.85 g 100 g-1) were reduced by about 50% (0.42 g 100 g-1), while in the enriched chocolate (1.17 g 100 g-1) by only 22% (0.97 g 100 g-1). The proposed process significantly enriched the chocolate bars with phenolic antioxidants recovered from cocoa waste without increasing the sensations of bitterness and astringency.

Neurofibromatosis type 1 and optic pathway glioma. A long-term follow-up.

AIM: Optic pathway gliomas (OPG) are the predominant intracranial tumours associated with neurofibromatosis type 1 (NF1). The aim of this study was to evaluate the prevalence and the outcome of OPG in 200 NF1 patients (122 males and 78 females, aged 1-25 years) followed up to 16 years (mean of 6 years). METHODS: All children were evaluated by a detailed physical, neurological and ophthalmological examination. Fifteen out of 200 (7.5%) of these patients (7 males, 8 females) were identified with evidence of optic pathway tumours. RESULTS: Nine children had symptoms such as endocranial hypertension, seizures, headache; 4 patients only showed anomalies at ophthalmological examination; 2 patients had no symptoms or signs. All children had evidence of optic pathway tumour on magnetic resonance imaging. Three had a prechiasmal tumour, 2 had a chiasmal tumour, 1 had prechiasmal/chiasmal tumour, 2 had a prechiasmal/chiasmal and postchiasmal tumour, 2 had a chiasmal and postchiasmal tumour, 4 had a massive involvement of the optic system, 1 child exhibited a bilateral involvement of the optic nerves with additional impairment of the chiasm. Four patients had partial and/or subtotal spontaneous regression. CONCLUSIONS: Because optic pathway tumours arise in children younger than 6 years of age, all NF1 children should undergo yearly ophtalmologic examination and growth assessment to monitor signs of precocious puberty.

[Abdominal pregnancy. Clinical case in surgical emergncy]. / La gravidanza addominale. Caso clinico operato in emergenza.

A clinical case of abdominal pregnancy observed during emergency laparotomy in a woman suffering for acute abdominal pain, is described. The difficulty of an ectopic pregnancy diagnosis and the catastrophic consequence of an missing diagnosis are underlined.

[Surgical treatment of thyroid diseases in geriatric patients]. / Il trattamento delle tireopatie chirurgiche nel paziente in età geriatrica.

Thyroid diseases have a characteristic evolution in geriatric age, whether for the symptomatology frequently mingled with typical manifestations of again, or for glandular involution. Moreover, in the aged patient, the particular aspect of the epidemiology, physiopathology, clinic and therapy are to know and interpret. In most cases, the presence of a uni- or multi-nodular goiter does not cause compression problems or cancerization risk. In the presence of these problems and in multi-nodular goiter, we prefer total thyroidectomy because, at the present time, it is possible to put at zero the risks of this operation, neither we fear hypothyroidism which all the same also appears in less extensive operations. Between thyroid diseases, cancer has a typical biological behaviour and prognosis in geriatric patients. While most tumors have a better curability in geriatric age, these have a worse prognosis. So therapeutic indications very as a function of age. About this the authors present preliminary data of a prospective trial started in 1992.

[Use of mechanical staplers in surgery of aneurysms of the abdominal aorta]. / L'impiego delle cucitrici meccaniche nella chirurgia degli aneurismi dell'aorta addominale.

This research aims to illustrate the advantages of using staplers in abdominal aorta surgery. The authors describe their experience in a personal case, of a patient suffering from aneurysmatic expansion of the abdominal aorta extending to both the common iliac arteries. The use of staplers for the closing of the distal stumps in particularly advantageous because it makes less problematic the dissection of the iliac and by hypogastric artery from their underlying veins. That involves a risk diminution of the iliac vein accidental lesions, better by hypogastric artery revascularization, shortening of any times and the perfect haemostatic holding of the mechanical suture, allowing a reduction in mortality and morbidity.

[Post-phlebothrombotic venous insufficiency of the lower limbs. Echo-guided targetted surgery]. / Insufficienza venosa post-flebotrombotica degli arti inferiori. La chirurgia mirata eco-guidata.

The post-phlebothrombotic syndrome surgery has always had a limited space within the limits of the venous lower limbs surgery. This, either for the distrust of surgeon to operate a limb with deep thrombotic phenomenon, or because the range of possible operations is rather limited and constituted by very cruent and devasting operations. The introduction of very accurate method in the preoperative diagnostic, as the echo-color-Doppler, enables an accurate mapping of the new venous post-phlebothrombotic situation and a careful haemodynamic study of the deep or superficial venous circle. Hence, the surgeon has a new and significant chance to perform a minimal surgery generally directed to the ligation of the perforans veins that has become incontinent after the phlebothrombotic insult. In this way, the wide and devasting dissection can be avoided as previous Linton-type interventions.

[The "pedrada" ("coup-de-fouet") syndrome. A possibility to be considered in acute leg pain]. / Sindrome della "pedrada". Un'eventualità da considerare nel dolore acuto della gamba.

The authors describe a clinical case of pedrada syndrome in a patient formerly suffering from acute CID. It is a pathology enough rare and easily mistakable with phlebotrombosis of leg but from which is well to be able to do differential diagnosis because of therapy for an affection is clearly contraindicated for the other.