Impact of Raw, Roasted and Dehulled Chickpea Flours on Technological and Nutritional Characteristics of Gluten-Free Bread

The main objective of this study was to develop a healthy rice-based gluten-free bread by using raw, roasted, or dehulled chickpea flours. All breads containing chickpea flours showed a darker crust and were characterized by an alveolar (porosity 41.5–51.4%) and soft crumb (hardness 5.5-14.1 N). Roasted chickpea flour bread exhibited the highest specific volume, the softest crumb, and the slowest staling rate. Enriching rice-based breads with the chickpea flours resulted in increased protein (from 9.72 to 12.03–13.21 g/100 g dm), ash (from 2.01 to 2.45–2.78 g/100 g dm), fat (from 1.61 to 4.58–5.86 g/100 g), and total phenolic contents (from 49.36 up to 80.52 mg GAE/100 g dm), and in reduced (~10–14% and 13.7–17%, respectively) available starch levels and rapidly digestible starch compared to rice bread. Breads with roasted chickpea flour also showed the highest in vitro protein digestibility. The results of this study indicated that the enrichment of rice-based gluten-free breads with chickpea flours improved the technological and nutritional quality of the breads differently according to the processed chickpea flour used, also allowing recovery of a waste product.

Relation between proinflammatory to anti-inflammatory cytokine ratios and long-term prognosis in patients with non-ST elevation acute coronary syndrome

OBJECTIVE

To investigate the relation between serum high sensitivity (hs) C reactive protein (CRP), proinflammatory cytokine concentrations, proinflammatory to anti-inflammatory cytokine ratios and long-term prognosis in patients with non-ST elevation acute coronary syndrome (NSTEACS).

DESIGN

Prospective follow-up study for the first six months and then for the first year after admission to hospital.

SETTING

Tertiary referral centre.

PATIENTS

80 patients (60 men, 20 women, mean age 60 (SD 10) years) with NSTEACS and moderate to high TIMI (Thrombolysis In Myocardial Infarction) risk scores.

INTERVENTIONS

Blood samples from patients with NSTEACS were obtained at the time of admission. Serum concentrations of hs-CRP, (hs) pro-inflammatory (interleukin (IL) -1beta, IL-6, tumour necrosis factor alpha) and (hs) anti-inflammatory (IL-10) cytokines were analysed and proinflammatory to anti-inflammatory cytokine ratios were calculated by dividing proinflammatory cytokine concentrations by anti-inflammatory cytokine IL-10.

MAIN OUTCOME MEASURE

The primary end point of the study was new coronary events (NCE) defined as the combination of cardiac death, non-fatal myocardial infarction and recurrent rest angina that required hospitalisation within 12 months of follow up.

RESULTS

During the one-year follow-up period, 23 patients (29%) met the NCE criteria. Concentrations of hs-CRP, IL-1beta and IL-6 and ratios of IL-1beta:IL-10 and IL-6:IL-10 were significantly higher in patients with NCE than in patients without NCE. In the logistic regression analysis, IL-6:IL-10 ratio was the most important predictor for NCE (p = 0.006) with an odds ratio of 2.24 (95% CI 1.26 to 3.97).

CONCLUSIONS

Cytokine concentrations and proinflammatory to anti-inflammatory cytokine ratios may be useful markers for predicting vascular risk in patients with NSTEACS.

Hepatomesenteric trunk

An hepatomesenteric trunk, formed by the common hepatic and superior mesenteric arteries, was found in a 50-year-old male cadaver. The left gastric and splenic arteries arose as a common trunk, the gastrosplenic trunk, from the abdominal aorta; no typical celiac trunk was present. In addition, the hepatomesenteric trunk passed posterior to the portal vein. A knowledge of variations of the common hepatic artery may be important in pancreaticoduodenectomy, as well as during hepatic artery infusion chemotherapy.

Effect of the Valsalva manoeuver on diastolic filling indices in patients with essential hypertension

In some hypertensive patients, echocardiographic examination does not reveal any pathologic finding in spite of a documented blood pressure elevation. In our study, we investigated the effect of preload reduction with Valsalva manoeuver on transmitral flow velocities in hypertensive patients with normal mitral flow pattern and compared the results with a healthy control group. Sixty-eight patients without evidence of coronary artery disease or heart failure (28 female, 40 male, age 50 +/- 7) were divided in two groups according to their E/A ratio as those with diastolic dysfunction (n = 36) and without diastolic dysfunction (DD(-): n = 32). DD(-) patients and the control group (n = 20) performed Valsalva manoeuver and their pulsed-Doppler mitral flow measurements were repeated at the strain phase. During Valsalva manoeuver, E wave velocity decreased in all subjects. In the controls, peak A velocity showed a similar decline and E/A ratio remained over 1.0. However, in 72% of DD(-) patients A velocity did not change or increased and their E/A ratio fell below 1.0. In 47% of the patients with an E/A ratio reversal after Valsalva manoeuver, myocardial perfusion scintigraphy revealed reversible defects whereas none of the patients whose E/A ratio remained over 1.0 had perfusion defects. It is concluded that: (1) in hypertensive patients with normal E/A ratio Valsalva manoeuver should be performed in order to unmask a probable false normal finding, (2) an important percent of hypertensive individuals have left ventricular relaxation abnormalities, and (3) diastolic dysfunction develops together with a decrease in coronary reserve.