Olive co-processing consists of the addition of ingredients either in the mill or in the malaxator. This technique allows selecting the type of olives, the ingredients with the greatest flavoring and bioactive potential, and the technological extraction conditions. A new product—a gourmet flavored oil—was developed by co-processing olives with Thymus mastichina L. The trials were performed using overripe fruits with low aroma potential (cv. ‘Galega Vulgar’; ripening index 6.4). Experimental conditions were dictated by a central composite rotatable design (CCRD) as a function of thyme (0.4−4.6%, w/w) and water (8.3−19.7%, w/w) contents used in malaxation. A flavored oil was also obtained by adding 2.5% thyme during milling, followed by 14% water addition in the malaxator (central point conditions of CCRD). The chemical characterization of the raw materials, as well as the analysis of the flavored and unflavored oils, were performed (chemical quality criteria, sensory analysis, major fatty acid composition, and phenolic compounds). Considering chemical quality criteria, the flavored oils have the characteristics of “Virgin Olive Oil” (VOO), but they cannot have this classification due to legislation issues. Flavored oils obtained under optimized co-processing conditions (thyme concentrations > 3.5−4.0% and water contents varying from 14 to 18%) presented higher phenolic contents and biologic value than the non-flavored VOO. In flavored oils, thyme flavor was detected with high intensity, while the defect of “wet wood”, perceived in VOO, was not detected. The flavored oil, obtained by T. mastichina addition in the mill, showed higher oxidative stability (19.03 h) than the VOO and the co-processed oil with thyme addition in the malaxator (14.07 h), even after six-month storage in the dark (16.6 vs. 10.3 h).

Heart failure (HF) is a chronic progressive disease with high morbimortality and poor quality of life (QoL). Palliative care significantly improves clinical outcomes but few patients receive it, in part due to challenging decisions about prognosis. This retrospective study, included all patients consecutively discharged from an Acute Heart Failure Unit over a period of one year, aiming to assess the accuracy of the Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score in predicting mortality. Additionally, predictors of death at one and three years were explored using a multivariate regression model.The MAGGIC score was useful in predicting mortality, without significant difference between mortality observed at three-years follow-up compared with a mortality given by the score (p=0.115). Selected variables were statistically compared showing that poor functional status, high New York Heart Association (NYHA) at discharge, psychopharmacs use, and high creatininemia were associated with higher mortality (p<0.05).The multivariate regression model identified three predictors of one-year mortality: psychopharmacs baseline use (OR=4.110; p=0.014), angiotensin-converting enzyme inhibitors/angiotensin receptor blocker (ACEI/ARB) medication at discharge (OR=0.297; p=0.033), and higher admission's creatinine (OR=2.473; p=0.028). For three-year mortality outcome, two variables were strong independent predictors: psychopharmacs (OR=3.330; p=0.022) and medication with ACEI/ARB at discharge (OR=0.285; p=0.018). Models' adjustment was assessed through the receiver operating characteristic (ROC) curve. The best model was the one-year mortality (area under the curve, AUC 81%), corresponding to a good discrimination power.Despite prognostication, when setting goals of care an individualised patient-centred approach is imperative, based on the patient's objectives and needs. Risk factors related to poorer outcomes should be considered, in particular, higher NYHA at discharge which also represents symptom burden. Hospitalisation is an opportunity to optimize global care for heart failure patients including palliative care.

The marked increase in life expectancy seen in Portugal in the last five decades led to a change in the profile of patients being most commonly admitted in internal medicine wards. In deciding the best care for these patients, prognostication models are needed in order to reduce readmissions, mortality, and adequate care. We aimed to study short and long-term mortality and predictors of all-cause mortality, independently of cause admission, of patients admitted in an internal medicine ward. MethodsThis two-part, single-center study enrolled patients from October 2013 to October 2014 with a follow-up of 60 months. ResultsA total of 681 patients were included; the mean age was 75.86 years with 60.4% females. The most frequent comorbidities were anemia, hypertension, and renal impairment. More than half of the population died in the follow-up period (51.5%). Deaths were significantly higher in the first six months after discharge (53% of all deaths) and then decreased abruptly to 11.6% in the second half-year after discharge. Based on the multivariate logistic regression model, with age over 80 years, anemia and neoplasm were independent predictors of short-term (p<0.001, p=0.001, p<0.001, respectively) and long-term (p<0.001 for the three conditions) mortality. Heart failure (p=0.018) and diabetes (p=0.025) were also predictors of longterm mortality. ConclusionHigh mortality, mainly in the first six months after discharge, elicits strategies targeting transition of care and close follow-up in the first months, which can be the key to improving outcomes. Identification of patients at higher risk may help design realistic models aiming to improve care for this frail population and decrease morbimortality.

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