Zinc-fortified Cheddar cheese containing 228 mg of zinc/kg of cheese was manufactured from milk that had 16 mg/kg food-grade zinc sulfate added. Cheeses were aged for 2 mo. Culture activity during cheese making and ripening, and compositional, chemical, texture, and sensory characteristics were compared with control cheese with no zinc sulfate added to the cheese milk. Compositional analysis included fat, protein, ash, moisture, zinc, and calcium determinations. The thiobarbituric acid (TBA) assay was conducted to determine lipid oxidation during aging. Texture was analyzed by a texture analyzer. An untrained consumer panel of 60 subjects evaluated the cheeses for hardness, off-flavors, appearance, and overall preference using a 9-point hedonic scale. Almost 100% of the zinc added to cheese milk was recovered in the zinc-fortified cheese. Zinc-fortified Cheddar cheese had 5 times more zinc compared with control cheese. Zinc-fortified cheese had higher protein and slightly higher fat and ash contents, whereas moisture was similar for both cheeses. Zinc fortification did not affect culture activity during cheese making or during the 2-mo aging period. The TBA value of control cheese was higher than that of zinc-fortified cheese at the end of ripening. Although zinc-fortified cheese was harder as determined by the texture analyzer, the untrained consumer panel did not detect differences in the sensory attributes and overall quality of the cheeses. Fortification of 16 mg/kg zinc sulfate in cheese milk is a suitable approach to fortifying Cheddar cheese without changing the quality of Cheddar cheese.

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Introduction: Infective endocarditis (IE) is a rare disease with high mortality and morbidity. In recent years, an increase in the frequency of infective endocarditis has been observed due to the increase in the survival of cases with congenital heart diseases (CHDs) and the use of central catheters. In addition to revealing the incidence of IE in our clinic, this study aimed to evaluate the demographic characteristics, predisposing factors, clinical, laboratory, microbiological, and echocardiographic findings, and the complications of follow-up of our patients diagnosed with IE in light of the literature.Material and methods: Thirteen patients with IE who were hospitalized in Pediatric Cardiology Clinic, Pamukkale University Medical Faculty Hospital between January 2016 and August 2021 were retrospectively reviewed. The patients included in the study were evaluated in terms of demographic characteristics, predisposing factors, clinical, laboratory and microbiological findings, echocardiography data, surgical intervention needs, and complications. The incidence of IE in our clinic was defined as the rate of IE among patients admitted to the hospital and reported as the number of patients with IE per 100,000 hospital admissions.Results: The median age of these 13 patients was 11 (7-14) years, and the male/female ratio was 6/7. The five-year IE incidence in Pediatric Cardiology Clinic, Pamukkale University Medical Faculty Hospital, was found to be 2.5 in approximately 100,000 hospital admissions. A predisposing factor was detected in all patients. Six patients (46%) had CHDs, and four patients (31%) had acquired heart disease. The other three (23%) patients were receiving immunosuppressive therapy, and these patients had long-term port catheters. Eight (62%) patients had positive blood cultures. Streptococcus viridans, Streptococcus gordonii, Staphylococcus aureus, coagulase-negative Staphylococcus, Brucella spp, and Candida albicans were isolated in the blood cultures of these patients. IE-related complications developed in seven (54%) patients. Five (38%) had heart failure, three patients (23%) had thromboembolic events, two (15%) had glomerulonephritis, and one (8%) had thrombophlebitis. Four patients were referred to early surgery. Two patients with recurrent IE attacks were referred to surgery after their treatment was completed. Conclusion:The incidence of IE has shown an increase recently with increased rates of survival attributable to corrective surgeries performed for congenital heart diseases, increased prosthetic materials used in cardiac surgeries, and increased use of permanent catheters. In our study, the incidence of IE was found to be 2.5 in 100,000 hospital admissions. Our results have shown that rheumatic heart diseases, besides CHDs, are still an important risk factor for Turkey. Due to the low number of cases in IE studies in the pediatric population, there is a need for further studies to be conducted in large series in this field.