Experimental approach to optimize the use of alpha-Amylases in breadmaking.

alpha-Amylases from different origins (wheat, malted barley, fungi, and bacteria) are used extensively to improve breadmaking. However, the enzyme activities, in addition to the differences associated with their origins, are strongly affected by the process conditions and the presence of other compounds in the medium. The activity of different alpha-amylases was tested under different conditions (pH and temperature), and in the presence of some bread ingredients (salt and sugar), some breadmaking additives (ascorbic acid and sodium propionate), and some metabolites (organic acids and saccharides) generated during the fermentation step, to envisage the behavior of these alpha-amylases during the breadmaking process. The alpha-amylase activities were affected to a different extent by the addition of these compounds depending on the enzyme origin. In general, the alpha-amylases from cereals (wheat and malted barley) were less sensitive to the presence of some ingredients, additives, and metabolites. These results show the great variation of the alpha-amylase activity with the process conditions and the importance of its knowledge in the selection of the appropriate alpha-amylase for a specific breadmaking process.

Duodenal switch: an effective therapy for morbid obesity--intermediate results.

BACKGROUND: The duodenal switch (DS) is a variant of the biliopancreatic diversion (BPD), with a vertical subtotal gastrectomy and pylorus preservation. METHODS: DS was used to treat morbid obesity in 125 patients, with mean BMI 50, with 65% of the patients super obese (SO). Patients have been followed for an intermediate period. RESULTS: The percentage of excess weight loss (%EWL) was > 70% at 1 year, and reached 81.4% at 5 years when 97% of the patients had a %EWL > 50%. Comorbidities were cured or improved in all patients. CONCLUSION: DS was very effective for the treatment of the morbid obesity in the SO patients.

El cruce duodenal: una terapia efectiva en la obesidad mórbida. Estudio intermedio / Duodenal switch: an effective therapy for morbid obesity. An intermediate study

El cruce duodenal es una variante de la derivación biliopancreática. Se describen la técnica, su morbimortalidad, los resultados intermedios, los efectos secundarios y las indicaciones como una técnica mixta para el tratamiento de la obesidad mórbida. El porcentaje de sobrepeso perdido se incrementa del 70 por ciento al año hasta el 81,37 por ciento a los 5 años (AU)

Preliminary results of the duodenal switch.

BACKGROUND: The duodenal switch (DS), as a modification of the bilio-pancreatic diversion (BPD), is a 'complex' hybrid operation. METHODS: Sixty patients were operated on during the last 3 years. RESULTS: Two patients died early (3.3%); two late deaths occurred at 4 and 7 months, one due to liver failure and the other due to malnutrition and refeeding syndrome (3.57%); three patients required conversions (5.3%). The two early deaths and all the patients who required conversions had a previous vertical banded gastroplasty. Eleven patients had minor liver abnormalities corrected with medications, and one patient had severe diarrhea for more than a year. Eleven female patients have iron deficiency anemia that requires parenteral supplementation. Mean percent excess weight loss was 86% at 2.5 years. CONCLUSIONS: The DS has been, in our experience, an unsafe operation with unacceptably high operative and postoperative mortality. The conversion rate is acceptable. Weight loss, quality of food intake and life have been excellent. Inadequate follow-up can be dangerous if patients fail to report for regular visits.