Totally extraperitoneal repair of groin hernia in liver transplant patients: a case series study (TOHER).

PURPOSE: The present study aims to describe the feasibility and the postoperative results of groin hernia repair in liver transplant patients using a totally extra-peritoneal (TEP) repair approach. METHODS: From May 2022 to March 2023, liver transplant patients with groin hernia underwent TEP groin hernia repair, by the single common senior experimented surgeon. Background information, intraoperative findings, postoperative complications, postoperative pain, health, and well-being were registered. RESULTS: Thirteen TEP approach groin hernioplasties were performed in 10 patients, completing the procedure in all cases without the need for conversion either to open or transabdominal preperitoneal approaches. 70% of surgical explorations revealed multiple hernia defects: lateral hernias in all patients, medial defects in 62%, and femoral defects in 30.8%. Median hospital stay was 1 day [range (0.3)], with 30% treated as outpatients. Post-surgical complications occurred in 30% of cases: 1 hematoma and 2 seromas. Postoperative pain and physical functioning scored 100 (IQR 44) and 90 (IQR 15), respectively. CONCLUSION: TEP groin hernioplasty is safe and feasible for liver transplant patients, with low complication rates, short hospital stays, and a significant proportion treated as outpatients. The posterior approach allows comprehensive repair of myopectineal defects, crucial due to associated hernial defects.

Ceguera digna y degeneración macular asociada a la edad. Un necesario enfoque multidisciplinar / Dignified blindness and age-related macular degeneration. A necessary multidisciplinary approach

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Wine aromatic compound production and fermentative behaviour within different non-Saccharomyces species and clones.

AIMS: Twenty-five enological yeasts belonging to nine different species (Candida zeylanoides, Cryptococcus uzbekistanensis, Debaryomyces hansenii, Lachancea thermotolerans, Metschnikowia pulcherrima, Torulaspora delbrueckii, Williopsis pratensis, Zygosaccharomyces bailii and Saccharomyces cerevisiae) were screened for aroma formation and fermentative behaviour as part of a non-Saccharomyces yeast selection programme. METHODS AND RESULTS: Pure cultures were inoculated in pasteurized grape juice in order to perform alcoholic fermentations. Some non-Saccharomyces species did not ferment, others did not get established and none of them completed alcoholic fermentations. The physico-chemical parameters of the wines and the abundance of aromatic compounds at the end of alcoholic fermentation highlighted the notable differences in the aroma-forming ability and fermentative behaviour of the different non-Saccharomyces species, but not within clones. CONCLUSIONS: Lower diversity was detected within non-Saccharomyces species than that reported in S. cerevisiae with regard to enological behaviour and aromatic profiles. Metschnikowia pulcherrima and L. thermotolerans are the two species with higher possibilities to become an inoculum. SIGNIFICANCE AND IMPACT OF THE STUDY: Few significant differences were found within clones of the same species, but very important parameters in wine quality, such as volatile acidity, ethyl acetate and acetoin, which would justify selection programmes within those species. The results also demonstrated that T. delbrueckii and L. thermotolerans are two close species in their aromatic profiles.

Genetic and phenotypic intraspecific variability of non-Saccharomyces yeasts populations from La Rioja winegrowing region (Spain).

AIMS: To determine the intraspecific genetic diversity within five non-Saccharomyces yeast species and the diversity in phenotypic characteristic related to their technological properties. METHODS AND RESULTS: Seventy-one non-Saccharomyces yeasts isolated from different fermentations and facilities of the DOCa Rioja (Spain) belonging to five different wine species (Torulaspora delbrueckii, Lachancea thermotolerans, Metschnikowia pulcherrima, Zygosaccharomyces bailii and Williopsis pratensis) were subjected to clonal characterization by RAPD-PCR, which evidenced wide diversity between them. They were also submitted to a screening for some oenological traits related to the improvement of the aroma of the wine and yeast development in musts. Strains within the same species showed different enzyme activities, tolerated different levels of SO2 and possessed different killer phenotypes. These characteristics made them adjust better or worse to specific vinification processes or wine quality criteria. CONCLUSIONS: A significant genetic and phenotypic variation within the non-Saccharomyces species studied was found, which makes necessary to carry out a selection process in each one. SIGNIFICANCE AND IMPACT OF THE STUDY: Williopsis pratensis, a species that has not been thoroughly explored, may deserve further consideration for oenological applications. Due to the wide range of variation within species, the strains adaptation to the SO2 levels in musts has to be taken into account in selection processes.

Revisión de la seguridad en anesthesia ante un incendio en quirófano / Review: safety in anesthesia in case of fire in the operating room

Los incendios en quirófano son poco frecuentes pero potencialmente catastróficos. Suponen un peligro potencial en la práctica de la anestesia quirúrgica. El anestesiólogo debe prevenir este tipo de eventos, mediante el chequeo del funcionamiento de equipos y materiales, y la prevención de circunstancias que podrían llevar a la producción de fuego. Presentamos una revisión sobre las consideraciones principales en la seguridad intraoperatoria, a propósito de un caso acontecido en nuestro quirófano que precisó el empleo de sierra radial

Fires at operating are rare but catastrophic, supposing a potential hazard during the practice of surgical anesthesia. It is essential for the anesthesiologist the prevention of these events by identifiying the elements that could cause such situations, performing a correct checking of the equipment and materials, and taking extreme care with circumstances which could lead to the production of fire. We present main considerations about safety at operating room, by explaining our experience while using a radial jaw during an intestinal surgery

Comparison of culture media for the recovery of airborne yeast in wineries.

The direct air sampling impaction method on agar was evaluated using aerobiocollectors for the recovery of yeasts present in the winery air. Three culture media with different composition and specificity were studied. In addition, a resuscitation phase was included before the culture in the specificity medium [in the case of the Dekkera-Brettanomyces Differential Medium (DBDM) medium]. Sampling was conducted at different times of the year and in different parts of the wineries, which were different in age and design. Both the Chloramphenicol Glucose Agar (CGA) and Agar Lysine AL media recovered yeasts from the air without any prior resuscitation phase. CGA was able to recover a higher number of colony-forming units of yeasts than the other media. Consequently, to estimate the number of yeasts present in winery air, the best choice of medium would be CGA. The AL medium permitted the growth of the greatest range of genera and species. If the aim is to study the diversity of yeasts present in the air, the most suitable medium is AL. Neither CGA nor AL proved suitable for recovering yeasts of the Brettanomyces genus. The DBDM medium was the only one which provided sufficient specificity for their recovery and identification from the air, although their special characteristics made a prior protocol of resuscitation necessary.

Factors of influence in the distribution of mold in the air in a wine cellar.

UNLABELLED: This paper studies the presence of mold in the air of a vinification and ageing wine cellar. The influence of other factors such as the time of year, the sampling point, and the activity being carried out in the cellar has been analyzed. Neither the type of activity being carried out in the cellar nor the temperature or relative humidity fluctuations throughout the year are determining factors in the presence of mold in the air. For this group of microorganisms, the design of the cellar studied is the fundamental factor. Areas with little ventilation favor high levels of relative humidity and, hence, a higher presence of mold in the air. The mold population in these areas is not very diverse, which indicates that colonization by certain types of mold that have adapted to the conditions established therein is permanent. Areas with greater air flow, constant activity, and frequent cleaning show lower mold populations in the air and of a more varied composition. PRACTICAL APPLICATION: This work shows that given the growing importance of the presence of mold in wine cellars, the design thereof should take into account suitable ventilation of all the areas and control of the relative humidity. Hence, the presence of traditional underground areas for ageing wine, which is justifiable in seasons where temperature and humidity control lead to major technical problems, should be reconsidered in the design of new wine cellars.

Presence of non-Saccharomyces yeasts in cellar equipment and grape juice during harvest time.

The purpose of this study was to analyze the presence of different yeasts in the facilities of four wineries from the D.O.Ca. Rioja region in Spain. The study was conducted through the identification of the yeasts via the PCR-RFLP technique of the ITS region of rDNA. The diversity of non-Saccharomyces yeasts found in wineries has previously only been studied to a limited extent, despite the fact that these yeasts take part both in the start of spontaneous fermentation and in the changes which occur in the wines during their subsequent conservation. Most earlier studies carried out on cellar ecosystems have focussed on the clonal diversity of Saccharomyces cerevisiae. The results obtained in this study indicated that the presence of non-Saccharomyces yeasts in facilities is higher than that of the S. cerevisiae, with percentages of over 60% in all the wineries analyzed. Yeasts belonging to 10 genera and 18 species were isolated, but the only genera present in all four wineries were Cryptococcus, Pichia, and Saccharomyces. The Zygosaccharomyces bailii yeast responsible for taint was detected in one cleaned winery, in both the winemaking equipment and the fermenting must. It was also noted that the quantity and type of yeasts present in the facilities are related to the product used for cleaning them. It is also necessary to point out that the cleaning of the cellars prior to the reception of the grapes does not completely eliminate the yeasts present, so that these can subsequently become part of the vinification process.

Presence of lactic bacteria in the air of a winery during the vinification period.

In this paper we have studied the presence and evolution in the winery air of the lactic bacteria responsible for malolactic fermentation. Sampling took place during the winemaking process (between September 2007 and July 2008) in a winery from the Rioja appellation in Spain. The results obtained indicated that the presence of these microorganisms in the atmosphere was detected when grapes were entering the winery, while malolactic fermentation was taking place, and when liquid containing bacteria was manipulated. The species and clones of the lactic bacteria identified were also related to those present in the vinification tanks at any given stage of the process.

Orina pigmentada, hemólisis, hemoglobinuria / Pigmented urines with benign prognosis

Se presenta el caso de un hombre joven que refiere orinaspigmentadas de origen incierto y que tras un interrogatoriodirigido y del estudio pertinente se obtiene en las consultasde Atención Primaria un diagnóstico de benignidad (AU)

We discuss the case of a young man presenting pigmentedurine of uncertain origin which, following targeted questioingand the relevant study, was diagnosed as benign in PrimaryCare (AU)

Anestesia epidural en paciente con atrofia muscular espinal tipo Kugelber-Welander / No disponible

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«Saber envejecer. Prevenir la dependencia.» Un modelo para el diseño de materiales didácticos / «Knowing how to age and prevent dependency». A model for the design of didactic materials

El presente artículo aborda un proyecto de investigación-acción basado en metodología cualitativa con el propósito de fomentar un envejecimiento activo y exitoso, además de prevenir las situaciones de dependencia. Los objetivos básicos son: procurar información a las personas mayores sobre los aspectos que determinan un envejecimiento activo y saludable; dotar a las personas mayores de las habilidades necesarias para prevenir las situaciones de dependencia y lograr un envejecimiento satisfactorio; promover la autonomía de las personas mayores con discapacidad; facilitar a los profesionales de la salud y los servicios sociales herramientas para conseguir un envejecimiento saludable y prevenir la dependencia, y, finalmente, generar un cambio de actitudes y un pensamiento positivo ante el envejecimiento (AU)

The present article describes a research-action project based on qualitative methodology, which aims to promote active and successful ageing and prevent dependency. The main goals of the project are: to offer information to older adults on the factors leading to active and successful ageing; to provide elderly people with the skills needed to prevent dependency and achieve satisfactory ageing; to promote autonomy in elderly people with disabilities; to supply health and social services professionals with tools to achieve successful ageing and prevent dependency; and to change attitudes and generate positive thinking about ageing (AU)

Effect of the addition of inert cellulose substrates to grape must on Saccharomyces cerevisiae diversity and the evolution of alcoholic fermentation.

AIMS: To study the addition of cellulose-based adjuvant as a resource to offset the negative effects produced by grape juice clarification during alcoholic fermentations. METHODS AND RESULTS: The effect of the addition of two kinds of inert cellulose substrates in white wine vinification was investigated in two different musts. In one of these musts, stuck fermentations were detected. One of the types of cellulose examined had a fining effect, which caused a decrease in the number of viable yeasts in the medium and altered the distribution and frequency of the clones, which performed the fermentation. The other cellulose substrate made the medium cloudier but did not alter the distribution of yeasts in comparison with the control. CONCLUSIONS: The behaviour of the inert cellulose substrates on vinification depends on its physical characteristics and its capacity for making the must cloudy. SIGNIFICANCE AND IMPACT OF THE STUDY: The addition of inert cellulose substrates in white wine vinification improves the fermentation process and the quality of wines obtained. This effect is more noticeable in difficult fermentations. One variety of cellulose showed an inhibitory effect on Torulaspora delbrueckii yeasts.

Experiencia de la Unidad de Media Estancia dependiente de la Unidad Geriátrica Municipal del Ayuntamiento de Madrid / Experience of the middle stay unit within the Madrid Municipal Government Geriatrics Unit

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Rapid screening test evaluation for microalbuminuria in diabetes mellitus.

Microalbuminuria predicts clinical nephropathy and cardiovascular disease in diabetes mellitus. This study was undertaken to evaluate a screening microalbuminuria test with the Micral test II dipstick in a general practice setting and compare whether, if three urine samples are tested, any advantage is offered over a testing single sample. Two hundred and eighty diabetic patients attending a primary health care centre were studied. The first morning urine albumin concentration was determined by dipstick over 3 consecutive days. We studied two valuation methods: Method 1. Three-sample method: the test was considered positive if albumin was equal to or above 20 mg/l in at least two of three tests; Method 2. Single-sample method: we selected the third test, i.e. the most recent urine sample; if albumin was equal to or above 20 mg/l it was considered positive. The gold standard was the albumin excretion rate measured by a nephelometric method in a 24-h urine collection. Sensitivity, specificity, predictive values and Kappa coefficient were calculated. The diagnostic performance was assessed by a receiver operating characteristic curve. Microalbuminuria was defined for different thresholds of albumin excretion rate, 15, 20, 25 and 30 microg/min: their frequency was 38, 29, 23 and 18%, respectively. For method 1, the sensitivity of Micral test II oscillated between 70-94% and the specificity between 93-83%. For method 2, the sensitivity oscillated between 64-86%, and the specificity between 88-80%. Both methods had a high diagnostic performance. The Kappa coefficient was 84 and 60% for method 1 and 2, respectively. The Micral test II is a rapid, valid and reliable method for microalbuminuria screening in diabetic patients. It constitutes an important tool for diabetic surveillance in general practice. Although the use of three samples provides better results, the use of a single sample produces acceptable results at a low cost.