Variation, during Shelf Life, of Functional Properties of Biscuits Enriched with Fibers Extracted from Artichoke (Cynara scolymus L.).

To boost revaluation of industrial by-products of artichoke, this research tries to determine the stability throughout storage of phenolic compounds and their antioxidant activity in biscuits enriched with fiber-rich powders extracted from b y-products of artichokes (FRPA). To determine the most stable extraction method, biscuits were formulated with FRPA extracted by two different environmentally friendly extraction solvents: water (W) and a solution of 1% CaCl2∙5H2O (CA) and compared with biscuits made with pea fiber (P) and control biscuits (B) without fiber added. Initially and during storage, the biscuits enriched with FRPA (W, CA) showed a higher content of bioavailable polyphenols and antioxidant activity compared to the control biscuits (B) and the reference fiber (P, pea fiber). In conclusion, FRPA are an excellent source of bioavailable fiber with antioxidant activity, but especially the FRPA extracted with 1% CaCl2∙5H2O (CA), and they could present a good alternative to the use of pea fiber.

Emergency visits and mortality caused by ischemic heart disease attributable to fine particulate matter during the COVID-19 pandemic in Chile.

POSITION DU PROBLèME: Le confinement mis en place au deuxième trimestre 2020 a entrainé une amélioration de la qualité de l'air de Santiago, capitale et plus grande ville du Chili, caractérisée par de fortes concentrations en particules fines PM2,5 liées, en grande partie, au trafic routier. L'objectif était de mettre en évidence une potentielle réduction des visites aux urgences pour infarctus du myocarde aigu (IDM) et des décès dus à une cardiopathie ischémique (CPI) attribuable à l'émission de PM2,5, en comparant les périodes équivalentes de 2019 et de 2020. MéTHODES: À Santiago, la surveillance de la qualité de l'air se fait grâce à neuf moniteurs situés dans neuf communes différentes : Cerro Navia, Cerrillos, El Bosque, Pudahuel, Independencia, La Florida, Quilicura, Santiago centre-ville et Las Condes (classées de la plus haute à la plus basse en matière de pauvreté multidimensionnelle). La concentration moyenne quotidienne de PM2,5 a été décrite avec des séries temporelles, et les visites aux urgences pour IDM et les décès dus à une CPI ont été analysés de façon trimestrielle pour chaque année. Pour estimer l'impact de l'excès de PM2,5, les fractions de risque attribuables (FRA) pour les visites aux urgences pour IDM et les décès pour CPI ont été calculées. RéSULTATS: La moyenne quotidienne des PM2,5 a diminué dans huit des neuf communes de Santiago. Cependant, la réduction n'a été significative que dans trois communes. Les visites aux urgences pour IDM et les décès par CPI attribuables aux PM2,5 ont diminué légèrement mais significativement dans ces trois communes. Les FRA dans les autres communes sont restées similaires à 2019. CONCLUSIONS: Une réduction significative de la FRA des PM2,5 pour les décès par CPI et les visites aux urgences d'IDM n'a été observée que dans les communes avec une réduction significative de la concentration quotidienne moyenne de PM2,5 pendant la pandémie de COVID-19.

Combination of light-driven co-delivery of chemodrugs and plasmonic-induced heat for cancer therapeutics using hybrid protein nanocapsules.

BACKGROUND: Improving the water solubility of hydrophobic drugs, increasing their accumulation in tumor tissue and allowing their simultaneous action by different pathways are essential issues for a successful chemotherapeutic activity in cancer treatment. Considering potential clinical application in the future, it will be promising to achieve such purposes by developing new biocompatible hybrid nanocarriers with multimodal therapeutic activity. RESULTS: We designed and characterised a hybrid nanocarrier based on human serum albumin/chitosan nanoparticles (HSA/chitosan NPs) able to encapsulate free docetaxel (DTX) and doxorubicin-modified gold nanorods (DOXO-GNRs) to simultaneously exploit the complementary chemotherapeutic activities of both antineoplasic compounds together with the plasmonic optical properties of the embedded GNRs for plasmonic-based photothermal therapy (PPTT). DOXO was assembled onto GNR surfaces following a layer-by-layer (LbL) coating strategy, which allowed to partially control its release quasi-independently release regarding DTX under the use of near infrared (NIR)-light laser stimulation of GNRs. In vitro cytotoxicity experiments using triple negative breast MDA-MB-231 cancer cells showed that the developed dual drug encapsulation approach produces a strong synergistic toxic effect to tumoral cells compared to the administration of the combined free drugs; additionally, PPTT enhances the cytostatic efficacy allowing cell toxicities close to 90% after a single low irradiation dose and keeping apoptosis as the main cell death mechanism. CONCLUSIONS: This work demonstrates that by means of a rational design, a single hybrid nanoconstruct can simultaneously supply complementary therapeutic strategies to treat tumors and, in particular, metastatic breast cancers with good results making use of its stimuli-responsiveness as well as its inherent physico-chemical properties.

Group Psychotherapy Could Improve Depression in Cirrhotic Patients on the Liver Transplant Waiting List.

BACKGROUND: It is well-known that there is a high incidence of depression in patients on the liver transplant (LT) waiting list. However, there have been few studies of psychological intervention on these patients. OBJECTIVES: To determine symptoms of depression in patients on the LT waiting list and the impact of group psychotherapy. METHODS: Study population: patients on the LT waiting list who received group psychotherapy (n = 15). CONTROL GROUP: patients who did not receive psychotherapy (n = 10). Measurement instrument: Beck's depression test, which was provided before psychotherapy was initiated and after it was completed (after 6 months). The control group was given the questionnaire at the same 2 points in time as the study group. The psychotherapeutic method consisted of discussing patients' feelings, which dealt with several matters related to transplantation. Different coping strategies were considered. RESULTS: More than half of those surveyed initially had depressive symptoms. When the second survey was administered to the study population, all the patients improved in their psychopathological assessment. When the survey was administered to the control group, a worse psychopathological assessment was obtained in all cases. CONCLUSIONS: Our data suggest an improvement in depressive symptoms in patients on the LT waiting list after receiving group psychotherapy.

Quality of Life and Group Psychological Intervention in Patients With Cirrhosis on Liver Transplant Waiting List.

BACKGROUND: The patients on the liver transplant (LT) waiting list usually present with deterioration in their quality of life. Previous studies on psychological intervention have shown how the quality of life can be improved. OBJECTIVE: To analyze preliminary results of the influence of group psychotherapy on the quality of life of patients on the LT waiting list. METHOD: Fifteen patients on the LT waiting list who accepted receiving group psychotherapy were selected. The development of each 1 of these sessions was carried out at fortnightly periods for 6 months (12 sessions). Those patients who received a transplant and those patients who did not attend more than 6 group psychotherapy sessions were excluded. The Nottingham Health Profile was used to assess the quality of life. It consists of 38 items belonging to 6 health dimensions: energy, pain, physical mobility, emotional reaction, sleep, and social isolation. The study population was given a questionnaire before starting group psychotherapy and after it was finished. RESULTS: Of the 15 patients selected from the study population, 3 patients were given a transplant before the psychotherapy had finished, and 5 patients were excluded for not having attended more than 50% of the sessions. Therefore, the study was completed on 7 patients (n = 7). Overall, a better assessment can be seen in the second questionnaire. CONCLUSIONS: Group psychotherapy might favorably influence the quality of life of patients on the LT waiting list; therefore, it might be interesting to carry out studies on a larger scale in order to confirm these results.

Posterior wall as atypical localization of left atrial myxoma : Diagnosis and management.

Atrial myxomas are the most common benign cardiac neoplasms. Although the majority occur in the left atrium (LA) and are attached to the interatrial septum (75-80 % of cases), they can arise from any part of the LA and the cardiac chambers. We report the case of a 65-year-old woman who presented with features of worsening dyspnea and persistent headache. During transthoracic echocardiography, a suspected cardiac myxoma was found arising from the posterior wall of the LA.

Recommendations of the Spanish Brachytherapy Group of SEOR for HDR endoluminal treatments. Part 1: oesophagus

The endoesophageal brachytherapy technique provides good results in the treatment of oesophageal cancer, when indicated. In a consensus meeting, the Spanish Brachytherapy Group of SEOR and the Spanish Society of Medical Physics (SEFM) agreed on the indications, dose, fractionation schedule, prescription and reporting to be performed in endoesophageal brachytherapy. The results of this consensus are presented here as recommendations for medical practice (AU)

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Recommendations of the Spanish Brachytherapy Group of SEOR for HDR endoluminal treatments. Part 1: Oesophagus.

The endoesophageal brachytherapy technique provides good results in the treatment of oesophageal cancer, when indicated. In a consensus meeting, the Spanish Brachytherapy Group of SEOR and the Spanish Society of Medical Physics (SEFM) agreed on the indications, dose, fractionation schedule, prescription and reporting to be performed in endoesophageal brachytherapy. The results of this consensus are presented here as recommendations for medical practice.

Metastatic liposarcoma of the heart. Case series and brief literature review.

Secondary cardiac tumors are 20-40 times more frequent than primary lesions. Primary cardiac lesions are represented by myxomas when related to benign tumors, and by sarcomas in terms of malignant disease. Metastases to the heart from liposarcomas are very rare. We present three cases of secondary liposarcomas involving the left atrium, the right atrium, and the pericardium.

Sincronía neuronal y esquizofrenia: luces y sombras / Neural synchrony and schizophrenia: lights and shadows

Introducción: La sincronía neuronal se muestra como un elemento central en la unificación de la actividad cerebral y en la emergencia de nuestra conciencia, y parece ser fundamental en el desarrollo del pensamiento, atención, memoria, acciones motoras y en la capacidad de percibir estímulos externos e internos de forma balanceada y unificada. La disfunción de estos mecanismos podría dar cuenta de las alteraciones que subyacen a la esquizofrenia. Objetivo: Proporcionar una visión general sobre los mecanismos mediante los cuales nuestro cerebro realiza la integración de la realidad y dar una visión crítica acerca de considerar la alteración de la sincronía neuronal como un proceso subyacente a la amplia gama de problemas observados en la esquizofrenia. Método: Se resumen los resultados de varios estudios en el contexto de una revisión de la literatura. Resultados: Distintos estudios indican que alteraciones en el desarrollo de redes neuronales podrían tener un rol etiológico fundamental en la esquizofrenia, generando disfunciones en la sincronía neuronal. Estas alteraciones en la sincronización se traducirían en regiones hipoconectadas, pero también en otras hiperconectadas, dando lugar a síntomas negativos y positivos, respectivamente. Conclusiones: La sincronía neuronal parece tener un papel crucial en el procesamiento de la información, la integración cerebral y la percepción unitaria de la realidad. La alteración de la sincronía neuronal podría ser un determinante central en el desarrollo de esta enfermedad. La comprensión de estos mecanismos podría otorgar conocimientos valiosos, capaces de mejorar nuestra capacidad predictiva, diagnóstica y terapéutica en relación a la esquizofrenia.

Background: Neuronal synchrony seems to be a central element in the unification ofbrain activity and the emergence ofconsciousness. It appears to be fundamental in the development of thought, attention, memory, motor actions and in the ability to perceive external and internal stimuli in a balanced and unified way. The dysfunction ofthese mechanisms could accountfor the disturbances that underlie schizophrenia. Objective: To provide an overview of the mechanisms underlying schizophrenia and give a critical vision about considering the alteration of neuronal synchrony as a core process in this disease. Methods: The results of several studies are summarized in the context ofa literature review. Results: Several studies indicate that alterations in the development of neural networks may have a fundamental role in schizophrenia, resulting in neuronal synchrony dysfunctions. These dysfunctions seem to determine the presence of hypoconnected, but also of hyperconnected regions, resulting in negative and positive symptoms, respectively. Conclusion: Neuronal synchrony seems to play a crucial role in information processing, brain integration and unified perception ofreality. The alteration of neuronal synchrony could be a central determinant in the development of this disease. Understanding these mechanisms could provide valuable knowledge for improving our predictive, diagnostic and therapeutic capacities in relation to schizophrenia.

The sensitivity of interferon-gamma release assays is not compromised in tuberculosis patients with diabetes.

SETTING AND OBJECTIVES: the sensitivity of the interferon-gamma release assays (IGRAs) in the detection of Mycobacterium tuberculosis infection or disease may be affected by immune dysregulation in diabetes. As millions of type 2 diabetes patients are at risk for tuberculosis (TB) worldwide, it is important to determine if the sensitivity of IGRAs is compromised in this vulnerable population. DESIGN: the sensitivity of the IGRAs QuantiFERON®-TB Gold (QFT-G) and T-SPOT®.TB was evaluated among specimens from newly diagnosed adults with microbiologically confirmed TB with and without diabetes. We also evaluated the association between QFT-G results and diabetes-associated conditions (dyslipidemia, obesity). RESULTS: QFT-G sensitivity was 70% among TB patients. Patients with diabetes, chronic hyperglycemia or overweight/obesity were more than twice as likely to have positive test results in multivariate models (P < 0.05). Low high-density lipoprotein cholesterol or high triglycerides were not associated with assay results. In a separate group of TB patients (n = 43), T-SPOT.TB was 93% sensitive, with similar performance in patients with and without diabetes. CONCLUSION: IGRA sensitivity is not compromised by diabetes in TB patients. Accordingly, IGRAs may also be suitable for diagnosing TB infection in diabetes patients, which is required to assess TB risk.

Reunión clínica inter-hospitales: hipertensión arterial y microangiopatía trombótica en lupus eritematoso sistémico / Inter-hospital clinical meeting: hypertension and thrombotic microangiopathy in systemic lupus erythematosus

Se presenta una paciente portadora de lupus eritematoso sistémico (LES), descompensado por múltiples factores, que desarrolló una nefropatía lúpica e hipertensión arterial severa de difícil manejo, asociadas a disfunción orgánica múltiple y microangiopatía trombótica, tratadas con plasmaféresis e inmunosupresión. Se exponen las causas y mecanismos fisiopatológicos más importantes de la hipertensión arterial (HTA) severa en pacientes con LES. Enseguida se analizará específicamente el púrpura trombocitopénico trombótico como causa y/o efecto de HTA en LES.

We present a patient with systemic lupus erythematosus (SLE), outweighed by multiple factors, who developed lupus nephritis and severe hypertension difficult to handle, associated with organ dysfunction and thrombotic microangiopathy treated with plasmapheresis and immunosuppression. This document explains the causes and pathophysiological mechanisms leading to hypertension (HT) in patients with severe SLE. Then specifically analyzed as thrombotic thrombocytopenic purpura cause and / or effect of hypertension in SLE.

Continuidad/discontinuidad de los trastornos hipercinéticos en la vida adulta / Continuity/discontinuity in hyperkinetic disorders in adulthood

Objetivo: el trastorno hipercinético, cuadro de inicio en la infancia y conocido como un trastorno de la psiquiatría infantil, tiene su espacio en la nosología psiquiátrica adulta debido a las altas tasas de continuidad del trastorno. En los diferentes estudios realizados, el 34-70% de los sujetos continúan sufriendo el trastorno de diversas formas en la vida adulta, así como altas tasas de comorbilidad psiquiátrica y la persistencia de las alteraciones neuropsicológicas presentes desde la infancia. Los objetivos del presente trabajo fueron analizar la continuidad del trastorno hipercinético en la vida adulta en una muestra de niños con el trastorno después de 13 años de seguimiento, y evaluar, en los que aún presentaban el trastorno, la psicopatología y las alteraciones neurocognitivas asociadas. Metodología: la muestra estuvo formada por 21 pacientes de un grupo inicial de 45, que cumplían criterios CIE-10 para el diagnóstico de Trastorno Hipercinético 13 años atrás, y reevaluados pasado este tiempo. Administramos un protocolo de evaluación constituido por las siguientes pruebas: Cuestionario de Achenbach (CBCL), Cuestionario de salud mental general de Goldberg (GHQ, versión de 28 ítems), Test visomotor de Bender, Test de retención visual de Benton y CPT (Continuous Performance Test). Resultados: en este estudio de seguimiento, 16 sujetos (76,9 %) continúan presentando el trastorno hipercinético en la adolescencia/adultez. Si bien existe una mejoría neurocognitiva, persisten déficits en la edad adulta, evidenciados mediante el Test de retención visual de Benton. Es de destacar que ningún sujeto de los 21 estudiados presenta comorbilidad con otro trastorno psiquiátrico (en algunos de ellos habían aparecido en algún momento de su vida síntomas del área depresiva y ansiosa, pero sin llegar a cumplir criterios diagnósticos). Hay síntomas en la infancia de las áreas hiperactiva (atención mantenida, distraibilidad), conductual (agresividad hacia objetos y hacia personas) y afectiva (ánimo, fobias e hipocondría) que están relacionados con síntomas del área ansioso-depresiva en el adulto. Igualmente, déficits en medidas atencionales en la infancia (falsos positivos en CPT) y de memoria (número de errores en el Test de Benton, puntuaciones en la figura de Rey) se relacionan con déficit neurocognitivos y alteraciones psicopatológicas en el adulto. Conclusiones: en nuestra muestra existe una clara continuidad del Trastorno Hipercinético en la vida adulta, con manifestaciones del trastorno y ligeras alteraciones neurocognitivas. Por otro lado, está ausente la comorbilidad psiquiátrica, por lo que el pronóstico en esta población no es tan negativo como se refiere en la mayoría de los estudios. Ello podría deberse a la ausencia de asociación a trastorno disocial o a cualquier otro cuadro psiquiátrico en la infancia, y a que habían seguido revisiones psiquiátricas periódicas y tratamiento psicofarmacológico hasta la vida adulta

Aim: hyperkinetic disorder, a psychiatric childhoodonset disorder, has its place in the adult nosology due to the high rates of persistence of the disorder. In various studies, 34-70% of patients continue to suffer some form of the disorder in adulthood, and high rates of psychiatric comorbidity and persistence of neuropsychological disorders present since childhood. The objectives of this study were to analyze the continuity of hyperkinetic disorder in adulthood in a sample of children with the disorder after 13 years of monitoring; and to evaluate their psychopathology and neurocognitive disorders. Methodology: the sample consisted of 21 patients from an initial group of 45 who met criteria for hyperkinetic disorder (ICD-10) 13 years ago, and re-assessed after this time. The study protocol administered was: Questionnaire CBCL, General Health Questionnaire (GHQ, 28-item version), Bender visual motor Test, Benton Visual Retention Test, and CPT (Continuous Performance Test). Results: in this follow-up study, 16 subjects (76.9%) continue to present the hyperkinetic disorder in adolescence/adulthood. While there is a neurocognitive improvement, deficits persist into adulthood as evidenced by the Benton Visual Retention Test. It is noteworthy that no subject has psychiatric comorbidity (some of them had suffered at some point in their life depressive and anxious symptoms, without fulfilling diagnostic criteria). Some symptoms in childhood hyperactive (sustained attention, distractibility), behavioral (aggression toward objects and to people) and affective areas (mood, phobias and hypochondriasis) are associated with symptoms of anxiety-depression in adulthood. Likewise, deficits in attentional measures in childhood (false positive CPT) and memory (number of errors on the Benton Test, scores on the Rey figure) are related to neurocognitive deficits and psychopathology in adults. Conclusions: in our sample there is a continuity of hyperkinetic disorder to adulthood, with manifestations of the disorder and slight neurocognitive disorders. Furthermore, psychiatric comorbidity is absent, so the prognosis in this sample is not as negative as the majority of the studies. This could be due to the lack of association with conduct disorder or other psychiatric disorders in childhood, and to the regular psychiatric reviews and psychopharmacological treatment followed until adulthood

Reunión clínica inter-hospitales: síndrome antifosfolípidos catastrófico, un cuadro de microangiopatía / Catastrophic antiphospholipid syndrome, a case of microangiopathy

Se presenta el caso de una mujer joven, sin antecedentes de importancia, que muestra trombosis de grandes y pequeños vasos. A pesar del tratamiento con anticoagulación y corticoides en dosis altas, desarrolla necrosis cutánea y una importante respuesta inflamatoria sistémica con disfunción orgánica múltiple, por lo que .se le indicó plasmaféresis y, posteriormente, rituximab, con buena respuesta. Se discute el síndrome antifosfolípidos con énfasis en los anticuerpos antiprotrombina y la patogenia de la microangiopatía en el síndrome antifosfolípidos catastróficos.

We present the case of a young, otherwise healthy woman, who developed thrombosis of large and small vessels and capillaries. Despite anticoagulation treatment and high doses of glucocorticoids, she developed cutaneous necrosis and systemic inflammatory response with multiple organ dysfunction. Plasmapheresis and rituximab were administered with good response. We discuss the antiphospholipid syndrome, with emphasis on antiprothrombin antibodies and the pathogenesis of microangiopathy in antiphospholipid syndrome.

Photoactivated release of cargo from the cavity of polyelectrolyte capsules to the cytosol of cells.

Polyelectrolyte capsules with metal nanoparticles in their walls and fluorescently labeled polymers as cargo inside their cavity were prepared. Capsules were ingested by living cells with no uncontrolled release of the cargo upon the incorporation process. Photoinduced heating of the metal nanoparticles in the capsule walls lead to rupture of the capsule walls, and the polymeric cargo was released to the whole cytosol. Viability tests demonstrate that opening of capsules at moderate light intensities does not impair the cellular metabolism, whereas capsule opening at high light intensities ultimately leads to cell death.

[Protocol based sedation versus conventional treatment in critically ill patients on mechanical ventilation]. / Sedación guiada por protocolo versus manejo convencional en pacientes críticos en ventilación mecánica.

BACKGROUND: Sedatives and analgesic drugs give comfort and allow adequate respiratory support to critically ill patients in mechanical ventilation (MV). Its improper use may increase the duration of MV. Clinical guidelines suggest implementation of protocols, however this is seldom done in clinical practice. AIM: To compare in MV patients, nurse-applied guided by protocol administration of sedatives and analgesic drugs (protocol: group P) with the habitual practice using physicians criteria (control: group C). MATERIAL AND METHODS: Inclusion criteria was the need of MV more than 48 h. The exclusion criteria were acute neurological diseases, hepatic cirrhosis, chronic renal failure and limitation of therapeutic efforts. Midazolam and fentanyl were used in both groups. The level of sedation was monitored with the Sedation Agitation Scale (SAS). In the P group, trained nurses applied algorithms to adjust the sedative doses according to a predefined SAS goal. RESULTS: Forty patients were included, 22 aged 65+/-19 years in group P and 18 aged 54+/-21 years in group C. Apache II scores were 16+/-8 and 19+/-8 in each group. SAS score was more frequently evaluated within goal boundaries in group P than in group C (44% and 32%, respectively p =0.001). No differences in the proportion of patients with inadequate sedation were observed between treatment groups. Midazolam doses were lower in P than in C group (0.04 (0.02-0.07) and 0.06 (0.03-0.08) mg/kg/h respectively, p =0.005). CONCLUSIONS: The implementation of sedation protocol applied by nurses improved the quality of sedation and reduced the doses of Midazolam in mechanically ventilated patients.

Sedación guiada por protocolo versus manejo convencional en pacientes críticos en ventilación mecánica / Protocol based sedation versus conventional treatment in critically ill patients on mechanical ventilation

Background: Sedatives and analgesic drugs give comfort and allow adequate respiratory support to critically ill patients in mechanical ventilation (MV). Its improper use may increase the duration of MV. Clinical guidelines suggest implementation of protocols, however this is seldom done in clinical practice. Aun: To compare in MV patients, nurse-applied guided by protocol administration of sedatives and analgesic drugs (protocol: group P) with the habitual practice using physicians criteria (control: group C). Material and methods: Inclusión criteria was the need of MV more than 48 h. The exclusión criteria were acute neurological diseases, hepatic cirrhosis, chronic renal failure and limitation of therapeutic efforts. Midazolam and fentanyl were used in both groups. The level of sedation was monitored with the Sedation Agitation Scale (SAS). In the P group, trained nurses applied algorithms to adjust the sedative doses according to a predefined SAS goal. Results: Forty patients were included, 22 aged 65±19 years in group P and 18 aged 54±21 years in group C. Apache II scores were 16±8 and 19±8 in each group. SAS score was more frequently evaluated within goal boundaries in group P than in group C (44 percent and 32 percent, respectively p =0.001). No differences in the proportion of patients with inadequate sedation were observed between treatment groups. Midazolam doses were lower in P than in C group (0.04 (0.02-0.07) and 0.06 (0.03-0.08) mg/kg/h respectively, p =0.005). Conclusions: The implementation of sedation protocol applied by nurses improved the quality of sedation and reduced the doses of Midazolam in mechanically ventilated patients.