ABSTRACT
The relationship between the proanthocyanidin profile and the perceived astringency was assessed in 13 commercial Tempranillo red wines. The concentration and compositional information were obtained by liquid chromatography with diode array detection coupled to electrospray ionization mass spectrometry after acid-catalyzed depolymerization of wine proanthocyanidins in the presence of excess phloroglucinol. Statistical analysis of the results showed significant correlations between sensory and chemical determinations. Astringency was more affected by the subunit composition than by the total concentration or the average degree of polymerization of wine proanthocyanidins. Higher proportions of epicatechin (EC) subunits in extension positions and gallocatechin (GC) subunits in terminal positions were shown to increase astringency. On the contrary, the amount of epigallocatechin (EGC) in both extension and terminal positions was negatively correlated with the perceived astringency.
Subject(s)
Flavonols/analysis , Taste , Wine/analysis , Astringents/analysis , Humans , Spectrometry, Mass, Electrospray IonizationABSTRACT
Los pacientes con mieloma múltiple (MM) no tienen mayor incidencia de pancreatitis aguda ni diferente etiología de ésta que la población general. Sin embargo, pueden presentar pancreatitis aguda, o hiperamilasemia o hiperlipasemia aisladas, por causas que son poco habituales sin la presencia de la enfermedad hematológica. En los pacientes con MM, la afectación hepática aparece en el 30 al 50% de los casos. Fundamentalmente se produce como infiltración difusa de predominio sinusoidal, y la aparición en forma de nódulos es menos frecuente. Se presenta el caso de un paciente que recibió un trasplante de médula ósea por MM y que presentó un cuadro compatible clínica y analíticamente con pancreatitis aguda de etiología no filiada, durante el que se identificó la presencia de múltiples lesiones hepáticas ocupantes de espacio que se diagnosticaron mediante biopsia como recidiva extramedular de mieloma (AU)
Patients with multiple myeloma (MM) do not have a higher incidence of acute pancreatitis or pancreatitis of other etiologies than the general population. However, these patients may develop acute pancreatitis, or hyperamylasemia or isolated hyperlipasemia, due to etiologies that are highly infrequent in the absence of hematological disease. Liver involvement is found in 30 50% of patients with MM and mainly manifests as diffuse sinusoidal infiltration and less frequently in the form of nodules. We report the case of a patient who underwent bone marrow transplantation due to MM who showed clinical and laboratory findings compatible with acute pancreatitis of unknown origin, during which the presence of multiple space-occupying hepatic lesions was identified. Based on the results of biopsy, a diagnosis of extramedullary recurrence of MM was established (AU)
Subject(s)
Humans , Male , Adult , Bone Marrow Transplantation/adverse effects , Pancreatitis, Acute Necrotizing/diagnosis , Liver Neoplasms/pathology , Multiple Myeloma/surgery , RecurrenceABSTRACT
Patients with multiple myeloma (MM) do not have a higher incidence of acute pancreatitis or pancreatitis of other etiologies than the general population. However, these patients may develop acute pancreatitis, or hyperamylasemia or isolated hyperlipasemia, due to etiologies that are highly infrequent in the absence of hematological disease. Liver involvement is found in 30-50% of patients with MM and mainly manifests as diffuse sinusoidal infiltration and less frequently in the form of nodules. We report the case of a patient who underwent bone marrow transplantation due to MM who showed clinical and laboratory findings compatible with acute pancreatitis of unknown origin, during which the presence of multiple space-occupying hepatic lesions was identified. Based on the results of biopsy, a diagnosis of extramedullary recurrence of MM was established.
Subject(s)
Bone Marrow Transplantation , Liver Neoplasms/secondary , Multiple Myeloma/pathology , Multiple Myeloma/secondary , Pancreatitis/etiology , Postoperative Complications/diagnosis , Acute Disease , Adult , Amylases/blood , Humans , Lipase/blood , Liver Neoplasms/diagnostic imaging , Male , Multiple Myeloma/surgery , Pancreatitis/blood , Postoperative Complications/pathology , Tomography, X-Ray Computed , Transplantation, Autologous , UltrasonographyABSTRACT
Introducción. Presentamos nuestra experiencia en el tratamiento endoscópico del divertículo de Zenker. Pacientes y método. Tres pacientes con divertículos de Zenker de tamaño medio fueron sometidos a una cricofaringomiotomía endoscópica realizada con un esfinterotomo de aguja modificado a través de un gastroscopio terapéutico. El procedimiento se realizó en la unidad de endoscopia digestiva bajo sedación consciente sin apoyo anestésico. Resultado. La cricofaringomiotomía endoscópica se completó en una única sesión sin complicaciones inmediatas ni tardías. En los 3 pacientes desapareció completamente la disfagia y todos fueron dados de alta a las 48 h con indicación de dieta sólida. Tras 12, 18 y 17 meses de seguimiento no ha reaparecido la disfagia ni otros síntomas atribuibles al divertículo de Zenker. Conclusión. La cricofaringomiotomía mediante endoscopio flexible es un tratamiento simple, eficaz y seguro del divertículo de Zenker que ahorra la cirugía abierta cervical y la anestesia general (AU)
Introduction. We report our experience in the endoscopic (flexible) treatment of Zenker's diverticulum. Patients and method. Three patients with medium-sized Zenker's diverticula were treated by endoscopic cricopharyngeal myotomy with a modified needle-knife sphincterotome through a therapeutic gastroscope. The procedure was performed in the digestive endoscopy unit under conscious sedation without anesthetic support. Result. Endoscopic cricopharyngeal myotomy was completed in a single session without immediate or late complications. In all three patients dysphagia disappeared and all were discharged at 48 hours with a solid diet. After 12, 18 and 17 months of follow-up there has been no recurrence of dysphagia or other symptoms attributable to Zenker's diverticulum. Conclusion. Flexible endoscopic cricopharyngeal myotomy is a simple, effective and safe treatment of Zenker's diverticulum that avoids the need for open cervical surgery and general anesthesia (AU)
Subject(s)
Male , Female , Middle Aged , Aged , Humans , Zenker Diverticulum/diagnosis , Zenker Diverticulum/surgery , Endoscopy/methods , Deglutition Disorders/diagnosis , Deglutition Disorders/therapy , Minimally Invasive Surgical Procedures/methods , Zenker Diverticulum , Endoscopy/classification , Endoscopy , Pharynx/pathology , Pharynx/surgery , PharynxABSTRACT
INTRODUCTION: We report our experience in the endoscopic (flexible) treatment of Zenker's diverticulum. PATIENTS AND METHOD: Three patients with medium-sized Zenker's diverticula were treated by endoscopic cricopharyngeal myotomy with a modified needle-knife sphincterotome through a therapeutic gastroscope. The procedure was performed in the digestive endoscopy unit under conscious sedation without anesthetic support. RESULT: Endoscopic cricopharyngeal myotomy was completed in a single session without immediate or late complications. In all three patients dysphagia disappeared and all were discharged at 48 hours with a solid diet. After 12, 18 and 17 months of follow-up there has been no recurrence of dysphagia or other symptoms attributable to Zenker's diverticulum. CONCLUSION: Flexible endoscopic cricopharyngeal myotomy is a simple, effective and safe treatment of Zenker's diverticulum that avoids the need for open cervical surgery and general anesthesia.
Subject(s)
Gastroscopy , Zenker Diverticulum/surgery , Aged , Aged, 80 and over , Female , Humans , MaleABSTRACT
BACKGROUND: Endocannabinoids may participate in the homeostasis of arterial pressure. Recently, anandamide, the most extensively studied endocannabinoid, has been proposed as a key mediator in the peripheral arterial vasodilation of cirrhosis. OBJECTIVES: To determine if circulating levels of anandamide are related to the extent of the peripheral arterial vasodilation, the severity of portal hypertension and the degree of liver and renal dysfunction of patients with cirrhosis. METHODS: Plasma levels of anandamide and several systemic, portal and renal hemodynamic parameters were determined in 18 patients with cirrhosis and eight healthy subjects (control group). RESULTS: Plasma levels of anandamide were elevated in patients compared to the control group (P<0.05), nevertheless, no differences between patients with ascites and well-compensated patients were found. There was no correlation between anandamide concentration and arterial pressure, cardiac output and systemic vascular resistance, Child-Pugh's score, portal pressure, renal vascular resistance, plasma renin activity or plasma aldosterone concentration. CONCLUSIONS: Circulating levels of anandamide are increased in cirrhotic patients. However, this elevation was unrelated to the extent of arterial vasodilation, the severity of portal hypertension or the degree of hepatic and renal dysfunction. Although a local hormonal action cannot be excluded, our results do not support a relevant contribution of this system in the hemodynamic disturbance of cirrhosis.
Subject(s)
Arachidonic Acids/blood , Cannabinoid Receptor Modulators/blood , Glomerular Filtration Rate , Hypertension, Portal/physiopathology , Liver Cirrhosis/physiopathology , Endocannabinoids , Female , Humans , Hypertension, Portal/blood , Hypertension, Portal/etiology , Liver Cirrhosis/blood , Liver Cirrhosis/complications , Male , Middle Aged , Polyunsaturated Alkamides , Stroke Volume/physiology , Vascular Resistance/physiologyABSTRACT
Alcohol consumption, age at infection, and male gender have been identified as risk factors for faster fibrosis progression in patients with chronic hepatitis C (CHC). Yet the influence of liver steatosis, light to moderate alcohol consumption, or iron overload on this progression remains controversial. To analyze the effect of individual risk factors and their interaction on fibrosis progression in a group of patients with CHC and a definite date of infection, we studied 133 consecutive untreated patients. Covariates included were age, body mass index (BMI), gender, age at infection, alcohol intake, serum lipids, glycemia, serum ALT, AST, GGT, iron, and ferritin, grade and stage (METAVIR and Scheuer), and hepatic stainable iron (Perl's stain). The rate of fibrosis progression was inferred from the METAVIR score. By logistic regression analysis, hepatic steatosis (odds ratio [OR], 3.035; 95% confidence interval [CI], 1.16-7.93), serum ferritin levels higher than 290 ng/ml (OR, 5.5; 1.6-18.65), and light to moderate ethanol intake (1-50 g/day) (OR, 5.22; 1.5-17.67) were independently associated with faster fibrosis progression. There was no effect of interaction between these variables on the rate of fibrosis progression. Liver steatosis, serum ferritin levels, and light to moderate alcohol intake are associated with faster fibrosis progression in chronic hepatitis C. Combination of these factors did not further accelerate this progression. The impact of modification of these factors on progression should be tested in longitudinal studies.
