Pre-freezing raw hams affects quality traits in cooked hams: potential influence of protein oxidation.

The influence of protein carbonylation and lipid oxidation on colour and texture changes in cooked hams from fresh and pre-frozen (frozen/thawed) raw material was studied. Samples from three muscles, biceps femoris (BF) quadriceps femoris (QF) and semimembranosus (SM) were analysed for the gain of specific protein carbonyls, α-aminoadipic and γ-glutamic semialdehydes, the gain of TBA-RS and their colour and texture properties by instrumental and sensory techniques. The formation of protein carbonyls occurred concomitantly with an intense loss of redness and increase of hardness. Both phenomena were found to be more intense in QF and SM muscles in cooked hams elaborated from frozen material. Lipid oxidation played a negligible role on the impaired quality traits observed in cooked hams as a result of pre-freezing. Plausible mechanisms by which protein carbonylation may be implicated in the loss of quality in cooked hams produced from pre-frozen material are discussed.

Ácidosis D-láctica secundaria a síndrome de intestino corto / D-lactic acidosis secondary to short bowel syndrome

El síndrome de intestino corto aparece por la reducción de la superficie absortiva intestinal efectiva por pérdida funcional o anatómica de una parte de intestino delgado. Se presenta el caso de una mujer de 35 años con síndrome de intestino corto severo secundario a isquemia intestinal aguda en la edad adulta, que presenta a los 5 años de evolución episodios de mareos con inestabilidad en la marcha y pérdida de fuerza en las manos, llegándose al diagnóstico de acidosis D-láctica. La acidosis D-láctica representa una complicación infrecuente, pero importante por su sintomatología, de este síndrome. Se debe a un cambio en la flora intestinal debido a un sobre crecimiento de bacterias acidolácticas, que producen D-lactato. Debe sospecharse en aquellos casos de acidosis sin causa aparente y manifestaciones neurológicas sin focalidad en pacientes con síndrome de intestino corto o intervenidos de by-pass yeyuno-ileal. El tratamiento apropiado resuelve con frecuencia los síntomas neurológicos y previene o reduce las recurrencias (AU)

The short bowel syndrome appears for the reduction of intestinal absorptive surface due to functional or anatomical loss of part of the small bowel. We present the case of a 35-year-old woman with severe short bowel syndrome secondary to acute intestinal ischemia in adults, who presented at 5 years of evolution episodes of dizziness with gait instability and loss of strength in hands. The diagnosis was D-lactic acidosis. D-lactic acidosisis a rare complication, but important for their symptoms, of this syndrome. It is due to a change in intestinal flora secondary to an overgrowth of lactic acid bacteria that produce D-lactate. D-lactic acidosis should be looked for in cases of metabolic acidosis in which the identity of acidosis is not apparent, neurological manifestations without focality and the patient has short bowel syndrome or patients who have had jejunoileal bypass surgery. Appropiate treatment usually results in resolution of neurologic symptoms and prevents or reduces further recurrences (AU)

[D-Lactic acidosis secondary to short bowel syndrome]. / Ácidosis D-láctica secundaria a síndrome de intestino corto.

The short bowel syndrome appears for the reduction of intestinal absorptive surface due to functional or anatomical loss of part of the small bowel. We present the case of a 35-year-old woman with severe short bowel syndrome secondary to acute intestinal ischemia in adults, who presented at 5 years of evolution episodes of dizziness with gait instability and loss of strength in hands. The diagnosis was D-lactic acidosis. D-lactic acidosis is a rare complication, but important for their symptoms, of this syndrome. It is due to a change in intestinal flora secondary to an overgrowth of lactic acid bacteria that produce D-lactate. D-lactic acidosis should be looked for in cases of metabolic acidosis in which the identity of acidosis is not apparent, neurological manifestations without focality and the patient has short bowel syndrome or patients who have had jejunoileal bypass surgery. Appropriate treatment usually results in resolution of neurologic symptoms and prevents or reduces further recurrences.

[Guillain Barré syndrome in an intensive care unit]. / Síndrome de Guillain Barré en Unidad de Cuidados Intensivos.

INTRODUCTION AND OBJECTIVE: The Guillain Barré syndrome is an inflammatory process of the peripheral nervous system. It is potentially reversible. Nowadays it is the commonest cause of acute, generalized, flaccid paralysis in the western world. Our objective was to present the clinical and electrophysiological characteristics of patients with the Guillain Barré syndrome who required admission to an intensive care unit. We therefore report our experience over a period of four years with patients with this syndrome who were admitted to the intensive care unit and given mechanical ventilation. We analyze the current incidence of this syndrome, the proportion of patients requiring admission to the intensive care unit and connection to mechanical ventilators due to their muscle weakness, and the mortality rates of the major case series published. We analyze the electrophysiological findings which indicate worse prognosis. Greater axonal involvement is seen in patients with poorer recovery, whilst those who made a better recovery had a predominantly demyelinating pattern. We studied certain clinical features which implied more severe illness and worse functional recovery such as the appearance of signs of autonomic nervous system involvement, rate of progression until the maximum affectation occurred and advanced age. Finally, we discuss the role of current immunomodulation treatment and the evidence of its effectiveness. The Guillain Barré syndrome patients admitted to the intensive care unit with the greatest index of long term sequelae are characterized by being older, with a higher proportion of neurovegatative disorders and have an electrophysiological pattern showing signs of greater axonal degeneration.

Síndrome de Guillain-Barré en Unidad de Cuidados Intensivos / Guillain-barré syndrome in an intensive care unit

Introducción y objetivo. El síndrome de Guillain-Barré es un proceso inflamatorio del sistema nervioso periférico, potencialmente reversible, que constituye actualmente la primera causa de parálisis flácida, aguda y generalizada, en el mundo occidental. Nuestro objetivo fue presentar las características clínicas y electrofisiológicas de los pacientes con síndrome de Guillain-Barré que requieren ingreso en unidad de cuidados intensivo (UCI). Pacientes y métodos. Presentamos nuestra experiencia con los pacientes ingresados en la UCI y con conexión, aquejados por dicha dolencia, durante un período de cuatro años. Analizamos la incidencia actual de dicho proceso, la proporción de los enfermos que requieren el ingreso en la UCI y conexión a ventilación mecánica por debilidad de la musculatura respiratoria, así como la tasa de mortalidad en las series más relevantes. Resultados. Analizamos los hallazgos electrofisiológicos que implican un peor pronóstico evolutivo; aparece mayor afectación axonal en los pacientes con peor índice de recuperación, mientras que en aquellos que se recuperaron mejor observamos un patrón predominantemente desmielinizante. Estudiamos determinadas manifestaciones clínicas que conllevan un mayor índice de gravedad y peor recuperación funcional, como la aparición de signos de afectación del sistema nervioso autónomo, la velocidad de progresión hasta alcanzar el máximo de afectación, y la edad avanzada.Finalmente, discutimos el papel de las terapias inmunomoduladoras al uso y la evidencia de su efectividad (AU)

[Angiogram-negative subarachnoid hemorrhage. Should the procedure be repeated?]. / Hemorragia subaracnoidea con angiografía negativa. Debe repetirse el estudio?

Most cases of non-traumatic subarachnoid hemorrhage are caused by rupture of an arterial aneurysm or an arteriovenous malformation. The first angiogram performed is normal nearly 20% of the time. To review the need to repeat angiography if the first study is negative. Review of patients admitted to our hospital with subarachnoid hemorrhage in recent years. All had had high quality angiography performed, that was repeated if the first study was negative. We analyzed 112 cases of subarachnoid hemorrhage, of which 27 (24.1%) had angiographic studies of the four main cerebral vessels that failed to reveal the origin of the hemorrhage. An aneurysm that had not previously been seen was detected in 2 patients (7.4%), whether or not there had been vasospasm in the first study. Given our findings, the low incidence of complications in the first study and the seriousness of the pathology under consideration, we suggest that angiography should be repeated unless there are major contraindications.