Apricot Seed Shells and Walnut Shells as Unconventional Sugars and Lignin Sources.

The present study focuses on using apricot seeds shells and walnut shells as a potential renewable material for biorefinery in Ukraine. The goal of the research work was to determine the relationship between the chemical composition of solid residues from biomass after acid pretreatment with H2SO4, alkaline pretreatment with NaOH, and a steam explosion pretreatment and the recovery of sugars and lignin after further enzymatic hydrolysis with the application of an industrial cellulase Cellic CTec2. Apricot seeds shells and walnut shells consist of lots of cellulose (35.01 and 24.19%, respectively), lignin (44.55% and 44.63%, respectively), hemicelluloses (10.77% and 26.68%, respectively), and extractives (9.97% and 11.41%, respectively), which affect the efficiency of the bioconversion of polysaccharides to sugars. The alkaline pretreatment was found to be more efficient in terms of glucose yield in comparison with that of acid and steam explosion, and the maximum enzymatic conversions of cellulose reached were 99.7% and 94.6% for the solids from the apricot seeds shells and the walnut shells, respectively. The maximum amount of lignin (82%) in the residual solid was obtained during the processing of apricot seed shells submitted to the acid pretreatment. The amount of lignin in the solids interferes with the efficiency of enzymatic hydrolysis. The results pave the way for the efficient and perspective utilization of shells through the use of inexpensive, simple and affordable chemical technologies, obtaining value-added products, and thus, reducing the amount of environmental pollution (compared to the usual disposal practice of direct burning) and energy and material external dependency (by taking advantage of these renewable, low-cost materials).

Enrichment of Refined Olive Oils with Phenolic Extracts of Olive Leaf and Exhausted Olive Pomace.

Refined olive oils (ROOs) are commonly enriched with synthetic antioxidants. Antioxidant extracts obtained from natural products can be used to improve the stability of these oils. In this study, ROOs were enriched through the addition of phenolic extracts from olive leaves (OLs) and exhausted olive pomace (EOP). In addition to replacing synthetic antioxidants with natural ones, this results in the valorization of these olive-derived biomasses. The most suitable method for mixing and enriching refined oils was probe-type ultrasonication using lecithin as the emulsifier. Thereafter, the change in the content of antioxidant compounds and the antioxidant capacity of the oils at 25, 35, and 45 °C were studied over 28 and 50 days of storage. The experimental results were fitted using a pseudo-first-order kinetic model. The oxidative stability index of the ROO enriched with a 2 g/L OL extract (70 h) was higher than that of a commercial ROO (46.8 h). Moreover, the oxidative stability index of the refined olive pomace oil (ROPO) enriched with a 2 g/L EOP extract (44.1 h) was higher than that of a commercial ROPO (38.9 h). In addition, the oxidative stabilities and antioxidant capacities of the oils were significantly correlated.

Patterns of physiological parameters and nitrogen partitioning in flag leaf explain differential grain protein content in rice.

The grain protein content (GPC) in rice is low, and more efforts with agronomic and molecular approaches were performed to increase them. However, the rice research focusing on the plant physiological behaviour that modulates the phenomenon of grain protein filling is very scarce. This work contains physiological parameters related to photosynthetic activity in the flag leaf in the grain filling period and N partitioning assays of high (Nutriar) and traditional (Camba) GPC cultivars. Results indicated a higher photosynthetic capacity, a better capacity to provide CO2 to the chloroplast and a healthier PSII structure in Camba relative to Nutriar. Chlorophyll fluorescence parameters decreased more steeply over time in the high protein variety, and a strong negative correlation was observed between GPC and PSII structure parameters. N content in the flag leaf at anthesis showed lower values and higher remobilisation during the grain filling period in Nutriar compared to Camba. The results of this work suggested that the inactivation of some PSII structures in higher GPC cultivars is associated with N remobilisation and would contribute to an increase in the free N available to be translocated to the grain.

Processing Effect and Characterization of Olive Oils from Spanish Wild Olive Trees (Olea europaea var. sylvestris).

Wild olive trees have important potential, but, to date, the oil from wild olives has not been studied significantly, especially from an analytical point of view. In Spain, the wild olive tree is called "Acebuche" and its fruit "Acebuchina". The objective of this work is to optimize the olive oil production process from the Acebuchina cultivar and characterize the oil, which could be marketed as healthy and functional food. A Box-Behnken experimental design with five central points was used, along with the Response Surface Methodology to obtain a mathematical experimental model. The oils from the Acebuchina cultivar meet the requirements for human consumption and have a good balance of fatty acids. In addition, the oils are rich in antioxidants and volatile compounds. The highest extraction yield, 12.0 g oil/100 g paste, was obtained at 90.0 min and the highest yield of phenolic compounds, 870.0 mg/kg, was achieved at 40.0 °C, and 90.0 min; but the maximum content of volatile compounds, 26.9 mg/kg, was obtained at 20 °C and 30.0 min. The oil yield is lower than that of commercial cultivars, but the contents of volatile and phenolic compounds is higher.

Fresh and Aromatic Virgin Olive Oil Obtained from Arbequina, Koroneiki, and Arbosana Cultivars.

Three factors for the extraction of extra virgin olive oil (EVOO) were evaluated: diameter of the grid holes of the hammer-crusher, malaxation temperature, and malaxation time. A Box-Behnken design was used to obtain a total of 289 olive oil samples. Twelve responses were analyzed and 204 mathematical models were obtained. Olives from super-intensive rainfed or irrigated crops of the Arbequina, Koroneiki, and Arbosana cultivars at different stages of ripening were used. Malaxation temperature was found to be the factor with the most influence on the total content of lipoxygenase pathway volatile compounds; as the temperature increased, the content of volatile compounds decreased. On the contrary, pigments increased when the malaxation temperature was increased. EVOO from irrigated crops and from the Arbequina cultivar had the highest content of volatile compounds. Olive samples with a lower ripening degree, from the Koroneiki cultivar and from rainfed crops, had the highest content of pigments.

Randomized double-blind comparison of remifentanil and alfentanil in patients undergoing laparoscopic cholecystectomy using total intravenous anesthesia.

BACKGROUND AND AIMS: To compare the use of remifentanil and alfentanil to suppress intraoperative adrenergic response of pain and the influence of these drugs on the recovery profile in patients undergoing laparoscopic cholecystectomy using a total intravenous anesthesia (TIVA) technique. MATERIAL AND METHODS: One hundred patients undergoing elective laparoscopic cholecystectomy were randomized to be managed with either remifentanil (group R) or alfentanil (group A). During general anesthesia, we evaluated adrenergic responses to intubation to first surgical incision and over the surgical procedure. We also recorded time to first spontaneous breathing, time to successful ventilation, time to respond to verbal orders, and time to extubation. RESULTS: The R group reported a significantly lower number of responses to intubation and responses to first surgical incision (14% vs. 30%; P = 0.013 and 8% vs. 18%; P = 0,037, respectively). The event of one or more responses during the surgical procedure was also lower in the R group (56% vs. 70%; P = 0.017). Hypertensive response to surgical stimuli during the procedure was lower in the R group as well as a lower frequency of tachycardia episodes in this group (34% vs. 56%; P = 0.033 and 28% vs. 44%; P = 0.041, respectively). No differences were found between groups relating to the percentage of hypotensive episodes and no episodes of bradycardia were appreciated. Both groups were similar relating to recovery times: time to the first spontaneous breathing, time to successful ventilation, time to respond to verbal orders, and time to extubation. CONCLUSION: Remifentanil showed a more stable hemodynamic response during the surgery compared with the use of alfentanil in anesthetized patients undergoing laparoscopic cholecystectomy using TIVA. Both opioids, alfentanil and remifentanil, have a similar recovery profile, and they do not delay time to awakening.

Role of laryngeal mask airway in laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is one of the most commonly performed surgical procedures and the laryngeal mask airway (LMA) is the most common supraglottic airway device used by the anesthesiologists to manage airway during general anesthesia. Use of LMA has some advantages when compared to endotracheal intubation, such as quick and ease of placement, a lesser requirement for neuromuscular blockade and a lower incidence of postoperative morbididy. However, the use of the LMA in laparoscopy is controversial, based on a concern about increased risk of regurgitation and pulmonary aspiration. The ability of these devices to provide optimal ventilation during laparoscopic procedures has been also questioned. The most important parameter to secure an adequate ventilation and oxygenation for the LMA under pneumoperitoneum condition is its seal pressure of airway. A good sealing pressure, not only state correct patient ventilation, but it reduces the potential risk of aspiration due to the better seal of airway. In addition, the LMAs incorporating a gastric access, permitting a safe anesthesia based on these commented points. We did a literature search to clarify if the use of LMA in preference to intubation provides inadequate ventilation or increase the risk of aspiration in patients undergoing laparoscopic cholecystectomy. We found evidence stating that LMA with drain channel achieves adequate ventilation for these procedures. Limited evidence was found to consider these devices completely safe against aspiration. However, we observed that the incidence of regurgitation and aspiration associated with the use of the LMA in laparoscopic surgery is very low.

Laryngeal mask, laryngeal tube, and Frova introducer in simulated difficult airway.

BACKGROUND: The use of supraglottic devices is rising in the prehospital management of difficult airway; moreover, we think that patients with multiple trauma or cervical instability can take advantage of these devices without opening or retiring the cervical collar. OBJECTIVE: To compare speed and ease of use between Laryngeal Tube S (LTS) and the Ambu AuraOnce laryngeal mask (LMA).Our second objective was to evaluate changing these devices to an endotracheal tube (ETT) using a Frova introducer. METHODS: We studied the use of LTS and LMA in an experimental model, represented by a manikin with a rigid cervical collar and a limited mouth opening. This study was carried out in Complutense University of Madrid with 145 2(nd)-year students for the degree in Dentistry who have knowledge of the airway but lack experience in intubation. Number of attempts and time for the device's insertion were measured, as well as time for the exchange maneuver using the Frova introducer. RESULTS: Insertion of all devices was possible on the first attempt; time for insertion was LTS 12.2 ± 1.28 s and LMA 6.87 ± 0.97 s. Once these devices were inserted, a Frova introducer is used to perform an exchange by an endotracheal tube; all devices could be exchanged on the first attempt, and exchange time was LTS 26.9 ± 1.2 s and LMA 16.79 ± 1.32 s. Results for both time for insertion and exchange of the LMA were significantly lower than those for the LTS (p < 0.001). CONCLUSION: The method used can be considered quick and easy, even for personnel inexperienced in intubation. This exchange maneuver has not been described previously, so we can consider it as a new application of the Frova introducer.

A modified Delphi survey on the signs and symptoms of low back pain: indicators for an interventional management approach.

BACKGROUND: Low back pain (LBP) symptoms and signs are nonspecific. If required, diagnostic blocks may find the source of pain, but indicators of suspect diagnosis must be defined to identify anatomical targets. OBJECTIVE: To reach a consensus from an expert panel on the indicators for the most common causes of LBP. MATERIAL AND METHODS: A 3-round (2 telematic and 1 face-to-face) modified Delphi survey with a questionnaire on 78 evidence-based indicators of 7 LBP etiologies was completed by 23 experts. RESULTS: 98.7% of the questionnaire was consensuated. The most accepted indicators were for zygapophysial joint pain, painful ipsilateral paravertebral palpation, worsening with trunk extension, paravertebral musculature spasm on the affected articulation, and referred pain above the knee, without radicular pattern. For sacroiliac joint pain, unilateral pain when seating, with at least 3 described provoking tests: Approximation; gapping; Patrick's; Gaenslen's; thigh thrust; Fortin finger; and Gillet's tests. For discogenic pain, midline pain that may be provoked by pressure on the spinal processes at the affected level; for quadratus lumborum muscle, painful palpation on both the L1 level paravertebral region, referred to iliac crest, and the iliac crest, referred to greater trochanter. For iliopsoas muscle, pain elicited by thigh flexion, referred to buttock, inguinal region, and anterior thigh. For pyramidal muscle, pain while sitting on the affected side and positive Freiberg's test. For radicular pain, paresthesias and positive Lassègue's test at 60°. CONCLUSION: Seventy-seven diagnostic suspect indicators of LBP conditions were consensuated. These may facilitate conservative or interventional pain management decision-making.

[X-linked Kallmann's syndrome: intra and interfamilial heterogeneity]. / Síndrome de Kallmann ligado al cromosoma X: heterogeneidad interfamiliar e intrafamiliar.

BACKGROUND AND OBJECTIVE: Hypogonadotropic hypogonadism and anosmia characterize Kallmann's syndrome, whose X-linked form is due to mutations in the KAL1 gene. We studied a family with 6 affected members. PATIENTS AND METHOD: We compare their clinical (chryptorchidism, micropenis, puberty, associated malformations), analytical (gonadotrophin releasing hormone test, and human chorionic gonadotropin test), genetic (cariotype), and radiological data of the described familiar cases with other reported sporadic cases. RESULTS: The described cases carried the R191X mutation. We found phenotypic heterogeneity between the patients. CONCLUSIONS: We report the first familiar cases of Kallmann's syndrome due to the R191X mutation. Probably other genes and/or epigenetic factors determine the phenotype.

Síndrome de Kallmann ligado al cromosoma X: heterogeneidad interfamiliar e intrafamiliar / X-linked Kallmann's syndrome: intra and interfamilial heterogeneity

Fundamento y objetivo: El síndrome de Kallmann se caracteriza por hipogonadismo hipogonadotropo y anosmia, y su forma ligada al cromosoma X se debe a mutaciones en el gen KAL1. Estudiamos a una familia con 6 miembros afectados por dicho síndrome. Pacientes y método: Comparamos las características clínicas (criptorquidia, micropene, pubertad, malformaciones asociadas), analíticas (test de la hormona liberadora de gonadotropinas y test de gonadotropina coriónica humana), genéticas (cariotipo) y radiológicas de los casos familiares con las de otros casos esporádicos de la bibliografía. Resultados: Los casos descritos eran portadores de la mutación R191X. Encontramos una gran heterogeneidad fenotípica entre los casos familiares y esporádicos de esta mutación. Conclusiones: Describimos los primeros casos conocidos de síndrome de Kallmann por la mutación R191X. Probablemente otros genes y/o factores epigenéticos influyen en el fenotipo

Background and objective: Hypogonadotropic hypogonadism and anosmia characterize Kallmann's syndrome, whose X-linked form is due to mutations in the KAL1 gene. We studied a family with 6 affected members. Patients and method: We compare their clinical (chryptorchidism, micropenis, puberty, associated malformations), analytical (gonadotrophin releasing hormone test, and human chorionic gonadotropin test), genetic (cariotype), and radiological data of the described familiar cases with other reported sporadic cases. Results: The described cases carried the R191X mutation. We found phenotypic heterogeneity between the patients. Conclusions: We report the first familiar cases of Kallmann's syndrome due to the R191X mutation. Probably other genes and/or epigenetic factors determine the phenotype

Chronic radiation enteritis after ovarian cancer: from home parenteral nutrition to oral diet.

INTRODUCTION: External beam radiation of abdominal and pelvic cavities is a current therapy for gynaecological cancer that often produces radiation-induced bowel injury and malnutrition. CASE REPORT: A 72-year old patient underwent surgery and external beam radiation therapy for an ovarian carcinoma. Two years later she was found to have intestinal pseudoobstruction related to chronic radiation enteritis and protein-energy malnutrition. Home parenteral nutrition was prescribed due to poor oral intake, but it was discontinued after 6 catheter-related sepsis and upper cava vein thrombosis. Parenteral nutrition could be reintroduced after an angioplasty of that vein, and the patient was operated on with the finding of an incarcerated ileum eventration. Nowadays she maintains a normal nutritional status with oral diet. DISCUSSION: Radiation enteritis can lead to perforation, fistulae or strictures of the bowel. Malnutrition is common and parenteral nutrition may be necessary. Surgery can solve these complications, achieves good survival rates and can allow stopping parenteral nutrition.

Dermatomiositis, lipodistrofia y resistencia a la insulina / Dermatomyositis, lipodystrophy and insulin resistance

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Spermine accumulation under salt stress.

Polyamines have long been recognized to be linked to stress situations, and it is generally accepted that they have protective characteristics. However, little is known about their physiological relevance in plants subjected to long-term salt stress. In order to precise their importance, two rice (Oryza sativa) cultivars differing in their salt tolerance were salinized for 7, 14 and 21 days. The activities of some of the enzymes involved in polyamine metabolism, free polyamines and proline contents were evaluated. Arginine decarboxylase and S-adenosyl-L-methionine decarboxylase activities were reduced in both cultivars as a consequence of salt treatment. However, spermidine synthase activity was reduced in the salt tolerant cultivar (var Giza) but not in the salt sensitive (var El Paso), while no polyamine oxidase activity was detected. During the salinization period, putrescine and spermidine levels decreased in both cultivars, although less dramatically in Giza. Simultaneously, spermine accumulations occur in both varieties, while proline accumulation was major in the sensitive one. However, spermine accumulation induced by treatment with spermidine synthase inhibitor cyclohexylamine, determined no reduction in leaf injury associated with salt stress in both cultivars. The data presented suggest that spermine accumulation is not a salt tolerance trait.