Effects of multiphase transitions and reactive extrusion on in situ thermoplasticization/succination of cassava starch.

In this work, the effects of the multiphase transitions of starch, the screw configuration, and the conditions of reactive extrusion (REX) on the in situ thermoplasticization/succination of cassava starch were studied. Spectroscopic analyses indicated successful esterification during the REX with the appearance of characteristic bands of carbonyl ester groups. After the REX, the starch developed B- and V-type structures, with the OSA starches showing an additional peak at 7.1°. As the degree of substitution increased, a greater number of partially gelatinized granules were embedded in the starch matrix; an additional degradation temperature of 364.5 °C and a lower weight loss at the degradation temperature of the starch were observed. The incorporation of OS groups via REX imparts better thermal stability. The processing conditions helped prepare a thermoplastic-succinate starch in a single step through an environmentally friendly process.

Nódulo de la hermana María José y cáncer de páncreas / The Sister Mary Joseph nodule and cancer of the pancreas

Con el epónimo «nódulo de la hermana María José» nos estamos refiriendo a la presencia de una lesión umbilical, generalmente de larga evolución, y que en realidad representa una metástasis cutánea umbilical ya que se relaciona habitualmente con una neoplasia intraabdominal. La hermana María José (instrumentista de los hermanos Mayo y nacida en Rochester, EE. UU., en 1856) fue la primera persona en llamar la atención de la presencia de un nódulo paraumbilical que, a menudo, era la única señal de la existencia de un cáncer intraabdominal de carácter maligno. En 1949, Hamilton Bailey, en su décima primera edición de su manual titulado Physical Signs in Clinical Surgery, publicado en 1949, fue quien utilizó por vez primera el epónimo. Se presenta el caso de un paciente visto en el equipo de atención primaria (EAP) que presentaba lesión umbilical indicativa del nódulo de la hermana María José y que representaba la primera manifestación de un adenocarcinoma de páncreas (AU)

The eponymous “Sister Mary Joseph Nodule” refers to a palpable nodule bulging into the umbilicus, usually of long term onset, as a result of dermal umbilical metastasis of a malignant intra-abdominal cancer. Sister Mary Joseph was born in Rochester/USA in 1856, and she was the surgical assistant of the Mayo brothers. She drew attention to the nodule, which was sometimes the only sign of a malignant intra-abdominal neoplasm. The eponym was coined by Hamilton Bailey in Physical Signs in Clinical Surgery, 11th Edition, published in 1949. We present a patient from our clinic with an umbilical mass suggestive of a Sister Mary Joseph nodule, as the first sign of pancreatic adenocarcinoma (AU)

Mexican Queso Chihuahua: functional properties of aging cheese.

Queso Chihuahua, a semi-hard cheese manufactured from raw milk (RM) in northern Mexico, is being replaced by pasteurized milk (PM) versions because of food safety concerns and the desire for longer shelf life. In this study, the functional traits of authentic Mexican Queso Chihuahua made from RM or PM were characterized to identify sources of variation and to determine if pasteurization of the cheese milk resulted in changes to the functional properties. Two brands of RM cheese and 2 brands of PM cheese obtained in 3 seasons of the year from 4 manufacturers in Chihuahua, Mexico, were analyzed after 0, 4, 8, 12, and 16 wk of storage at 4°C. A color measurement spectrophotometer was used to collect color data before and after heating at 232°C for 5 min or 130°C for 75 min. Meltability was measured using the Schreiber Melt Test on samples heated to 232°C for 5 min. Sliceability (the force required to cut through a sample) was measured using a texture analyzer fitted with a wire cutter attachment. Proteolysis was tracked using sodium dodecyl sulfate-PAGE. Compared with PM cheeses, RM cheeses showed less browning upon heating, melted more at 232°C, and initially required a greater cutting force. With aging, cheeses increased in meltability, decreased in whiteness when measured before heating, and required less cutting force to slice. Seasonal variations in the cheesemilk had minimal or no effect on the functional properties. The differences in the functional properties can be attributed, in part, to the mixed microflora present in the RM cheeses compared with the more homogeneous microflora added during the manufacture of PM cheeses. The degree of proteolysis and subsequent integrity of the cheese matrix contribute to melt, slice, and color properties of the RM and PM cheeses. Understanding the functional properties of the authentic RM cheeses will help researchers and cheesemakers develop pasteurized versions that maintain the traditional traits desired in the cheeses.

Ruptura tendinosa en paciente pluripatológica / Tendon rupture in patients with multiple diseases

Las fluoroquinolonas son un grupo de antibacterianos útiles en una amplia variedad de situaciones clínicas por su amplio espectro de actividad y su biodisponibilidad oral. La tendinopatía es una complicación rara asociada a estos fármacos. Entre los factores de riesgo destacan la edad avanzada, el tratamiento previo con esteroides y la insuficiencia renal crónica. Reviste una gran importancia medir cuidadosamente el perfil de beneficio riesgo en aquellos pacientes que presentan factores predisponentes, así como informar con claridad de los síntomas compatibles para poder suspender precozmente el tratamiento. Presentamos un caso clínico de una mujer de 86 años pluripatológica valorada en consultas de atención primaria y de reumatología, que tras el tratamiento con quinolonas presenta ruptura unilateral del tendón de Aquiles. Una indicación más adaptada a las características de la paciente podría haber evitado dicho efecto (AU)

Fluoroquinolones are a group of antibacterial drugs useful in a wide range of clinical conditions due to their wide spectrum of activity and oral bioavailability. Tendon injury is a rare complication associated to these drugs. Standing out among the risk factors are elderly age, previous treatment with steroids and chronic renal failure. It is very important to carefully measure the risk-benefit profile of those patients who have predisposing factors, and to clearly inform on the consistent symptoms in order to be able to discontinue the treatment early. We present a clinical case of an 86-year old woman with multiple conditions evaluated in primary care and rheumatology after treatment with quinolones who presented unilateral rupture of the Achilles tendon. An indication more adapted to the patient's characteristics could have avoided this effect (AU)

Insecticide residues in stored grains in Sonora, Mexico: quantification and toxicity testing.

Food safety has acquired great attention by food importer and exporters. Food rejection or acceptance across international borders is based on the compliance with international food regulations. Due to the lack of recent data on pesticide residues in Mexican grains, this study focused on detecting and quantifying insecticide residues in stored wheat, corn, chickpeas, and beans, as well as to determine their mutagenic potential. Grains were sampled from primary storage sites in Sonora, Mexico. Malathion, chlorpyrifos, deltamethrin, cypermethrin, 4,4-DDE, 4,4-DDD and 4,4-DDT were analyzed in 135 samples. Grain samples were not mutagenic and most pesticide levels were within regulation limits.

Organ donation in the Basque country: 18 years experience.

PURPOSE: We reviewed of the trends in organ donation within a coordinated transplant program over the last 18 years. METHODS: Two thousand three hundred and fifty five potential donors (PD) were evaluated in 18 years including 1282 who were effective donors (EDs) and the 4081 harvested organs. A retrospective analysis of various parameters was performed comparing four different periods: 1981 to 1986 (P0); 1987 to 1992 (P1); 1993 to 1998 (P2); and 1999 to 2004 (P3). RESULTS: The potential donor detection rate (PD/PMP) increased from 18 in P0 to 47 in P3. The ED rate (ED/PMP) was 10 in P0 and 47 in P3. Organs donated ED evolved from 2.8 in P1 to 3.3 in P3. Mean donor age increased: 32 years in P1 and 53 in P3. ED/PD rate did not vary significantly in the three periods: P1, 54%; P2, 53%; and P3, 55%. There was a change in the main causes of death among our EDs: 54% head trauma, 36% stroke, and 16% other causes in P1 versus 30% head trauma and 64% stroke in P3. Failed donations due to medical contraindications were in P1 17% and in P3; whereas failed donation due to donor management problems and family denials to donation, both dropped: P1 16%; P3 10% and P1 13%; P3 7%, respectively. CONCLUSIONS: The ED rate increased almost fivefold since 1981 to 1986. We think that this was the result of a better detection since the beginning of our program. Failed donation due to medical exclusion criteria along with the mean donor age of our donors increased, but we noticed a significant drop in family denials and exclusions secondary to donor management problems. Our donor profile has changed considerably during 18 years: an increase of more than 20 years in the mean donor age along with an increase of more than 28% among strokes as the cause of death, leading to more failed donations secondary to medical exclusion criteria.

Mexican chihuahua cheese: sensory profiles of young cheese.

Sensory profiles of fresh semihard Chihuahua cheese produced in the northern Mexican state of Chihuahua were developed to characterize the flavors and textures of this traditionally made Hispanic-style cheese. Multiple allotments of Chihuahua cheese, 9 brands made with raw milk (RM) and 5 brands made with pasteurized milk (PM), were obtained within 3 d of manufacture from 12 different cheese plants throughout Chihuahua, México. Cheeses were shipped overnight to Wyndmoor, Pennsylvania, and flavor analyses were conducted within 14 to 18 d after manufacture. Four brands (2 RM and 2 PM cheeses) were then selected and multiple allotments were shipped at 3 distinct seasons over a 1-yr period for evaluation of flavor and texture. Microbial analysis was conducted prior to testing to ensure product safety. Descriptive analyses of cheese flavors and textures were conducted with panelists trained to use a universal or product-specific Spectrum intensity scale, respectively. Sensory profiles of cheeses varied among the different manufacturers. The most prominent flavor attributes were salty, sour, diacetyl, cooked, whey, bitter, and milk-fat. The RM cheeses had more intense sour, bitter, and prickle scores than the PM cheeses. Many cheese texture attributes were similar, but RM cheeses were perceived as softer than PM cheeses. As the demand for Hispanic-style cheeses increases, defining and understanding the sensory attributes of traditionally made Mexican cheeses provides guidance to cheese manufacturers as new ways are explored to improve the production and shelf life of the cheeses.

Maltrato a las personas mayores: algunas respuestas a muchos interrogantes / Mistreatment to the elderly: some answers to many questions

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Estudio cualitativo SEGG-IMSERSO: la perspectiva de los mayores españoles sobre el maltrato al anciano* / SEGG-IMSERSO qualitative study: the perspective of Spanish elderly on mistreatment of the aged

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Identification of possible areas of high prevalence of Paget's disease of bone in Spain.

OBJECTIVE: In view of the fact that Paget's disease of bone (PD) tends to appear in so-called 'foci', a case-control study was undertaken with the dual aim of: 1) identifying areas having a higher likelihood of constituting PD 'foci'; and 2) detecting the geographic origin of 'PD-carrier' families. METHODS: Two data sets were analysed, one covering the place of birth of 231 cases and 436 controls, and the other covering the place of birth of cases, controls and their parents. Analysis was restricted to six Autonomous Regions accounting for 60% of Spain's towns and cities. To identify geographical areas of high prevalence we used the scan statistic. RESULTS: In the first analysis, 6 possible clusters were detected, corresponding to the districts of Avila (Avila), Lozoya-Somosierra (Madrid), Tierra de Campos(Palencia), the Guadalajara Range, South-west Madrid and Cuenca Hills. The second analysis confirmed the 6 groupings identified by the above procedure and, in addition, detected a further 8 possible clusters. Geographical proximity suggests that in some cases, rather than individual groupings, these may instead constitute larger foci. CONCLUSION: The results point to the possible existence of different PD foci, some coinciding with clusters that have already been reported, and others indicating familial origin in areas that had never previously received PD-specific attention.

Is clinical expressiveness of Paget's disease of bone decreasing?

Recent data have suggested secular changes implying a current trend toward decreased clinical severity of Paget's disease of bone (PD). To test this hypothesis, we conducted a study comparing the characteristics of two groups of PD patients, as disclosed from a sample assessed systematically. The investigation was a hospital-based study of all cases followed up at our unit since 1980. Throughout the follow-up period, diagnosis was based on standard X-ray criteria and the same clinical assessment was applied. Group I (n = 124) represented patients born before 1926, whereas group II (n = 109) included those born after that year. A bone scan performed with 99mTc-EHDP was available for all patients. X-rays of the pelvis and spine, and views of any hot spot observed on the scintigraphy scans were reviewed. The skeletal extent of PD, based on bone scan uptake, was determined by using the index proposed by Coutris. Alkaline phosphatase and hydroxyproline excretion levels were determined in blood and urine, respectively. Baseline characteristics were recorded on a purpose-designed computerized database. The proportion of males (47% in group I vs. 65% in group II; p = 0.007) and the mean (+/-SD) age at diagnosis (69.0 +/- 8.15 vs. 54.3 +/-9.14; p < 0.001) differed significantly between groups. The year of birth showed a strong negative correlation with age at diagnosis (r = -0.83, p < 0.0001) and a weak, but significant, negative correlation with extent of bone lesion (r = -0.20; p = 0.002). Likewise, subjects born prior to 1926 showed a greater percentage of affected skeleton cases (9.6 plus minus 8.01 vs. 7.06 +/- 5.79; p = 0.001). Group I individuals who had pelvic and/or femoral bone lesions were more prone to suffer "pagetic coxopathy" (65% vs. 40%; p = 0.003) with "protrusio acetabuli" (32% vs. 17%; p = 0.01), and the percentage of patients showing radiographic Monckeberg-type vascular calcifications (36% vs. 14%; p = 0.0006) was higher than in those born after 1926. No other epidemiologically clinically, or biochemically relevant differences were seen in the crude analysis. Multivariate analysis identified extent of skeletal lesions (OR = 0.76; p = 0.01), age at diagnosis (OR = 0.79; p = 0.008), number of bones involved (OR = 1.53; p = 0.03), and occupation (p < 0.0001) as the predictive variables linked to year of birth. Our data are consistent with a temporal tendency toward a smaller number of bone lesions and a decreased percentage of instances of affected skeleton. An earlier age at recent diagnosis times and absence of any relevant clinical or biochemical differences seems more likely linked to recent changes in referral and sociological patterns.

Pre-infarction angina elicits greater myocardial viability on reperfusion after myocardial infarction: a dobutamine stress echocardiographic study.

OBJECTIVES: We sought to evaluate myocardial viability (inotropic reserve) after myocardial infarction (MI) and its relationship with the presence of unstable pre-infarction angina (PIA). BACKGROUND: Several studies have suggested that PIA can limit infarct size, but it is not known whether PIA can elicit myocardial viability after an acute MI, with left ventricular function improvement. METHODS: Before discharge from the hospital, 91 patients with a reperfused MI (either fibrinolysis or primary coronary angioplasty) had low-dose dobutamine echocardiography performed to assess the myocardial inotropic reserve of the infarct-related area. RESULTS: Twenty-nine patients (31.9%) had PIA in the 24-h period before the onset of MI. Nine patients were treated with primary coronary angioplasty: five (8.1%) in the group with PIA and four (13.8%) in the group without PIA. There were no other significant differences in the baseline characteristics of the patients. There were more viable segments in patients with PIA (44.9% vs. 30.7%, p = 0.007), and the number of patients with significant viability was higher in the PIA group (73.9% vs. 46.3%, p = 0.026). This occurred despite a similar number of segments with segmental wall abnormalities at baseline in both groups (46.1% vs. 46.9%, p = NS). CONCLUSIONS: The presence of previous unstable PIA induces greater myocardial viability of the infarct-related area upon reperfusion and, as such, could have considerable therapeutic and clinical implications.

Nuestros ancianos se vuelven itinerantes / Our elderly people become itinerant

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Tuberculomas intracraneales en un paciente inmunocompetente / Intracranial tuberculomas in an immunocompetent patient

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