Rheological effects of high substitution levels of fats by inulin in whole cassava dough: chemical and physical characterization of produced biscuits.

Inulin has been used as a fat substitute in baked goods due to its gelling properties and functionality. However, it usually has been done in low substitution levels. The aim of this study was to evaluate the effect in rheological parameters in cassava dough caused by high substitution levels of fats by inulin. Physical and chemical characterization of biscuits were done for evaluation of dough's potential usage in bakery products. Substitution of mozzarella cheese by inulin showed that up to 12.5 g inulin per 100 g cassava flour led to a lower storage modulus, suggesting bakery potential for bread like products. Higher substitutions (25 g, 37.5 g, and 50 g per 100 g cassava flour) led to a higher storage modulus and suggest a potential for cookies and similar products. Hardness results obtained support rheological ones, suggesting higher substitution levels are suitable for cookies and similar products. This is inferred by observing an increase in hardness ranging from 5.80 N up to 17.47 N. Cassava dough with fat substituted by inulin in high levels, has potential in the development of different baked goods.

Potential functional bakery products as delivery systems for prebiotics and probiotics health enhancers.

Several health benefits have been associated to probiotics and prebiotics, most of these are involved in the regulation of the host's gut microbiome. Their incorporation to diverse food products has been done to develop potential functional foods. In the case of bakery products, their incorporation has been seen to improve several technological parameters such as volume, specific volume, texture along with sensorial parameters such as flavor and aroma. Scientific literature in this topic has been divided in three main research branches: nutrition, physical quality and sensory analyzes, however, studies rarely cover all of them. Due to the harsh thermal stress during baking, sourdough technology along with microencapsulation of probiotics, has been studied as an alternative to enhance its nutritional values and increase cell viability, though in few occasions. The potential functional baked goods have maintained acceptable physical characteristics and sensorial acceptability, while in some cases an improvement is seen due to the effect of probiotics and prebiotics. The results obtained from several studies done, have shown the viability of developing functional bakery products by applying prebiotics or probiotics. This could be used as an encouragement for more research to be done in this topic.

El olivo en la cultura mediterránea / No disponible

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Tratamiento del asma bronquial infantil, 2006 / Treatment of childhood bronchial asthma, 2006

En este artículo se resume la actualización de las medidas preventivas y terapéuticas más consolidadas en el cuidado del asma bronquial infantil. Se parte de la creciente y alarmante morbilidad y de la necesidad de un enfoque terapéutico amplio pero individualizado, revisando sucesivamente los recursos en la fase aguda, el período de regresión y la terapéutica básica. Se distinguen las medidas para modificar los factores predisponentes, el tratamiento sintomático (broncodilatadores) y patogénico (antileucotrienos, corticoides), los recursos frente a los factores ambientales y el tratamiento etiológico (reducción o eliminación de alérgenos, inmunoterapia)

The authors present an update of the most widely accepted preventiva and therapeutic measures in the management of children with bronchial asthma. After pointing out the alarming and increasing morbidity and the need for a broad but individualized approach, they review the available resources for the acute phase, regression period and base therapy. The measures for modifying the predisposing factors, the management of the symptoms (antileukotrienes, corticosteroids) and the possible defensas against environmental factors and treatment of the underlying causes (reduction or elimination of allergens, immunotherapy) are discussed

¿Es necesario un cambio profundo de la educación pediátrica? / Is a profound change in pediatric education needed?

Aunque siempre resulta arriesgado, cabe un planteamiento sinóptico del futuro de la enseñanza de la Pediatría: En primer lugar, es necesaria su adaptación al terreno de la Pediatría del siglo XXI con su panorama de enfermedades erradicadas, pero otras emergentes o reemergentes. En segundo lugar, tendrá en cuenta los acelerados progresos científicos, con las vacunaciones crecientes, unos métodos de diagnóstico más eficaces, pero más costosos, y los avances en el tratamiento, sin duda más activo, si bien con mayor yatrogenia. En tercer lugar, parece imposible dar marcha atrás al fenómeno de la especialización y superespecialización. Si resultan obligadas por la complejidad de los conocimientos, serán bien aceptadas cuando sigan considerando al menor como un todo. Se considerarán las modificaciones en el perfil profesional del pediatra, incluido cada vez más en un equipo multidisciplinario, donde debe mantener su posición directiva (AAP, 003), prestando atención al aumento de las demandas asistenciales (a pesar de la mejoría sanitaria media), pero también al incremento de las exigencias, tanto clínicas como administrativas y jurídicas. Hay una indudable influencia de la burocracia y de los responsables socioeconómicos que imponen sus normas dependiendo cada vez más el pediatra de los servicios nacionales de salud o de las grandes compañías aseguradoras. Se detecta el impacto especial de la nueva genética tanto en el diagnóstico como en la prevención y, algo más adelante, en la terapéutica, lo que va en parte paralelo al incremento de los dilemas bioéticos. Estos factores, y alguno más no citado, contestan a la pregunta inicial afirmando que parece oportuno un cambio en la enseñanza de la Pediatría, en el marco de dos actuaciones básicas: la actualización metodológica y la conveniente armonización, europea y mundial (AU)

[The changing situation of pediatric training in medical school]. / Situación cambiante de la enseñanza de la pediatría en el curso de la licenciatura.

We review the change produced in pediatric training in the last few years. To unify teaching criteria in the European Union, a minimum of 2 years practical training after the 6 years of undergraduate education were introduced. The number of students is not equally distributed among the 30 faculties with pediatrics departments. This number should be adapted to health requirements and teaching capacity and evaluation should be improved. Among the teaching staff, training, methodology and teaching hours should continue to be brought up to date. Student self-learning should be stimulated. "Clinician-teachers" still predominate, followed by "teacher-researchers" and a smaller number of "teacher-clinician-researchers". We recommend better evaluation of teacher training and teaching ability. The program aims at state, and even European, unification and emphasizes primary care and the implementation of new methods. It also gives greater prominence to social, preventive and adolescent pediatrics, child psychology and the normal child.

Situación cambiante de la enseñanza de la pediatría en el curso de la licenciatura / The changing situation of pediatric training in medical school

Se presenta una revisión del cambio producido en la enseñanza de la pediatría en los últimos años, acentuado con motivo de la armonización de criterios docentes en la Unión Europea, implantando un mínimo de 2 años de formación práctica, después de los 6 años de licenciatura o pregrado. En el alumnado se comprueba algún desequilibrio numérico en las 30 facultades con departamento de pediatría. Se preconiza una adecuación del número de alumnos a las necesidades sanitarias y a la capacidad docente, junto con una mejor evaluación. En el profesorado es preciso seguir actualizando la preparación, metodología y dedicación. Se debe estimular el autoaprendizaje del estudiante. Predomina todavía el profesor "clínico-docente", seguido del "docente-investigador" y en menor número el "docente-clínico-investigador". Se postula la mejor valoración de la preparación y capacidad docente. En el programa se apunta el interés de una armonización, estatal e incluso europea, destacando la atención primaria y la incorporación de nuevos métodos, así como conceder una mayor dedicación a la pediatría social y preventiva, adolescencia, psicología y niño normal (AU)

Deberes y derechos del pediatra enatención primaria / Rights and duties of the primary care pediatrician

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[Attention deficit hyperactivity disorder. A survey to evaluate risk factors, associated factors and parental child rearing behavior]. / Trastorno por déficit de atención con hiperactividad. Estudio para valorar los factores de riesgo, los factores asociados y el estilo educativo de los progenitores.

OBJECTIVE: The aim of this study was to determine the relationship between several adversity factors and Attention Deficit Hyperactivity Disorder (ADHD), to evaluate the existence of associated factors and to investigate parental rearing behaviors. PATIENTS AND METHODS: Eighty subjects between 7 and 8 years of age were studied. These patients belonged to a transversal study of 263 subjects that had completed the Revised Conners' Parent and Teacher Rating Scales. The authors evaluated the presence of seven probable adversity factors including: low socio-economic status, large family size, history of psychiatric disorders in first grade family members, drug abuse in parents, presence of psychological problems in the mother, perinatal pathology in the child and "difficult" temperament during early childhood. The associated factors studied were accident proneness, left motor preference, soft neurological signs, low vocabulary coefficient, poor academic achievement, low self-esteem, symptoms of anxiety and depression. EMBU-P questionnaires were used to assess parental rearing behavior. RESULTS: Two adversity factors were present in a statistically significant proportion, large family size and "difficult" temperament in early childhood, as well as two associated factors, left-handedness and low self-esteem. No statistically significant association between parental rearing behavior and ADHD was observed. CONCLUSIONS: It is necessary to keep in mind the different risk factors and associated factors of ADHD which could help to make an early diagnosis of the disorder which is very important because of its high prevalence and co-morbility.

[Newborn infant of drug-addicted mother: maternal, perinatal, neonatal aspects, and neonatal abstinence syndrome]. / Recién nacido de madre adicta a las drogas: aspectos maternos, perinatológicos, neonatales y síndrome de abstinencia.

Maternal drug addiction has increased in an alarming way over the last ten years. Therefore, the withdrawal syndrome in the newborn has also increased. 53% of the newborns (of chemical dependent mother) studied from 1985 to 1989 in HCP have presented this syndrome. We have analysed: perinatal, neonatal and maternal factors, and their clinical features and treatment: There is a great incidence of perinatal asphyxia, acidosis, premature rupture of the fetal membranes, etc. The newborns are usually premature or of low birth weight for their gestational age. They present diverse pathology: syphilis, HBsAg +, HIV +, gonorrhea, congenital malformations, etc. The mothers are often prostitutes, belong to a low socioeconomic status, have had previous abortions and have had no control of the actual pregnancy, etc. The syndrome of abstinence presents with: jitteriness, sweating, high-pitched or continuous crying, vomits, diarrhea, and even seizures. The neurological and digestive manifestations are the most difficult to treat. The treatment consists of general measures (little stimulation dim light, etc.), phenobarbital, and chlorpromazine.

Tumores del intestino delgado: presentación de 4 casos

Se presentaron 4 casos de tumores de intestino delgado (3 malignos y 1 benigno) intervenidos de urgencia en el Hospital Provincial Docente Clínico-Quirúrgico de Sancti Spíritus entre 1981 y 1988. Demostramos que la obstrucción y la hemorragía son las dos formas clínicas de presentación más frecuentes en este tipo de tumoración como ha sido descrito. Además, insistimos en las dificultades diagnósticas en el caso de hemorragías presentadas. Las variaciones histológicas encontradas fueron: 2 Leiomiosarcomas, 1 linfoma linfocitico poco diferenciado y 1 fibromixoma pediculado. Se revisa la literatura sobre el tema. (AU)

Tumores del intestino delgado: presentación de 4 casos

Se presentaron 4 casos de tumores de intestino delgado (3 malignos y 1 benigno) intervenidos de urgencia en el Hospital Provincial Docente Clínico-Quirúrgico de Sancti Spíritus entre 1981 y 1988. Demostramos que la obstrucción y la hemorragía son las dos formas clínicas de presentación más frecuentes en este tipo de tumoración como ha sido descrito. Además, insistimos en las dificultades diagnósticas en el caso de hemorragías presentadas. Las variaciones histológicas encontradas fueron: 2 Leiomiosarcomas, 1 linfoma linfocitico poco diferenciado y 1 fibromixoma pediculado. Se revisa la literatura sobre el tema. (AU)

[Diagnostic value of cranial computerized tomography in pediatric practice]. / Valoración diagnóstica de la tomografía computarizada craneal en clínica pediátrica.

A total of 100 clinical records have been studied to as certain the diagnostic use of brain CT. Most frequent diagnoses are: hypoxic-ischemic encephalopaty, seizure disorders, psychomotor delay, head enlargement and trauma. The first years of life was the period with a higher frequency of applications and the greater percentage of pathologic results (75-80 por 100) was found among intracranial hypertension, fetal distress, macrocephaly or infections of Central Nervous System and their sequelae. Minus than 50 por 100 of CT scans requested for seizures, psychomotor delay and trauma demonstrated true abnormal findings. Nearly half (53 por 100) of exams were pathological and 87 por 100 of them were useful to confirm or complete the diagnosis. It is possible to predict an increase in the number of examinations to perform in the future, although it many be replaced by alternative techniques.

[Prognosis factors in hypoxico-ischemic encephalopathy in full term infants]. / Factores pronósticos en la encefalopatía hipoxicoisquémica del recién nacido a término.

This study analyzes 61 full-term neonates affected by hypoxic-ischemic encephalopathy, who were followed for a minimum of 15 months to determine the factors related to the later appearance of neurological sequels. No severe sequels have been detected, while 8.2% showed moderate sequels and 4.9% slight sequels. The degree of cerebral suffering and the intensity of convulsions influence both the appearance of sequels and their severity, contrary to the scores of the Apgar tests after one minute or 5 minutes and the birth weight. By applying the formula (Sequel Rate = 0.2143* Cerebral suffering + 0.3228* Convulsions - 0.2276* EEG RN - 0.0851), if the "sequel rate" is equal to or lower than 0.55, the probability of later sequels is null, whereas a value in excess of this figure indicates a 57.1% probability of their arising.