Assessment of 24 h Sodium and Potassium Urinary Excretion in Normotensive and Hypertensive Dominican Adults.

Higher salt (sodium) intake has been associated with higher blood pressure (BP). The degree of association may be influenced by factors such as age, origin, and dietary components. This study aimed to evaluate the 24 h urinary sodium (Na) and potassium (K) excretion in normotensive and hypertensive Dominican adults and estimate their salt intake. 163 volunteers (18-80 years old) participated in a cross-sectional study. The 24 h Na and K urinary excretion were measured using an ion-selective electrode technique. Na and K urinary excretion (99.4 ± 46.5 and 35.0 ± 17.5 mmol/24 h) did not correlate with BP, except in the normotensive group, in which K correlated with SBP (0.249, p = 0.019). Na and K excretion were similar in normotensive and hypertensive subjects. When considering two age groups (18-45, 46-80 years), the Na-to-K molar ratio (3.1 ± 1.3) was higher in younger subjects (p = 0.040). Na-to-K ratio was associated with DBP in the total group (r = 0.153, p = 0.052), in the hypertensive group (r = 0.395, p < 0.001), and in the older group with SBP (0.350, p = 0.002) and DBP (0.373, p < 0.001). In the older group, Na-to-K ratio and DBP correlated after controlling for subjects with hypertension controlled by treatment (r = 0.236, p = 0.041). The Na-to-K ratio correlated, when salt intake was over 5 g/day (52.2%), with SBP (rho = 0.219, p = 0.044) and DBP (rho = 0.259, p = 0.017). Determinants of BP in the total sample were age (SBP, beta: 0.6 ± 0.1, p < 0.001; DBP, beta: 0.2 ± 0.1, p < 0.002), sex (SBP, beta: 11.2 ± 3.5, p = 0.001), body mass index (BMI) (SBP, beta: 1.0 ± 0.3, p < 0.001; DBP, beta: 0.4 ± 0.2, p = 0.01), and Na-to-K ratio (SBP, beta: 3.0 ± 1.1, p = 0.008; DBP, beta: -12.3 ± 4.0, p = 0.002). Sex and BMI were determinants in the younger group. Na-to-K molar ratio was determinant in the older group (SBP, beta: 6.7 ± 2.4, p = 0.005; DBP, beta: 3.8 ± 1.1, p < 0.001). The mean Na and salt intakes (2.3 and 5.8 g/day) were slightly higher and the K intake lower (1.4 g/day) than WHO recommendations.

[Assessment of pain in patients with rheumatic disease under biological therapy treatment].

BACKGROUND: To assess pain in patients with rheumatic disease under biological therapy treatment. METHODS: Observational retrospective study of patients with rheumatic disease under biological therapy treatment who visited the health care center as outpatients in February/August 2020. We collected demographic (sex and age), clinical (diagnosis, pain presence, intensity, and location), and pharmacological (biological therapy, concomitant treatment with traditional DMARDs, and analgesic treatment) variables from the electronic medical records and Farmatools Dominion®. RESULTS: We included 138 patients; mean age was 56 years and 71% were female. The most frequent diagnosis (47%) was ankylosing spondylitis. Anti-TNF-a was the most prescribed biological drug (64%); 60.1% of study patients received traditional drugs, particularly methotrexate and leflunomide (51.8 and 28.9%, respectively). Pain was reported in 81% of the cases, particularly in hands (73.2%) and knees (69.6%); mean pain intensity was 6.5 (VAS). Although 83.3% of the patients had been prescribed analgesics, pain persisted in 84.8% of the cases (VAS >4), being severe or very severe in 67.9%. Over half of the patients (52.2%) used more than one analgesic. The most frequently prescribed medications were non-steroidal anti-inflammatory drugs (NSAIDs) (60%), paracetamol (52.2%), and opioids (56.5%). NSAIDs controlled pain (14.5%) better than opioids (8.3%); there was no post-treatment improvement of pain in 29.6% of the patients. The number of prescribed drugs increased with pain intensity (rho= 0.264; p= 0.006). CONCLUSION: Almost 70% of study patients had uncontrolled severe rheumatic-related pain. This implies a challenge for esta­blishing effective treatments for this type of pain.

Evaluación del dolor en pacientes con patologías reumáticas entratamiento con terapias biológicas / Assessment of pain in patients with rheumatic disease under biological therapy treatment

Fundamento: El objetivo fue evaluar el dolor en pacientes con patologías reumáticas en tratamiento con terapias biológicas. Material y métodos: Estudio observacional, retrospectivo, de pacientes con enfermedad reumatológica tratada con terapias biológicas, atendidos en consulta externa en febrero/agosto de 2020. Se recogieron variables demográficas (sexo y edad), clínicas (diagnóstico, presencia de dolor, intensidad y localización) y farmacológicas (terapia biológica, tratamiento concomitante con FAME tradicionales, y tratamiento analgésico). Las fuentes de información utilizadas fueron la historia clínica electrónica y Farmatools Dominion®. Resultados: Se incluyeron 138 pacientes, con edad media 56 años, 71% mujeres. El diagnóstico más frecuente fue espondilitis anquilosante (47%). El fármaco biológico más utilizado fue anti TNF-α (64%) y el 60,1% recibían fármacos tradicionales, especialmente metotrexato y leflunomida (51,8 y 28,9%). El 81% de los pacientes presentaban dolor, especialmente en manos (73,2%) y rodillas (69,6%), de intensidad media 6,5 en la escala EVA. El 84,8% de los pacientes no tenía el dolor controlado (EVA >4) y era severo o muy severo en el 67,9% de los pacientes, a pesar de que el 83,3% tenían pautado tratamiento antiálgico, el 52,2% con más de un fármaco, con antiinflamatorios no esteroideos (AINE) (60%), paracetamol (52,2%) y opioides (56,5%). El dolor se controló mejor con AINE (14,5%) que con opioides (8,3%); en un 29,6% el dolor no mejoraba con el tratamiento. El número de fármacos aumentó con la intensidad del dolor (rho = 0,264; p = 0,006). Conclusiones: Más del 69% de los pacientes presentaba dolor no controlado y severo, reflejando el desafío que supone instaurar un tratamiento efectivo para el dolor.(AU)

Background: To assess pain in patients with rheumatic disease under biological therapy treatment. Methods. Observational retrospective study of patients with rheumatic disease under biological therapy treatment who visited the health care center as outpatients in February/August 2020. We collected demographic (sex and age), clinical (diagnosis, pain presence, intensity, and location), and pharmacological (biological therapy, concomitant treatment with traditional DMARDs, and analgesic treatment) variables from the electronic medical records and Farmatools Dominion®. Results: We included 138 patients; mean age was 56 years and 71% were female. The most frequent diagnosis (47%) was ankylosing spondylitis. Anti-TNF-α was the most prescribed biological drug (64%); 60.1% of study patients received traditional drugs, particularly methotrexate and leflunomide (51.8 and 28.9%, respectively). Pain was reported in 81% of the cases, particularly in hands (73.2%) and knees (69.6%); mean pain intensity was 6.5 (VAS). Although 83.3% of the patients had been prescribed analgesics, pain persisted in 84.8% of the cases (VAS >4), being severe or very severe in 67.9%. Over half of the patients (52.2%) used more than one analgesic. The most frequently prescribed medications were non-steroidal anti-inflammatory drugs (NSAIDs) (60%), paracetamol (52.2%), and opioids (56.5%). NSAIDs controlled pain (14.5%) better than opioids (8.3%); there was no post-treatment improvement of pain in 29.6% of the patients. The number of prescribed drugs increased with pain intensity (rho = 0.264; p = 0.006). Conclusion. Almost 70% of study patients had uncontrolled severe rheumatic-related pain. This implies a challenge for establishing effective treatments for this type of pain.(AU)

Conciliación terapéutica al ingreso hospitalario en el servicio de urgencias / Therapeutic Reconciliation on Admission to Hospital in the Emergency Department

Objetivos: Evaluar el proceso de conciliación de la medicación en el Servicio de Urgencias y analizar los problemas relacionados con la medicación identificados, su gravedad potencial y las intervenciones farmacéuticas realizadas durante este proceso. Métodos: Estudio observacional prospectivo, realizado en el Servicio de Urgencias de un hospital de tercer nivel. Se recogieron los datos correspondientes durante tres meses (abril-junio 2020). Se elaboraron criterios de priorización, para poder seleccionar a los pacientes con mayor riesgo de sufrir errores de conciliación. El proceso de conciliación se llevó a cabo mediante: Historia Clínica Electrónica, historial farmacoterapéutico de atención primaria y prescripción electrónica en el Servicio de Urgencias. Se consideraron errores de conciliación todas las discrepancias no justificadas por el médico y se valoraron su gravedad potencial según National Coordinating Council for Medication Error Reporting and Prevention. Resultados: Se incluyeron 23 pacientes, 13 fueron hombres. La edad media fue de 77,8 años (DE 11,2). Durante el proceso de conciliación se encontraron 116 discrepancias, de éstas 56 (48,3%) precisaron aclaración. Se detectaron 36 errores de conciliación, éstos fueron por: omisión medicamento (n=18; 50%), error de dosis (n=13; 36,1%) o error en la frecuencia de administración (n=5; 13,9%). La aceptación de estas intervenciones de conciliación fue del 92,6%. Además, se realizaron 22 intervenciones farmacéuticas con una aceptación del 100%.Conclusiones: La realización de un proceso de conciliación de la medicación en el Servicio de Urgencias ha evitado errores de medicación, la mayoría de ellos con relevancia clínica y ha mejorado la atención farmacoterapéutica de estos pacientes.(AU)

Objectives: To evaluate the medication reconcilia-tion procedure in the Emergency Department and to analyze the medication-related problems identi-fied, their potential severity and the pharmaceutical interventions made during this process.Methods: It was conducted a prospective and ob-servational study in the Emergency Department of a tertiary care hospital. Data were collected during three months (April-June 2020). Priority criteria were developed in order to select patients with a higher risk of suffering reconciliation errors. The reconciliation process was carried out by means of: Electronic Medical Record, primary care pharma-cotherapeutic history and electronic prescription in the Emergency Department. All discrepancies not justified by the physician were considered reconciliation errors and their potential severity was assessed according to the National Coordinating Council for Medication Error Reporting and Preven-tion.Results: 23 patients were included, 13 were men. The average age was 77.8 years (SD 11.2). During the reconciliation process 116 discrepancies were found, 56 (48.3%) of which required clarification. 36 reconciliation errors were detected, these were due to: medication omission (n = 18; 50%), dosage error (n = 13; 36.1%) or administration frequency error (n = 5; 13.9 %). The uptake of these reconciliation interventions was 92.6%. In addition, 22 pharma-ceutical interventions were performed with 100% acceptance.Conclusions: The implementation of a medication reconciliation process in the Emergency Depart-ment prevented medication errors, most of them with clinical relevance. Besides, it improved the pharmacotherapeutic care of these patients.(AU)

ADHD subtypes are associated differently with circadian rhythms of motor activity, sleep disturbances, and body mass index in children and adolescents: a case-control study.

To date, few studies have examined the circadian pattern of motor activity in children and adolescents newly diagnosed with attention-deficit/hyperactivity disorder (ADHD). The objective was to study the circadian pattern of motor activity in subjects with ADHD (medication naïve) and to investigate the relationships between alterations in circadian patterns, the ADHD subtype (combined or inattentive), sleep disturbances and body mass index (BMI). One-hundred twenty children and adolescents (60 medication naïve ADHD and 60 controls) were included in a gender- and age-matched case-control study. ADHD was diagnosed according to the DSM-IV-TR, the Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version, and the Conner's Parents Rating Scale-Revised. Circadian rhythms of motor activity and sleep parameters were measured using actigraphy and the Sleep Disturbance Scale for Children. BMI and dietary intake were also evaluated. ADHD patients showed a trend towards eveningness and greater sleep disturbances than controls. Additionally, patients with ADHD-combined had significantly higher mean values of motor activity and showed a significant delay in bedtime. Furthermore, among ADHD-C patients hyperactivity symptoms were significantly associated with the least 5 h of activity. Regarding patients with ADHD-inattentive, increased fragmentation of the circadian pattern was associated with inattention symptoms, and they also showed a significant increase in BMI of 2.52 kg/m2 [95% CI 0.31, 4.73] in comparison with controls. Our findings highlight the potential use of actigraphy as a clinical tool to aid in the diagnosis of ADHD. It should be noted that evaluating motor activity variables could also allow the differentiation between ADHD subtypes.

Current situation of adult women with Turner syndrome in Spain / Situación actual de mujeres adultas afectas de Síndrome de Turner en España

No disponible

Clinical and surgical characteristics of infected diabetic foot ulcers in a tertiary hospital of Mexico.

Background: The objective of this study was to determine the clinical and surgical characteristics of diabetic foot ulcers in a tertiary level hospital in Mexico. Methods: We performed a longitudinal, descriptive study from July, 2012 to August, 2015 on a sample composed of 100 patients with type 2 diabetes mellitus and infected diabetic foot ulcers. We analyzed socio-demographic variables, comorbidities, characteristics of ulcers, and the applied treatment. Results: We found that the most affected areas were the forefoot (48%) and the plantar region (55%) of the foot. Also, most of the patients arrived with advanced stages of diabetic foot ulcers, since 93% of the lesions were of grades III-V according to the Wagner classification. Moreover, lesions usually present with advanced states of infection, since 60% of the lesions were of grades 3-4 in the PEDIS scale. In addition, the great majority of the patients are prone to complications because we found that 43% of the patients suffered from hypertension, 47% of the patients had chronic kidney disease, and 45% reported smoking. In fact, 45% of the patients eventually suffered an amputation. We also found that the situation is more difficult because the great majority of the patients (96%) have a low level of education and very low income and they do not have any health insurance. Nevertheless, we also found that an efficient treatment can help in avoiding amputations, since 53% of grade IV and 25% of grade V lesions according to the Wagner system did not suffer an amputation. Conclusions: Therefore, an effective antibiotic treatment and an education of the patient on the adequate care of their lesions are essential in increasing the welfare of patients, especially when they have a low level of education.

Positive and Negative Consequences of Making Coffee among Breakfast Related Irrelevant Objects: Evidence from MCI, Dementia, and Healthy Ageing.

OBJECTIVES: Previous studies have reported impairments in activities of daily living (ADL) performance in the presence of irrelevant but physically/functionally related objects in dementia patients. The aim of the present study was to increase our knowledge about the impact of the presence of contextually related non-target objects on ADL execution in patients with multi-domain mild cognitive impairment (MCI) and dementia. METHODS: We compared ADL execution in patients with MCI, dementia, and healthy elderly participants under two experimental conditions: One in which the target objects were embedded with contextually related non-target items that constituted the object set necessary to complete two additional (but unrequired) ADL tasks related to the target task, and a second, control condition where target objects were surrounded by isolated objects (they never constituted a whole set needed to complete an alternative ADL task). RESULTS: Separate analysis of ADL errors associated with the target task versus errors involving the non-target objects revealed that, although the presence of contextually related objects facilitated the accomplishment of the target task, such a condition also led to errors involving the use of irrelevant objects in dementia and MCI. CONCLUSIONS: The presence of contextually related non-target items produces both positive and negative effects on ADL performance. These types of non-target objects might help to cue the retrieval of the action schema related to the target task, particularly in patients with MCI. In contrast, the presence of these objects might also lead to distraction in dementia and MCI. (JINS, 2017, 23, 481-492).

The Mediterranean Diet and ADHD in Children and Adolescents.

OBJECTIVES: Although attention-deficit/hyperactivity disorder (ADHD) has been related to nutrient deficiencies and "unhealthy" diets, to date there are no studies that examined the relationship between the Mediterranean diet and ADHD. We hypothesized that a low adherence to a Mediterranean diet would be positively associated with an increase in ADHD diagnosis. METHODS: A total of 120 children and adolescents (60 with newly diagnosed ADHD and 60 controls) were studied in a sex- and age-matched case-control study. ADHD diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Energy, dietary intake, adherence to a Mediterranean diet, and familial background were measured. Logistic regression was used to determine associations between the adherence to a Mediterranean diet and ADHD. RESULTS: Lower adherence to a Mediterranean diet was associated with ADHD diagnosis (odds ratio: 7.07; 95% confidence interval: 2.65-18.84; relative risk: 2.80; 95% confidence interval: 1.54-5.25). Both remained significant after adjusting for potential confounders. Lower frequency of consuming fruit, vegetables, pasta, and rice and higher frequency of skipping breakfast and eating at fast-food restaurants were associated with ADHD diagnosis (P < .05). High consumption of sugar, candy, cola beverages, and noncola soft drinks (P < .01) and low consumption of fatty fish (P < .05) were also associated with a higher prevalence of ADHD diagnosis. CONCLUSIONS: Although these cross-sectional associations do not establish causality, they raise the question of whether low adherence to a Mediterranean diet might play a role in ADHD development. Our data support the notion that not only "specific nutrients" but also the "whole diet" should be considered in ADHD.

Staphylococcus aureus small colony variants in diabetic foot infections.

Background : Staphylococcus aureus (S. aureus) is one of the major pathogens causing chronic infections. The ability of S. aureus to acquire resistance to a diverse range of antimicrobial compounds results in limited treatment options, particularly in methicillin-resistant S. aureus (MRSA). A mechanism by which S. aureus develops reduced susceptibility to antimicrobials is through the formation of small colony variants (SCVs). Infections by SCVs of S. aureus are an upcoming problem due to difficulties in laboratory diagnosis and resistance to antimicrobial therapy. Methods : A prospective study was performed on 120 patients diagnosed with both type 2 diabetes mellitus and infected diabetic foot ulcers. The study was carried out from July 2012 to December 2013 in Hospital General de Mexico. The samples were cultured in blood agar, mannitol salt agar, and MacConkey agar media, and incubated at 37°C in aerobic conditions. Results : We describe the first known cases of diabetic foot infections caused by MRSA-SCVs in patients diagnosed with type 2 diabetes mellitus and infected diabetic foot ulcers. In all of our cases, the patients had not received any form of gentamicin therapy. Conclusions : The antibiotic therapy commonly used in diabetic patients with infected diabetic foot ulcers fails in the case of MRSA-SCVs because the intracellular location protects S. aureus-SCVs from the host's defenses and also helps them resist antibiotics. The cases studied in this article add to the spectrum of persistent and relapsing infections attributed to MRSA-SCVs and emphasizes that these variants may also play a relevant role in diabetic foot infections.

Infections of diabetic foot ulcers with methicillin-resistant Staphylococcus aureus.

Infected diabetic foot is the most common reason for hospitalization and complications in patients with type 2 diabetes mellitus (DM2). Methicillin-resistant Staphylococcus aureus (MRSA) is frequently isolated from such lesions, and its presence is growing, seriously deteriorating the infected patient's quality of life. The aim of this study was to assess the prevalence of MRSA as well as other microbiota in 100 patients diagnosed with (DM2) and with infected foot ulcers at the Hospital General de Mexico. The main results obtained show a prevalence of Staphylococcus aureus (42%), followed by Escherichia coli (36%) and, in lower percentages, other bacteria. MRSA was predominant (34%), and we conclude that the use of cefoxitin instead of oxacillin as the first-choice antibiotic has an advantage because it is a better inducer of methicillin-resistance expression.

Análisis de la demanda de pruebas microbiológicas en el área sanitaria sur de Lugo: influencia del nivel asistencial y del servicio peticionario / Analysis of the demand of microbiological tests in the sanitary south area of Lugo: influence of the health care level and of the petitioner service

Introducción. El objetivo de este trabajo es estudiar la influencia del nivel asistencial y del centro de salud o servicio peticionario en la demanda de pruebas microbiológicas. Material y métodos. Se utilizaron como fuentes de información para este estudio el sistema informático del laboratorio central y la memoria del Hospital Comarcal de Monforte. Resultados. El porcentaje de peticiones realizadas al laboratorio que contenían pruebas microbiológicas fue superior en atención primaria que en atención especializada (31,9 vs 23,8%). Se encontraron diferencias significativas en las tasas de peticiones de pruebas microbiológicas no serológicas entre los distintos centros de salud de atención primaria, las cuales oscilaron entre una tasa máxima del 294‰ y una tasa mínima del 54‰ Las tasas de peticiones de pruebas serológicas fueron similares entre los distintos centros de salud. Sin embargo, hubo diferencias significativas en el porcentaje de cultivos de orina positivos. En la atención especializada hubo diferencias significativas entre los distintos servicios en las tasas de peticiones de pruebas microbiológicas no serológicas y serológicas y la intensidad de uso de las pruebas microbiológicas en pacientes hospitalizados estuvo asociada con el peso medio de los GRD relacionados con las enfermedades infecciosas. Conclusiones. Existen diferencias en el uso de pruebas microbiológicas tanto entre niveles asistenciales como entre los distintos centros de salud de atención primaria o servicios de atención especializada. Las diferencias entre los distintos centros de salud de atención primaria podrían ser debidas a factores no relacionados con necesidades de salud de la población (AU)

Background. The aim of this work is to study the influence of the health care level and of the health centre and petitioner service on the demand for microbiological tests. Material and methods. The computer system of the central laboratory and the annual report of the Regional Hospital of Monforte were used as sources of information for this study. Results. The percentage of requests made to the laboratory that contained microbiological tests was higher in primary than in specialized care (31.9% vs 23.8%). We found significant differences in the rates of requests for non-serological microbiological tests between the different primary care health centres, which ranged between a maximum rate of 294‰ and a minimal rate of 54‰. Rates of serology requests were similar between for the different health centres. Nevertheless, there were significant differences between the health centres in the percentage of positive urine cultures. In specialized care there were significant differences between the different services in the rates of requests of both non-serological and serological microbiological tests and the intensity of use of the microbiological tests in hospitalized patients was associated with the average weight of the DRG (diagnosis related group) related to infectious diseases. Conclusions. There are differences in the use of microbiological tests both between health care levels (primary or specialized care) and between primary care health centres or specialized care services. The differences between primary care health centres might be due to factors unrelated to the needs of health of the population (AU)

Volatile compounds in low-acid fermented sausage "espetec" and sliced cooked pork shoulder subjected to high pressure processing. A comparison of dynamic headspace and solid-phase microextraction.

Two extraction techniques, dynamic headspace extraction (DHE) and solid-phase microextraction (SPME), were compared to assess the effect of high-pressure treatment (400MPa, 10min, 12°C) on the volatile compounds of low-acid fermented sausage "espetec" and sliced cooked pork shoulder stored at 4°C. DHE was more efficient at extracting low-boiling compounds such as ethanal, 2,3-butanedione and alcohols, while SPME extracted more efficiently a higher number of chemical families, especially fatty acids. The effect of pressurisation on the volatile fraction of "espetec" was better categorized by DHE, whereas SPME was more appropriate for cooked pork shoulder. The volatile fraction of "espetec" changed slightly after pressurisation, mainly showing a decrease in the levels of lipid-derived compounds, like linear alkanes, aldehydes, or 1-alcohols in pressurised samples. The volatile profile of cooked pork shoulder underwent substantial changes during refrigerated storage, mainly due to microbial metabolism, most of these changes being limited by HPP.

Computer-aided detection system applied to full-field digital mammograms.

BACKGROUND: although mammography remains the mainstay for breast cancer screening, it is an imperfect examination with a sensitivity of 75-92% for breast cancer. Computer-aided detection (CAD) has been developed to improve mammographic detection of breast cancer. PURPOSE: to retrospectively estimate CAD sensitivity and false-positive rate with full-field digital mammograms (FFDMs). MATERIAL AND METHODS: CAD was used to evaluate 151 cases of ductal carcinoma in situ (DCIS) (n=48) and invasive breast cancer (n=103) detected with FFDM. Retrospectively, CAD sensitivity was estimated based on breast density, mammographic presentation, histopathology type, and lesion size. CAD false-positive rate was estimated with screening FFDMs from 200 women. RESULTS: CAD detected 93% (141/151) of cancer cases: 97% (28/29) in fatty breasts, 94% (81/86) in breasts containing scattered fibroglandular densities, 90% (28/31) in heterogeneously dense breasts, and 80% (4/5) in extremely dense breasts. CAD detected 98% (54/55) of cancers manifesting as calcifications, 89% (74/83) as masses, and 100% (13/13) as mixed masses and calcifications. CAD detected 92% (73/79) of invasive ductal carcinomas, 89% (8/9) of invasive lobular carcinomas, 93% (14/15) of other invasive carcinomas, and 96% (46/48) of DCIS. CAD sensitivity for cancers 1-10 mm was 87% (47/54); 11-20 mm, 99% (70/71); 21-30 mm, 86% (12/14); and larger than 30 mm, 100% (12/12). The CAD false-positive rate was 2.5 marks per case. CONCLUSION: CAD with FFDM showed a high sensitivity in identifying cancers manifesting as calcifications or masses. CAD sensitivity was maintained in small lesions (1-20 mm) and invasive lobular carcinomas, which have lower mammographic sensitivity.

Volatile compounds in Spanish dry-fermented sausage 'salchichón' subjected to high pressure processing. Effect of the packaging material.

The effect of high pressure treatment (400MPa, 10min at 12°C) on the volatile profile of Spanish dry-fermented sausage 'salchichón', packaged with or without aluminium foil in a multilayer polymeric bag, was investigated. The analysis of the volatile fraction was carried out by dynamic headspace extraction coupled to gas chromatography-mass spectrometry. Pressure-treated samples showed significantly higher levels of alcohols, aldehydes and alkanes and lower levels of two methylketones as compared with control samples. An intense migration was observed of compounds from the plastic material into the product, mainly linear and branched-chain alkanes, alkenes and benzene compounds. Most of these migrating compounds were significantly more abundant in pressurized samples than in untreated samples.

Volatile compounds in dry-cured Serrano ham subjected to high pressure processing. Effect of the packaging material.

The effect of high pressure treatment (400MPa, 10min at 12°C) on the volatile profile of Spanish dry-cured Serrano ham, packaged with or without aluminum foil in a multilayer polymeric bag, was investigated. The analysis of the volatile fraction was carried out by dynamic headspace extraction coupled to gas chromatography-mass spectrometry. Pressure treatment only had a slight effect on the volatile fraction of Serrano ham. Most compounds affected by pressurization, such as alkanes (C(9)-C(12)), 2-undecene, 2-nonanone, 1-octen-3-one, 1-heptanol, 2-hexanol, 2-heptanol, ethyl pentanoate, benzaldehyde and styrene, presumably originated from the metabolism of moulds. A significant effect of pressurization on the migration of compounds from the plastic material was found. Linear and branched chain alkanes, alkenes as well as benzene compounds, were generally less abundant in pressurized samples than in untreated samples. A scalping effect was also observed for compounds such as butanal, pentanal, ethyl esters and pyrazines.

Volatile compounds in fresh meats subjected to high pressure processing: Effect of the packaging material.

The effect of high pressure treatment (400MPa, 10min at 12°C) on the volatile profile of minced beef and chicken breast, packaged with or without aluminum foil in a multilayer polymeric bag, was investigated. The analysis of the volatile fraction was carried out by dynamic headspace extraction coupled to gas chromatography-mass spectrometry. Pressurization produced significant changes in the levels of some volatile compounds presumably coming from microbial activity. Some alcohols and aldehydes decreased, while other compounds, such as 2,3-butanedione and 2-butanone, were more abundant in high pressure processed meats. A significant migration of compounds from the plastic material was observed, mainly branched-chain alkanes and benzene compounds. Two functions built by the principal component analysis explained a high percentage of the variance and could be used to separate the samples into four distinct groups, according to high pressure treatment and packaging material.

Modification of the volatile compound profile of cheese, by a Lactococcus lactis strain expressing a mutant oligopeptide binding protein.

Lactococcus lactis strain AMP2I expresses OppA(D471R), a mutant oligopeptide binding OppA protein in which the aspartyl residue at position 471 was replaced by arginine. As a consequence of a different peptide transport in this strain, experimental Hispánico cheese made with Lc. lactis AMP2I had a higher content of total free amino acids than control cheese made with Lc. lactis AMP1I, an isogenic strain expressing wild-type OppA (Picon et al. 2005, 2007). In this work higher levels of diketones, hydroxy-ketones and, to a lesser extent, branched chain aldehydes were recorded for experimental cheese compared with control cheese. These differences levelled off as ripening proceeded. Strong correlations support the hypothesis that the increased levels of these volatile compounds in cheese made with Lc. lactis AMP2I are linked to higher concentrations of free amino acids threonine, valine and leucine.

Effect of high-pressure treatment and a bacteriocin-producing lactic culture on the odor and aroma of hispánico cheese: correlation of volatile compounds and sensory analysis.

The effect on the volatile compounds and on the odor and aroma of Hispánico cheese of a high-pressure (HP) treatment (400 MPa for 5 min at 10 degrees C, applied to 15-day-old cheeses), by itself or combined with the addition of a bacteriocin-producing (BP) culture to milk, was investigated. HP-treated cheeses showed higher levels of hexanal, 3-hydroxy-2-pentanone, 2-hydroxy-3-pentanone, and hexane and lower levels of ethanal, ethanol, 1-propanol, ethyl acetate, ethyl butanoate, ethyl hexanoate, 2-pentanone, and butanoic acid than untreated cheeses. HP cheeses received higher "milky" odor descriptor scores and lower scores for odor quality and intensity and for "buttery", "yogurt-like", and "caramel" odor descriptors. Addition of the BP culture enhanced the formation of three aldehydes, three alcohols, three ethyl esters, and three ketones but decreased the levels of seven ketones and butanoic acid. BP cheeses received higher scores for aroma intensity and for "yogurt-like" and "cheesy" aroma descriptors. Principal component analysis showed the correlation between diketones and aroma descriptors "caramel", "buttery", and "milky" and between 3-methylbutanal and the odor and aroma intensity scores and aroma descriptors "sheepy" and "meat broth".