Viability of Lactobacillus reuteri DSM 17938 Encapsulated by Ionic Gelation during Refractance Window® Drying of a Strawberry Snack.

The selection of appropriate probiotic strains is vital for their successful inclusion in foods. These strains must withstand processing to reach consumers with ≥106 CFU/g, ensuring effective probiotic function. Achieving this in commercial products is challenging due to sensitivity to temperature during processing. In this work, Lactobacillus reuteri DSM 17938 was microencapsulated by ionic gelation (with alginate or pectin) followed by polymeric coating (with whey protein concentrate or chitosan). Then, such microcapsules were incorporated into a strawberry puree, which was subsequently dehydrated at three temperatures (40 °C, 45 °C, and 50 °C) by Refractance Window®. The ultimate aim was to demonstrate the efficacy of the proposed methods from a technological point of view. Kinetic curves of the probiotic's viability showed a high cell loading (>109 CFU/g). Additionally, an average encapsulation efficiency of 91% and a particle size of roughly 200 µm were found. A decrease in the viability of the microorganism was observed as drying temperature and time increased. As a demonstration of the above, in a particular case, drying at 45 °C and 50 °C, viable cells were found up to 165 min and 90 min, respectively; meanwhile, drying at 40 °C, viable cells were reported even after 240 min. The greatest viability preservation was achieved with Refractance Window® drying at 40 °C for 240 min when microcapsules coated with whey protein concentrate were incorporated into puree; this procedure showed great potential to produce dehydrated strawberry snacks with moisture (15%), water activity (aw < 0.6), and viability (≥106 CFU/g) suitable for functional foods. The membrane-stabilizing properties of whey protein concentrate could prevent cell damage. In contrast, probiotics in chitosan-coated capsules showed reduced viability, potentially due to antimicrobial properties and the formation of cracks. These findings signify a breakthrough in the production of dehydrated snacks with the addition of probiotics, addressing challenges in preserving the viability of these probiotics during processing; thus, opening the possibility for the development of a probiotic strawberry snack.

Fístula pancreática: una complicación temida. Experiencia en una unidad de cirugía hepatobiliopancreática de cuarto nivel / Pancreatic fistula: A feared complication. Experience in a fourth level hepatobiliopancreatic surgery unit

Introducción. La fístula pancreática postoperatoria es una de las complicaciones más importantes en la cirugía hepatobiliopancreática. Su diagnóstico se hace mediante la presencia de un nivel de amilasa en el líquido de drenaje al menos tres veces por encima del valor de la amilasa en suero a partir del tercer día postoperatorio. El objetivo de este estudio fue caracterizar los pacientes con fístula pancreática postoperatoria en nuestra institución, evaluando la importancia de la detección temprana y el establecimiento de un manejo oportuno. Métodos. Estudio descriptivo, retrospectivo, que incluyó los pacientes sometidos a pancreatoduodenectomía, con diagnóstico de fístula pancreática postoperatoria como complicación de cirugía hepatobiliopancreática, en el Hospital Internacional de Colombia, en Piedecuesta, entre enero del 2017 y diciembre de 2020. Se excluyeron los pacientes con otro tipo procedimiento quirúrgico y aquellos que decidieron no participar en el estudio. Resultados. Se evaluaron 69 pacientes, con un predominio del sexo femenino (n=38; 55,1 %) y mediana de la edad de 57 años. El 33,3 % (n=24) de los pacientes intervenidos desarrollaron fístula pancreática postoperatoria, siendo el 23,2 % fuga bioquímica, grado B 8,7 % y grado C 2,9 %, para quienes se indicaron manejo expectante, control ecográfico y reintervención, respectivamente. Fallecieron 5 pacientes (7,2 %). Conclusiones. La fístula pancreáticapostoperatoria es una complicación para tener en cuenta en todos los pacientes sometidos a pancreatoduodenectomía. Existen estrategias que pueden permitir disminuir la incidencia de esta complicación, con el fin de mejorar el desenlace, el pronóstico y la morbilidad posquirúrgica.

Introduction. Postoperative pancreatic fistula is one of the most important complications in hepatobiliopancreatic surgery. Its diagnosis is made by the presence of an amylase level in the drainage fluid at least three times above the serum amylase value from the third postoperative day. The objective of this study was to characterize patients with postoperative pancreatic fistula at our institution, evaluating the importance of early detection and to establish a timely management. Methods. Descriptive, retrospective study that included patients who underwent pancreatoduodenectomy with a diagnosis of postoperative pancreatic fistula as a complication of hepatobiliopancreatic surgery at the Hospital Internacional Colombia, between January 2017 and December 2020. Patients with another type of procedure performed by this specialty and those who did not decide to participate in the study were excluded. Results. A total of 69 patients were included, the median age was 57 years with a predominance of females (n=38; 55.1%). 33.3% (n=24) of the operated patients developed postoperative pancreatic fistula, with 23.2% having a biochemical leak, grade B in 8.7% and grade C in 2.9%, for whom expectant management, ultrasound control and reintervention were indicated, respectively. Five patients died (7.2%). Conclusions. Pancreatic fistula is a complication to take into account in all patients undergoing pancreatoduodenectomy. There are strategies that can reduce the incidence of this complication and thus improve not only the outcome but also the prognosis and postoperative morbidity.

Molecular Bases of Protein Antigenicity and Determinants of Immunogenicity, Anergy, and Mitogenicity.

BACKGROUND: The immune system is able to recognize substances that originate from inside or outside the body and are potentially harmful. Foreign substances that bind to immune system components exhibit antigenicity and are defined as antigens. The antigens exhibiting immunogenicity can induce innate or adaptive immune responses and give rise to humoral or cell-mediated immunity. The antigens exhibiting mitogenicity can cross-link cell membrane receptors on B and T lymphocytes leading to cell proliferation. All antigens vary greatly in physicochemical features such as biochemical nature, structural complexity, molecular size, foreignness, solubility, and so on. OBJECTIVE: Thus, this review aims to describe the molecular bases of protein-antigenicity and those molecular bases that lead to an immune response, lymphocyte proliferation, or unresponsiveness. CONCLUSION: The epitopes of an antigen are located in surface areas; they are about 880-3,300 Da in size. They are protein, carbohydrate, or lipid in nature. Soluble antigens are smaller than 1 nm and are endocytosed less efficiently than particulate antigens. The more the structural complexity of an antigen increases, the more the antigenicity increases due to the number and variety of epitopes. The smallest immunogens are about 4,000-10,000 Da in size. The more phylogenetically distant immunogens are from the immunogen-recipient, the more immunogenicity increases. Antigens that are immunogens can trigger an innate or adaptive immune response. The innate response is induced by antigens that are pathogen-associated molecular patterns. Exogenous antigens, T Dependent or T Independent, induce humoral immunogenicity. TD protein-antigens require two epitopes, one sequential and one conformational to induce antibodies, whereas, TI non-protein-antigens require only one conformational epitope to induce low-affinity antibodies. Endogenous protein antigens require only one sequential epitope to induce cell-mediated immunogenicity.

Elevada tasa de resistencia a macrólidos y fluoroquinolonas en Mycoplasma genitalium en el área sur de Tenerife / High macrolides and fluoroquinolones resistance rate in Mycoplasma genitalium in southern Tenerife

Introducción. Mycoplasma genitalium (MG) es un reconocido patógeno de transmisión sexual. El aumento de las resistencias asociadas a las principales líneas de tratamiento (macrólidos y quinolonas) justifican un estudio genético de mutaciones para mejorar las tasas de curación. Material y métodos. Un total de 8.508 muestras fueron analizadas entre abril de 2018 y julio de 2022 para la detección de MG mediante la técnica de PCR multiplex AllplexTM STI Essential Assay. En los casos positivos para MG se estudió el dominio V del gen 23S rRNA y los genes gyrA y parC. Se evaluó la importancia clínica de las mutaciones y se revisaron las historias clínicas para obtener información demográfica y de tratamiento. Resultados. Se realizó estudio de resistencias a 92 muestras (65 hombres y 27 mujeres). En lo relativo al estudio genotípico, 28 pacientes presentaban mutaciones a macrólidos (30,43%). La más habitual fue A2059G (18.48%). Para las quinolonas, 5 pacientes (5,43%) presentaron mutaciones clínicamente relevantes en el gen parC. Destaca un paciente con la mutación G295 en gyrA asociada a G248T en parC. Treinta individuos se sometieron al test de cura (TOC). La azitromicina fue el régimen empírico más común y el moxifloxacino la principal alternativa. Conclusiones. La elevada tasa de resistencias en nuestro entorno evidencia la necesidad de realizar una terapia dirigida por el estudio genotípico de resistencias a macrólidos, apoyándonos en la detección de mutaciones en parC y gyrA para predecir la susceptibilidad a quinolonas y en el uso del TOC para evaluar la respuesta al tratamiento (AU)

Introduction. Mycoplasma genitalium (MG) is a recognized sexually transmitted pathogen. Increasing resistance to main lines of treatment (macrolides and quinolones) justifies a genetic study of mutations to improve cure rates. Material and methods. A total of 8,508 samples from April 2018 to July 2022 were processed using AllplexTM STI Essential Assay. In MG positive cases 23S rRNA V domain, gyrA and parC genes were studied. Mutations detected were checked to assess their clinical significance and medical records were reviewed to obtain demographic and treatment information. Results. Resistance study was performed on 92 samples (65 men and 27 women). In relation to the genotypic study, 28 patients presented mutations to macrolides (30.43%). Most common was A2059G (18.48%). For quinolones, 5 patients (5.43%) had clinically relevant mutations in parC gene. Of note was a patient with G295 mutation in gyrA associated with G248T in parC. Thirty subjects underwent a test of cure (TOC). Azithromycin was the most common empirical regimen and moxifloxacin the main alternative. Conclusions. High rate of resistance in our environment evidences the need for targeted therapy by genotypic study of macrolide resistance, supported by the detection of mutations in parC and gyrA to predict quinolones susceptibility and the use of TOC to evaluate treatment response (AU)

Recent advances in bio-based extraction processes for the recovery of bound phenolics from agro-industrial by-products and their biological activity.

Usually found bound to other complex molecules (e.g., lignin, hemicellulose), phenolic compounds (PC) are widely present in agro-industrial by-products, and their extraction is challenging. In recent times, research is starting to highlight the bioactive roles played by bound phenolics (BPC) in human health. This review aims at providing a critical update on recent advances in green techniques for the recovery of BPC, focusing on enzymatic-assisted (EAE) and fermentation-assisted extraction (FAE) as well as in the combination of technologies, showing variable yield and features. The present review also summarizes the most recent biological activities attributed to BPC extracts until now. The higher antioxidant activity of BPC-compared to FPC-coupled with their affordable by-product source make them medicinally potent and economically viable, promoting their integral upcycling and generating new revenue streams, business, and employment opportunities. In addition, EAE and FAE can have a biotransformative effect on the PC itself or its moiety, leading to improved extraction outcomes. Moreover, recent research on BPC extracts has reported promising anti-cancer and anti-diabetic activity. Yet further research is needed to elucidate their biological mechanisms and exploit the true potential of their applications in terms of new food products or ingredient development for human consumption.

A Rare Complication of Gastrointestinal Bleeding: Jejunal Diverticulosis. A Case Report

Introduction: Small intestine diverticula are a rare condition with an incidence of 0.6% to 2%. Their location at the level of the jejunum is a rare alteration, and their diagnosis is often delayed due to low clinical suspicion. The clinical manifestation of this pathology is related to the development of complications -15% to 30% of patients, with approximately 10% requiring surgical intervention. Clinical case: We present a case of a middle-aged adult patient who experienced a complication due to a bleeding jejunal diverticulum. The patient underwent surgical management, which resulted in a satisfactory outcome. Objective: This article aims to describe jejunal diverticulosis, a rare condition that can have a significant impact on affected individuals. Emphasizing its clinical suspicion as a differential diagnosis for gastrointestinal bleeding is crucial. Additionally, we discuss diagnostic methods and highlight various therapeutic options, including surgical management.

Introducción: los divertículos del intestino delgado presentan una incidencia del 0,6% al 2%, su localización a nivel del yeyuno es una alteración poco frecuente y, dada su baja sospecha clínica, se retrasa el diagnóstico oportuno. La manifestación clínica de esta patología se encuentra relacionada con el desarrollo de complicaciones, las cuales ocurren entre el 15% y el 30% de los pacientes, y el 10% de estos pacientes requiere manejo quirúrgico. Caso clínico: un paciente adulto medio cursó con una complicación secundaria a la presencia de un divertículo del yeyuno sangrante, al cual se le dio un manejo quirúrgico con un resultado satisfactorio. Objetivo: este artículo tiene como objetivo describir la diverticulosis yeyunal que, aunque poco frecuente, puede generar un compromiso importante en quien la padece, lo que prioriza su sospecha clínica como diagnóstico diferencial causante de hemorragia gastrointestinal, así como dilucidar métodos diagnósticos y estar al tanto de las diferentes opciones terapéuticas que existen, incluido el manejo quirúrgico.

Medicinal plants used by rural communities in the arid zone of Viesca and Parras Coahuila in northeast Mexico.

This study is the first record of medicinal plants in the southwest of the Coahuila state, an arid zone where extreme dry conditions prevail. One hundred twenty-two residents (in sixteen communities) were interviewed. The residents were questioned with a questionnaire-guided ethnomedical survey protocol about the various plants used. Seventy-seven species of medicinal plants belonging to 36 botanical families were cited. The highest use-value (UV) was calculated for Lippia graveolens Kunth (0.30); Aloe vera (L.) Burm.f. (0.20); Eucalyptus abdita Brooker & Hopper, Chamaemelum nobile (L.) All. (0.16); Mentha spicata L. (0.15) and Salvia officinalis L. (0.10). Informant consensus factor (ICF) about usages of medicinal plants ranges from 0.41 to 0.80; the highest level of agreement was determined between the informants and Respiratory System Diseases (0.80). The highest fidelity level (FL) values (100%) were identified in Flourensia cernua DC., Artisia ludoviciana Nutt., and Parthenium incanum Kunth to Gastro-intestinal System Diseases; Eucalyptus abdita Brooker & Hopper, Bougainvillea berberidifolia Heimerl, and Lippia graveolens Kunth to Respiratory System Diseases (RSD) and Cyclolepis genistoides D.Don and Ephedra antisyphilitica Berland. ex C.A.Mey. to Obstetrics, Gynecology and Urinary tract Diseases. These last two medicinal plant species ("palo azul" and "pitoreal") used by the rural communities in Viesca in the treatment of urinary tract infections and kidney stones have not been reported previously. These findings can provide new research directions for further phytochemical studies. The present study revealed that the residents are rich in ethno-medicinal knowledge and actively use medicinal plants to treat various diseases. New phytochemical and pharmacological research are needed to confirm the therapeutic potential and safety of the identified plants.

Insects, Plants, and Microorganisms from Dry Lands as Novel Sources of Proteins and Peptides for Human Consumption.

Protein malnutrition is present in developing countries but also in developed ones due to actual eating habits involving insufficient protein intake. In addition to this, it is estimated by the Food and Agricultural Organization of the United Nations that the world's population will increase to 9.1 billion people in less than 30 years. This poses a significant challenge in terms of nourishing the population. Different strategies have been proposed to address this challenge, including exploring novel protein sources such as plants. For instance, Prosopis alba pods have an 85.5% protein content. Other examples are microorganisms, such as Halobacillus adaensis which produces 571 U/mL of protease, and insects such as those belonging to the Orthoptera order, like grasshoppers, which have a protein content of 65.96%. These sources have been found in dry lands and are being explored to address this challenge.

Nonvalvular atrial fibrillation in anticoagulated patients

Objective: to analyze the epidemiological and clinical characteristics of a population with nonvalvular atrial fibrillation (NVAF) treated with oral anticoagulation at Instituto Cardiovascular del Tolima in Ibagué, Colombia. Reference framework: NVAF is a prevalent disease in Colombian patients over the age of 60, who are at greater risk of a cerebrovascular accident, which is preventable with anticoagulation treatment. However, complications inherent or secondary to the disease may occur despite treatment. Methods: a cross-sectional study which describes the baseline characteristics of a total of 146 participants with NVAF being treated with oral anticoagulants, using information from their clinical charts between 2018 and 2019. Results: of the participants, 53% were female, and 57% of the participants had permanent NVAF, this being the most frequent type in the study cohort. Ninety-nine percent were treated with non-vitamin K oral anticoagulants (NOACs) (76% with rivaroxaban), and 1% with a VKA (warfarin). Eighty-nine percent of the participants had a CHADS2 classification between 1-3 and 87% fell in the HASBLED 1-3 categories; of these, 95% did not have a CVA/TIA, 99% did not have a systemic embolism and 97% did not have major bleeds, respectively for each classification. There were no fatal outcomes in any of the patients. Conclusions: an association was confirmed between CHADS2, CHADS2VASC2 and HASBLED classifications and CVA/TIA and hemorrhages in the study population (p<0.05). (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2202).

Objetivo: analizar las características epidemiológicas y clínicas de una población con fibrilación auricular no valvular (FANV) tratada con anticoagulación oral en el Instituto Cardiovascular del Tolima (Ibagué, Colombia). Marco de referencia: la FANV es una patología prevalente en pacientes colombianos mayores de 60 años, quienes tienen mayor riesgo de accidente cerebrovascular, el cual es prevenible con el tratamiento de anticoagulación; sin embargo, a pesar de la terapia se pueden presentar complicaciones propias de la patología o secundarias a él. Metodología: estudio de corte transversal, que describe las características basales de un total de 146 participantes con FANV en manejo con anticoagulantes orales, con seguimiento a través del registro de su historia clínica entre 2018 y 2019. Resultados: de los participantes, el 53% corresponde a mujeres, el 57% de los participantes presentaron FANV tipo permanente siendo la más frecuente en la cohorte estudiada; recibieron manejo en 99% con anticoagulante oral no antagonista de la vitamina K (NOAC) (76% con rivaroxabán) y 1% con AVK (warfarina). El 89% de los participantes tuvo una clasificación dentro de CHADS2 de 1-3 y 87% dentro de HASBLED de 1-3; de estos, el 95% no presentó ACV/AIT, el 99% no presentó embolismo sistémico y 97% no presentó sangrados mayores, respectivamente con cada clasificación. No se documentaron eventos fatales para el 100% de los pacientes. Conclusiones: se confirma asociación para las clasificaciones de tipo CHADS2, CHADS-2VASC2, HASBLED y el desarrollo de ACV/AIT y hemorragias en la población estudiada (p<0.05). (Acta Med Colomb 2022; 47. DOI:https://doi.org/10.36104/amc.2022.2202).

Antioxidant Dietary Fiber Sourced from Agroindustrial Byproducts and Its Applications.

Agroindustrial activities generate various residues or byproducts which are inefficiently utilized, impacting the environment and increasing production costs. These byproducts contain significant amounts of bioactive compounds, including dietary fiber with associated phenolic compounds, known as antioxidant dietary fiber (ADF). Phenolic compounds are related to the prevention of diseases related to oxidative stress, such as neurodegenerative and cardiovascular diseases. The mechanism of ADF depends on its chemical structure and the interactions between the dietary fiber and associated phenolic compounds. This work describes ADF, the main byproducts considered sources of ADF, its mechanisms of action, and its potential use in the formulation of foods destined for human consumption. ADF responds to the demand for low-cost, functional ingredients with great health benefits. A higher intake of antioxidant dietary fiber contributes to reducing the risk of diseases such as type II diabetes, colon cancer, obesity, and kidney stones, and has bile-acid retention-excretion, gastrointestinal laxative, hypoglycemic, hypocholesterolemic, prebiotic, and cardioprotective effects. ADF is a functional, sustainable, and profitable ingredient with different applications in agroindustry; its use can improve the technofunctional and nutritional properties of food, helping to close the cycle following the premise of the circular economy.

Quality of Physalis peruviana fruits coated with pectin and pectin reinforced with nanocellulose from P. peruviana calyces.

Physalis peruviana is marketed without its calyx, which generates byproducts and a decrease in the shelf life of these fruits. The aim of this study was to evaluate the effect of edible pectin-coatings reinforced with nanocellulose from calyx on the physical-chemical and physiological parameters of P. peruviana fruits during refrigerated storage (5 °C) for ten days. The nanocellulose extraction was carried out using a combined extraction method (chemical procedures and ultrasound radiation). The characterization of the fibers showed that the maximum degradation temperatures ranged between 300 and 311 °C. The SEM analysis revealed the presence of fibers after the chemical treatment. The removal of lignin and hemicellulose was validated using Fourier Transform Infra Red (FTIR) spectroscopy. The results showed that the fruits treated with pectin and pectin reinforced with nanocellulose at 0.5 % (w/w) had an adequate visual appearance and showed a minor color change (ΔE of 19.04 and 21.04, respectively) and the highest retention of L∗ during storage. Although the addition of nanocellulose at 0.5% presented the lowest respiratory rate (29.60 mgCO2/kg h), the treatment with pectin offered the least weight loss and showed the highest firmness retention at the end of storage. Thus, the edible pectin-coating may be useful for improving the postharvest quality and storage life of fresh P. peruviana fruit. Nanocellulose from P. peruviana calyces can be used under the concept of a circular economy; although, its use as a reinforcement of pectin showed some limitations.

Mexican Oregano (Lippia graveolens Kunth) as Source of Bioactive Compounds: A Review.

Lippia graveolens is a traditional crop and a rich source of bioactive compounds with various properties (e.g., antioxidant, anti-inflammatory, antifungal, UV defense, anti-glycemic, and cytotoxicity) that is primarily cultivated for essential oil recovery. The isolated bioactive compounds could be useful as additives in the functional food, nutraceuticals, cosmetics, and pharmaceutical industries. Carvacrol, thymol, ß-caryophyllene, and p-cymene are terpene compounds contained in oregano essential oil (OEO); flavonoids such as quercetin O-hexoside, pinocembrin, and galangin are flavonoids found in oregano extracts. Furthermore, thermoresistant compounds that remain in the plant matrix following a thermal process can be priced in terms of the circular economy. By using better and more selective extraction conditions, the bioactive compounds present in Mexican oregano can be studied as potential inhibitors of COVID-19. Also, research on extraction technologies should continue to ensure a higher quality of bioactive compounds while preventing an undesired chemical shift (e.g., hydrolysis). The oregano fractions can be used in the food, health, and agricultural industries.

Ultrasound-microwave-assisted extraction of polyphenolic compounds from Mexican "Ataulfo" mango peels: Antioxidant potential and identification by HPLC/ESI/MS.

INTRODUCTION: Mango is used in traditional medicine in many countries. However, the processing by-products are not currently used and generate large pollution problems and high handling costs. OBJECTIVE: To study the effect of different parameters in the extraction of polyphenolic compounds from mango peels using modern and ecological ultrasound-microwave-assisted extraction technology. METHODOLOGY: Various parameters of these processes were studied: the extract was recovered by liquid chromatography using Ambetlite XAD-16. The total polyphenol content was determined by Folin-Ciocalteu's and HCl-butanol methods. Antioxidant activity was determined by 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid (ABTS+), 1,10-diphenyl-2-20-picrylhydrazyl (DPPH), and lipid oxidation inhibition methods. The recovered compounds were identified by high-performance liquid chromatography-mass spectrometry (HPLC-MS). RESULTS: The best extraction conditions were solid/liquid ratio of 1/5 g/mL, ethanol percentage of 50%, and an extraction time of 10 min. Under these conditions, the total polyphenol content was 54.15 mg/g, and the antioxidant activities were greater than 90% inhibition in the three assays evaluated. According to the high-performance liquid chromatography/electrospray ionization/mass spectrometry (HPLC/ESI/MS) analysis, nine polyphenolic compounds were identified; most of them were gallotannins, such as pentagalloyl glucose. CONCLUSION: Ultrasound-microwave-assisted extraction was shown to be effective and allowed the recovery of antioxidant polyphenolic compounds. The results indicated that mango peel extracts can be used as natural antioxidant components in the pharmaceutical and functional food industries.

Candelilla Wax Edible Coating with Flourensia cernua Bioactives to Prolong the Quality of Tomato Fruits.

The improvement of the postharvest quality of tomato fruits was evaluated using an edible coating functionalized with an Flourensia cernua extract evaluating the antifungal, structural, barrier, and optical properties. The formulation and evaluation of an edible coating and its application on tomato was evaluated using a response surface methodology to determine the ideal concentrations of candelilla wax, whey protein, and glycerol. Edible films showed good barrier properties, with water vapor permeability varying from 0.435-0.404 g mm/m2 day kPa. The addition o F. cernua extract showed significant improvement in the transparency of films. The edible coating applied to tomato reduced weight and firmness loss. The sensory evaluation proved that the product obtained is acceptable for consumers. The edible coating added with F. cernua extract was the most effective in inhibiting the growth of pathogenic fungi and the visual appearance at the end of storage confirmed the beneficial effect of the edible coating.

Serie de Casos Clínicos: Displasia Osteofibrosa Craneofacial. Resolución Quirúrgica / Case Series: Craniofacial Fibrous Dysplasia. Surgical Treatment

INTRODUCCIÓN: La Displasia Fibrosa Ósea Craneofacial es una lesión ósea benigna en la que se da una sustitución de tejido óseo normal por tejido fibro-óseo. Desarrollada a partir de una mutación genética. Subordinada en variantes: monostósica y polistósica. Escasos casos son reportados sobre malignización de la patología. El Diagnóstico se realiza con la sospecha clínica y se confirma mediante exámenes de imagen y anatomopatológicos. CASO CLÍNICO: El presente trabajo presenta una serie de tres casos diagnosticados de Displasia Osteofibrosa Craneofacial en el Hospital José Carrasco Arteaga y Hospital del Río, Cuenca-Ecuador, en los que por el cuadro clínico de los pacientes se decidió tratamiento quirúrgico. EVOLUCIÓN: En todos los casos, la evolución fue favorable. Se logró resultados positivos, reducción de síntomas y mejoría estética general en todos los casos. CONCLUSIÓN: Se obtienen mejores resultados con los tratamientos quirúrgicos actuales (remodelado más congelamiento óseo), entre ellos: buenos resultados estéticos, mejor calidad de vida, menor riesgo de infecciones. En el presente trabajo los tres participantes sometidos a resolución quirúrgica señalaron que el tratamiento reflejó positivamente en el ámbito funcional, estético y emocional. (au)

BACKGROUND: Craniofacial Bone Fibrous Dysplasia is a benign bone lesion where normal bone tissue is replaced with fibrous tissue. Developed from a genetic mutation. Subordinated in variants: monostotic and polyistotic. Few cases are reported on malignancy of the pathology. The diagnosis is determined with clinical suspicion and confirmed by imaging and pathology tests. CASE REPORT: In this paper, we present a series of three cases diagnosed with Craniofacial Fibrous Dysplasia at José Carrasco Arteaga Hospital and Hospital del Río, Cuenca-Ecuador. All of patients were treated with surgery, because of the clinical features. EVOLUTION: In all the cases, the patient evolution was favorable. Reduction of symptoms and general aesthetic improvement were achieved in all cases. CONCLUSION: Better results are obtained with the current surgical treatments (bone remodeling plus bone freezing), among them: good aesthetic results, better quality of life, lower risk of infections. In the present paper, the three patients treated with the surgical procedure indicated that the treatment reflected positively in the functional, aesthetic and emotional aspects.(au)

Alta frecuencia de sintomatología depresiva en cuidadores de pacientes pediátricos en diálisis peritoneal y hemodiálisis en un hospital público de Lima / High frequency of depressive symptoms in caregivers of pediatric patients on peritoneal dialysis and hemodialysis in a public Hospital in Lima

Objetivo: El objetivo del estudio fue describir la frecuencia de sintomatología depresiva en cuidadores de pacientes pediátricos en diálisis peritoneal y hemodiálisis. Material y Métodos: Estudio descriptivo de corte transversal en el cual participaron 33 cuidadores de pacientes pediátricos con enfermedad renal crónica de la unidad de hemodiálisis y diálisis peritoneal del Hospital Cayetano Heredia en Lima (Perú). El nivel de sintomatología depresiva de los cuidadores fue evaluado mediante el Patient Health Questionnaire (PHQ-9). Resultados: Un total de 54,54% de cuidadores presentaron sintomatología depresiva; el 9,09% moderadamente severa, el 18,18% moderada y el 27,27% leve; solo el 3,03% reportó uso de antidepresivos. Todos los cuidadores con depresión moderada y moderadamente severa reportaron algún grado de dificultad para realizar sus labores. Conclusiones: Se evidenció una alta frecuencia de sintomatología depresiva en cuidadores de pacientes pediátricos en diálisis. El reconocimiento de la depresión en los cuidadores principales es importante a fin de conducir intervenciones dirigidas a la preservación de su bienestar emocional.

Objective: To describe the frequency of depressive symptomatology in caregivers of pediatric patients on peritoneal dialysis and hemodialysis. Material and methods: Descriptive, cross-sectional study of 33 caregivers of pediatric patients with Chronic Kidney Disease, under treatment in the Hemodialysis and Peritoneal Dialysis Unit of the Cayetano Heredia Hospital in Lima (Peru). The participants completed the Patient Health Questionnaire (PHQ-9), which assessed their degree of depressive symptomatology. Results: A total of 54.54% of caregivers showed depressive symptomatology; 9.09% moderately severe, 18.18% moderate and 27.27% mild; only 3.03% reported intake of antidepressants. All caregivers with moderate and moderately severe depression reported some degree of difficulty in performing their tasks. Conclusions: A high frequency of depressive symptomatology in caregivers of pediatric patients on dialysis was found. The recognition of depression in primary caregivers is important, in order to carry out interventions aimed at maintaining their emotional well-being.

[Effect of intravenous infusion of KCl on the electrocardiogram and serum potassium in dogs with normal renal function]. / Efecto de la infusión endovenosa de KCl en el electrocardiograma y potasio sérico en perros con función renal normal.

Variations in serum potassium (K+) and electrocardiographic changes at different infusion speeds of intravenous K+ were studied in dogs. Solutions of 20, 40, 60 and 80 mEq of K+ were infused in one hour to dogs with normal renal function and normal serum K+. Nine dogs were studied: three without prior hydration and six with previous hydration. Infusing 20 mEq/hour of K+ produced an increase in heart rate without changes in the electrocardiogram. With 40 mEq/hour there were changes in the "t" and "p" waves, and with 60 and 80 mEq/hour, alterations consistent with cardiac ischemia and ventricular tachycardia. Dogs without hydration had more obvious and fatal electrocardiographic changes. Doses of 20 mEq/hour of K + caused no morbidity or mortality in the animals studied. Higher doses showed various complications which depended on the hydration status of the animal, its urinary flow and potassium level.

Efecto de la infusión endovenosa de KCl en el electrocardiograma y potasio sérico en perros con función renal normal / Effect of intravenous infusion of KCl on the electrocardiogram and serum potassium in dogs with normal renal function

Se estudiaron las variaciones del potasio sérico (K+) y las alteraciones electrocardiográficas al infundir diferentes velocidades de K+ endovenoso en perros. Se infundió soluciones de 20, 40, 60 y 80 mEq de K+ en una hora a perros con función renal y K+ sérico normal. Se estudiaron 9 perros: tres sin hidratación previa y seis con hidratación previa. Al infundir 20 mEq/hora de K+ los animales presentaron incremento de la frecuencia cardiaca sin alteraciones del electrocardiograma. Con 40 mEq/hora hubo alteraciones en las ondas ôtõ y ôpõ, y con 60 y 80 mEq/hora, alteraciones compatibles con isquemia cardiaca y taquicardia ventricular. Los perros sin hidratación tuvieron alteraciones electrocardiográficas más notorias y fatales. Dosis de 20 mEq/hora de K+, no causaron morbilidad ni mortalidad en los animales estudiados. Dosis mayores mostraron complicaciones variables que dependieron del estado de hidratación del animal, su flujo urinario y su nivel de potasio.

Variations in serum potassium (K+) and electrocardiographic changes at different infusion speeds of intravenous K+ were studied in dogs. Solutions of 20, 40, 60 and 80 mEq of K+ were infused in one hour to dogs with normal renal function and normal serum K+. Nine dogs were studied: three without prior hydration and six with previous hydration. Infusing 20 mEq / hour of K+ produced an increase in heart rate without changes in the electrocardiogram. With 40 mEq / hour there were changes in the ôtõ and ôpõ waves, and with 60 and 80 mEq / hour, alterations consistent with cardiac ischemia and ventricular tachycardia. Dogs without hydration had more obvious and fatal electrocardiographic changes. Doses of 20 mEq / hour of K + caused no morbidity or mortality in the animals studied. Higher doses showed various complications which depended on the hydration status of the animal, its urinary flow and potassium level.

Injuria renal aguda, perfil epidemiológico intrahospitalario y factores asociados al riesgo de muerte / Acute kidney injury, hospital epidemiologic profile and associated factors of death risk

La injuria renal aguda (IRA) es un evento mórbido de gran impacto en la vida de las personas. La tasa de letalidad de la IRA ha sido un tema relevante y se han estudiado muchos factores relacionados. Objetivos: Determinar el perfil epidemiológico de los pacientes con IRA en un hospital de Lima y los factores asociados a la mortalidad durante el periodo de hospitalización. Material y métodos: Estudio descriptivo, retrospectivo de una cohorte de pacientes incidentes con diagnóstico de IRA. Se calculó la letalidad bruta y la ajustada a tiempo de permanencia hospitalaria. Se usó la regresión multivariante de Cox, así como el mejor modelo para regresión logística binaria asociada a letalidad. Se aceptó una significancia estadística de p<0,05. Resultados: Se identificaron 90 pacientes con IRA en los años 2002, 2003 y 2004 (incidencia de 30, 39 y 21 pacientes/año, respectivamente). Su permanencia hospitalaria fue 13,44 ± 1,66 (promedio±1ES) días, la tasa bruta de letalidad 39% y la tasa ajustada 2,89 fallecidos/100 días de hospitalización. Las variables relacionadas al riesgo de muerte en el tiempo fueron el estado de shock, el diagnóstico de sepsis y la disfunción respiratoria al momento de la admisión. Conclusiones: La gravedad clínica como condición al momento de la admisión al centro hospitalario, el estado séptico y la presencia de disfunción respiratoria, fueron los factores que influenciaron en el pronóstico de supervivencia de pacientes con IRA. (AU)

Acute kidney injury (AKI) is a morbid event of great impact on the lives of people. The fatality rate of the IRA has been prominent and studied many related factors. Objectives: To determine the epidemiological profile of patients with AKI in a hospital in Lima and factors associated with mortality during the hospitalization. Methods: A retrospective descriptive study of a cohort of incident patients diagnosed with AKI was performed. Gross lethality was calculated and adjusted to length of hospital stay. Multivariate Cox regression was used as well as the best model for binary logistic regression associated with lethality. Statistical significance of p<0.05 was accepted. Results: 90 patients with AKI were identified in 2002, 2003 and 2004 (incidence of 30, 39 and 21 patients / year, respectively). Their average hospital stay was 13.44 ± 1.66 days, crude case fatality rate of 39% and an adjusted rate of 2.89 deaths/100 days of hospitalization, variables related to the risk of death at the time also was shock, sepsis diagnosis and respiratory dysfunction at the time of admission. Conclusions: The critical condition of admission to a hospital, a septic state and the presence of respiratory dysfunction, are the elements that influence the prognosis of survival of patients with AKI. (AU)