¿Qué esconde una mancha de Roth? / What is a Roth's spot hiding?

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AJOE: pasado, presente y futuro. ¿Qué ocurre con los jóvenes oftalmólogos? / AJOE: Past, present and future. What happens to young ophthalmologists?

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Efectividad del consejo médico para dejar de fumar en pacientes con orbitopatía de Graves / Effectiveness of oral counselling for smoke cessation in Graves orbitopathy patients

Objetivo: El tabaco es un factor de riesgo en la orbitopatía de Graves (GO) y es modificable. El consejo médico para dejar de fumar se ha incluido en todas las guías de práctica clínica de esta enfermedad, aunque su efectividad no ha sido evaluada. El objetivo de este estudio es conocer el cambio producido en el hábito tabáquico en pacientes con GO tras una recomendación verbal para dejar de fumar. Material y métodos: Se estudió una cohorte retrospectiva de pacientes con GO. Todos los pacientes recibieron consejo médico sobre la importancia de dejar de fumar en la primera consulta del oftalmólogo. Entre 2013 y 2014 se atendió a 33 pacientes en la consulta, que fueron preguntados sobre el cambio en su hábito tabáquico en 2015. La variable principal de estudio fue el número de cigarros fumados al día antes y después de las consultas en endocrinología y oftalmología. Aparte, se recogieron otros datos personales médicos y socioeconómicos. Resultados: El número medio de cigarros fumados fue de 13,6 (DE 9,66) y 6,3 (DE 7,73) antes y después de la primera consulta en oftalmología, respectivamente (test t pareado, p < 0,05). El 42,42% de los pacientes dejó de fumar y el 30,3% disminuyó el consumo de cigarrillos. Los pacientes que consiguieron dejar de fumar presentaban con mayor frecuencia formas de enfermedad de Graves activas y graves, tenían trabajos estables y estaban apoyados por sus familiares y amigos. Conclusión: Un consejo fuerte y firme recomendando dejar de fumar es efectivo en pacientes con GO. Esta enfermedad afecta seriamente la calidad de vida de los pacientes, lo que hace que sean más susceptibles de cambiar a la hora de modificar sus hábitos

Objective: Smoking is an important risk factor for Graves orbitopathy (GO) and it is modifiable. The advice to stop smoking has been included in all the clinical practice guidelines of GO. However, the effectiveness of this practice remains unknown. The purpose of this study is to assess the change in the smoking habit in patients affected with GO after an oral counselling for smoking cessation. Material and methods: A retrospective cohort of GO patients was studied. The patients received a significant oral counsel during the first consultation with the ophthalmologist. 33 GO patients were explored in the ophthalmology clinic during 2013 and 2014 and the study was done throughout a telephone questionnaire in 2015. The main outcome was the number of cigarettes smoked daily before and after consultation with the endocrinologist and the ophthalmologist. Other medical and socioeconomic factors were recorded. Results: The mean number of cigarettes that were smoked was 13.6 (SD 9.66) and 6.3 (SD 7.73) before and after the consultation done at the ophthalmology office (T-test paired, P = 0.0006). 42.42% achieved smoking cessation and 30.3% decreased their smoking habit. Patients who stopped smoking suffered usually from active and severe GO, had more stable jobs and received greater support from their relatives and friends. Conclusion: A firm and strong oral counsel held for smoke cessation was effective in GO patients. This disease deeply affects patients’ quality of life, making them more prone to change their habits

Effectiveness of oral counselling for smoke cessation in Graves orbitopathy patients. / Efectividad del consejo médico para dejar de fumar en pacientes con orbitopatía de Graves.

OBJECTIVE: Smoking is an important risk factor for Graves orbitopathy (GO) and it is modifiable. The advice to stop smoking has been included in all the clinical practice guidelines of GO. However, the effectiveness of this practice remains unknown. The purpose of this study is to assess the change in the smoking habit in patients affected with GO after an oral counselling for smoking cessation. MATERIAL AND METHODS: A retrospective cohort of GO patients was studied. The patients received a significant oral counsel during the first consultation with the ophthalmologist. 33 GO patients were explored in the ophthalmology clinic during 2013 and 2014 and the study was done throughout a telephone questionnaire in 2015. The main outcome was the number of cigarettes smoked daily before and after consultation with the endocrinologist and the ophthalmologist. Other medical and socioeconomic factors were recorded. RESULTS: The mean number of cigarettes that were smoked was 13.6 (SD 9.66) and 6.3 (SD 7.73) before and after the consultation done at the ophthalmology office (T-test paired, P=0.0006). 42.42% achieved smoking cessation and 30.3% decreased their smoking habit. Patients who stopped smoking suffered usually from active and severe GO, had more stable jobs and received greater support from their relatives and friends. CONCLUSION: A firm and strong oral counsel held for smoke cessation was effective in GO patients. This disease deeply affects patients' quality of life, making them more prone to change their habits.

Use of Schizosaccharomyces strains for wine fermentation-Effect on the wine composition and food safety.

Schizosaccharomyces was initially considered as a spoilage yeast because of the production of undesirable metabolites such as acetic acid, hydrogen sulfide, or acetaldehyde, but it currently seems to be of great value in enology.o ced Nevertheless, Schizosaccharomyces can reduce all of the malic acid in must, leading to malolactic fermentation. Malolactic fermentation is a highly complicated process in enology and leads to a higher concentration of biogenic amines, so the use of Schizosaccharomyces pombe can be an excellent tool for assuring wine safety. Schizosaccharomyces also has much more potential than only reducing the malic acid content, such as increasing the level of pyruvic acid and thus the vinylphenolic pyranoanthocyanin content. Until now, few commercial strains have been available and little research on the selection of appropriate yeast strains with such potential has been conducted. In this study, selected and wild Sc. pombe strains were used along with a Saccharomyces cerevisiae strain to ferment red grape must. The results showed significant differences in several parameters including non-volatile and volatile compounds, anthocyanins, biogenic amines and sensory parameters.

Selection of appropriate Schizosaccharomyces strains for winemaking.

This paper describes the selection of Schizosaccharomyces yeasts with adequate oenological suitability and high capacity for the degradation of malic acid. Despite the almost non-existent number of commercial strains, the use of this yeast genus has recently been recommended by the International Organisation of Vine and Wine (OIV, in French). Thus, in the present study, a large number of Schizosaccharomyces strains were isolated using a selective differential medium. Initially, classic parameters of oenological interest for the use of fermentative strains of Saccharomyces cerevisiae (the most frequently used type of yeast) were assessed. Only five strains of moderate acetic acid production lower than 0.4 g/L were obtained at the end of fermentation. Other, more specific features of this yeast genus' physiology were also studied, including urease activity and the production of pyruvic acid and glycerol. Finally, oenological suitability was determined by comparing selected strains with other Schizosaccharomyces reference and S cerevisiae control strains. Schizosaccharomyces strains produced 80% less urea content, four times higher pyruvic acid levels and 1 g higher glycerol contents than the Saccharomyces reference strains. The results confirmed that it is possible to perform selective processes on microorganisms from the genus Schizosaccharomyces using methodology developed in this work to obtain strains of industrial interest.

Reduction of 4-ethylphenol production in red wines using HCDC+ yeasts and cinnamyl esterases.

Hydroxycinnamate decarboxylase (HCDC) activity has been evaluated in several commercial yeast strains. The combined effect of using cinnamyl esterases (CE) and HCDC+ Saccharomyces cerevisiae strains has been studied in the formation of vinylphenolic pyranoanthocyanins (VPAs) during fermentation, analysing the kind and concentration of pigments formed according to the yeast strain used. Wines fermented with yeasts HCDC+ were contaminated with Dekkera bruxellensis and afterwards analysed to evaluate the formation of ethylphenols (EPs). The musts treated with CE and later fermented with HCDC+ yeast strains showed lower contents of 4-ethylphenol than those fermented with HCDC- strains. This reduction in the EP content is due to the transformation of hydroxycinnamic acids in stable VPAs pigments. The associated use of CEs and HCDC+ Saccharomyces strains is a natural strategy to reduce the formation of EPs in wines contaminated by Dekkera/Brettanomyces.

Formation of pyranoanthocyanins by Schizosaccharomyces pombe during the fermentation of red must.

Schizosaccharomyces pombe is a non-Saccharomyces yeast strain that can ferment grape musts with high sugar contents - but it also has other metabolic and physiological properties that render it of great interest to wine biotechnologists. This work compares the production of pyranoanthocyanins by S. pombe, Saccharomyces cerevisiae and Saccharomyces uvarum during fermentation. Total pyranoanthocyanins ranged from 11.9 to 19.4 mg/l depending on the strain of S. pombe used. On average, S. pombe produced more pyruvic acid than did either Saccharomyces species; as a consequence it also formed more vitisin A-type pigments. S. pombe 938 produced the largest quantity of vitisin A (11.03±0.82 mg/l). The formation of large amounts of pyranoanthocyanins intensifies the post-fermentation colour of wines somewhat, a phenomenon that helps them maintain their colour over ageing as the natural grape anthocyanins become degraded. Some of the S. pombe strains showed hydroxycinnamate decarboxylase activity, which favours the formation of vinylphenolic pyranoanthocyanins. Fermentation with S. pombe therefore provides an interesting way of increasing the overall pyranoanthocyanin content of red wines, and of stabilising their colour during ageing.

Minimization of ethylphenol precursors in red wines via the formation of pyranoanthocyanins by selected yeasts.

Different strains of Saccharomyces with different hydroxycinnamate decarboxylase (HCDC) activities, estimated by a bioconversion assay, were used for the fermentation of musts enriched with p-coumaric acid and grape anthocyanins, with the aim of favouring the formation of vinylphenolic pyranoanthocyanins, colour stabilization and (especially) the minimization of 4-ethylphenol. The development of anthocyanin-3-O-glucosides (precursors of vinylphenolic adducts), the decarboxylation of p-coumaric acid, and the formation of 4-vinylphenol, 4-ethylphenol and vinylphenolic pyranoanthocyanins were monitored by HPLC-DAD-ESI/MS. After fermentation, the wines were inoculated with large numbers (10(4) CFU/ml) of Dekkera bruxellensis to establish their potential for ethylphenol production. The HCDC activity of the strains significantly increased the formation of vinylphenolic pyranoanthocyanins and reduced the final concentration of 4-ethylphenol and 4-ethylguaiacol generated by the vinylreductase activity (VPhR) of D. bruxellensis. Early decarboxylation of hydroxycinnamates to vinylphenols, by means of Saccharomyces strains with strong HCDC activity, and their subsequent binding with anthocyanins to form stable pyranoanthocyanins, is a possible way to reduce the likelihood of ethylphenol production by Brettanomyces during in-barrel aging.

Factors affecting the hydroxycinnamate decarboxylase/vinylphenol reductase activity of dekkera/brettanomyces: application for dekkera/brettanomyces control in red wine making.

The growth of Dekkera/Brettanomyces yeasts during the ageing of red wines-which can seriously reduce the quality of the final product-is difficult to control. The present study examines the hydroxycinnamate decarboxylase/vinylphenol reductase activity of different strains of Dekkera bruxellensis and Dekkera anomala under a range of growth-limiting conditions with the aim of finding solutions to this problem. The yeasts were cultured in in-house growth media containing different quantities of growth inhibitors such as ethanol, SO(2), ascorbic acid, benzoic acid and nicostatin, different sugar contents, and at different pHs and temperatures. The reduction of p-coumaric acid and the formation of 4-ethylphenol were periodically monitored by HPLC-PDA. The results of this study allow the optimization of differential media for detecting/culturing these yeasts, and suggest possible ways of controlling these organisms in wineries.

A method for estimating Dekkera/Brettanomyces populations in wines.

AIMS: The formation of ethylphenols in wines, a consequence of Dekkera/Brettanomyces metabolism, can affect their quality. The main aims of this work were to further our knowledge of Dekkera/Brettanomyces with respect to ethylphenol production, and to develop a methodology for detecting this spoilage yeast and for estimating its population size in wines using differential-selective media and high performance liquid chromatography (HPLC). METHODS AND RESULTS: This work examines the reduction of p-coumaric acid and the formation of 4-vinylphenol and 4-ethylphenol (recorded by HPLC-DAD) in a prepared medium because of the activities of different yeast species and populations. A regression model was constructed for estimating the population of Dekkera/Brettanomyces at the beginning of fermentation via the conversion of hydroxycinnamic acids into ethylphenols. CONCLUSIONS: The proposed methodology allows the populations of Dekkera/Brettanomyces at the beginning of fermentation to be estimated in problem wines. Moreover, it avoids false positives because of yeasts resistant to the effects of the selective elements of the medium. SIGNIFICANCE AND IMPACT OF THE STUDY: This may help prevent the appearance of organoleptic anomalies in wines at the winery level.

Bile acid secretion during rat liver carcinogenesis.

Retro-differentiation of liver parenchyma during neoplastic processes is characterized by the expression of tumor antigens, such as alpha-fetoprotein and the placental isoenzyme of glutathione-S-transferase (GST-P). To investigate whether this may also affect a typical liver function such as bile acid secretion was the aim of this work. Rat hepatocarcinogenesis was induced by diethylnitrosamine (i.p., 200 mg/Kg body weight at day 0) and promoted by two-thirds partial hepatectomy (at day 21) plus 2-acetamidofluorene administration (50 mg/Kg body weight, subcutaneously, twice a week from day 14 to day 35). In order to carry out planimetric measurements of neoplastic tissue after immunohistochemical staining, a novel monoclonal antibody (MAb 14.1.3) against GST-P with no cross-reactivity against the major liver isoform of GST (GST-H) was raised. Analysis of total biliary bile acid output using the 3alpha-hydroxysteroid dehydrogenase method indicated that a significant reduction (-26%) occurred during the formation of GST-P-positive foci (12 wk). This was restored to normal values during adenoma formation (16-20 wk), but decreased again during carcinoma transformation (32 wk). These changes were not parallel to that observed in bile flow, which was progressively but slightly decreased throughout the whole period under study. HPLC analysis of bile samples collected for 1 h at different time points during hepatocarcinogenesis revealed that in contrast to what happens during cholestatic disease, a continuous and progressive increase in the cholic acid-to-chenodeoxycholic acid ratio (from 4.4+/-0.5 in control animals to 15.1+/-1.9 in rats with hepatocellular carcinoma) occurs. A significant and transient increase at 16 wk (+120%) in the proportion of bile acids amidated with glycine as compared to those conjugated with taurine was also observed. These results indicate that the mechanisms accounting for the secretion of major bile acids are modified differently at various steps of rat liver tumor development.

Effects of selective zonal injury on bile acid-induced bile flow in the isolated rat liver.

The importance of acinar heterogeneity in ursodeoxycholic acid (UDCA)-induced bile flow was assessed in isolated rat livers that underwent restricted acinar damage by antegrade (A; 50 nmol) or retrograde (R; 500 nmol) digitonin infusion, as confirmed by histological evaluation. Stability of reduced (-40%) bile flow and perfusion flow (-25%) at constant pressure and potassium and lactate dehydrogenase release indicated similar viability of A and R preparations. They also showed similar abilities to secrete increasing doses of taurocholate (TC, maximal secretion rate approximately 105 nmol.min-1.g liver-1). TC-induced bile flow was not reduced by digitonin. In contrast, UDCA-induced choleresis was sensitive to zonal injury. Moreover, increases in bile flow and bicarbonate secretion observed under UDCA infusion (1.5 mumol/min) were lower in R than in A (-33 and -51%, respectively). No significant difference was observed in UDCA amidation or glucuronation between A and R preparations. With the use of single-pass perfusion on intact isolated livers that received 1 or 10 mumol UDCA, an early peak in bile acid output was observed to occur before the appearance of the major secretory peak. This was not found when 1 mumol of chenodeoxycholic acid bolus or trace amounts of [14C]TC were given. High-performance liquid chromatographic analysis of the early peak revealed it to be mainly due to unconjugated UDCA. This suggests the existence of a diffusional pathway for protonated bile acids and hence that the exist of lipophilic UDCA from bile during its way through the intra-acinar canaliculi across this pathway is also possible.(ABSTRACT TRUNCATED AT 250 WORDS)