Preventive Intake of a Multiple Micronutrient Supplement during Mild, Acute SARS-CoV-2 Infection to Reduce the Post-Acute COVID-19 Condition: A Double-Blind, Placebo-Controlled, Randomized Clinical Trial.

Patients hospitalized with COVID-19 have low levels of vitamins and trace elements. This could lead to a post-acute COVID-19 condition (PCC) that can worsen a patient's quality of life. We aimed to study the baseline micronutrient status of patients and assess whether a multiple micronutrient supplement (MMS) taken for 2 weeks at the first sign of COVID-19 symptoms would be able to reduce the incidence of PCC. This double-blind, placebo-controlled, randomized clinical trial was conducted in adult outpatients with acute COVID-19, recruited between 2021 and 2023 in Spain. Of the 285 patients assessed for eligibility, 267 were randomized and 246 were included in the intent-to-treat population. The mean age was 46.8 years, and 68% were female. Overall, 54.6% had micronutrient deficiencies in the acute phase of COVID-19 at baseline, and 26.2% had PCC after 180 days of follow-up (D180). The most frequently recorded PCC symptoms were neurological (14.1%), with 24% patients scoring worse in the cognitive tests compared to their baseline status. The rate of PCC at D180 was similar between the placebo (25.0%) and intervention (27.7%) groups, without significant differences (p = 0.785). Age over 50 years was the most relevant risk factor for developing PCC, followed by female sex. The most important protective factor against PCC was SARS-CoV-2 vaccination. In this population of predominantly middle-aged, white women with acute COVID-19 not requiring hospital admission, MMS intake for 14 days at symptom onset did not prevent PCC nor improve their micronutrient status at D180.

Malnutrition, Functional Decline, and Institutionalization in Older Adults after Hospital Discharge Following Community-Acquired Pneumonia.

BACKGROUND AND AIMS: Community-acquired pneumonia (CAP) is a major threat to older adults, but mid-term implications are poorly described. The aim was to analyze functional decline, institutionalization, malnutrition, and risk factors after hospital admission for CAP. METHODS: This prospective observational study included patients over 65 years discharged after CAP between May 2019 and July 2021. We performed a comprehensive geriatric assessment and a general nutritional assessment 30-60 days after CAP. This included the MNA and blood test with trace elements and vitamins. The main outcomes were functional decline, institutionalization, and malnutrition. Multivariate logistic regression was used for the analyses. RESULTS: In total, 144 patients of 77.15 ± 7.91 years, 55.6% male, and 9% previously institutionalized were analyzed. At hospital admission, the Charlson Comorbidity Index (CCI) was 1.5 ± 1.6, the Pneumonia Severity Index was 98.1 ± 25.9, and the previous Barthel Index (BI) was 93.06 ± 17.13. Hospital stay was 9.72 ± 7.88 days. After 44.6 ± 14.4 days, 48.6% patients showed functional decline and 19.4% were institutionalized. Age (OR 1.17; CI 95% 1.09-1.26), previous institutionalization (29.1; 3.7-224.7), BI (1.09; 1.05-1.14), CCI (1.5; 1.1-2.1), and length of stay (1.1, 1.02-1.18) were independently associated with functional decline. The only predictors of new institutionalization were previous BI (0.96; 0.93-0.99) and length of stay (1.06; 1.00-1.13). The MNA indicated malnutrition in 28% of the community-dwelling patients and 67.9% of those institutionalized, with risk of malnutrition being 45.7% and 9.5%, respectively, after an average of 44.6 days of CAP diagnosis. The predictors of malnutrition were previous institutionalization (10.62; 2.20-51.21), BI (0.95; 0.92-0.98), and length of stay (1.12; 1.04-1.20). Micronutrient deficiencies were mainly zinc (61.8%), vitamin D (54.5%), and vitamin C (45.1%). An MNA score < 17 points or hypoalbuminemia showed good specificity to identify these deficiencies. CONCLUSIONS: After CAP admission, functional decline, institutionalization, and malnutrition rates were high. Longer hospital stay was a common risk factor for all outcomes. The presence of hypoalbuminemia or an MNA < 17 in older patients should prompt suspicion of deficiencies in micronutrients, such as vitamin D, C, and zinc.

Effects and mechanisms of mindfulness training and physical exercise on cognition, emotional wellbeing, and brain outcomes in chronic stroke patients: Study protocol of the MindFit project randomized controlled trial.

Background: Post-stroke cognitive and emotional complications are frequent in the chronic stages of stroke and have important implications for the functionality and quality of life of those affected and their caregivers. Strategies such as mindfulness meditation, physical exercise (PE), or computerized cognitive training (CCT) may benefit stroke patients by impacting neuroplasticity and brain health. Materials and methods: One hundred and forty-one chronic stroke patients are randomly allocated to receive mindfulness-based stress reduction + CCT (n = 47), multicomponent PE program + CCT (n = 47), or CCT alone (n = 47). Interventions consist of 12-week home-based programs five days per week. Before and after the interventions, we collect data from cognitive, psychological, and physical tests, blood and stool samples, and structural and functional brain scans. Results: The effects of the interventions on cognitive and emotional outcomes will be described in intention-to-treat and per-protocol analyses. We will also explore potential mediators and moderators, such as genetic, molecular, brain, demographic, and clinical factors in our per-protocol sample. Discussion: The MindFit Project is a randomized clinical trial that aims to assess the impact of mindfulness and PE combined with CCT on chronic stroke patients' cognitive and emotional wellbeing. Furthermore, our design takes a multimodal biopsychosocial approach that will generate new knowledge at multiple levels of evidence, from molecular bases to behavioral changes. Clinical trial registration: www.ClinicalTrials.gov, identifier NCT04759950.

Application of Neutral Electrolyzed Water on pork chops and its impact on meat quality.

Physicochemical and microbiological properties of pork chops sprayed with Neutral Electrolyzed Water (NEW) were evaluated during storage at refrigeration temperature. Pork chops were randomly allocated into three groups and were artificially contaminated with an inoculum of 106 CFU/mL of Listeria monocytogenes. Each group was treated with either NEW (58 ppm), NaClO (35 ppm), or saline solution (SS). Subsequently, recovered bacteria were plated on TSA petri dishes and the reduction percentage of Listeria monocytogenes was calculated 24 h and 8 days after treatment. Physicochemical analysis [pH, content of lactic acid, thiobarbituric acid reactive substances (TBARS) and total volatile base nitrogen (TVBN)] were performed to evaluate the effect of all solutions used on pork meat kept at 4 °C for 19 days. In vitro NEW reduced L. monocytogenes titers by > 99.98% and 80.19% and 90.35% in artificially contaminated pork 24 h and 8 days after NEW treatment, respectively. Compared to the SS treatment, NEW and NaClO solutions caused a 0.67 Log UFC/g and 0.65 Log UFC/g reduction respectively. After eight days post-treatment, NEW and NaClO bacterial titers were below the SS treatment. NEW caused little color change in treated meat. It helped to reduce the formation of lactic acid and TVB-N when pork chops are kept at 4 °C for 19 days. Therefore, NEW could be considered as a new alternative to sanitize and preserve pork meat.

Analysis of Neutral Electrolyzed Water anti-bacterial activity on contaminated eggshells with Salmonella enterica or Escherichia coli.

Neutral Electrolyzed Water (NEW) was tested in vitro and on artificially contaminated eggs against Salmonella enterica subsp. enterica or Escherichia coli. The antibacterial effect was measured 30 s after treatment. NEW microbicide activity results were compared against 2% citric acid and 0.9% saline solutions. NEW caused an in vitro decrease in Salmonella titers by ˃5.56 Log10 CFU mL-1 and in artificially contaminated eggs by ˃1.45 Log10 CFU/egg. When it was tested against E. coli, it decreased in vitro bacterial titers by ˃3.28 Log10 CFU mL-1 and on artificially contaminated eggs by ˃6.39 Log10 CFU/egg. The 2% citric acid solution caused an in vitro decrease of 0.4 Log10 CFU mL-1 of Salmonella and E. coli and on eggs artificially contaminated with E. coli or Salmonella there was a decrease of 0.06 and 0.62 Log10 CFU/egg respectively. We evaluated egg cuticle integrity by scanning electron microscopy after treatments with evaluated solutions; the 2% citric acid solution caused damage to the cuticle and exposed eggshell pores and no interaction of NEW or NaCl with the cuticle was observed. NEW treatment showed a fast-bactericidal effect in vitro and table eggs.

Refrescamiento de los guardianes de la medicina tradicional nasa: actitudes y prácticas en el Instituto Técnico Agropecuario e Industrial Juan Tama del Resguardo Indígena de Canoas, Municipio de Santander de Quilichao / Refreshment of the guardians of traditional Nasa medicine: attitudes and practices in the Agricultural and Industrial Technical Institute Juan Tama of the Indigenous Reservoir of Canoas, Municipality of Santander de Quilichao

Este estudio como parte de la Educación Popular, "interviene" en la reconstrucción de la experiencia del proceso que adelanta la comunidad educativa del Instituto Técnico e Industrial Juan Tama, en el Resguardo Indígena de Canoas de Santander de Quilichao, Colombia. En el cual, se establece la inclusión de la Educación Propia mediante acciones pedagógicas que retoman y fortalecen los valores ancestrales de su comunidad. Este importante proceso, permite constatar que la reconstrucción de esta experiencia significativa, es la búsqueda colectiva y participativa en torno a un origen común: la forma de organización comunitaria; semejanza en las prácticas educativas; y recuperación de las mismas mediante acciones dinámicas desde el entorno. La fundamentación conceptual de la reconstrucción de esta experiencia, se apoya esencialmente en dos propósitos: el social comunitario y el pedagógico; el primero se plantea reivindicar y fortalecer los valores ancestrales de su comunidad, en las nuevas generaciones traspasando las tradicionales fronteras entre el mundo escolar y el de la vida cotidiana; a lo cual, se da inicio con un proceso de revitalización de su medicina tradicional como pilar fundamental en la pervivencia de su cultura. En cuanto a lo pedagógico se busca el logro de un ambiente integral, al interior de la escuela, de carácter participativo, organizativo en la noción filosófica de Educación Propia fundada en el desarrollo de espacios de dialogo, encuentro y reflexión, generando verdaderos espacios de movilización comunitaria

Características del Líquido de Drenaje Pleural en pacientes Toracotomizados / Characteristics of the pleural fluid in patients who underwent a thoracotomy

Se realiza un estudio descriptivo entre enero y noviembre de 1992 de 16 pacientes toracotomizados por el Servicio de Cirugía Esplácnica del INOR, para evaluar las características del líquido de drenaje pleural. Se estudian la cantidad (volumen) y calidad (hemoglobina) del líquido evacuado, relacionándolos con otros parámetros (hemoglobina sérica, líquidos infundidos). Los volúmenes promedio de drenaje pleural en los 3 primeros días posoperatorios fueron de 612 mL; 277 mL y 132 mL. El drenaje acumulado total en 3 días luego de una toracotomía debe ser generalmente menor de 1 500 a 2 000 mL. La medición de la hemoglobina (Hb) del líquido drenado mostró en esos 3 días valores promedio de 3,0; 1,9 y 0,88 g/L. La cuantía del drenaje guardó relación con la envergadura de la operación, y fue un promedio de 1,500 mL como acumulado total en 3 días. La Hb del líquido drenado es mayor en las primeras 24 horas (3 g/L). Los parámetros fundamentales para evaluar a estos pacientes son hemodinámicos, y las preocupaciones sobre la pérdida hemática por el drenaje se resuelven fácilmente midiendo su concentración hemoglobínica (AU)

Caracteristicas del Liquido de Drenaje Pleural en pacientes Toracotomizados / Characteristics of the pleural fluid in patients who underwent a thoracotomy

Se realiza un estudio descriptivo entre enero y noviembre de 1992 de 16 pacientes toracotomizados por el Servicio de Cirugia Esplacnica del INOR, para evaluar las caracteristicas del liquido de drenaje pleural. Se estudian la cantidad (volumen) y calidad (hemoglobina) del liquido evacuado, relacionandolos con otros parametros (hemoglobina serica, liquidos infundidos). Los volumenes promedio de drenaje pleural en los 3 primeros dias posoperatorios fueron de 612 mL; 277 mL y 132 mL. El drenaje acumulado total en 3 dias luego de una toracotomia debe ser generalmente menor de 1 500 a 2 000 mL. La medicion de la hemoglobina (Hb) del liquido drenado mostro en esos 3 dias valores promedio de 3,0; 1,9 y 0,88 g/L. La cuantia del drenaje guardo relacion con la envergadura de la operacion, y fue un promedio de 1,500 mL como acumulado total en 3 dias. La Hb del liquido drenado es mayor en las primeras 24 horas (3 g/L). Los parametros fundamentales para evaluar a estos pacientes son hemodinamicos, y las preocupaciones sobre la perdida hematica por el drenaje se resuelven facilmente midiendo su concentracion hemoglobinica