Effects of Whole and Malted Quinoa Flour Addition on Gluten-Free Muffins Quality.

Gluten-free flours based products present technological difficulties in their preparation, the texture is very different in comparison to products that contain gluten and their nutritional quality is often deficient due to the use of starches and refined flours, which provide high energy density and low nutritional value. The aim of this research was to assess the effects of addition both whole and malted quinoa flours on the physical, nutritional and sensory characteristics of gluten-free muffins. Different formulations were assessed: with 100% rice flour and with a 30% replacement for whole or malted quinoa flour. Proximate composition analysis, baking associated weight loss, size, specific volume, crumb structure, texture profile and consumer test sensory analysis were tested on the samples. Quinoa flours produced an increase of between 12% and 18% on protein, 8% to 18% on minerals and 22% to 25% on amino acids, in comparison to samples that contained only rice flour (used as reference). Technological and sensory improvements on the quality of assessed muffins were also associated to quinoa flours addition. 24 hr-malted quinoa flour added muffins had moisture, height, volume and firmness that were close to the reference ones. On all samples, small cells (0.002 to 0.005 cm2 ) were predominant on crumb structure and sensory evaluation resulted on similar outcomes for color and texture. However, the formula with 24 hours-malted quinoa flour had the best scored on taste and smell. PRACTICAL APPLICATIONS: Adding whole or malted quinoa flours to formulations of gluten-free products improves their nutritional and technological characteristics. These new products not only widen food variety for people with celiac disease but also increase the added value of quinoa grains, which motivates its production and industrialization.

Evaluación de las condiciones de desamargado en húmedo de quinoa (Chenopodium quinoa Willd) / Evaluation of wet de-bittering conditions of quinoa (Chenopodium quinoa Willd)

Introducción: los granos de quinoa presentan en su episperma saponinas, compuestos con actividad antinutricional y que le otorgan sabor amargo al grano, por lo que deben desamargarse previo a su consumo. La falta de precisión acerca de las condiciones más adecuadas para realizarlo por método húmedo, evidencia la necesidad de contar con información que aporte claridad. Objetivo: el objetivo del trabajo fue evaluar las condiciones de desamargado vía húmeda en granos de quinoa, con el fin de comparar su efectividad con un método cuantitativo. Materiales y métodos: se evaluaron como variables el tiempo, relación agua/granos y temperatura. Para determinar el contenido de saponinas residuales, se utilizó el método de la espuma (estimación afrosimétrica) y se compararon los resultados con espectrofotometría. Resultados y discusión: todas las variables ejercieron un efecto significativo y una correlación negativa sobre el contenido de saponinas. La interacción de las variables permitió establecer las condiciones de extracción que tuvieron mayor eficiencia: 6 minutos, relación masa granos/solvente 10 mL/g, independientemente de la temperatura. Por espectrofotometría, se observó la misma tendencia. Conclusiones: la conjugación de estas condiciones permite realizar lavados en tiempos breves, con una cantidad de agua determinada y sin la necesidad de aplicar temperatura. El método demostró ser sencillo, práctico y eficiente para la remoción de las saponinas

Introduction: quinoa grains present in its episperm saponins, compounds with antinutritional activity that give bitter flavor to the grain. Therefore, they must be previously removed for their consumption. The lack of precision about the most appropriate conditions to perform it by wet method, demonstrates the need to have information that provides clarity. Aim: the aim of this work was to evaluate the conditions of wet de-bittering in grains of quinoa, in order to compare its effectiveness with a quantitative method. Materials and methods: Time, water/grain mass ratio and temperature were evaluated as variables. To determine the content of saponins, foam method (afrosimetric estimation) was used and the data obtained by spectrophotometric method was used to compare. Results and discussion: All the variables presented a significant effect and a negative correlation on the saponin content. The interaction between the variables allowed establishing the conditions of extraction that had greater efficiency: 6 minutes, solvent/grain mass ratio 10:1, independently of the temperature. The same tendency was observed by spectrophotometry. Conclusions: the conjugation of these conditions enables to carry out washes in short periods of time, with a certain amount of water and without the need to apply temperature. The method proved to be simple, practical and efficient for the removal of saponins

A multicentre randomized pilot trial on the effectiveness of different levels of cooling in comatose survivors of out-of-hospital cardiac arrest: the FROST-I trial.

PURPOSE: To obtain initial data on the effect of different levels of targeted temperature management (TTM) in out-of-hospital cardiac arrest (OHCA). METHODS: We designed a multicentre pilot trial with 1:1:1 randomization to either 32 °C (n = 52), 33 °C (n = 49) or 34 °C (n = 49), via endovascular cooling devices during a 24-h period in comatose survivors of witnessed OHCA and initial shockable rhythm. The primary endpoint was the percentage of subjects surviving with good neurologic outcome defined by a modified Rankin Scale (mRS) score of ≤ 3, blindly assessed at 90 days. RESULTS: At baseline, different proportions of patients who had received defibrillation administered by a bystander were assigned to groups of 32 °C (13.5%), 33 °C (34.7%) and 34 °C (28.6%; p = 0.03). The percentage of patients with an mRS ≤ 3 at 90 days (primary endpoint) was 65.3, 65.9 and 65.9% in patients assigned to 32, 33 and 34 °C, respectively, non-significant (NS). The multivariate Cox proportional hazards model identified two variables significantly related to the primary outcome: male gender and defibrillation by a bystander. Among the 43 patients who died before 90 days, 28 died following withdrawal of life-sustaining therapy, as follows: 7/16 (43.8%), 10/13 (76.9%) and 11/14 (78.6%) of patients assigned to 32, 33 and 34 °C, respectively (trend test p = 0.04). All levels of cooling were well tolerated. CONCLUSIONS: There were no statistically significant differences in neurological outcomes among the different levels of TTM. However, future research should explore the efficacy of TTM at 32 °C. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov unique identifier: NCT02035839 ( http://clinicaltrials.gov ).

Calidad nutricional y propiedades físicas de panes libres de gluten / Nutritional quality and physical properties of gluten-free breads

Introducción: los panificados libres de gluten (LG) presentan dificultades tecnológicas en su elaboración, una textura muy diferente a sus homólogos con gluten y una calidad nutricional muchas veces deficiente por el uso de harinas refinadas y almidones, que proveen alta densidad energética y bajos valores nutricionales. Objetivo: evaluar las características nutricionales y físicas de panes libres de gluten empleando mezclas de harinas y almidones. Materiales y métodos: Los panes fueron elaborados con harina integral de quinoa (HQ), harina de arroz (HA), harina de lupino blanco (HL), almidones de maíz (MZ) y mandioca (MA). Se aplicó un diseño experimental de mezclas D-optimal ajustándose a una ecuación de segundo orden y considerando como variables predictoras el contenido de carbohidratos, proteínas, lípidos y minerales. Fueron elaboradas 20 formulaciones donde se analizaron el volumen específico, la dureza y uniformidad alveolar. La formulación optimizada fue comparada su composición proximal y perfil de aminoácidos con panes LG comerciales. Resultados y discusiones: los panes con mezclas del 35- 41% HQ, 18% HL y HA entre 18 y 29%, mostraron un destacado contenido en proteínas (9%), lípidos (3%) y minerales totales (1,8%). Estas formulaciones de panes LG presentaron una dureza que varió entre 4,09 y 7,51 N, un volumen específico entre 1,53 y 1,95 cm3/g y una uniformidad alveolar entre 1,38 y 2,7. La formulación optimizada (P0) fue la compuesta por 41% HQ, 20% HA, 18% HL, 11% MZ y 10% MA. Al comparar P0 con los panes comerciales, se pudo observar diferencias significativas (P<0,05) en el contenido de proteínas (11,21%), lípidos (3%) y minerales totales (2,27%), destacándose P0 por presentar los mayores valores nutricionales. Conclusiones: Se logró un producto panificable apto para celíacos donde el uso HQ y HL, como principales componentes, tuvieron un efecto positivo sobre la calidad nutricional y características físicas de los panes evaluados

Introduction: The gluten free bread (GF) free bread have technological difficulties in its development, the texture is very different from their counterparts with gluten and the nutritional quality is often poor by the use of refined flours and starches, which provide high energy density and low nutritional values. Aim: Nutritional and physical characteristics evaluation of breads from mixtures of gluten-free flours and starches. Materials & methods: Quinoa flour (HQ), rice flour (HA), white lupine flour (HL), cornstarch (MZ) and starch from cassava (MA) were used to make the breads dough. It was applied an experimental design of mixing D-optimal, adjusting to a second order equation and considering the content of carbohydrates, proteins, lipids and minerals as predictor variables. Volume, hardness and alveolar uniformity of crumb were analysed in 20 formulations. The optimized formulation was compared by their proximate composition and profile of amino acids with GF commercial breads. Results and discussions: Breads with mixtures of 35- 41% HQ, 18% HL, 18-29% HA has presented an outstanding content in proteins (9%), lipids (3%), and total minerals (1.8%). The 20 LG bread formulations presented a hardness that ranged between 7.51 and 4.09 N, a specific volume ranging from 1.53 to 1.95 cm3/g and alveolar uniformity between 1.38 and 2.7. The optimized formulation (P0) was composed of 41% HQ, 20%, 18% HL, 11% MZ and 10% MA. Comparing the P0 with the LG commercial bread loaf, significant differences could be observed (P<0.05) in the content of proteins (11.21%), lipids (3%) and total minerals (2.27%), highlighting the bread of the P0 by presenting the highest nutritional values. Conclusions: It was achieved a suitable gluten-free product where the use of quinoa and sweet lupine flours as main components had a positive effect on the nutritional quality and to the physical properties of testing bread loafs

Functional Status and Quality of Life in Elderly Intensive Care Unit Survivors.

OBJECTIVES: To evaluate functional status and quality of life in elderly intensive care unit (ICU) survivors at 1-year follow-up. DESIGN: Prospective 18-month observational study. SETTING: University medical-surgical ICU. PARTICIPANTS: ICU survivors aged 75 and older. MEASUREMENTS: Functional status at baseline (Barthel Index (BI)) was compared with that at hospital discharge and 1-year follow-up. Health-related quality of life (HRQL Spanish version of the Medical Outcomes Study 36-item Short-From Survey) was measured at 1-year follow-up and compared with that of the Spanish population of same age. RESULTS: Of 176 individuals admitted to the ICU, 110 (62.1%) were discharged alive from the hospital, and 94 (53.1%) were alive at 1-year follow-up. ICU admission was associated with significant clinical deterioration (median BI 100 points (interquartile range (IQR) 85-100) at baseline vs 85 (IQR 60-100) at hospital discharge, P < .001). Three months after discharge, there was a significant although modest improvement in functional status (BI 95 (IQR 80-100) P = .03). Baseline functional status was not recovered at 1-year follow-up (BI 95 (IQR 80-100) P < .001). More ICU survivors had moderate to severe dependence at the end of follow-up (20.3%) than at ICU admission (6.6%) (P < .001). Factors independently associated with poor functional recovery were low baseline BI and ICU stay longer than 4 days. At 1-year follow-up, 76.8% of participants who survived were living in their own homes. HRQL was similar to that of the Spanish population of the same age. CONCLUSION: Elderly ICU survivors experienced significant deterioration in functional status, and although they recovered modestly during the following year, they never regained their baseline status. Good recovery was associated with short ICU stay and better baseline functional status.

Characteristics and outcomes of elderly patients refused to ICU.

BACKGROUND: There are few data regarding the process of deciding which elderly patients are refused to ICU admission, their characteristics, and outcome. METHODS: Prospective longitudinal observational cohort study. We included all consecutive patients older than 75 years, who were evaluated for admission to but were refused to treatment in ICU, during 18 months, with 12-month followup. We collected demographic data, ICU admission/refusal reasons, previous functional and cognitive status, comorbidity, severity of illness, and hospital and 12-month mortality. RESULTS: 338 elderly patients were evaluated for ICU admission and 88 were refused to ICU (26%). Patients refused because they were "too ill to benefit" had more comorbidity and worse functional and mental situation than those admitted to ICU; there were no differences in illness severity. Hospital mortality rate of the whole study cohort was 36.3%, higher in patients "too ill to benefit" (55.6% versus 35.8%, P < 0.01), which also have higher 1-year mortality (73.7% versus 42.5%, P < 0.01). High comorbidity, low functional status, unavailable ICU beds, and age were associated with refusal decision on multivariate analysis. CONCLUSIONS: Prior functional status and comorbidity, not only the age or severity of illness, can help us more to make the right decision of admitting or refusing to ICU patients older than 75 years.

Activation of the serotonergic 5-HT1A receptor in the paraventricular nucleus of the hypothalamus inhibits water intake and increases urinary excretion in water-deprived rats.

The paraventricular nucleus (PVN) may be considered as a dynamic mosaic of chemically-specified subgroups of neurons. 5-HT(1A) is one of the prime receptors identified and there is expressed throughout all magnocellular regions of the PVN. Several reports have demonstrated that a subpopulation of the magnocellular neurons expressing 5-HT(1A) receptors are oxytocin (OT) neurons and activation of 5-HT(1A) receptors in the PVN increases the plasma OT. Increasing evidence shows that OT inhibits water intake and increases urinary excretion in rats. The aim of this study was to investigate the role of serotonergic 5-HT(1A) receptors in the lateral-medial posterior magnocellular region of the PVN in the water intake and diuresis induced by 24 h of water deprivation. Cannulae were implanted in the PVN of rats. 5-HT injections in the PVN reduced water intake and increased urinary excretion. 8-OH-DPAT (a 5-HT(1A) agonist) injections blocked the water intake and increased urinary output in all the periods of the observation. pMPPF (a 5-HT(1A) antagonist) injected bilaterally before the 8-OH-DPAT blocked its inhibitory effect on water intake and its diuretic effect. We suggest that antidipsogenic and diuretic responses seem to be mediated via 5-HT(1A) receptors of the lateral-medial posterior magnocellular region of the PVN in water-deprived rats.

Activation of paraventricular nucleus of hypothalamus 5-HT1A receptor on sodium intake.

Hypothalamic paraventricular nucleus (PVN) has an important role in the regulation of water and sodium intake. Several researches described the presence of 5-HT(1) receptors in the central nervous system. 5-HT(1A) was one of the prime receptors identified and it is found in the somatodendritic and post-synaptic forms. Therefore, the aim of this study was to investigate the participation of serotonergic 5-HT(1A) receptors in the PVN on the sodium intake induced by sodium depletion followed by 24 h of deprivation (injection of the diuretic furosemide plus 24 h of sodium-deficient diet). Rats (280-320 g) were submitted to the implant of cannulas bilaterally in the PVN. 5-HT injections (10 and 20 microg/0.2 microl) in the PVN reduced NaCl 1.8% intake. 8-OH-DPAT injections (2.5 and 5.0 microg/0.2 microl) in the PVN also reduced NaCl 1.8% intake. pMPPF bilateral injections (5-HT(1A) antagonist) previously to 8-OH-DPAT injections have completely blocked the inhibitory effect over NaCl 1.8% intake. 5-HT(1A) antagonists partially reduced the inhibitory effect of 5-HT on NaCl 1.8% intake induced by sodium depletion. In contrast, the intake of palatable solution (2% sucrose) under body fluid-replete conditions was not changed after bilateral PVN 8-OH-DPTA injections. The results show that 5-HT(1A) serotonergic mechanisms in the PVN modulate sodium intake induced by sodium loss. The finding that sucrose intake was not affected by PVN 5-HT(1A) activation suggests that the effects of the 5-HT(1A) treatments on the intake of NaCl are not due to mechanisms producing a nonspecific decrease of all ingestive behaviors.

Serum cystatin C concentration as a marker of acute renal dysfunction in critically ill patients.

INTRODUCTION: In critically ill patients sudden changes in glomerular filtration rate (GFR) are not instantly followed by parallel changes in serum creatinine. The aim of the present study was to analyze the utility of serum cystatin C as a marker of renal function in these patients. METHODS: Serum creatinine, serum cystatin C and 24-hour creatinine clearance (CCr) were determined in 50 critically ill patients (age 21-86 years; mean Acute Physiology and Chronic Health Evaluation II score 20 +/- 9). They did not have chronic renal failure but were at risk for developing renal dysfunction. Serum cystatin C was measured using particle enhanced immunonephelometry. Twenty-four-hour body surface adjusted CCr was used as a control because it is the 'gold standard' for determining GFR. RESULTS: Serum creatinine, serum cystatin C and CCr (mean +/- standard deviation [range]) were 1.00 +/- 0.85 mg/dl (0.40-5.61 mg/dl), 1.19 +/- 0.79 mg/l (0.49-4.70 mg/l), and 92.74 +/- 52.74 ml/min per 1.73 m2 (8.17-233.21 ml/min per 1.73 m2), respectively. Our data showed that serum cystatin C correlated better with GFR than did creatinine (1/cystatin C versus CCr: r = 0.832, P < 0.001; 1/creatinine versus CCr: r = 0.426, P = 0.002). Cystatin C was diagnostically superior to creatinine (area under the curve [AUC] for cystatin C 0.927, 95% confidence interval 86.1-99.4; AUC for creatinine 0.694, 95% confidence interval 54.1-84.6). Half of the patients had acute renal dysfunction. Only five (20%) of these 25 patients had elevated serum creatinine, whereas 76% had elevated serum cystatin C levels (P = 0.032). CONCLUSION: Cystatin C is an accurate marker of subtle changes in GFR, and it may be superior to creatinine when assessing this parameter in clinical practice in critically ill patients.

Interaction between paraventricular nucleus and medial septal area on the renal effects induced by adrenaline.

The aim of the present study was to analyze the role of alpha1, alpha2-adrenoceptors, and the effects of losartan and PD123319 (selective ligands of the AT1 and AT2 angiotensin receptors, respectively) injected into the paraventricular nucleus (PVN) on the diuresis, natriuresis, and kaliuresis induced by administration of adrenaline into the medial septal area (MSA). Male Holtzman rats with a stainless steel cannula implanted into the MSA and bilaterally into the PVN were used. The administration of adrenaline into the MSA increased in a dose-dependent manner the urine, sodium, and potassium excretions. The previous administration of prazosin (an alpha1-adrenoceptor antagonist) injected into the PVN abolished the above effects of adrenaline, whereas yohimbine (an alpha2-adrenoceptor antagonist) doesn't affect the diuresis, natriuresis, and kaliuresis induced by adrenaline. Pretreatment with losartan into the PVN decreased in a dose-dependent manner the urine, sodium, and potassium excretions induced by MSA administration of adrenaline (50 ng), while PVN PD123319 was without effect. These results indicate that urinary and electrolyte excretion effects induced by adrenaline into the MSA are mediated primarily by PVN AT1 receptors. However, the doses of losartan were more effective when combined with the doses of PD123319 than given alone, suggesting that the urinary, natriuretic, and kaliuretic effects of MSA adrenaline may involve activation of multiple angiotensin II receptors subtypes into the PVN.

Two low-cost food attractants for capturing Toxotrypana curvicauda (Diptera: Tephritidae) in the field.

Adults of the papaya fruit fly, Toxotrypana curvicauda Gerstaecker, living in wild vegetation in Yautepec, Morelos, Mexico, were captured using McPhail traps baited with pineapple juice or brown sugar. Maximum capture peaks occurred during August and November in the afternoon. Baits were most effective when aged over a 4-d period. Traps baited with brown sugar captured the highest number of adults, and both baits were more attractive to females than males. Potential use of these baits for pest management and research is discussed, considering that this is the first report of pineapple juice being attractive to the papaya fruit fly.

An evaluation of the tear function in menopausic women

Dry Eye is one of the most common eye disorders. Although this occurs in both men and women at any age, women in their menopausic years are often afflicted with this condition. This may be due to the loss of hormonal support after menopause. The purpose of this study is to determine the tear function of menopausic women and also to determine whether there is a correlation between advancing age and tear function. 62 menopausic women between the ages of 55-78 years underwent four different types of tear function tests (Schirmer Test, Tear Breakup Time, Vital Staining with Fluorescein Dye and the Ferning Test). These women were not under any type of medication. Results showed that in both the Schirmer Test and the Tear Breakup Time Test, there was a significant decrease in the tear function as age progressed. Although there were no statistically significant changes in the corneal uptake with increasing age, it was noted that the number of subjects with significant fluorescein dye uptake increased in the older age group. Likewise, there was no significant change in the Ferning test although a decreasing trend in the ferning pattern was observed as the age progressed. Based on the data collected, menopause and aging play a vital role in the development of dry eyes. Although the actual process remains uncertain, this can be attributed to the changes in the sex hormonal levels in menopausic women. (Author)

Asistencia ventricular mecanica un nuevo reto para el profesional de enfermeria / Mechanical ventricular assistance and Nursing

La investigación clínica en dispositivos de asistencia ventricular mecánica, data de finales de los años 50. En 1966 Michael DeBakey obtiene resultados positivos asistiendo a un paciente durante 10 días. En la última década la tecnología ha evolucionado rápidamente pasando del balón de contrapulsación a los sistemas neumáticos. Para enfermería esta revolución tecnológica representa un gran reto, ya que el cuidado de los pacientes sometidos a asistencia ventricular significa además de una gran responsabilidad, el acceso a nuevas tecnologías, conocimientos y habilidades para el crecimiento profesional. Enfermería necesita trabajar mancomunadamente con otros profesionales para lograr su objetivo, como es el de mantener y/o mejorar la calidad de vida de los pacientes. La experiencia en asistencia ventricular mecánica en niños, es poca. La sobrevida de un paciente de 10 años sometido a asistencia ventricular derecha durante 48 horas, motiva este reporte de caso y pretende dar a conocer los aspectos más importantes tanto técnicos (manejo de consola, técnicas de canulación) como prácticos (indicaciones, técnicas de asistencia, contraindicaciones, complicaciones, principios fisiológicos y registro) necesarios para entender el funcionamiento de éstos dispositivos, finalmente plantear intervenciones de enfermería en términos de diagnósticos de enfermería...