[Repetition of microbiological tests in suspect of SARS-CoV-2 infection: utility of a score based on clinical probability]. / Repetición de las pruebas microbiológicas en la sospecha de la infección por SARS-CoV-2: utilidad de un score basado en la probabilidad clínica.

OBJECTIVE: The diagnosis of SARS-CoV-2 infection presents some limitations. RT-PCR in nasopharyngeal swabs is considered the gold standard for the diagnosis, although it can have false negative results. We aimed to analyze the accuracy of repeating nasopharyngeal swabs based on different clinical probabilities. METHODS: Retrospective observational study of the first patients admitted to a two COVID Internal Medicine wards at the University Hospital Marqués de Valdecilla, Santander, from March to April 2020. RT-PCR targering E, N, RdRP and ORFab1 genes and antibody tests detecting IgG. RESULTS: A total of 145 hospitalized patients with suspected SARS-Cov2 infection were admitted and in 98 (67.5%) diagnosis was confirmed. The independent predictive variables for SARS-CoV-2 infection were: epidemiological contact, clinical presentation as pneumonia, absence of pneumonia in the last year, onset of symptoms > 7 days, two or more of the following symptoms -dyspnea, cough or fever- and serum lactate dehydrogenase levels >350 U/L (p<0.05). A score based on these variables yielded an AUC-ROC of 0.89 (CI95%, 0.831-0.946; p<0.001). The accuracy of the first nasopharyngeal swabs was 54.9%. Repeating nasopharyngeal swabs two or three times allows to detect an additional 16% of positive cases. The overall accuracy of successive RT-PCR tests in patients with low pre-test probability was <5%. CONCLUSIONS: We have defined a pre-test probability score based on epidemiological and clinical data with a high accuracy for diagnosis of SARS-CoV-2. Repeating nasopharyngeal swabs avoids sampling errors, but only in medium of high probability pre-test clinical scenarios.

Prevention of parastomal hernia after abdominoperineal excision with a prophylactic three-dimensional funnel mesh.

AIM: A prophylactic three-dimensional (3D) funnel mesh using the keyhole technique (intraperitoneal onlay mesh position) in abdominoperineal excision (APR) may significantly decrease the parastomal hernia (PSH) index without increasing morbidity. The aim of this retrospective observational study was to analyse the incidence of PSH and postoperative complications in patients who underwent permanent colostomy with the use of a prophylactic 3D preformed mesh compared with patients without a mesh. METHOD: Patients who underwent an end-colostomy after APR for primary or recurrent rectal cancer in a colorectal surgery unit were divided into two groups: group 1 without a prophylactic mesh and group 2 with a prophylactic synthetic mesh. The main end-point was to analyse the incidence of PSH after a median follow-up of 2.8 years. RESULTS: One hundred and ten patients (64 in group 1 and 46 in group 2, without significant clinical differences) underwent a permanent colostomy after APR. In group 1 70.3% developed a PSH, compared with 13% in group 2 (P < 0.001). Age (especially for patients ≥ 75 years) represented a significant risk factor for PSH. There were no differences in postoperative complications between the groups. CONCLUSION: A prophylactic parastomal 3D mesh using the keyhole technique may reduce the incidence of PSH after permanent colostomy without an increase in postoperative complications.

[Hypertension and Framingham general vascular risk score in retinal vein occlusion]. / La hipertensión arterial y el score de Framingham de riesgo vascular en la obstrucción venosa retiniana.

OBJECTIVES: To determine the prevalence of arterial hypertension (AHT), systolic blood pressure (SBP), the diastolic blood pressure (DPB), and the Framingham vascular risk score (FRS), in subjects with retinal vein occlusion (RVO), as well as in a control group. PATIENTS AND METHOD: A prospective, cross-sectional case and control study was conducted on all patients with a diagnosis of RVO referred to the General Medicine Clinic, and comparing them with a control group. An analysis was performed on the clinical and laboratory variables. RESULTS: A total of 253 patients with RVO were studied (132 males and 121 females) and 244 controls (112 males and 132 females) of similar age (67.9±12.3 vs. 68.1±9.2 años). The prevalence of AHT, and the SBP and DPB values in the clinic after the RVO were significantly higher in patients with RVO than in the controls (71.5% vs. 51.2%), SBP mmHg (148±22 vs. 138±18mmHg), DBP mmHg (83±10 vs. 77±10mmHg). The de novo diagnosis of AHT was made from the RVO in 23.8% of the cases. Significant differences were found in the FRS between the patients with RVO and the controls (11±8.3 vs. 8.25±6.3. There were no differences in any of the parameters studied between patients with peripheral or central RVO. CONCLUSIONS: Hypertension is very prevalent as significantly more common in patients with RVO than in controls. Its diagnosis and treatment is often established from the RVO. The FRS is greater in patients with RVO. There were no differences in any of the parameters studied between patients with peripheral or central RVO. It is suggested that RVO should be considered a vascular event when defining therapeutic objectives.

Fiebre Mediterránea familiar: un diagnóstico a tener en mente / Familial Mediterranean fever: a diagnosis to keep in mind

Familial Mediterranean Fever is a hereditary inflammatory disease of predominantly autosomal recessive inheritance, produced by mutations in the MEFV gene that is found on the short arm of chromosome 16, characterized by recurrent episodes of fever accompanied by peritonitis, pleuritis, arthritis or erysipelaslike erythema. An episode lasts from one to three days, and its frequency is very variable. This disease is more frequent among Mediterranean populations, Jews from North Africa (not Ashkenazi), Armenians, Turks and Arabs. However, in recent years more cases have been reported in countries not related to this area. There are no formal studies of epidemiology in Chile. We present the case of one patient of Egyptian/ Jewish ancestry, and the case of a family of German/Spanish ancestry, all Chileans with semiology and characteristic evolution of familial Mediterranean fever and heterozygous positive molecular study. The absence of diagnosis in non-Mediterranean countries may be due to the lack of awareness of this disease. In Chile there has been a rise in cases given by migrants and their offspring, so it is very important to keep in mind as possible diagnosis in case of pain and fever of unknown origin. On the other hand, the familial Mediterranean fever is mainly of autosomal recessive inheritance, but dominant variants have been described. Both cases described in this work present the variant in which the disease manifests itself in its heterozygous form, generating an autosomal dominant inheritance, which would increase the number of affected individuals in the population.

La fiebre mediterránea familiar es un trastorno auto inflamatorio hereditario de herencia predominantemente autosómica recesiva, producida por mutaciones en el gen MEFV que se encuentra en el brazo corto del cromosoma 16, y que se caracteriza por episodios recurrentes de fiebre acompañada de peritonitis, pleuritis, artritis o eritema tipo erisipela. Un episodio dura entre uno y tres días, y su frecuencia es muy variable. Esta enfermedad es más frecuente entre las poblaciones mediterráneas, judíos del norte de África (no ashkenazíes), armenios, turcos y árabes. Sin embargo, en los últimos años se han reportado más casos en países no relacionados con esta área. No hay estudios epidemiológicos formales en Chile. Presentamos el caso de una paciente de ascendencia egipcia/judía, y el caso de una familia de ascendencia alemana/española, todos chilenos con semiología y evolución característica de fiebre mediterránea familiar y estudio molecular positivo heterocigoto. La falta de diagnóstico en países no mediterráneos puede deberse a la falta de conocimiento de esta enfermedad. En Chile han aumentado los casos dado el aumento de migrantes y sus descendientes, por lo que es importante tener este diagnóstico como posibilidad en caso de dolor y fiebre de origen desconocido. Por otro lado, la fiebre mediterránea familiar es principalmente de herencia autosómica recesiva, pero se han descrito variantes dominantes. Los dos casos descritos en este trabajo presentan la variante en la que la enfermedad se manifiesta en su forma heterocigota, generando una herencia autosómica dominante, lo que aumentaría el número de individuos afectados en la población.

αv integrins on mesenchymal cells regulate skeletal and cardiac muscle fibrosis.

Mesenchymal cells expressing platelet-derived growth factor receptor beta (PDGFRß) are known to be important in fibrosis of organs such as the liver and kidney. Here we show that PDGFRß+ cells contribute to skeletal muscle and cardiac fibrosis via a mechanism that depends on αv integrins. Mice in which αv integrin is depleted in PDGFRß+ cells are protected from cardiotoxin and laceration-induced skeletal muscle fibrosis and angiotensin II-induced cardiac fibrosis. In addition, a small-molecule inhibitor of αv integrins attenuates fibrosis, even when pre-established, in both skeletal and cardiac muscle, and improves skeletal muscle function. αv integrin blockade also reduces TGFß activation in primary human skeletal muscle and cardiac PDGFRß+ cells, suggesting that αv integrin inhibitors may be effective for the treatment and prevention of a broad range of muscle fibroses.

Prevalence and risk factors for intestinal parasitic infections in a rural community in "consolación del sur" municipality, cuba.

Intestinal parasites are very common infections worldwide and they are responsible for significant public health problems. The World Health Organization estimates that one-third of the world population is infected and some epidemiologic factors related to the transmission have been identified. The purpose of this investigation was to study the prevalence of intestinal parasitic infections in people living in the rural community of "El Canal", Consolación del Sur municipality and the association with some epidemiologic risk factors. All participants were subjected to three methods of parasitological examinations on the stool samples and by immunodiagnostic tests which allow the detection of excretory-secretory antigens of adults with Fasciola hepatica. The global prevalence rate of intestinal parasitic infections (IPIs) was 18%, and 16.7% for protozoan infections, while the rate of helminth infection was lower (5.3%) in the population studied. The univariate analysis identified three factors associated with intestinal pathogenic protozoan infections which include livestock work, drinking water from well\river and eating unwashed fruits\vegetables. The multivariate analysis using introduction test logistic regression ratified the association of these risk factors. Contrary to what have been published in the majority of Cuban studies carried out in rural places, a higher prevalence of protozoan than helminth infection was found. This discrepancy may be explained because the majority of the workers in this rural community were stock-breeders and they are not involved in other agricultural work. The identification of risk factors is important in order to design appropriate strategies for control of IPIs in communities.

[Spontaneous coronary artery dissection in the post partum: report of one case]. / Disección coronaria espontánea post parto: reporte de un caso clínico y revisión de la literatura.

Coronary artery dissection is a rare cause of acute coronary syndrome. Most cases occur in women during the peripartum period, most likely influenced by hormonal changes, hemodynamic stress and modifications in the immune system during pregnancy. The pathogenesis of coronary artery dissection is unknown, hence numerous theories have been postulated such as pregnancy-related conditions, the presence of connective tissue disorders, trauma, etc. The clinical presentation ranges from asymptomatic patients to the whole spectrum of acute coronary syndrome manifestations. The management of these patients requires a multidisciplinary approach, with two options: medical therapy or an invasive approach, with percutaneous coronary intervention or coronary artery bypass graft surgery. The choice of treatment options depends on the hemodynamic status of the patient, the extension of the dissection and the myocardial territory at risk. In this case report we present a 38-year-old female who had a coronary artery dissection seven days postpartum. Coronary catheterization showed dissection of the left main coronary artery that extended until the circumflex artery. An intra-aortic balloon pump was installed and the patient then underwent coronary artery bypass graft surgery, with satisfactory results.

Disección coronaria espontánea post parto: reporte de un caso clínico y revisión de la literatura / Spontaneous coronary artery dissection in the post partum: report of one case

Coronary artery dissection is a rare cause of acute coronary syndrome. Most cases occur in women during the peripartum period, most likely influenced by hormonal changes, hemodynamic stress and modifications in the immune system during pregnancy. The pathogenesis of coronary artery dissection is unknown, hence numerous theories have been postulated such as pregnancy-related conditions, the presence of connective tissue disorders, trauma, etc. The clinical presentation ranges from asymptomatic patients to the whole spectrum of acute coronary syndrome manifestations. The management of these patients requires a multidisciplinary approach, with two options: medical therapy or an invasive approach, with percutaneous coronary intervention or coronary artery bypass graft surgery. The choice of treatment options depends on the hemodynamic status of the patient, the extension of the dissection and the myocardial territory at risk. In this case report we present a 38-year-old female who had a coronary artery dissection seven days postpartum. Coronary catheterization showed dissection of the left main coronary artery that extended until the circumflex artery. An intra-aortic balloon pump was installed and the patient then underwent coronary artery bypass graft surgery, with satisfactory results.

Ethical, legal and practical issues of establishing an adipose stem cell bank for research.

Access to human tissue is critical to medical research, however the laws and regulations surrounding gaining ethical and legal access to tissue are often poorly understood. Recently, there has been a huge increase in the interest surrounding the therapeutic application of adipose tissue, and adipose-derived stem cells. To facilitate our own research interests and possibly assist our local colleagues and collaborators, we established a Research Tissue Bank (RTB) to collect, store and distribute human adipose tissue derived cells with all the appropriate ethical approval for subsequent downstream research. Here we examine the legal, ethical and practical issues relating to the banking of adipose tissue for research in the UK, and discuss relevant international guidelines and policies. We also share our experiences of establishing an RTB including the necessary infrastructure and the submission of an application to a Research Ethics Committee (REC).

Resultados del tratamiento de la hepatitis crónica por virus C en un hospital público, en Chile / Results of chronic hepatitis C treatment in a public hospital

Background: Chronic hepatitis C is an important health problem in Chile. In 2005, the Ministry of Health started a pilot treatment program with peg interferon and ribavirin, to be developed in public hospitals all over the country. Aim: To report the results ofhepatitis C treatment obtained at our institution. Patients and Methods: Between 2005 and 2009, 63 patients were referred for treatment. In all, the viral load and genotype were determined. Peg interferon alpha-2a or alpha-2b plus ribavirin were used for therapy for up to 48 weeks in genotypes (G) 1 or 4 or 24 weeks in genotypes 2 or 3. If at the end oftreatment, viral load measured by polymerase chain reaction (PCR) was negative, it was repeated 6 months later. A negative viral load at that time was considered a sustained viral response (SVR). Results: Among the 51 patients who started treatment, 42 (80.4%) were G1,1 was G2,1 was G4 and 7 were G3. A SVR was reached in 51.1% ofG 1 and 4 and in 87.5% in G 3 and 2. In a univariate analysis, the variables significantly associated with a positive viral response were the degree offibrosis and body mass index. Conclusions: These results are similar to those obtained in other international series, demonstrating that Hispanic ethnicity does not influence the response to treatment. Our good results could be explained by the excellent compliance of the patients to the treatment. A higher degree offibrosis and a higher BMI were associated with a poor response.

Adrenalectomía laparoscópica en patología benigna / Laparoscopic adrenalectomy in benign disease

Introduction: Nowadays the laparoscopic approach is the procedure of choice in adrenal diseases, except malignant adrenal tumors. Methods: A descriptive and retrospective study of the first 55 cases of laparoscopic adrenalectomy performed in our hospital between 1998 and 2011, we reviewed the short and long term results. Results: We had one case of conversion to open surgery in a patient with accidental section of the right renal vein. One case of reoperation due to hepatic injury. One case of postoperative mortality in a 71 year old woman with high anesthetic risk operated for Cushing's syndrome. Other complications were a case of hydropneumothorax and three cases of abdominal wall hematoma in site of laparoscopic trocar. In the follow up at 45 months all the patients remain asymptomatic, except one with ectopic Cushing's syndrome due to bronchial carcinoid. Conclusions: Laparoscopic adrenalectomy has good results and is an easily reproducible procedure, but must be performed by expert laparoscopic surgeons with a good knowledge of adrenal anatomy and experience in open surgery which allow them to solve the complications that may arise during the laparoscopic procedure.

Introducción: Al día de hoy el abordaje laparoscópico es el procedimiento de elección en la mayoría de lesiones que asientan sobre la glándula suprarrenal, a excepción del tumor maligno suprarrenal. Material y Métodos: Estudio descriptivo y retrospectivo de los 55 primeros casos de adrenalectomía laparoscópica realizados en nuestro centro en el período comprendido entre 1998 y 2011, evaluando los resultados a corto y largo plazo. Resultados: Hubo un caso de conversión a cirugía abierta (1,8 por ciento) en un paciente con sección accidental de la vena renal derecha. Un caso de reintervención por laceración hepática que pasó inadvertida durante la cirugía. Un caso de mortalidad en el postoperatorio inmediato por parada cardiorrespiratoria en una paciente de 71 años con riesgo anestésico ASAIII, intervenida por síndrome de Cushing. Otras complicaciones menores fueron un caso de hidroneumotórax y 3 casos de hematoma parietal en el trayecto del trocar. Se consiguió el control de la enfermedad de base después de un seguimiento medio de 45 meses en todos los casos menos en un paciente con síndrome de Cushing ectópico por un carcinoide bronquial. Conclusiones: La adrenalectomía laparoscópica es una técnica con buenos resultados y fácilmente reproducible, pero ha de ser realizada por cirujanos laparoscopistas expertos con un buen conocimiento de la anatomía de las glándulas suprarrenales y con experiencia en la cirugía abierta que les permita resolver las complicaciones que puedan surgir durante el procedimiento laparoscópico.

Production of pulp and energy using orange tree prunings.

The aim of this work was to chemically characterize orange tree prunings and use it in pulping and combustion processes. Soda-anthraquinone pulping of the main fraction of orange pruning (stems with a diameter > 0.5 cm) was simulated with polynomial and neurofuzzy models, that predicted pulp properties as a function of operating variables (155-185°C, 40-90 min, soda concentration, 10-16%) with errors less than 20%. The heating values (16,870 kJ/kg), the flame temperature (1150-2150 °C) and dew point temperature of fuel gas (47-53 °C) for the residual fraction from orange pruning (stems diameter < 0.5 cm and leaves) was determined and compared with other non-wood lignocellulosic materials. As a consequence the price of kJ obtained by combustion of this residual fraction is less than other lignocellulosic materials, much lower than those of fossil fuels.

[Anemia and transfusion therapy: an update]. / Actualización en anemia y terapia transfusional.

Anemia is one of the most prevalent diseases in the general population and is a very frequently found condition in medical and surgical patients in all medical specialties. A good evaluation of its clinical impact and its therapeutic possibilities is essential. Allogenic blood transfusion is a useful procedure in anemia management, although it has important adverse effects. It is the responsibility of the clinician to know and to take into account all the available alternatives for the treatment of anemia. Blood transfusions, erythropoiesis-stimulating agents, iron therapy (oral and endovenous) and other therapeutic alternatives must be rationally used, in accordance with the currently available clinical evidence. This review article summarizes some epidemiological characteristics of anemia, its clinical evaluation and the main therapeutic possibilities based on the present knowledge, placing special emphasis on the critically ill patient.

Gastrectomía vertical laparoscópica transumbilical / Transumbilical sleeve gastrectomy: experience in six patients

Background: The transumbilical route can be used to perform sleeve gastrectomies. Aim: To report the experience with transumbilical sleeve gastrectomy. Material and Methods: A prospective protocol of transumbilical sleeve gastrectomy was applied among patients with a body mass index of 36 kg/m² or less, and a distance between the xiphoid process and the umbilicus of less than 22 cm. Results: Six female patients, with a body mass index between 32.5 and 35.3 kg/m² have been operated. The operative time ranged from 90 to 170 min. An additional 5 mm trochar was required in the first two patients. The postoperative barium swallow showed a good distal passage and the absence of stenosis, residual fundus or nitrations in all patients. No patient had complications. Conclusions: Transumbilical sleeve gastrectomy is feasible among patients with a body mass index of less than 36 kg/m².

Introducción: La cirugía laparoscópica ha estado orientada los últimos años a buscar otras alternativas mínimamente invasivas de acceso abdominal. La transumbilical es una vía que ha comenzado a ser aplicada clínicamente, con o sin dispositivos de acceso único. Hemos comenzado a realizar la gastrectomía vertical laparoscópica (GVL) por vía transumbilical, en ciertos casos seleccionados. Objetivo: Evaluar la factibilidad de realizar la GVL por vía transumbilical, utilizando un dispositivo de acceso único y el resto del instrumental laparoscópico tradicional. Método: Protocolo prospectivo aplicado a pacientes que cumplan con criterios de inclusión como: ser candidato a GVL, tener IMC igual o menor a 36 kg/m², distancia entre apéndice xifoides y ombligo menor a 22 cm. El peso promedio de las pacientes operadas fue de 90,5 kg, (82,5-98), IMC promedio de 33,8 kg/m² (32,5-35,3). Se describe la técnica de inserción del dispositivo, de la gastrectomía y del manejo postoperatorio. Resultados: Se logró realizar GVL en las 6 pacientes en las que se intentó. El tiempo operatorio promedio fue de 127 min (90 a 170 min), en las dos primeras pacientes se requirió el uso de un trocar adicional de 5 mm. En todas las pacientes, la radiografía baritada de esófago, estómago y duodeno mostró buen paso a distal y ausencia de estenosis, fondo residual o filtraciones. No hubo morbilidad en este grupo. Conclusiones: La GVL es factible de realizar en pacientes portadores de obesidad menor a 36 kg/ m²de superficie corporal, usando un dispositivo de acceso único e instrumental laparoscópico tradicional.

Pasta untable de pavo enriquecida con fibras, vitaminas y minerales antioxidantes como ingredientes funcionales para el adulto mayor / Turkey spread with fiber, anti-oxidant vitamins and minerals as functional ingredients for elderly people

A spread for the elderly with turkey, fibers (insulin and oligofructose), anti-oxidant vitamins (A and E) and minerals (selenium and zinc) has been developed. The methodology of Taguchi was used for the optimization of the formulation, considering control factors such as pig butter, hydrated insulin, lactonal, salt, oregano/pepper, garlic and ice. Experimental designs L8 (27) and L9 (34) were used, and sensorial assessments were made. The optimized formulation obtained a value of4.51 (greater than "good"). The low fat and calorie levels as well as the smooth and pleasant texture stand out in the product. Furthermore, it has been shown that the product is apt and safe for consumption. The spread maintained an optimal sensorial and sanitary quality during storage for 28 days under refrigeration. Elderly showed a 90 percent of acceptance and a high preference by the spread. Therefore, the methodology of Taguchi optimized the spread, making it a good alternative of food for the elderly.

Se desarrolló una pasta untable destinada al adulto mayor con pavo, fibras solubles (inulina y oligofructosa), vitaminas (A y E) y minerales antioxidantes (selenio y zinc). La formulación se optimizó con la metodología de Taguchi, considerando como factores de control: manteca de cerdo, inulina hidratada, emulsionante, sal, orégano/pimienta, ajo y hielo. Se utilizaron los diseños experimentales L8(27) y L9(34) y se realizaron evaluaciones sensoriales, obteniendo la formulación optimizada un puntaje de 4,51 (superior a "bueno"). Del producto destacó el bajo nivel de lípidos y calorías, la textura suave-agradable y se demostró que el producto es apto y seguro para el consumo, manteniendo su calidad sensorial y sanitaria durante 28 días de almacenamiento en refrigeración. El adulto mayor mostró un 90 por ciento de aceptación y alta preferencia por la pasta. Por lo tanto, la metodología de Taguchi logró optimizar la pasta untable, constituyendo una buena alternativa de alimento para el adulto mayor.

Aceptabilidad de sopas deshidratadas de leguminosas adicionadas de realzadores del sabor (UMAMI) / Acceptability of dehydrated legume soups with the addition of flavor enhancers (UMAMI)

The enhancer effect of glutamate monosodium (MSG) flavor was evaluated and its synergistic action with 5'-ribonucleotides: ionone rib nucleotides 5'-monophosphate (IMP) and guano sine monophosphate (GMP) in dehydrated soups consisting of lentils and peas. Four formulations were developed for both soups: the first was the target with the original level of MSG, the following had different concentrations and mixtures of these enhancers (6 percent MSG; 6 percent MSG and 0.26 percent IMP; 0.6 MSG and 0.12 percent IMP-GMP). A five-.point Graphic Hedonic Scale test was used, where 1 represented the most upset face and 5 represented the happiest face. The most accepted soup was selected by thirty elderly adults. The lentils soup with 0,6 MSG and 0J2 percent IMP-GMP and the pea's soup with 6 percent MSG and 0.26 percent IMP obtained the greatest level of acceptance. So, the effectiveness of the synergistic action between the MSG and 5'-ribonucleotides was demonstrated, because they can improve the acceptance of the evaluated formulation.

Se evaluó el efecto realzador del sabor del glutamato monosódico (GMS) y su acción sinergista con 5'-ribonucleótidos: inosinato monofosfato (IMP) y guanilato monofosfato (GMP), cuando se adicionaron a sopas deshidratadas de lentejas y arvejas. Se elaboraron 4 formulaciones para cada sopa, la primera formulación correspondió al control con su nivel de GMS original, las siguientes formulaciones contaron con distintas concentraciones y mezclas de estos realzadores (6 por ciento GMS; 6 por ciento GMS mas 0,26 por ciento IMP y 0,6 GMS mas 0,12 por ciento IMP-GMP). Se utilizó la evaluación sensorial de Escala Hedónica Gráfica, con una escala de 1 al 5, donde 1: representa "la carita más disgustada" y 5: "la más feliz". Treinta adultos mayores determinaron la formulación más aceptada. La sopa de lentejas con 6 por ciento de GMS mas 0,12 por ciento de IMP-GMP fue la que tuvo mayor aceptación, mientras que para la sopa de arvejas fue aquella que contenía 6 por ciento de GMS más 0,26 por ciento de IMP. Por tanto, se pudo demostrar la efectividad de la acción sinergista entre el GMS y los 5'-ribonucleótidos, al mejorar las aceptación de las formulaciones evaluadas.