Impact of CT-measured sarcopenic obesity on postoperative outcomes following colon cancer surgery.

OBJECTIVE: This study aimed to investigate the influence of sarcopenic obesity on anastomotic leak following elective colon resection for non-metastatic colon cancer. Secondary outcomes included overall morbidity, mortality and length of hospital stay. METHODS: This retrospective observational study, conducted at a colorectal surgery referral centre, spanned from January 1, 2015, to January 1, 2020. A total of 544 consecutive patients who underwent elective colon resection were included in the analysis, excluding patients with rectal cancer, urgent surgery, absence of anastomosis, lack of imaging, multivisceral resections and synchronic tumours. RESULTS: Postoperative complications were observed in 177 (32.3%) patients, with 51 (9.31%) classified as severe (Clavien-Dindo > II). Sarcopenic obesity was identified in 9.39% of the sample and emerged as an independent predictor of increased overall morbidity [OR 2.15 (1.14-3.69); p = 0.016] and 30-day mortality [OR 5.07 (1.22-20.93); p = 0.03] and was significantly associated with the development of anastomotic leak [OR 2.95 (1.41-6.18); p = 0.007]. Furthermore, it increased the risk of reoperation and was linked to a prolonged length of hospital stay. CONCLUSIONS: CT-measured sarcopenic obesity demonstrates a discernible correlation with an elevated risk of postoperative morbidity and mortality in the context of colon cancer surgery.

Axillary staging and management of cN + breast cancer patients treated with neoadjuvant chemotherapy: results of a survey among breast cancer surgeons in Spain.

INTRODUCTION: Given the high rate of complete nodal response, the role of axillary lymph node dissection on staging the axilla has been questioned. This survey, addressed to breast cancer surgeons in Spain, has the objective of assessing current clinical trends on axillary staging of cN + patients treated with NAC. METHODS: An online survey was conducted among breast surgeons from the Spanish Society of Surgery (AEC), Spanish Surgical Oncology Society (SEOQ), Spanish Breast Cancer Surgeons Society (AECIMA) and Spanish Gynecology and Obstetrics Society (SEGO). It was structured in 5 sections: general information and clinical practice, knowledge of clinical trials, diagnosis work-up and nodal marking, axillary staging, and axillary treatment. RESULTS: 150 breast cancer surgeons completed the full survey (96.7%). 81.8% of respondents performed SLNB or targeted axillary dissection in cN1 patients treated with NAC. Radiological axillary response was the preferred parameter guiding the surgical strategy. The excision of the clipped node (92.0%), use of dual tracer (73.2%), and axillary US (65.9%) after treatment were the most important variables considered by respondents, to increase the accuracy of SLNB in cN + patients. CONCLUSION: This survey confirms a trend toward a less invasive approach for axillary staging in cN + patients treated with NAC among breast cancer surgeons in Spain. While there is widespread agreement in less invasive approaches to axillary staging, there is, however, a lack of consensus around treatment strategy. Further, it shows a wide heterogeneity in their clinical practice. This study highlights the need for clear evidence concerning less invasive staging procedures and their oncological safety, to ensure consistent recommendations in surgical practice.

4D-CT as a second line preoperative localization test for the evaluation of primary hyperparathyroidism.

INTRODUCTION: Four-dimensional computerized tomography (4D-CT) offers a good sensitivity for the localization of the pathological gland responsible of primary hyperparathyroidism. The aim was to evaluate its results as a second line preoperative localization test after inconclusive or discordant results of usual preoperative studies. MATERIAL AND METHODS: Observational retrospective study that included all patients intervened for primary hyperparathyroidism with 4D-CT scan as preoperative study, from 1st October 2016 to 1st October 2021, in a tertiary referral centre. The results of 4D-CT, cervical ultrasound, and Nuclear Medicine explorations (scintigraphy, SPECT and SPECT-CT) were compared with the gold standard of the surgical exploration and the pathological result. The correct lateralization and the approximate localization rates of the pathological gland were evaluated. RESULTS: A total of 64 patients were analysed, with a 93,8% (60/64) remission rate. 4DCT showed a correct lateralization in 57,8% (37/64) of the cases and revealed the approximate localization of the gland in 48,4% (31/64) of the cases. The cervical ultrasound had a rate of 31,1% (19/61) and 18% (11/61) for the correct lateralization and approximate localization, respectively, compared to 34,9% (22/63) and 28,6% (18/63) in Nuclear Medicine explorations, and 32,7% (16/49) and 24,5% (12/49) in SPECT-CT. These differences were statistically significant. CONCLUSION: 4D-CT demonstrated acceptable results for the localization of the lesions responsible of primary hyperparathyroidism, thus its use should be considered with the absence of localization in routinely studies.

Effect of preoperative potassium iodide administration on Graves' disease surgery: a propensity score analysis.

BACKGROUND: Preoperative administration of a saturated solution of potassium iodide (SSKI) is recommended in the guidelines for the management of hyperthyroidism due to Graves' disease. Studies addressing its effect on complications after thyroidectomy are inconclusive. METHODS: Retrospective multicenter Propensity Score study of patients undergoing total thyroidectomy for Graves' disease, from January 2013 to September 2019 in two tertiary centers in Madrid, Spain. Patients were given SSKI prior to surgery or not according to surgeons' preferences. Electronic clinical records were reviewed searching: baseline characteristics surgical variables, pathological findings, and postoperative complications. RESULTS: Ninety patients were analyzed: 44 received SSKI and 46 were not given SSKI. No significant differences were found in the main postoperative complications with or without SSKI: transient hypoparathyroidism (40.9% vs. 50%), permanent hypoparathyroidism (6.8% vs. 13%), transient recurrent laryngeal nerve (RLN) palsy (2.3% vs. 8.7%), definitive RLN palsy (2.3% vs. 2.2%), or cervical hematoma (2.3% vs. 4.3%). CONCLUSION: Preoperative administration of SSKI had no impact on postoperative complications after thyroidectomy for Graves' disease.

Factors contributing to satisfaction with care in cancer outpatients.

OBJECTIVES: To evaluate satisfaction with care (SC) in cancer patients treated at a Spanish day hospital, to identify determinants of SC, and to assess the association between SC and quality of life (QL). METHODS: Cross-sectional study in which 119 patients undergoing outpatient chemotherapy completed the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30), the Cancer Outpatient Satisfaction with Care questionnaire for chemotherapy (OUT-PATSAT35 CT), and an item on loyalty. Bivariate correlations between each subscale of the OUT-PATSAT35 CT and overall satisfaction, and between the subscales of OUT-PATSAT35 CT and QLQ-C30, were calculated. Multiple linear regression models were used to analyze determinants of patients' SC. RESULTS: Mean age was 62.5 years (SD 11.7), and 54.6% of the sample were female. Mean scores for SC were > 75 out of 100 on all OUT-PATSAT35 CT subscales, except environment. Overall satisfaction was higher than satisfaction in any subscale, and all patients would choose the same day hospital again. Correlation with overall satisfaction was moderate but statistically significant for all subscales. Patients treated for tumor recurrence and those undergoing palliative treatment manifested significantly lower overall satisfaction. Correlation between the EORTC QLQ-C30 and the OUT-PATSAT35 CT was not statistically significant, although patients with better health status reported higher satisfaction in several subscales. CONCLUSION: Patient-reported SC and loyalty towards the day hospital were high. Disease evolution and aim of treatment were determinants of overall satisfaction. The correlation between SC and QL was unclear. Some areas for improving care were noted.

An inner filter effect based sensing system for the determination of caffeine in beverage samples.

In this work, the inner filter effect (IFE) of caffeine (CF) over the fluorescence signal of glibenclamide (GLB) was used for the determination of CF in beverage samples. The system worked in a turn-off mode since the absorption spectrum of CF overlaps the excitation band of GLB resulting in a decline in its fluorescence signal (λexc = 234 nm, λem = 350 nm). No changes in the fluorescence lifetime of GLB (0.29 ns) were observed in the presence of CF up to 127.6 mg L-1 concentration. The parameters that affect the fluorescence intensity were investigated, such as fluorophore concentration (16 mg L-1), pH (3.2) and temperature (25 °C). Under optimized conditions, the IFE-based approach can determine CF in a range between 1.00 and 100.0 mg L-1, with a detection limit (LOD) of 0.10 mg L-1. The relative standard deviation (% RSD) values for the intra-day and inter-day precision were 0.75 and 1.24, respectively. The new method was successfully tested in the determination of the target analyte in beverage samples without previous treatment. The results were compared with those obtained by a reference method, leading to the conclusion that there were no significant differences at the studied confidence level (α = 0.05).

Lipolysis and aroma generation as mechanisms involved in masking boar taint in sodium reduced fermented sausages inoculated with Debaryomyces hansenii yeast.

BACKGROUND: The use of boar back fat for processing of fermented sausages may cause the presence of abnormal odours. In dry-cured products, ripening time is essential to develop the sensory characteristics. Yeast has been proposed as an alternative to mask boar taint odour through its metabolic activity but it is necessary to elucidate which mechanisms are involved. The aim is to study the effect of Debaryomyces hansenii inoculation on the lipolysis process and generation of aroma compounds in fermented sausages manufactured with boar back fat at two different ripening times. RESULTS: D. hansenii inoculated sausages had a higher degree of lipolysis as demonstrated by higher content of free fatty acids, ester compounds and branched aldehydes which contribute the fruity odour. The increase in lipolysis produced by D. hansenii inoculation was not followed by an increase in oxidation during processing possibly due to the metabolic activity of yeast. The effect of back fat type was scarcely appreciated whereas ripening time had a stronger effect on sausage. Boar sausages were characterised by a lower polyunsaturated fatty acid profile and lesser lipolysis than gilt sausages. CONCLUSION: Yeast inoculation with D. hansenii and long ripening time were appropriate strategies to limit the perception of boar taint in dry fermented sausages. © 2017 Society of Chemical Industry.

DIFERENCIAS ESPACIO-TEMPORALES DE LA LOCOMOCIÓN EN ADULTOS VARONES CON NORMOPESO Y SOBREPESO / DIFERENÇAS ESPAÇO-TEMPORAIS NA LOCOMOÇÃO DE ADULTOS DO SEXO MASCULINO COM PESO NORMAL E SOBREPESO / SPATIO-TEMPORAL DIFFERENCES OF LOCOMOTION OF ADULT MALES WITH NORMAL WEIGHT AND OVERWEIGHT

RESUMEN Introducción: La obesidad ha estado relacionada con la presencia de adaptaciones estructurales y funcionales que provocan limitaciones en el control del movimiento. Objetivo: Determinar el efecto del exceso de peso sobre las variables espacio-temporales de la locomoción en varones jóvenes y activos. Métodos: Estudio de corte transversal de muestreo no probabilístico con 55 sujetos con normopeso (IMC ≤25) y 22 sujetos con sobrepeso (IMC >25). Se analizó el IMC, % de masa grasa, y el % de masa magra de ambos grupos con un bioimpedanciómetro multifrecuencia (Inbody 230). También se analizaron las variables cinemáticas de la locomoción utilizando una plataforma de presiones GaitRite. Resultados: El grupo con sobrepeso mostró una disminución significativa de la fase de oscilación y fase de apoyo monopodal (p <0,001) junto con un aumento de la fase de apoyo y fase de apoyo bipodal (p <0,001) comparado con el grupo normopeso. Conclusión: La reducción de la fase de oscilación y el incremento de la fase de apoyo y fase de apoyo bipodal que manifestaron el grupo con sobrepeso puede ser consecuencia del aumento de la inestabilidad que se produce durante la marcha debido al sobrepeso.

RESUMO Introdução: A obesidade tem sido relacionada com a presença de adaptações estruturais e funcionais que podem limitar o controle dos movimentos. Objetivo: Determinar o efeito do excesso de peso sobre as variáveis espaço-temporais da locomoção em homens jovens e ativos. Métodos: Estudo transversal de amostragem não probabilística, com 55 indivíduos com peso normal (IMC ≤25) e 22 indivíduos com sobrepeso (IMC >25). Analisaram-se IMC e porcentagem de massa gorda e massa magra em ambos os grupos, com um bioimpedanciômetro multifrequência (Inbody 230). Foram analisadas também as variáveis cinemáticas de locomoção, usando-se um sistema de plataforma de pressão (GaitRite). Resultados: O grupo sobrepeso apresentou diminuição significativa na fase de balanço e fase de apoio monopodal (p <0,001), com aumento da fase de apoio e da fase de apoio bipodal (p <0,001) com relação ao grupo peso normal. Conclusão: A redução da fase de balanço e o aumento da fase de apoio e da fase de apoio bipodal manifestado pelo grupo sobrepeso pode ser resultado do aumento da instabilidade que ocorre durante a marcha, devido ao sobrepeso.

ABSTRACT Introduction: Obesity has been associated with the presence of structural and functional adaptations that may limit movement control. Objective: To determine the effect of overweight on spatio-temporal variables of locomotion in young and active men. Methods: A cross-sectional study of non-probability sampling, with 55 subjects with normal weight (BMI ≤25) and 22 overweight subjects (BMI >25). Body mass index and percentage of fat mass and lean mass were analyzed in both groups, with a multi-frequency bioimpedanciometer (Inbody 230). The kinematic variables of locomotion were also analyzed with a pressure platform system (GaitRite). Results: The overweight group showed a significant decrease in the swing phase and monopodal stance phase (p <0.001) with an increase in the stance phase and double stance phase (p<0.001) in relation to the normal weight group. Conclusion: The reduction of the swing phase and the increase of the stance phase and double stance phase presented by the overweight group may be a result of increased instability that occurs during gait due to overweight.

Yeast inoculation as a strategy to improve the physico-chemical and sensory properties of reduced salt fermented sausages produced with entire male fat.

Yeast inoculation of dry fermented sausages manufactured with entire male fat was evaluated as a strategy to improve sausage quality. Four different formulations with entire male/gilt back fat and inoculated/non-inoculated with Debaryomyces hansenii were manufactured. The use of entire male back fat produced the highest weight losses, hardness and chewiness in dry sausages. Consumers clearly distinguished samples according to drying time and D. hansenii inoculation while the use of entire/gilt back fat was not highly perceived. The presence of androstenone and skatole was close to their sensory thresholds. Androstenone was not degraded during the process but skatole was affected by yeast inoculation. D. hansenii growth on the surface regulated water release during ripening, reduced hardness and chewiness in entire male sausages and resulted with similar texture to gilt sausages. Yeast inoculation inhibited lipid oxidation providing fruity odours and less oxidized fatty sausages in the sensory analysis. The effectiveness of yeast to mask boar taint was demonstrated by sensory analysis.

Effect of the use of entire male fat in the production of reduced salt fermented sausages.

The effect of the use of entire male fat and salt reduction in dry fermented sausages was evaluated. Four different sausage formulations were manufactured with back fat from gilt or entire male and two different salt contents. The physicochemical parameters, sensory characteristics, texture, lipid composition, volatile compounds and boar taint compounds were analysed. The use of entire male fat produced the highest weight losses producing high hardness and chewiness while salt reduction produced a decrease in hardness. Entire male sausages had the lowest oxidation values due to the low content of C18:2n6 while salt reduction did not affect the oxidation process. Boar taint odour was due to the presence of androstenone and skatole but entire male fat sausages had different generations of volatile compounds. The presence of androstenone was perceived by consumers as abnormal odours but also other sausage characteristics such as texture (high hardness) and oxidation were detected due to the different chemical compositions of entire males versus gilts.

Determination of sulfur and nitrogen compounds during the processing of dry fermented sausages and their relation to amino acid generation.

The identification of odor-active sulfur and nitrogen compounds formed during the processing of dry fermented sausages was the objective of this study. In order to elucidate their possible origin, free amino acids (FAAs) were also determined. The volatile compounds present in the dry sausages were extracted using solvent assisted flavor evaporation (SAFE) and monitored by one and two-dimensional gas chromatography with different detectors: mass spectrometry (MS), nitrogen phosphorous (NPD), flame photometric (FPD) detectors, as well as gas chromatography-olfactometry. A total of seventeen sulfur and nitrogen compounds were identified and quantified. Among them, 2-acetyl-1-pyrroline was the most potent odor active compound, followed by methional, ethylpyrazine and 2,3-dihydrothiophene characterized by toasted, cooked potato, and nutty notes. The degradation of FAAs, generated during processing, was related to the production of aroma compounds, such as methionine forming methional and benzothiazole while ornithine was the precursor compound for 2-acetyl-1-pyrroline and glycine for ethylpyrazine.

Yeast strains as potential aroma enhancers in dry fermented sausages.

Actual healthy trends produce changes in the sensory characteristics of dry fermented sausages therefore, new strategies are needed to enhance their aroma. In particular, a reduction in the aroma characteristics was observed in reduced fat and salt dry sausages. In terms of aroma enhancing, generally coagulase-negative cocci were selected as the most important group from the endogenous microbiota in the production of flavour compounds. Among the volatile compounds analysed in dry sausages, ester compounds contribute to fruity aroma notes associated with high acceptance of traditional dry sausages. However, the origin of ester compounds in traditional dry sausages can be due to other microorganisms as lactic acid bacteria, yeast and moulds. Yeast contribution in dry fermented sausages was investigated with opposite results attributed to low yeast survival or low activity during processing. Generally, they affect sausage colour and flavour by their oxygen-scavenging and lipolytic activities in addition to, their ability to catabolize fermentation products such as lactate increasing the pH and contributing to less tangy and more aromatic sausages. Recently, the isolation and characterization of yeast from traditional dry fermented sausages made possible the selection of those with ability to produce aroma active compounds. Molecular methods were used for genetic typing of the isolated yeasts whereas their ability to produce aroma compounds was tested in different systems such as in culture media, in model systems and finally on dry fermented sausages. The results revealed that the appropriate selection of yeast strains with aroma potential may be used to improve the sensory characteristics of reformulated fermented sausages.

Elucidation of key aroma compounds in traditional dry fermented sausages using different extraction techniques.

BACKGROUND: The use of different extraction techniques - solid phase microextraction (SPME) and solvent assisted flavour evaporation (SAFE) - can deliver different aroma profiles and it is essential to determine which is most suitable to extract the aroma compounds from dry fermented sausages. RESULTS: Forty-five aroma-active compounds were detected by SPME and SAFE, with 11 of them reported for the first time as aroma compounds in dry fermented sausages: ethyl 3-hydroxy butanoate, trimethyl pyrazine, D-pantolactone, isobutyl hexanoate, ethyl benzoate, α-terpineol, ethyl 3-pyridinecarboxylate, benzothiazole, 2,3-dihydrothiophene, methyl eugenol, γ-nonalactone. The aroma concentration and odour activity values (OAVs) were calculated. Flavour reconstitution analyses were performed using 20 odorants with OAVs above 1 obtained from the SAFE and SPME extracts to prepare the aroma model. CONCLUSION: SPME and SAFE techniques were complementary and necessary to reproduce the overall dry fermented sausage aroma. The final aroma model included the odorants from both extraction techniques (SPME and SAFE) but it was necessary to incorporate the compounds 2,4-decadienal (E,E), benzothiazole, methyl eugenol, α-terpineol, and eugenol to the final aroma model to evoked the fresh sausage aroma although a lowest cured meat aroma note was perceived.

Salt reduction in slow fermented sausages affects the generation of aroma active compounds.

Slow fermented sausages with different salt content were manufactured: control (2.7% NaCl, S), 16% salt reduced (2.26% NaCl, RS) and 16% replaced by KCl (2.26% NaCl and 0.43% KCl, RSK). The effect of salt reduction on microbiology and chemical parameters, sensory characteristics, texture and volatile compounds was studied. The aroma compounds were identified by GC-MS and olfactometry analyses. Small salt reduction (16%) (RS) affected sausage quality producing a reduction in the acceptance of aroma, taste, juiciness and overall quality. The substitution by KCl (RSK) produced the same acceptability by consumers as for high salt (S) treatment except for the aroma that was not improved by KCl addition. The aroma was affected due to the reduction in sulfur and acids and the increase of aldehyde compounds. Aroma compounds that characterized the high salt treatment (S) were dimethyl trisulfide, 3-methyl thiophene, 2,3-butanedione, 2-nonanone and acetic acid.