Acute Limb Ischemia in a Peruvian Cohort Infected by COVID-19.

BACKGROUND: Coronavirus disease 2019 (COVID-19) infection can cause alterations in the coagulation mechanism conditioning thrombotic phenomena such as acute limb ischemia (ALI) as the only manifestation of the infection. The aim of the study was to describe clinical and surgical characteristics of a group of patients infected with severe acute respiratory syndrome coronavirus 2 who presented ALI in the context of the COVID-19 pandemic at Lima, Peru. METHODS: A multicenter, observational, and retrospective study was performed in six general hospitals, from March to July 2020. The variables considered were the pathological history and associated habits, laboratory tests, the severity of COVID-19 infection and ALI, the anatomic location of the lesion, treatment, evolution, and discharge conditions. RESULTS: Thirty patients with ALI infected with COVID-19 were evaluated. Their mean age was 60 ± 15 years, the condition being more frequent in men (76.6%). The main comorbidities were arterial hypertension (33.3%), obesity (33.3%), and diabetes mellitus 2 (26.6%). There were 23.3% asymptomatic patients, and their only manifestation was ALI. Rutherford IIA and IIB stage included 93.2% of patients. The most frequent location of the thrombosis was the lower limbs (73.3% vs. 26.6%). Thrombectomy was performed in 76.6% of the patients, and amputation (primary and secondary) was performed in 30% of the patients. The mortality rate was 23.3%, all of it because of acute respiratory distress syndrome. CONCLUSIONS: ALI is a vascular pathology associated with embolic and thrombotic processes. COVID-19 infection can cause severe alterations in coagulation mechanisms, leading some patients to present severe acute arterial complications such as thrombosis, as the only associated manifestation. We report a younger cohort than those described in other studies and with a high frequency of amputations despite adequate surgical treatment.

Efecto del ácido fumárico en las características de calidad de muffins / Effect of fumaric acid on the quality characteristics of muffins / Efeito do ácido fumárico sobre as características de qualidade dos queques

Resumen Introducción. El ácido fumárico se utiliza en la industria alimenticia como agente reductor, mejorador de textura, agente de leudado, regulador de pH y agente conservante. Objetivo. Evaluar los efectos del ácido fumárico encapsulado y sin encapsular en las propiedades de calidad de muffins. Materiales y métodos. El ácido fumárico con y sin encapsulante se incorporó a una formulación de muffins a un nivel de 0.25 y 0.125 g / g peso seco de harina de trigo. Las propiedades evaluadas fueron actividad de agua, pérdida de peso, altura, volumen específico, parámetros de color y propiedades texturales de muffins. Además, se verificó el comportamiento, durante el almacenamiento, de la firmeza y aceptación sensorial de una muestra sin ácido fumárico (control) y el tratamiento que presentó los mejores resultados en las pruebas de calidad. Resultados. Los niveles de adición de ácido fumárico utilizados no afectaron significativamente la actividad de agua, pérdida de peso, altura y parámetros de color de las muestras. La formulación seleccionada para evaluar el comportamiento en el almacenamiento durante 8 días fue la que contenía 0.25% de ácido fumárico encapsulado con respecto a la harina de trigo por tener el mayor volumen y los menores valores de firmeza. Conclusión. Los muffins con ácido fumárico encapsulado a 0.25% presentaron menor firmeza que la muestra control durante todo el tiempo de almacenamiento. Además, no se obtuvieron diferencias significativas en las características sensoriales de estos muffins, comprobando la efectividad de este aditivo como mejorador de la calidad en productos de repostería.

Abstract Introduction. Fumaric acid is used in the food industry as a reducing agent, texture improver, leavening agent, pH regulator and preservative. Objective. Evaluate the effects of encapsulated and non-encapsulated fumaric acid on the quality properties of muffins. Materials and methods. Fumaric acid with and without encapsulant was incorporated into a muffins formulation at a level of 0.25 and 0.125 g/g of wheat flour on a dry weight basis. Water activity, weight loss, height, specific volume, color parameters and textural properties of muffins were evaluated. In addition, the storage behavior of the firmness and sensory acceptance of a sample without fumaric acid (control) and the treatment that presented the best results in the quality tests was assessed. Results. The levels of fumaric acid used in muffins did not significantly affect the water activity, weight loss, height and color parameters of the samples. The formulation selected to evaluate the storage behavior for 8 days was the sample with 0.25% of encapsulated fumaric acid with respect to wheat flour because it had the highest volume and the lowest values of firmness. Conclusion. The muffins with 0.25% encapsulated fumaric acid had lower firmness than the control sample during the storage. Moreover, no significant differences were found in the sensory characteristics of these two samples, proving the effectiveness of this additive as a quality improver in bakery products.

Resumo Introduςấo. O ácido fumárico é utilizado na indústria alimentar como um agente redutor, melhorador de textura, agente de fermentaςấo, regulador do pH e conservante. Objetivo. Avaliar os efeitos do ácido fumárico encapsulado e nấo encapsulado nas propriedades de qualidade de queques. Materiais e Métodos. Ácido fumárico com e sem encapsulante juntou queques formulaςão a um nível de 0.25 e 0.125 g / g de peso seco de farinha de trigo. As propriedades avaliadas foram atividade de água, perda de peso, altura, volume específico, parâmetros de cor e propriedades de textura de muffins. Além disso, o comportamento em armazenamento de firmeza e aceitação sensorial de uma amostra sem ácido fumárico (controlo) e tratamento apresentou os melhores resultados em testes de qualidade verificada. Resultados. Não houve diferenças significativas nos níveis de adição de ácido fumárico utilizado na actividade de água, obteve-se perda de peso, altura e cor parâmetros das amostras. A formulação seleccionada para avaliar o desempenho em armazenamento durante 8 dias foi a amostra que contém 0.25% de ácido fumárico encapsulado em relação à farinha de trigo por ter o maior volume e os menores valores de firmeza. Conclusão. Queques com ácido fumárico encapsulados para 0.25% tiveram menor firmeza do que a amostra de controlo ao longo do tempo de armazenamento. Além disso, não houve diferenças significativas foram obtidos nas características sensoriais destas duas amostras, a verificação da eficácia deste aditivo como o improver da qualidade em produtos de panificação e confeitaria.