Predictors of retrieval and long-term mortality in patients treated with inferior vena cava filters.

OBJECTIVE: Inferior vena cava filters (VCFs) are a therapeutic resource for the treatment of patients with thromboembolic disease who have a contraindication to full-dose anticoagulation. In the present study, we report the retrieval rate and long-term mortality of patients receiving optional inferior VCFs and identify the predictors for retrieval and all-cause mortality during follow-up. METHODS: We conducted a retrospective cohort study of 739 consecutive recipients of optional inferior VCFs from January 2002 to December 2021 in two hospitals. Different clinical characteristics and procedure-related variables were included in the analysis. The all-cause mortality rate and retrieval rate and the predictive factors were evaluated using multivariate analysis. RESULTS: Of the 739 patients, 393 (53%) were women. The mean patient age was 69 ± 15 years. Of the patients, 67% presented with pulmonary thromboembolism and 43% with deep vein thrombosis (DVT). A contraindication to anticoagulation was present for nearly 90% of the patients, mainly (47%) related to the surgical procedure. In addition, 44% of the patients had active cancer. Follow-up data were available for 94% of the patients, with an average follow-up time of 6.08 ± 5.83 years. Long-term mortality was 53%. Cancer (odds ratio [OR], 3.60; 95% confidence interval [CI], 2.22-5.83), age (OR, 1.03; 95% CI, 1.08-1.42), and DVT (OR, 2.01; 95% CI, 1.08-1.42) were identified as independent predictors of mortality. The retrieval rate at follow-up was 33%. The predictors for retrieval included the indication of the filter related to a surgical procedure (OR, 4.85; 95% CI, 2.54-9.59), the absence of cancer (OR, 2.89; 95% CI, 1.45-5.75), and younger age (OR, 0.98; 95% CI, 0.97-0.99). CONCLUSIONS: High long-term mortality was observed. The predictors of mortality were cancer, older age, and DVT. One third of the filters implanted were retrieved. The predictors for retrieval were a contraindication to surgery-related anticoagulation, the absence of cancer, and younger age.

Quality Characteristics of Fresh Date Palm Fruits of "Medjoul" and "Confitera" cv. from the Southeast of Spain (Elche Palm Grove).

The quality characteristics (physical, techno-functional, and chemical) of date fruits (at the tamar stage) of two cultivars ("Confitera", autochthonous and unknown vs. "Medjoul", widely distributed and well-known), grown in the Southeast of Spain (Elche palm grove) were evaluated in order to reinforce decisions aimed at organizing the production of fresh dates from Elche by selecting the most profitable cultivar. Morphologically, Confitera dates were longer and with higher pulp yield than Medjoul dates (4.58 cm vs. 3.88 cm, and 84% vs. 78%, respectively) (p < 0.05). Nutritionally, both dates are a good source of carbohydrates (total sugars (43-48%) and dietary fiber (20-22%)), with small amounts of fat and proteins. The main free sugars in dates from both cultivars were glucose and fructose (reducing sugars). The most abundant mineral found in both date fruits were K, followed by Ca or Mg (depending on the cultivar; Ca in Medjoul and Mg in Confitera). Confitera dates showed a higher total antioxidant activity than Medjoul, corresponding with their higher (p < 0.05) content in polyphenolic compounds, mainly flavonoids (catechin and epicatechin predominantly). Confitera dates should be promoted in this region not only for their contribution to sustainable agricultural development and biodiversity, but also for their higher overall quality.

Chitosan Edible Films and Coatings with Added Bioactive Compounds: Antibacterial and Antioxidant Properties and Their Application to Food Products: A Review.

Chitosan is the deacetylated form of chitin regarded as one of the most abundant polymers and due to its properties, both chitosan alone or in combination with bioactive substances for the production of biodegradable films and coatings is gaining attention in terms of applications in the food industry. To enhance the antimicrobial and antioxidant properties of chitosan, a vast variety of plant extracts have been incorporated to meet consumer demands for more environmentally friendly and synthetic preservative-free foods. This review provides knowledge about the antioxidant and antibacterial properties of chitosan films and coatings enriched with natural extracts as well as their applications in various food products and the effects they had on them. In a nutshell, it has been demonstrated that chitosan can act as a coating or packaging material with excellent antimicrobial and antioxidant properties in addition to its biodegradability, biocompatibility, and non-toxicity. However, further research should be carried out to widen the applications of bioactive chitosan coatings to more foods and industries as well was their industrial scale-up, thus helping to minimize the use of plastic materials.

Development of Chincho (Tagetes elliptica Sm.) Essential Oil Organogel Nanoparticles through Ionic Gelation and Process Optimization with Box-Behnken Design.

The aim of this work was to obtain chitosan nanoparticles (<1000 nm) with chincho (Tagetes elliptica Sp.) essential oil (CEO-CSNPs) using the ionic gelation method. A Box−Behnken design (BBD) was applied, using chitosan solution (CS) pH (4.0, 4.4, 4.8); the mass ratio of CS/CEO (1:0.7, 1:0.85, 1:1.0) and the mass ratio of CS/CS-tripolyphosphate (1:0.46, 1:0.58, 1:0.7) as independent variables. The formulation-dependent variables, encapsulation efficiency (EE) and loading capacity (LC) of the CEO-CSNPs were evaluated. BBD determined that optimal conditions for CEO-CSNPs were pH: 4.4, CS/CEO mass ratio 1:0.7 and CS/TPP mass ratio 1:0.46. Once the optimization was defined, particle size (PS), zeta potential (ZP), polydispersity index (PDI), CEO-CSNPs morphological studies, in vitro CEO release, and antibacterial activity were determined. The CEO-CSNPs showed an EE of 52.64% and a LC of 11.56%, with a diameter of 458.5 nm, with a ZP of 23.30mV, and a PDI of 0.418. The SEM studies showed that the nanoparticles were rounded and had uniform shapes. In addition, CEO-CSNPs showed a minimum inhibitory concentration against Staphylococcus aureus, Salmonella infantis and Escherichia coli of 5.29, 10.57 and 10.57 µg/mL, respectively. These results could be very useful for the stabilization of chincho essential oil for food industry purposes. However, several studies about the release, as well as interaction with food matrices, will be necessary.

Impacto de infecciones y enterobacterias productoras de betalactamasa de espectro extendido en la supervivencia del injerto y del paciente en un programa de trasplante renal en México / Impact of infections and extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae on graft and patient survival in a kidney transplantation program in Mexico

Resumen Introducción: Los tratamientos inmunosupresores han mejorado las tasas de supervivencia del injerto y del paciente, pero pueden incrementar las infecciones postrasplante. Objetivos: Analizar los datos de pacientes con trasplante renal y describir las bacterias responsables de las infecciones que presentan. Métodos: Estudio observacional, longitudinal y analítico de 103 pacientes sometidos a trasplante renal. El periodo de seguimiento fue de 5.07 ± 1.28 años. Resultados: La tasa de mortalidad fue de 10.68 % y la de pérdida del injerto de 14.56 %. Respecto al riesgo de muerte del receptor, el modelo de regresión de Cox mostró un cociente de riesgo (HR, hazard ratio) de 5.66 en los pacientes con cultivo bacteriano positivo y de 2.22 en aquellos con cepas productoras de betalactamasas de espectro extendido (BLEE); en cuanto a la pérdida del injerto, el HR fue de 4.59 en quienes tuvieron cultivo bacteriano positivo y de 4.25 en aquellos con cepas productoras de BLEE. Conclusiones: Se encontró riesgo significativo de muerte en receptores de trasplante renal con cultivo bacteriano positivo y mayor riesgo de pérdida del injerto en aquellos con cultivo bacteriano positivo y aislamiento de cepas productoras de BLEE. La tasa de enterobacterias productoras de BLEE es alta, por ello son necesarias estrategias más estrictas para controlar del uso de antibióticos.

Abstract Introduction: Immunosuppressive treatments have improved graft and patient survival rates, but can increase the incidence of post-transplant infections. Objectives: To analyze data from kidney transplant patients and describe the pathogens responsible for the infections they experience. Methods: Longitudinal, analytical, observational study of 103 patients who underwent kidney transplantation. The follow-up period was 5.07 ± 1.28 years. Results: Overall mortality rate was 10.68% and graft loss rate was 14.56%. Regarding recipient risk of death, the Cox regression model showed a hazard ratio (HR) of 5.66 for positive bacterial cultures and 2.22 for positive extended-spectrum beta-lactamase (ESBL)-producing strains; as for graft loss, HR was 4.59 in those with positive bacterial cultures and 4.25 in those who were positive for ESBL-producing strains Conclusions: Significant death risk was found in kidney transplant recipients with positive bacterial cultures and an increased risk of graft loss in those with positive bacterial cultures and in those who were positive for ESBL-producing Enterobacteriaceae isolates. The rate of ESBL-producing Enterobacteriaceae is high, and stricter strategies are therefore necessary to control the use of antibiotics.

Effect of Gelled Emulsions Elaborated with Soybean Oil, Maca (Lepidium meyenni) Flour, and Chincho (Tagetes elliptica Sm.) Essential Oil upon Animal Fat Substitution in Beef Burgers.

The aim of this study was to analyze the effect of pork backfat (PB) substitution in a meat burger with a gelled emulsion (GE) elaborated with maca flour, soybean oil, and chincho essential oil (CEO). Lipid profile (gas chromatography­GC), health indices, physicochemical properties (CIELAB color, pH, texture profile­TPA), and cooking and sensory characteristics of meat burgers were analyzed. Five formulations were evaluated: control (BC) (80% beef meat and 20% PB); BSM (10% PB + 10% GE); BSMC0.25 (BSM + 0.25% CEO); BSMC0.5 (BSM + 0.5% CEO), and BSMC1.0 (BSM + 1.0% CEO). GE substitution in meat burgers provided a healthier lipid profile; the amount of SFA was reduced (p < 0.05), while PUFA content was significantly increased (p < 0.05). Furthermore, the use of GE resulted in healthier PUFA/SFA ratios and lower atherogenic and thrombogenic indices. The addition of GE increased moisture content and decreased fat and protein contents. Color parameters (L*, b*, and C*) decreased after cooking. Hardness (p < 0.05), cooking losses, and shrinkage changes decreased with GE addition. Lipid oxidation levels were significantly (p < 0.05) affected by GE substitution. Therefore, the substitution of PB by GE can be considered as an effective strategy to produce healthier meat burgers without negatively affecting their physicochemical and technological properties.

Cocoa Coproducts-Based and Walnut Oil Gelled Emulsion as Animal Fat Replacer and Healthy Bioactive Source in Beef Burgers.

The aim of this work was to evaluate the effects on the chemical, physic-chemical, technological, and sensory properties of beef burger when replacing different quantities of fat (50 and 100%) with different levels of oil-in-water-gelled emulsion elaborated with walnut oil and cocoa bean shell flour (GECW). The chemical composition of the samples was affected by the fat replacement. The reformulation increased the moisture and ash content while the fat and protein content decreased with respect to the control sample. The linolenic and linolenic acid content of the beef burgers increased as the GECW replacement was augmented. The polyunsaturated fatty/saturated fatty acid ratio increased in both raw and cooked burgers, whereas the atherogenicity index and thrombogenicity index were reduced in both raw and cooked burgers with respect to the control sample. The use of GECW as a fat replacer was found to be effective in improving the cooking loss. Similarly, there were positive effects on reductions in the diameter and the increases in the thickness of the beef burgers. Regarding lipid stability, in both the raw and cooked burgers, the reformulation increased the 2-thiobarbituric acid reactive substance (TBARs) values with respect to the control sample. In both types of reformulated burgers, three bound polyphenols (mainly catechin and epicatechin) and two free polyphenols were identified, as were methylxanthines theobromine and caffeine. The sensory properties for the control and partial pork backfat replacement treatments were similar, while the sample with the total pork backfat replacement treatment showed the lowest scores. The blend of cocoa bean shell flour and walnut oil could be used as new ingredients for the development of beef burgers with a healthier nutritional profile without demeriting their sensory or cooking characteristics and physic-chemical properties.

Valorization of Citrus Co-Products: Recovery of Bioactive Compounds and Application in Meat and Meat Products.

Citrus fruits (orange, lemon, mandarin, and grapefruit) are one of the most extensively cultivated crops. Actually, fresh consumption far exceeds the demand and, subsequently, a great volume of the production is destined for the citrus-processing industries, which produce a huge quantity of co-products. These co-products, without proper treatment and disposal, might cause severe environmental problems. The co-products obtained from the citrus industry may be considered a very important source of high-added-value bioactive compounds that could be used in the pharmaceutical, cosmetic, and dietetic industries, and mainly in the food industry. Due to consumer demands, the food industry is exploring a new and economical source of bioactive compounds to develop novel foods with healthy properties. Thus, the aim of this review is to describe the possible benefits of citrus co-products as a source of bioactive compounds and their applications in the development of healthier meat and meat products.

¿La detección de toxinas de Clostridioides difficile es necesaria cuando se detecta la enzima glutamato deshidrogenasa? / Is Clostridioides difficile toxins detection necessary when the glutamate dehydrogenase enzyme is detected?

Resumen Introducción: Clostridioides difficile causa diarrea y colitis pseudomembranosa. Su diagnóstico se realiza con la detección de glutamato-deshidrogenasa (GDH) o las toxinas A y B y se confirma con pruebas de amplificación de ácidos nucleicos. Objetivo: Definir si la determinación de GDH es redundante a la de las toxinas. Métodos: Estudio observacional retrospectivo de muestras fecales de pacientes con sospecha de infección por Clostridioides difficile. Las toxinas y GDH se determinaron mediante inmunocromatografía. Se realizó una simulación bayesiana con los cocientes de probabilidad; se consideró significativo un valor de p < 0.05. Resultados: Se analizaron 329 resultados de GDH y toxinas A y B. Se encontró una prevalencia de infección de Clostridioides difficile de 18.2 %. La sensibilidad y especificidad de la prueba de GDH fue de 0.90 y 0.89, respectivamente. El cociente de probabilidad positivo fue de 8.9 y el negativo, de 0.11. Conclusiones: Un resultado negativo de GDH disminuye considerablemente la probabilidad de infección, pero no la descarta. La detección de toxinas de Clostridioides difficile puede ser necesaria en instituciones donde la amplificación de ácidos nucleicos no es económica o accesible.

Abstract Introduction: Clostridioides difficile causes diarrhea and pseudomembranous colitis. Its diagnosis is made with glutamate dehydrogenase (GDH) or toxins A and B detection and is confirmed with nucleic acid amplification tests. Objective: To define if GDH determination is redundant to that of toxins. Methods: Retrospective, observational study in diarrheal stools of patients with suspected Clostridioides difficile infection. Toxins and GDH were determined by immunochromatography. Bayesian simulation was performed with likelihood ratios; a p-value < 0.05 was regarded as significant. Results: 329 GDH and toxin A and B results were analyzed. Clostridioides difficile infection prevalence was 18.2 %. Sensitivity and specificity of the GDH test were 0.90 and 0.89, respectively. Positive likelihood ratio was 8.9, and negative was 0.11. Conclusions: A negative GDH result considerably reduces the probability of infection but does not rule it out. Clostridioides difficile toxins detection may be necessary in institutions where nucleic acid amplification is not affordable or accessible.

Familial hypercholesterolemia in Mexico: Initial insights from the national registry.

BACKGROUND: Familial hypercholesterolemia (FH) remains underdiagnosed and undertreated. OBJECTIVE: Report the results of the first years (2017-2019) of the Mexican FH registry. METHODS: There are 60 investigators, representing 28 federal states, participating in the registry. The variables included are in accordance with the European Atherosclerosis Society (EAS) FH recommendations. RESULTS: To date, 709 patients have been registered, only 336 patients with complete data fields are presented. The mean age is 50 (36-62) years and the average time since diagnosis is 4 (IQR: 2-16) years. Genetic testing is recorded in 26.9%. Tendon xanthomas are present in 43.2%. The prevalence of type 2 diabetes is 11.3% and that of premature CAD is 9.8%. Index cases, male gender, hypertension and smoking were associated with premature CAD. The median lipoprotein (a) level is 30.5 (IQR 10.8-80.7) mg/dl. Statins and co-administration with ezetimibe were recorded in 88.1% and 35.7% respectively. A combined treatment target (50% reduction in LDL-C and an LDL-C <100 mg/dl) was achieved by 13.7%. Associated factors were index case (OR 3.6, 95%CI 1.69-8.73, P = .002), combination therapy (OR 2.4, 95%CI 1.23-4.90, P = .011), type 2 diabetes (OR 2.8, 95%CI 1.03-7.59, P = .036) and age (OR 1.023, 95%CI 1.01-1.05, P = .033). CONCLUSION: The results confirm late diagnosis, a lower than expected prevalence and risk of ASCVD, a higher than expected prevalence of type 2 diabetes and undertreatment, with relatively few patients reaching goals. Recommendations include, the use of combination lipid lowering therapy, control of comorbid conditions and more frequent genetic testing in the future.

Assessment of chemical composition and antioxidant properties of defatted flours obtained from several edible insects.

The aims of this study were determined the chemical composition and the antioxidant properties of defatted flours obtained from several commercially available edible insects such as Acheta dosmesticus, Tenebrio molitor, Zophobas morio, and Rhynchophorus ferrugineus to establish their utilization as ingredient in the development of new food products. The proximate composition of flour was determined using AOAC methods while for antioxidant capacity, four different methodologies were employed (DPPH, ABTS, FIC, and FRAP). The total phenolic content and the tannin content were also determined. All flours analyzed had a high protein content with values ranging between 64.17 and 72.55 g/100 g flour. With regard to the antioxidant activity, R. ferrugineus showed the highest values for DPPH, ABTS, and FRAP assays with values of 2.03, 4.93, and 8.46 mg Trolox equivalent/g flour, respectively. For FIC assay, A. dosmesticus and T. molitor had the highest values 0.47 and 0.48 mg EDTA equivalent/g flour. Defatted flours obtained from edible insects analyzed could have several applications as ingredients to the development new foods due to its good nutrient content and as a functional food for the prevention of oxidation.

Complicaciones venosas centrales asociadas al aneurisma de aorta abdominal roto / Central Venous Complications Associated with Ruptured Abdominal Aortic Aneurysm

RESUMEN La ruptura del aneurisma de aorta abdominal (AAA) representa una verdadera emergencia quirúrgica. Asociada con dolor abdominal, hipotensión e incluso shock, exige una transferencia inmediata a una sala de operaciones adecuadamente equipada para tratar el aneurisma en forma efectiva y sin demora. Ocasionalmente puede manifestarse como resultado de su relación con estructuras adyacentes. Dos complicaciones venosas asociadas con el AAA roto son la fístula aortocava y la compresión de la vena cava inferior (VCI). Los autores informan casos particulares de fístula aortocava y compresión de VCI con trombosis venosa profunda (TVP) por AAA roto. Los cuatro pacientes fueron tratados mediante reparación endovascular. Además de discutir las circunstancias asociadas con las complicaciones venosas por AAA, los autores también discuten la estrategia de tratamiento adoptada y las posibles alternativas.

ABSTRACT Ruptured abdominal aortic aneurysms (rAAAs) represent a real surgical emergency. In the presence of abdominal pain, hypotension or even shock, patients require emergency transfer to an operating room adequately equipped to treat the aneurysm effectively and without delay. Occasionally, symptoms are the consequence of involvement of the adjacent structures, Aortocaval fistula and compression of the inferior vena cava (IVC) are venous complications associated with rAAAs. We report cases of aortocaval fistula and IVC compression with deep venous thrombosis (DVT) due to rAAA. The four patients underwent endovascular repair. The circumstances associated with the venous complications of rAAA, the treatment strategy used and the therapeutic options are described.

Evaluación de medidas morfométricas de tendones y ligamentos metacarpales palmares por ultrasonografía en caballos criollos colombianos / Evaluation of morphometric measures of tendons and metacarpal ligaments by ultrasonography in Colombian creole horses

RESUMEN Objetivo. Determinar los parámetros morfométricos ultrasonográficos de los tendones y ligamentos metacarpales palmares de caballos criollos colombianos clínicamente sanos. Materiales y métodos. Treinta caballos criollos colombianos clínicamente sanos de 6.4 ± 2.5 años se evaluaron en diferentes zonas del departamento de Córdoba (Colombia). Se midieron las variables área transversal (cm2), ancho latero medial (ALM) (cm) y espesor dorso palmar (EDP) (cm) en las estructuras de la región metacarpiana en los dos miembros anteriores mediante ultrasonografía. Resultados. La ecografía reveló que el área transversal del ligamento suspensorio fue la estructura de mayor área en las regiones proximales (1A, 1B y 2A), tanto para la extremidad izquierda como para la derecha. Por otro lado, no hubo una diferencia significativa (p>0.05) entre la extremidad izquierda y derecha para las mediciones de las estructuras en cualquier zona, y no hubo una diferencia significativa entre los grupos de edades e índice de masa corporal (IMC) de los caballos. Conclusiones. Se obtuvieron valores de referencia para los tendones y ligamentos en la región metacarpiana palmar en equinos proporcionando una guía de referencia cuando se sospechan condiciones patológicas metacarpo en equinos.

ABSTRACT Objective. To determine the ultrasonographic morphometric parameters of the palmar metacarpal tendons and ligaments of clinically healthy Colombian creole horses. Materials and methods. Thirty clinically healthy Colombian creole horses of 6.4 ± 2.5 years were evaluated in different areas of the department of Córdoba (Colombia). The variables cross-sectional area (cm2), medial lateral width (ALM) (cm) and dorsal palmar thickness (EDP) (cm) in the structures of the metacarpal region in the two anterior members were measured by means of ultrasound. Results. Ultrasonography revealed that the transverse area of the suspensory ligament was the structure with the largest area in the proximal regions (1A, 1B and 2A), for both the left and right limbs. On the other hand, there was no significant difference (P> 0.05) between left and right limb for measurements of structures in any area, and there was no significant difference between age groups and body mass index (BMI) of horses. Conclusions. Reference values for tendons and ligaments in the palmar metacarpal region were obtained in equines providing a reference guide when metacarpal pathological conditions in equines are suspected.

Assessment of emulsion gels formulated with chestnut (Castanea sativa M.) flour and chia (Salvia hispanica L) oil as partial fat replacers in pork burger formulation.

BACKGROUND: The aim of this work was to evaluate the effect on chemical composition, physico-chemical properties, cooking characteristics, fatty acid profile, lipid oxidation, and sensory acceptability of an oil-in-water emulsion gel that was prepared with chestnut flour, chia oil, gellan gum, and water (CEG), used as a fat replacer in pork burgers. The original mixture was used as a control sample (CS). The other samples were formulated partially replacing pork backfat with 5% of CEG (CEG5%) and 10% of CEG (CEG10%). RESULTS: Proximate analysis of samples showed several differences between samples. The CEG addition was found to be effective for improving the cooking yield while diameter reduction and thickness increase were positively affected. As regards lipid oxidation, in cooked burger, the 2-thiobarbituric acid (TBA) values for CS, CEG5% and CEG10% were 0.46, 0.57, and 0.59 mg malonaldehyde/kg sample, respectively. The linolenic and linolenic acid content of pork burger increased as CEG addition increased. Sensory properties for CS and CEG5% were similar whereas CEG10% showed the highest sensory scores. CONCLUSIONS: A combination of chestnut flour and chia oil could be used as a novel ingredient to develop pork burgers with a better nutritional profile without diminishing their sensory and physico-chemical properties. © 2019 Society of Chemical Industry.

Chia (Salvia hispanica L.) products as ingredients for reformulating frankfurters: Effects on quality properties and shelf-life.

Several strategies were examined for incorporating chia products (seeds, flour and a coproduct from cold-press oil extraction) in frankfurters. The nutritional composition, technological properties and sensory attributes of the resulting products were studied in relation to the formulation used and, lipid oxidation, pH, residual nitrite level and microbiological properties were evaluated during chilled storage. Application of these chia products (3%) was seen to enhance the nutritional composition of frankfurters, without adversely affecting the technological properties of the final product. In general, although differences were detected in the sensory attributes of the frankfurters reformulated with chia products (most of them when chia coproduct was added), all of them were judged acceptable. Besides the quality aspects, these reformulation strategies had beneficial effects on some technological properties during chilled storage: better resistance to oxidation (controlling the TBARS increase during storage) and lower residual nitrite levels than control (both effects presumably because the chia polyphenols content) and no effect on microbiological safety.

[Síndrome de Paget-Schrötter: presentación de cuatro casos]. / Paget-Schrötter syndrome: description of four cases.

Deep vein thrombosis (DVT) of the upper limb is a rare entity, estimated to account for 10% of all cases of DVT. Classically, they are classified into primary (idiopathic, due to subclavian vein compression or exercise related) and secondary (cancer, thrombophilia, trauma, shoulder surgery, associated to venous catheters or due to hormonal causes). The Paget- Schrötter syndrome is a primary thrombosis of the subclavian vein in the subclavian-axillary junction, related either to repetitive movements or to exercise; leading to microtrauma in the endothelium with consequent activation of the coagulation cascade. Clinically, it presents abruptly with pain, edema and feeling of heaviness in the affected limb. The treatment varies from thrombolytics and anticoagulation to surgical intervention, depending on the time of evolution. We present four cases of exercise-related subclavian vein thrombosis.

Síndrome de Paget-Schrötter: presentación de cuatro casos / Paget-Schrötter syndrome: presentation of four cases

La trombosis venosa profunda (TVP) del miembro superior es una entidad poco frecuente, se estima que representa el 10% de todos los casos de TVP. Clásicamente se clasifican en primarias (idiopáticas, por compresión de la vena subclavia o relacionadas con el ejercicio) y secundarias (cáncer, trombofilia, traumatismo, cirugía del hombro, asociadas a catéteres venosos o de causa hormonal). El síndrome de Paget- Schrötter es una trombosis primaria de la vena subclavia en la unión subclavio-axilar, ya sea por movimientos repetitivos o relacionada al ejercicio; llevando a microtrauma en el endotelio con la consiguiente activación de la cascada de coagulación. Clínicamente se presenta de forma brusca con dolor, edema y sensación de pesadez en el miembro afectado. El tratamiento varía desde trombolíticos y anticoagulación a la intervención quirúrgica, dependiendo del tiempo de evolución. Presentamos cuatro casos de trombosis de vena subclavia relacionada con el ejercicio.

Deep vein thrombosis (DVT) of the upper limb is a rare entity, estimated to account for 10% of all cases of DVT. Classically, they are classified into primary (idiopathic, due to subclavian vein compression or exercise related) and secondary (cancer, thrombophilia, trauma, shoulder surgery, associated to venous catheters or due to hormonal causes). The Paget- Schrötter syndrome is a primary thrombosis of the subclavian vein in the subclavian-axillary junction, related either to repetitive movements or to exercise; leading to microtrauma in the endothelium with consequent activation of the coagulation cascade. Clinically, it presents abruptly with pain, edema and feeling of heaviness in the affected limb. The treatment varies from thrombolytics and anticoagulation to surgical intervention, depending on the time of evolution. We present four cases of exercise-related subclavian vein thrombosis.

Changes in bioaccessibility, polyphenol profile and antioxidant potential of flours obtained from persimmon fruit (Diospyros kaki) co-products during in vitro gastrointestinal digestion.

The aim was to evaluate (i) the phenol and flavonoid recovery and bioaccessibility indexes, (ii) the stability of individual polyphenolic compounds and (iii) the antioxidant activity of persimmon flours (cultivars 'Rojo Brillante' and 'Triumph') during the in vitro digestion. The recovery index for phenolic and flavonoid content was dependent on flour type and digestion phase. After the dialysis phase, the bioaccessibility for phenolic compounds from both flours was similar; for flavonoids it was higher in 'Triumph' than 'Rojo Brillante' flour. After in vitro digestion, 13 polyphenolic compounds were detected in both flours, of which only six were detected in the intestinal phase. Their antioxidant activity (ABTS+, FRAP and DPPH) decreased after intestinal phase, while their chelating activity (FIC assay) increased in both flours. So, persimmon flours could be included in the formulation of foods to improve either their scarcity of bioactive compounds or an unbalanced nutritional composition.

Cell walls of the dimorphic fungal pathogens Sporothrix schenckii and Sporothrix brasiliensis exhibit bilaminate structures and sloughing of extensive and intact layers.

Sporotrichosis is a subcutaneous mycosis caused by pathogenic species of the Sporothrix genus. A new emerging species, Sporothrix brasiliensis, is related to cat-transmitted sporotrichosis and has severe clinical manifestations. The cell wall of pathogenic fungi is a unique structure and impacts directly on the host immune response. We reveal and compare the cell wall structures of Sporothrix schenckii and S. brasiliensis using high-pressure freezing electron microscopy to study the cell wall organization of both species. To analyze the components of the cell wall, we also used infrared and 13C and 1H NMR spectroscopy and the sugar composition was determined by quantitative high-performance anion-exchange chromatography. Our ultrastructural data revealed a bi-layered cell wall structure for both species, including an external microfibrillar layer and an inner electron-dense layer. The inner and outer layers of the S. brasiliensis cell wall were thicker than those of S. schenckii, correlating with an increase in the chitin and rhamnose contents. Moreover, the outer microfibrillar layer of the S. brasiliensis cell wall had longer microfibrils interconnecting yeast cells. Distinct from those of other dimorphic fungi, the cell wall of Sporothrix spp. lacked α-glucan component. Interestingly, glycogen α-particles were identified in the cytoplasm close to the cell wall and the plasma membrane. The cell wall structure as well as the presence of glycogen α-particles varied over time during cell culture. The structural differences observed in the cell wall of these Sporothrix species seemed to impact its uptake by monocyte-derived human macrophages. The data presented here show a unique cell wall structure of S. brasiliensis and S. schenckii during the yeast parasitic phase. A new cell wall model for Sporothrix spp. is therefore proposed that suggests that these fungi molt sheets of intact cell wall layers. This observation may have significant effects on localized and disseminated immunopathology.