Sex-Related Differences in the Phenotype and Course of Inflammatory Bowel Disease: SEXEII Study of ENEIDA.

BACKGROUND & AIMS: The impact of patient sex on the presentation of inflammatory bowel disease (IBD) has been poorly evaluated. Our aims were to assess potential disparities in IBD phenotype and progression between sexes. METHODS: We performed an observational multicenter study that included patients with Crohn's disease (CD) or ulcerative colitis from the Spanish Estudio Nacional en Enfermedad Inflamatoria intestinal sobre Determinantes genéticos y Ambientales registry. Data extraction was conducted in July 2021. RESULTS: A total of 51,595 patients with IBD were included, 52% were males and 25,947 had CD. The median follow-up period after diagnosis was 9 years in males and 10 years in females. In CD, female sex was an independent risk factor for medium disease onset (age, 17-40 y) (relative risk ratio, 1.45; 95% CI, 1.31-1.62), later disease onset (age, >40 y) (relative risk ratio, 1.55; 95% CI, 1.38-1.73), exclusive colonic involvement (odds ratio, 1.24; 95% CI, 1.14-1.34), inflammatory behavior (odds ratio, 1.14; 95% CI, 1.07-1.21), and extraintestinal manifestations (odds ratio, 1.48; 95% CI, 1.38-1.59). However, female sex was a protective factor for upper gastrointestinal involvement (odds ratio, 0.84; 95% CI, 0.79-0.90), penetrating behavior (odds ratio, 0.76; 95% CI, 0.70-0.82), perianal disease (odds ratio, 0.77; 95% CI, 0.71-0.82), and complications (odds ratio, 0.73; 95% CI, 0.66-0.80). In ulcerative colitis, female sex was an independent risk factor for extraintestinal manifestations (odds ratio, 1.48; 95% CI, 1.26-1.61). However, female sex was an independent protective factor for disease onset from age 40 onward (relative risk ratio, 0.76; 95% CI, 0.66-0.87), left-sided colonic involvement (relative risk ratio, 0.72; 95% CI, 0.67-0.78), extensive colonic involvement (relative risk ratio, 0.59; 95% CI, 0.55-0.64), and abdominal surgery (odds ratio, 0.78; 95% CI, 0.69-0.88). CONCLUSIONS: There is sexual dimorphism in IBD. The patient's sex should be taken into account in the clinical management of the disease.

Application of Dispersive Liquid-Liquid Aerosol Phase Extraction to the Analysis of Total and Individual Phenolic Compounds in Fried Extra Virgin Olive Oils.

Seventeen extra virgin olive oil samples from Valencian Community (Spain) were submitted to a domestic-frying process (180 °C) during different degradation times (5, 10, 30, 60, 120 min). A dispersive liquid-liquid aerosol phase extraction by using a methanol/water (50:50) extracting solution was used to isolate the polyphenol fraction. Total phenolic content (TPC) was determined, whereas the determination of seven individual target polyphenolic compounds (hydroxytyrosol, tyrosol, oleuropein, vanillic acid, p-coumaric acid, ferulic acid, and vanillin) was carried out by using ultrahigh-performance liquid chromatography coupled to a tandem mass spectrometer. Statistically significant differences in the TPC values were found for Blanqueta and Manzanilla samples from different harvesting years. The domestic-frying process impacted the TPC and the individual phenolic compounds content. Thermal treatment for 2 h gave rise to a 94% decrease in the TPC. A first-order kinetic model was suitable to accurately describe the degradation of the individual phenolic compounds.

Caustic Ingestion: A Risk-Based Algorithm.

INTRODUCTION: Caustic ingestion management could be improved with a diagnostic approach based on risk factors. This study aimed to develop an algorithm derived from predictive factors of a poor clinical course, to evaluate its diagnostic accuracy and resource consumption, and to compare it with 2 other approaches, a radiological one based on computed tomography and a classical one based on symptoms and endoscopy. METHODS: All patients older than 15 years presenting with caustic ingestion in our tertiary care hospital between 1995 and 2021 were prospectively included. Adverse outcome was defined as intensive care unit admission, emergency surgery, or death. Ingestion characteristics, symptoms, and laboratory and endoscopic findings were analyzed to determine the most relevant risk factors. Diagnostic accuracy and the number of examinations required were estimated and compared with the other 2 algorithms applied to our series. RESULTS: The sample included 532 cases of caustic ingestion, 13.2% (95% confidence interval [CI]: 10.3-16.0) of which had adverse outcomes. Volume and type of caustic substance; presence of symptoms and pharyngolaryngeal involvement; and neutrophilia, acidosis, and endoscopic injury were combined to develop an algorithm that would provide the highest diagnostic odds ratio (167.2; 95% CI: 71.9-388.7). Following this approach, half of the patients (50.6%; 95% CI: 46.2-55.1) would not require any examination and, overall, the need for endoscopy (20.0%; 95% CI: 16.4-23.5) and computed tomography (16.3%; 95% CI: 13.0-19.5) would be lower than that for the other 2 algorithms. DISCUSSION: A risk-based algorithm could improve caustic ingestion management by maintaining high diagnostic accuracy while reducing diagnostic test requirements.

Oxygen Scavenger and Antioxidant LDPE/EVOH/PET-Based Films Containing ß-Carotene Intended for Fried Peanuts (Arachis hypogaea L.) Packaging: Pilot Scale Processing and Validation Studies.

The aim of this study was to develop an oxygen scavenger and antioxidant active packaging material for fried peanuts. The packaging solution, which has been made at the laboratory previously, has been developed by cast film extrusion and is composed of low-density polyethylene-ethylene vinyl alcohol-polyethylene terephthalate (LDPE/EVOH/PET)-based films containing ß-carotene (CAR). In comparison with film without additive, developed film presented an orange colouring (higher L* and b* values and lower a* values) and an increase in oxygen induction time (OIt) from 4.5 to 14.1 min. The incorporation of ß-carotene to the formulation also brings about a significant effect on the thermal stability as maximum degradation temperatures increased around 1%. Regarding the oxygen absorption capacity of the films, values of 1.39 ± 0.10 mL O2 per g of film at laboratory scale and 1.7 ± 0.3 mL O2 per g of multilayer (ML)/LDPE_CAR were obtained, respectively, after 3 days, proving the suitability of the packaging solutions as oxygen absorbers. To validate the packaging solution, the oxidative stability of fried peanuts packed in fabricated multilayer ß-carotene bags was evaluated for 3 months at 40 °C. The hexanal content remained constant during this period. Meanwhile, peanuts packed in ML without ß-carotene increased their hexanal content to 294%. This fact indicated a lower extent of oxidation in fried peanuts compared to food samples packaged in control films, suggesting the potential of ML/LDPE_CAR films as sustainable and antioxidant food packaging systems to offer protection against lipid oxidation in foods. Sensory evaluation confirmed that ML/LDPE_CAR films provided the peanut samples with an extra aroma due to the volatile degradation products of ß-carotene (such as ß-cyclocitral or 6-methyl-5-hepten-2-ol).

Management of patients with Intestinal Bowel Disease and COVID-19: A review of current evidence and future perspectives.

The COVID-19 pandemic has been a challenge for countries and health professionals worldwide. Viral entry by ACE-2 receptor and an excessive activation of the immune system are key to understand both incidence and severity of disease. Inflammatory Bowel Disease (IBD) represents a special condition associated with an inordinate response of the immune system to external agents. IBD treatments have been associated to an increased risk of bacterial and viral infections. This has raised the question of possible higher incidence and severity of COVID-19 infection in IBD patients. Several papers have been published during this year of pandemic to answer that question. Moreover, COVID-19 vaccination offers great promise in controlling infection in patients with IBD. Based on current evidence, patients with IBD do not have a higher incidence of COVID-19 than the general population, and they do not have worse disease evolution. Advanced age and presence of a greater number of comorbidities have been associated with worse outcomes, similar to the general population. Corticosteroids are associated to an increased risk of COVID-19 infection, higher hospitalization rate and higher risk of severe COVID-19. 5-ASA/Sulfasalazine and Thiopurines have a possible increased risk of severe COVID-19, although studies are lacking. On the other hand, Anti-TNF may have a possible protective effect. It is recommended to maintain the treatment. Anti-IL-12/23, anti-integrins and tofacitinib have results comparable to anti-TNF. Based on the efficacy, expert recommendations, and the absence of other evidence, it is recommended that patients with IBD be vaccinated.

Potential of Industrial Pineapple (Ananas comosus (L.) Merrill) By-Products as Aromatic and Antioxidant Sources.

Pineapple is meanly commercially processed. However, it is a fruit that generates a high proportion of nonedible wastes, which are rich in antioxidant compounds and have a varied aromatic profile. These characteristics turn these by-products into potential agri-food waste that can be revalued and applied in different fields such as medical, pharmaceutical, or food applications. The aim of the present work was the characterization and extraction of the volatile compounds present in two pineapple by-products (peel and core) and the subsequent evaluation of their antioxidant capacity. For this purpose, the analysis of the aromatic profile of both by-products has been carried out using the headspace solid-phase microextraction technique coupled to gas chromatography with a mass spectrometry detector (HS-SPME-GC-MS). The optimization of the extraction conditions of the volatile compounds has been validated using a Box-Behnken experimental design. In addition, a quantitative analysis was carried out to determine the contents of two important volatiles in pineapple wastes, isopentyl, and ethyl acetate. Moreover, the estimation of the antioxidant capacity of the subproducts extracts was carried out using different methods All the antioxidant assays demonstrated that pineapple subproducts are rich in easily extractable antioxidants with possible applications in the food industry.

Optimization of Volatile Compounds Extraction from Industrial Celery (Apium graveolens) By-Products by Using Response Surface Methodology and Study of Their Potential as Antioxidant Sources.

In this study, the potential of industrial celery by-products (the stalk and root) serving as sources of aromatics and antioxidants was investigated. A headspace solid phase microextraction-gas chromatography-mass spectrometry (HS-SPME-GC-MS) procedure was optimized to isolate volatile compounds from celery by-products. A Box-Behnken experimental design was proposed to optimize the procedure through a response surface methodology. The optimal extraction conditions were found to be 1.6 g of homogenized fresh by-product at 30 °C for 60 min. Under these conditions, 26 volatile compounds in stalk and root samples were identified, monoterpenes and sesquiterpenes being the main components. The content of limonene and γ-terpinene found in the stalk was significantly higher in comparison with root samples. Total phenolic content and antioxidant activity (ABTS and FRAP) results underlined the celery wastes studied as good sources of free radical scavengers. This work suggests the potential application of these by-products in the food industry and opens new pathways to valorize celery residues, contributing to the circular economy.

Endoscopic submucosal dissection with an SB Knife® for the treatment of subcardial gastric leiomyoma.

Surgery has been considered the main treatment for submucosal tumors (SMTs). However, endoscopic resection is currently accepted for gastric SMTs smaller than 3 cm. Endoscopic submucosal dissection (ESD) is considered the technique of choice, and submucosal tunneling endoscopic resection has successful results with low complication rates according to the recent meta-analysis by Cao et al. The major limitation of these methods is the technical difficulty associated with certain anatomic locations.

Variability of Chemical Profile in Almonds (Prunus dulcis) of Different Cultivars and Origins.

Almonds show a great variability in their chemical composition. This variability is a result of the existence of a diverse range of almond cultivars, the self-incompatibility of most almond cultivars, and the heterogeneous harvesting conditions found around the different locations where almons are grown. In the last years, the discrimination among almond cultivars has been the focal point of some research studies to avoid fraud in protected geographical indications in almond products and also for selecting the best cultivars for a specific food application or the most interesting ones from a nutritional point of view. In this work, a revision of the recent research works related to the chemical characterization and classification of almond cultivars from different geographical origins has been carried out. The content of macronutrients, tocopherols, phytosterols, polyphenols, minerals, amino acids, and volatile compounds together with DNA fingerprint have been reported as possible cultivar and origin markers. The analysis of the results showed that no individual almond compound could be considered a universal biomarker to find differences among different almond cultivars. Hence, an adequate selection of variables or the employment of metabolomics and the application of multivariate statistical techniques is necessary when classification studies are carried out to obtain valuable results. Meanwhile, DNA fingerprinting is the perfect tool for compared cultivars based on their genetic origin.

Caustic ingestion: development and validation of a prognostic score.

BACKGROUND: Caustic ingestion is a potentially severe condition and early identification of poor outcome is essential to improve management; however, prediction based on endoscopy alone can overestimate severity. This study aimed to develop and validate a prognostic score. METHODS: A prospective cohort study was designed to include all consecutive patients aged > 15 years who presented with caustic ingestion between 1995 and 2017. Adverse outcome was defined by intensive care unit admission, urgent surgery, or death. The predictive value of clinical, analytical, and endoscopic variables was assessed in the first cohort (derivation cohort) and a prognostic score based on the resulting risk factors was developed by logistic regression. Internal validation (bootstrapping) was performed and then external validation was checked in an independent sample of patients (validation cohort). RESULTS: 469 cases of caustic ingestion were included, 265 in the derivation cohort and 204 in the validation cohort. Ingestion of acidic substances (odds ratio [OR] 3.13, 95 % confidence interval [CI] 2.33 - 4.21), neutrophil count (OR 1.05, 95 %CI 1.04 - 1.06), metabolic acidosis (bicarbonate value, OR 0.82, 95 %CI 0.78 - 0.85), and endoscopic injury (OR 3.81, 95 %CI 3.35 - 4.34) were independent risk factors for poor outcome. The prognostic score based on these variables provided better accuracy than endoscopy alone (P = 0.04), with high sensitivity, specificity, positive and negative predictive values (93.3 %, 92.7 %, 72.7 %, 98.5 %, respectively), and area under the curve (0.976, 95 %CI 0.973 - 0.979; P < 0.001). CONCLUSIONS: This score allowed a reliable prognosis of caustic ingestion and was more accurate than endoscopy-based evaluation.

Oxidative and Nitrosative Pattern in Circulating Leukocytes of Very Early/Early Hepatocellular Carcinoma Patients.

BACKGROUND/AIM: In chronic liver disease, various immune cell subsets exert pro or anti-tumour effects by releasing reactive oxygen and nitrogen species (ROS, RNS). Here, we evaluated the oxidative and nitrosative pattern in peripheral blood leukocyte subpopulations of early hepatocellular carcinoma (HCC) patients compared with HCC-free cirrhotic patients. MATERIALS AND METHODS: Venous blood samples from 18 HCC-free cirrhotic patients and 17 early stage HCC patients were collected to determine ROS, RNS and reduced glutathione levels in isolated leukocytes analyzed by flow cytometry. RESULTS: Intracellular levels of ROS and glutathione were higher in lymphocytes, monocytes, and neutrophils from HCC patients as well as mitochondrial superoxide in neutrophils and monocytes whereas intracellular levels of nitric oxide were lower in lymphocytes, monocytes, and neutrophils. CONCLUSION: Early HCC alters intracellular levels of ROS and RNS of some circulating leukocytes subsets. This finding may represent a potential area of interest concerning the development of new treatments and prognostic markers.

Authentication of "Adelita" Raspberry Cultivar Based on Physical Properties, Antioxidant Activity and Volatile Profile.

Agricultural selection programmes are, today, working hard to obtain novel raspberry cultivars with higher nutritional and commercial quality. One of those cultivars is "Adelita". This study aims to provide novel tools for raspberry cultivar identification-more specifically, the differentiation of "Adelita" from other raspberry cultivars. To perform this study, five "Adelita" samples were analysed-four cultivated in Spain and one, in Morocco-and they were compared to seven samples from six raspberry cultivars ("P04", "Lupita", "Enrosadira", "P10", "Quanza" and "Versalles"). The physical parameters (mass, length, equatorial diameter and firmness) combined with the Total Phenolic Content (TPC); the antioxidant capacity according to the antioxidant activity tested with the 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric-reducing antioxidant power (FRAP) and 2,2-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS) methods; and the main target volatile compounds were used as independent variables. Principal component and cluster analysis showed that the target volatiles and physical parameters together with the TPC and DPPH values could be useful to classify Adelita cultivars separately from the rest of the cultivars included in the work. Those results proved that the developed methodology could be proposed as a reliable approach for the identification of cultivar fraud in the supply chain.

Novel Antioxidant Packaging Films Based on Poly(ε-Caprolactone) and Almond Skin Extract: Development and Effect on the Oxidative Stability of Fried Almonds.

Antioxidant films based on poly(ε-caprolactone) (PCL) containing almond skin extract (ASE) were developed for food packaging applications. The effect of ASE incorporation on the morphological, structural, colour, mechanical, thermal, barrier and antioxidant properties of the prepared films were evaluated. The structural, tensile and thermal properties of the films were not altered due to ASE addition. Although no significant differences were observed for the oxygen permeability of samples, some increase in water absorption and water vapour permeability was observed for active films due to the hydrophilic character of ASE phenolic compounds, suggesting the suitability of this novel packaging for fatty foods conservation. ASE conferred antioxidant properties to PCL films as determined by the DPPH radical scavenging activity. The efficiency of the developed films was evaluated by the real packaging application of fried almonds at different ASE contents (0, 3, 6 wt.%) up to 56 days at 40 °C. The evolution of peroxide and p-anisidine values, hexanal content, fatty acid profile and characteristic spectroscopy bands showed that active films improved fried almonds stability. The results suggested the potential of PCL/ASE films as sustainable and antioxidant food packaging systems to offer protection against lipid oxidation in foods.

Disease severity and treatment requirements in familial inflammatory bowel disease.

PURPOSE: Several studies demonstrate an increased prevalence and concordance of inflammatory bowel disease among the relatives of patients. Other studies suggest that genetic influence is over-estimated. The aims of this study are to evaluate the phenotypic expression and the treatment requirements in familial inflammatory bowel disease, to study the relationship between number of relatives and degree of kinship with disease severity and to quantify the impact of family aggregation compared to other environmental factors. METHODS: Observational analytical study of 1211 patients followed in our unit. We analyzed, according to the existence of familial association, number and degree of consanguinity, the phenotypic expression, complications, extraintestinal manifestations, treatment requirements, and mortality. A multivariable analysis considering smoking habits and non-steroidal-anti-inflammatory drugs was performed. RESULTS: 14.2% of patients had relatives affected. Median age at diagnosis tended to be lower in the familial group, 32 vs 29, p = 0.07. In familial ulcerative colitis, there was a higher proportion of extraintestinal manifestations: peripheral arthropathy (OR = 2.3, p = 0.015) and erythema nodosum (OR = 7.6, p = 0.001). In familial Crohn's disease, there were higher treatment requirements: immunomodulators (OR = 1.8, p = 0.029); biologics (OR = 1.9, p = 0.011); and surgery (OR = 1.7, p = 0.044). The abdominal abscess increased with the number of relatives affected: 5.1% (sporadic), 7.0% (one), and 14.3% (two or more), p=0.039. These associations were maintained in the multivariate analysis. CONCLUSIONS: Familial aggregation is considered a risk factor for more aggressive disease and higher treatment requirements, a tendency for earlier onset, more abdominal abscess, and extraintestinal manifestations, remaining a risk factor analyzing the influence of some environmental factors.