Spontaneously fermented traditional beverages as a source of bioactive compounds: an overview.

Fermented food has been present throughout history, since fermentation not only helps preserving food, but also provides specific organoleptic characteristics typically associated to these foods. Most of the traditional fermented foods and artisanal beverages are produced by spontaneous generation, meaning no control of the microbiota, or the substrate used. Nevertheless, even not being standardized, they are an important source of bioactive compounds, such as antioxidant compounds, bioactive beeps, short chain fatty acids, amino acids, vitamins, and minerals. This review compiles a list of relevant traditional fermented beverages around the world, aiming to detail the fermentation process itself-including source of microorganisms, substrates, produced metabolites and the operational conditions involved. As well as to list the bioactive compounds present in each fermented food, together with their impact in the human health. Traditional fermented beverages from Mexico will be highlighted. These compounds are of high interest for the food, pharmaceutical and cosmetics industry. To scale-up the home fermentation processes, it is necessary to fully understand the microbiology and biochemistry behind these traditional products. The use of good quality raw materials with standardized methodologies and defined microorganisms, may improve and increase the production of the desirable bioactive compounds and open a market for novel functional products.

What makes hospitalized patients more vulnerable and increases their risk of experiencing an adverse event?

OBJECTIVE: To analyze the relationship between the appearance of adverse events (AEs) and both patient comorbidities and the use of medical devices. DESIGN: Retrospective medical records review study. SETTING: Twenty-four Spanish public hospitals. PARTICIPANTS: Clinical records of 5624 discharged patients. MAIN OUTCOME MEASURE: Incidence of AEs. RESULTS: Patients aged >65 have 2.4 times the risk of experiencing an AE compared with those aged <65. The presence of certain comorbidities and devices (neoplasia, chronic hepatic alteration, cardiac insufficiency, coronary disease, high blood pressure, urethral catheterization, catheterization of a vessel, tracheostomy or stay of >7 days) were associated with developing an AE during hospitalization. There is a trend effect if we consider the number of comorbidities and the number of devices used. Thus, the risk of an AE in subjects who present no comorbidities was 3.2%, which rose to 9.9% in those with one intrinsic risk factor, 16.7% in those with two and 29.3% in those with three or more. Similarly, subjects without extrinsic risk factor experienced an AE in 4.4% of cases, which rose to 9.6% when there was one risk factor, to 13.4% when there were two and to 33.0% when there were three or more risk factors. The effect of some of these pathologies and that associated with age disappeared on adjusting in line with other variables. CONCLUSIONS: The true risk resides in the number of exposures to potentially iatrogenic actions, rather than being intrinsic to age or the presence of certain comorbidities.

[Evolution of the adverse effects prevalence related to healthcare in hospitals of the Valencia community]. / Evolución de la prevalencia de eventos adversos relacionados con la asistencia en hospitales de la Comunidad Valenciana.

OBJECTIVE: Improvement of knowledge on patient safety by a study of the number, importance and impact of Adverse Events (AEs), analysing the patient and healthcare characteristics associated with their occurrence. MATERIAL AND METHODS: Cross-sectional study of prevalence carried out for one week every year in the years 2005-2008 in hospitals of the Comunidad Valenciana. RESULTS: AE prevalence in participating hospitals remained constant at around 6 % during the four years of study. The mean age and sex distribution were also constant. The predominant causal factors of AEs were nosocomial infection, procedures and medicines, in that order, although we did observe an increase in AEs due to nosocomial infection during the period of study. With regard to severity, we observed a decrease in the percentage of serious AEs (31.5 % in 2005 vs.17.8 % in 2008), as well as an increase in the proportion of avoidable AEs from 50.8 % to 63.2 % in 2008. CONCLUSIONS: The results of the study demonstrate the need for a cultural change among professionals that will stimulate the promotion of a proactive culture for patient safety, and allows us to anticipate a social problem of increasing repercussions. Knowledge of EA epidemiology will help in the development of prevention strategies to avoid or to minimise them.

[How to identify adverse events in emergency services? A guide agreed for the screening]. / ¿Cómo identificar los efectos adversos en urgencias? Una guía consensuada para el cribado.

OBJECTIVE: Since a third of adverse events (AE) occur outside hospital, the Emergency Services are a suitable place to look at their incidence. We considered designing a screening guide, adapted to the conditions of the emergency services, to identify AE. MATERIAL AND METHODS: A qualitative technique was applied (nominal group) in which 14 professionals participated. They analysed which factors of intrinsic risk, extrinsic risk, and alert conditions, were suitable for a screening guide of AE in emergency services. The session was chaired by a specialist in these types of techniques. RESULTS: Consensus was high in that the most frequent AE in emergencies were those related to medicines, diagnostic tests and with the correct identification of the reason for emergency. With respect to screening guide, the group proposed adding alcohol abuse, patient social problems, cognitive deterioration, basal autonomy and disability. In relation to extrinsic risk factors, they pointed to the need of including defibrillation, spinal tap or drainage implantation. With respect to the alert conditions form, the professionals agreed in that all the criteria seemed correct and suitable, except for that related to damage relation childbirth or amniocentesis. CONCLUSIONS: By using this technique we have managed to validate materials already recognized, and widely used in our country. The screening guide was considered useful, with slight modifications in some risk factors and alert conditions. The professionals agreed that the MRF2 modular questionnaire is appropriate for the characterisation of AE in emergencies.

[Computed tomography of dentigerous cyst. (Report of a case)]. / Tomografía computada del quiste dentígero. (Informe de un caso).

Although radiological diagnosis is easily and readily performed by orthopanthomography, with lateral oblique and anteroposterior projections, the image of dentigerous cysts may, on some occasions, be confusing. We submit the case history of a patient whose computerized tomography data may be useful in differential diagnosis.