Changes in general and abdominal obesity in children at 4, 6 and 9 years of age and their association with other cardiometabolic risk factors.

Temporary changes in childhood obesity and their association with cardiometabolic risk factors have been receiving increased attention. The objective of this study was to evaluate changes in general (GO) and abdominal (AO) obesity in children from 4 to 9 years of age and their associations with cardiometabolic risk factors at 9 years of age. This study includes 1344 children from the Longitudinal Childhood Obesity Study (ELOIN). Physical examinations performed at 4, 6 and 9 years of age and a blood sample was only taken at 9 years of age. Changes in obesity from 4 to 9 years of age were estimated using Body Mass Index and waist circumference. Participants were classified into four groups according to GO and AO: (1) stable without obesity (no obesity at all three measurements); (2) remitting obesity at 9 years (obesity at 4 and/or 6 years but not at 9 years); (3) incident or recurrent obesity at 9 years (obesity only at 9 years, at 4 and 9 years or at 6 and 9 years); and (4) stable or persistent with obesity (obesity at 4, 6 and 9 years). Dyslipidemia and dysglycemia were defined by the presence of at least one altered parameter of the lipid or glycemic profile. Odds ratios (OR) were estimated using logistic regression. Compared with children without GO at all ages, those with persistent GO had an OR of 3.66 (95% CI: 2.06-6.51) for dyslipidemia, 10.61 (95% CI: 5.69-19.79) for dysglycemia and 8.35 (95% CI: 4.55-15.30) for high blood pressure. The associations were fairly similar in the case of AO, with ORs of 3.52 (95% CI: 1.96-6.34), 17.15 (95% CI: 9.09-32.34) and 8.22 (95% CI: 4.46-15.15), respectively, when comparing persistent versus stable without AO. Children with incident obesity at 9 years presented a moderate cardiometabolic risk that was nevertheless higher compared to those stable without obesity, whereas those with remitting obesity did not show any significant associations. CONCLUSION: Incident, and especially, persistent obesity, is associated with an increased cardiometabolic risk. The very early prevention of obesity, with a focus on nutrition, physical activity and sedentary behaviour, as well as tracking growth from birth to age 5, should be a priority to prevent the burden of cardiometabolic disease with consequences for adulthood. WHAT IS KNOWN: • General and abdominal obesity has been shown to be associated with other cardiometabolic risk factors such as dyslipidemia, insulin resistance and hypertension. • Temporary changes in obesity and their associations with cardiometabolic risk factors have not been sufficiently explored in childhood. WHAT IS NEW: • Children with incident, and especially persistent, general and/or abdominal obesity, had an increased risk of dyslipidemia, dysglycemia and high blood pressure. •Remitting obesity was not associated with an increased cardiometabolic risk.

D-dimer and high-sensitivity C-reactive protein levels to predict venous thromboembolism recurrence after discontinuation of anticoagulation for cancer-associated thrombosis.

BACKGROUND: Optimal duration of anticoagulation for cancer-associated thrombosis (CAT) remains unclear. This study assessed D-dimer (DD) and high-sensitivity C-reactive protein (hs-CRP) levels after the withdrawal of anticoagulation treatment to predict the risk of venous thromboembolism (VTE) recurrence among patients with CAT. METHODS: Prospective, multicentre study to evaluate CAT with ≥3 months of anticoagulation that was subsequently discontinued. Blood samples were taken when patients stopped the anticoagulation and 21 days later to determine the DD and hs-CRP levels. All patients were followed up for 6 months to detect VTE recurrence. RESULTS: Between 2013 and 2015, 325 patients were evaluated and 114 patients were ultimately enrolled in the study. The mean age was 62 ± 14 years and nearly 40% had metastasis. Ten patients developed VTE recurrence within 6 months (8.8%, 95% confidence interval [CI]: 4.3-15.5%). The DD and hs-CRP levels after 21 days were associated with VTE recurrence. The subdistribution hazard ratios were 9.82 for hs-CRP (95% CI: 19-52) and 5.81 for DD (95% CI: 1.1-31.7). CONCLUSIONS: This study identified that hs-CRP and DD were potential biomarkers of VTE recurrence after discontinuation of anticoagulation in CAT. A risk-adapted strategy could identify low-risk patients who may benefit from discontinuation of anticoagulation.

Two systems for conditional gene expression in Myxococcus xanthus inducible by isopropyl-ß-D-thiogalactopyranoside or vanillate.

Conditional expression of a gene is a powerful tool to study its function and is typically achieved by placing the gene under the control of an inducible promoter. There is, however, a dearth of such inducible systems in Myxococcus xanthus, a well-studied prokaryotic model for multicellular development, cell differentiation, motility, and light response and a promising source of secondary metabolites. The few available systems have limitations, and exogenously based ones are unavailable. Here, we describe two new, versatile inducible systems for conditional expression of genes in M. xanthus. One employs isopropyl-ß-d-thiogalactopyranoside (IPTG) as an inducer and is inspired by those successfully applied in some other bacteria. The other requires vanillate as an inducer and is based on the system developed originally for Caulobacter crescentus and recently adapted for mammalian cells. Both systems are robust, with essentially no expression in the absence of an inducer. Depending on the inducer and the amounts added, expression levels can be modulated such that either system can conditionally express genes, including ones that are essential and are required at high levels such as ftsZ. The two systems operate during vegetative growth as well as during M. xanthus development. Moreover, they can be used to simultaneously induce expression of distinct genes within the same cell. The conditional expression systems we describe substantially expand the genetic tool kit available for studying M. xanthus gene function and cellular biology.

Role of Early Assesment of Diuresis and Natriuresis in Detecting In-Hospital Diuretic Resistance in Acute Heart Failure.

Background and Purpose: European Guidelines recommend early evaluation of diuresis and natriuresis after the first administration of diuretic to identify patients with insufficient diuretic response during acute heart failure. The aim of this work is to evaluate the prevalence and characteristics of patients with insufficient diuretic response according to this new algorithm. Methods: Prospective observational single centre study of consecutive patients with acute heart failure and congestive signs. Clinical evaluation, echocardiography and blood tests were performed. Diuretic naïve patients received 40 mg of intravenous furosemide. Patients on an oupatient diuretic regimen received 2 times the ambulatory dose. The diuresis volume was assessed 6 h after the first loop diuretic administration, and a spot urinary sample was taken after 2 h. Insufficient diuretic response was defined as natriuresis <70 mEq/L or diuresis volume <600 ml. Results: From January 2020 to December 2021, 73 patients were included (59% males, median age 76 years). Of these, 21 patients (28.8%, 95%CI 18.4; 39.2) had an insufficient diuretic response. Diuresis volume was <600 ml in 13 patients (18.1%), and 12 patients (16.4%) had urinary sodium <70 mEq/L. These patients had lower systolic blood pressure, worse glomerular filtration rate, and higher aldosterone levels. Ambulatory furosemide dose was also higher. These patients required more frequently thiazides and inotropes during admission. Conclusion: The diagnostic algorithm based on diuresis and natriuresis was able to detect up to 29% of patients with insufficient diuretic response, who showed some characteristics of more advanced disease.

Evaluation of Particleboards Made from Giant Reed (Arundo donax L.) Bonded with Cement and Potato Starch.

There is a general concern about the rationalization of resources and the management of waste. Plant residues can contribute to the development of new non-polluting construction materials. The objective of this study was to valorize a plant residue such as the giant reed and obtain a particleboard with cement using potato starch as a plasticizer in a manufacturing process involving compression and heat. The influence of cement and starch in different proportions and its stability over time were analyzed. Finally, their physical and mechanical properties were evaluated and compared to European Standards. High-quality sustainable particleboards (boards with high structural performance) were obtained and can be classified as P6 according to European Standards. Mechanical properties were improved by increasing the starch content and pressing time, whereas greater resistance to water was obtained by increasing the cement content. Giant reed particles seem to tolerate the alkalinity of the cement since there was no sign of degradation of its fibers. The use of these residues in the manufacture of construction materials offers a very attractive alternative in terms of price, technology and sustainability.

Scaffold hopping from pyridones to imidazo[1,2-a]pyridines. New positive allosteric modulators of metabotropic glutamate 2 receptor.

Imidazo[1,2-a]pyridines were identified via their shape and electrostatic similarity as novel positive allosteric modulators of the metabotropic glutamate 2 receptor. The subsequent synthesis and SAR are described. Potent, selective and metabolically stable compounds were found representing a promising avenue for current further studies.

[Accesibility and usability of computer-based cognitive stimulation: Telecognitio]. / Accesibilidad y usabilidad de las aplicaciones computarizadas de estimulación cognitiva: Telecognitio.

INTRODUCTION: Despite of the huge technological advance in the field of computer-based cognitive interventions, very few applications have been designed to be used by the elderly. The main objective of this study was to assess the adaptability of two psycho-stimulation applications used in geriatrics. A further aim was to design a table of the minimum requirements to be met through the use of these applications in a small sample of elders. In addition, Telecognitio-an application with some interesting functionalities-is presented. MATERIAL AND METHODS: We performed a pilot test of two cognitive intervention tools, which were evaluated by a sample of elderly people through a specifically designed questionnaire. A descriptive study of the results was performed, as well as of the possible correspondence between the subjects' cognitive status and the results. RESULTS: The results of this study indicate that, in general, elderly people and especially those with cognitive impairment had difficulties in understanding the instructions for the various activities, as well as little time to answer the questions. In the case of a touch screen, errors occurred, both due to accuracy and pulse time, although this device is more intuitive than the conventional mouse. CONCLUSIONS: Computer-based cognitive stimulation and evaluation applications will become widely used among the elderly. Therefore, these applications should be adapted for universal accessibility and usability.

Usefulness of natriuresis to predict in-hospital diuretic resistance.

BACKGROUND: Urinary sodium excretion predicts long-term adverse events after discharge in patients with acute heart failure (AHF). The role of natriuresis as an early marker of poor diuretic response during an AHF episode has been scarcely investigated. We sought to evaluate whether early natriuresis or its change during heart failure hospitalization is associated with the development of in-hospital diuretic resistance (DR). METHODS: This was a prospective, observational single center study of consecutive patients with AHF. Urine electrolytes were estimated from a spot urine sample within the first 6 hours following the first diuretic dose and 48 hours after admission. In-hospital DR was defined as poor diuretic response based on diuretic efficiency metrics and persistent congestion despite an intensive diuretic protocol. RESULTS: Between January and December 2018, 143 patients were admitted for AHF. Of these, 102 fulfilled the inclusion criteria (60% males, median age 77 years [interquartile range [IQR]: 69-83), and 20 patients (19.6%) met the definition of DR. Early natriuresis was lower in patients with DR than in non-resistant patients (46 mEq/L [IQR: 38.5-80.0] vs 97.5 mEq/L [IQR: 70.5-113.5], P<0.001). Urinary sodium <50 mEq/L increased the risk of developing in-hospital DR (risk ratio: 5.011 [95% confidence interval 2.408-10.429], P<0.001). The area under the receiver operating characteristic curve for early natriuresis to predict DR was 0.791 (95% confidence interval 0.681-0.902, P<0.001). CONCLUSIONS: Initial natriuresis can predict in-hospital DR. Patients with urinary sodium <50 mEq/L have an increased risk of early resistance to diuretic treatment.

Bactericidal activity of glutaraldehyde-like compounds from olive products.

The bactericidal effects of several olive compounds (nonenal, oleuropein, tyrosol, the dialdehydic form of decarboxymethyl elenolic acid either free [EDA] or linked to tyrosol [TyEDA] or to hydroxytyrosol [HyEDA]), other food phenolic compounds (catechin, epicatechin, eugenol, thymol, carvacrol, and carnosic acid), and commercial disinfectants (glutaraldehyde [GTA] and ortho-phthalaldehyde [OPA]), were tested against strains of Pseudomonas fluorescens, Staphylococcus aureus, Enterococcus faecalis, and Escherichia coli. It was found that the bactericidal activities of olive GTA-like compounds (EDA, HyEDA, and TyEDA) were greater than those exerted by several food phenolic substances. Surprisingly, these olive antimicrobials were as active as the synthetic biocides GTA and OPA against the four bacteria studied. Thus, it has been proposed that the bactericidal activity of the main olive antimicrobials is primarily due to their dialdehydic structure, which is similar to that of the commercial biocides GTA and OPA. Our results clearly reveal that olive GTA-like compounds possess a strong bactericidal activity even greater than that of other food phenolic compounds or synthetic biocides.

A bacterial light response reveals an orphan desaturase for human plasmalogen synthesis.

Plasmalogens are glycerophospholipids with a hallmark sn-1 vinyl ether bond. These lipids are found in animals and some bacteria and have proposed membrane organization, signaling, and antioxidant roles. We discovered the plasmanylethanolamine desaturase activity that is essential for vinyl ether bond formation in a bacterial enzyme, CarF, which is a homolog of the human enzyme TMEM189. CarF mediates light-induced carotenogenesis in Myxococcus xanthus, and plasmalogens participate in sensing photooxidative stress through singlet oxygen. TMEM189 and other animal homologs could functionally replace CarF in M. xanthus, and knockout of TMEM189 in a human cell line eliminated plasmalogens. Discovery of the human plasmanylethanolamine desaturase will spur further study of plasmalogen biogenesis, functions, and roles in disease.

Quality of life in patients with congestive heart failure and central sleep apnea.

OBJECTIVE: To assess the impact of Cheyne-Stoke respiration-central sleep apnea (CSR-CSA) on quality of life (QOL) in patients with congestive heart failure (CHF). QOL was established using the MLHFQ (Minnesota Living with Heart Failure Questionnaire), and the FOSQ (Functional Outcomes of Sleep Questionnaire). METHODS: We examined 90 patients with CHF. The diagnosis of CSR-CSA was performed by polysomnography. We established a correlation between the apnea-hypopnea index (AHI) and the MLHFQ and FOSQ scores. RESULTS: Five patients were excluded (obstructive sleep apnea). Of the 85 remaining patients, 25 presented CSR-CSA. The mean MLHFQ score was higher in patients with CHF and CSR-CSA (25.8+/-2.97 vs. 16.6+/-2.05; p=0.01), and showed a significant yet moderate correlation with the AHI. A lower mean FOSQ score was obtained for the group of patients with CHF and CSR-CSA (78.4+/-4.31 vs. 88.47+/-2.4; p=0.03), showing weak negative correlation with the AHI. CONCLUSION: According to the MLHFQ scores, it seems that CHF patients with CSR-CSA have a worse QOL than those with CHF alone. Although this could be attributable to a greater impairment of heart function in the former group, the FOSQ scores indicate some influence of their sleep disorder on the impairment of QOL.

Inhibitors of lactic acid fermentation in Spanish-style green olive brines of the Manzanilla variety.

Frequently, a delay or lack of lactic acid fermentation occurs during the processing of Spanish-style green olives, in particular of the Manzanilla variety. Many variables can affect the progress of fermentation such as temperature, nutrients, salt concentration, antimicrobials in brines, and others. In this study, it was demonstrated that an inappropriate alkaline treatment (low NaOH strength and insufficient alkali penetration) allowed for the presence of several antimicrobial compounds in brines, which inhibited the growth of Lactobacillus pentosus. These substances were the dialdehydic form of decarboxymethyl elenolic acid either free or linked to hydroxytyrosol and an isomer of oleoside 11-methyl ester. Olive brines, from olives treated with a NaOH solution of low concentration up to 1/2 the distance to the pit, contained these antimicrobials, and no lactic acid fermentation took place in them. By contrast, a more intense alkaline treatment (2/3 lye depth penetration) gave rise to an abundant growth of lactic acid bacteria without any antimicrobial in brines. Therefore, the precise cause of stuck fermentation in Manzanilla olive brines was demonstrated for the first time and this finding will contribute to better understand the table olive fermentation process.

[Assessment of beverage consumption, dietary water intake and adequacy to the recommendations of a group of Spanish schoolchildren from 7 to 12 years old]. / Evaluación del consumo de bebidas, ingesta dietética de agua y adecuación a las recomendaciones de un colectivo de escolares españoles de 7 a 12 años.

INTRODUCTION: the dietary water and the intake of beverages play a relevant role in the dietary and hydration patterns of children and few studies provide an overview of them. Objetives: to assess the dietary intake of water, its adaptation to the recommendations and its distribution throughout the day, and the average consumption of beverages by a group of Spanish schoolchildren. MATERIAL AND METHODS: a sample of 262 schoolchildren (139 boys and 123 girls) between seven and 12 years old was studied. A three-day dietary record (one day in weekend) was kept to assess beverage consumption. Dietary water intake obtained was compared to EFSA's adequate intake (AI) and other recommendations, its distribution throughout the day was studied, and personal and anthropometric date were collected too. The data were processed using DIAL and SPSS. RESULTS: the beverages consumed in greatest quantity were water as a beverage, milk and commercial juices and nectars. The average dietary water intake was 1,401 ± 432 ml/day (42% from food and 58% from beverages). Only 20.2% of schoolchildren were above the AIs. Dietary water intake was significantly higher at all intakes in the day in those schoolchildren who were above AIs. CONCLUSIONS: based on our results, 79.8% of children do not cover the AIs. For this reason it is important improve their hydration patterns. In this aspect, water as a beverage plays a key role to cover the recommendations.

INTRODUCCIÓN: la ingesta dietética de agua y el consumo de bebidas juegan un papel relevante en los hábitos de hidratación y alimentación de la población infantil y escasos estudios nos ofrecen una visión global de los mismos. OBJETIVOS: evaluar la ingesta dietética de agua y el consumo de bebidas, su adecuación a las recomendaciones y su distribución a lo largo del día en un colectivo de escolares españoles. MATERIAL Y MÉTODOS: se estudió una muestra de 262 escolares (123 niñas) entre siete y 12 años. Se realizó un registro dietético de tres días (uno de ellos festivo) para evaluar el consumo de bebidas. Se comparó la ingesta dietética de agua obtenida con las ingestas adecuadas (IA) marcadas por la EFSA y por otros organismos y se estudió su distribución a lo largo del día. También se procedió a recoger datos personales y antropométricos. Los datos fueron procesados mediante DIAL y SPSS. RESULTADOS: las bebidas más consumidas fueron agua de bebida, leche y zumos comerciales y néctares. La ingesta dietética media de agua fue de 1.401 ± 432 ml/día (42% aportada por alimentos y 58% por bebidas). Solo el 20,2% de los escolares superaron las IA. La ingesta dietética de agua fue significativamente superior en todos los momentos del día en aquellos escolares que superaron las IA establecidas. CONCLUSIÓN: el 79,8% de los escolares no alcanza las IA, por lo que es importante mejorar sus pautas de hidratación, jugando el agua de bebida un papel clave a la hora de alcanzar las recomendaciones.

Physical activity and sedentary behavior impacts on dietary water intake and hydration status in Spanish schoolchildren: A cross-sectional study.

BACKGROUND: The importance of maintaining an adequate hydration status and the complexity of the water balance make it necessary to study the lifestyle factors that can influence or modify these variables. The aim of this study was to evaluate the hydration status and dietary water intake for a sample of Spanish schoolchildren from 7 to 12 years old and their associations with physical activity (PA) and sedentary behaviors. METHODS: A total of 242 schoolchildren was studied (49.17% females). A 24-hour urine sample was collected from each child, and the urine volume and osmolality were measured to estimate the hydration status (adequate hydration ≤800 mOsm/kg). In addition, a 3-day dietary record was completed to evaluate their water intake according to EFSA parameters. Dietary information was processed with DIAL software, and a statistical analysis was performed using SPSS. Student's t-test was used to study the normal variables, and the Mann-Whitney U test was used for those that were not normal. In the case of the categorical variables, the Z and Chi-Square proportions tests were used. The Bonferroni test was used to adjust the values in multiple comparisons. To evaluate the influence of these lifestyles on the urine osmolality, a 2-way ANOVA and an odds ratio were used. RESULTS: A total of 48.3% of the sample presented an adequate hydration status, and the percentage was significantly higher in females (p = 0.003). Only 20.9% showed an adequate intake of dietary water. The lifestyle influence reveals that more inactive and non-sedentary schoolchildren were adequately hydrated (p = 0.008). PA (practice ≥1 h/day) was associated with a higher risk of having an inadequate hydration status, even when accounting for sex and other lifestyle factors (OR = 1.753(1.006-3.054), p = 0.048). CONCLUSIONS: Approximately half of the participants presented an inadequate hydration status (which was higher in males than in females). PA (practice ≥1 h/day) was associated with a higher risk of inadequate hydration. This fact highlighted the importance of raising awareness about hydration in children, especially in ones who are more active.

[Evolution in the supply of non-alcoholic beverages in the last 25 years: reduction of sugar as a critical nutrient and use of sweeteners]. / Evolución en la oferta de bebidas no alcohólicas en los últimos 25 años: reducción de azúcar como nutriente crítico y uso de edulcorantes.

INTRODUCTION: in recent years, consumers have been changing their food requirements, but always based on food safety as the primary premise. Among these advances, it has been realised the reduction and elimination of sugar and the use of sweeteners in non-alcoholic beverages, allowing these products to be adapted to the requirements of health organizations regarding the content of simple sugars. OBJECTIVES: to know the evolution of non-alcoholic beverages in Spain during the last 25 years, focusing on the reduction of sugar and the use of sweeteners. MATERIAL AND METHODS: bibliographic review of the available scientific literature and legislation. RESULTS: the development and innovation in the composition of non-alcoholic beverages has made it possible to reduce the amount of sugar in these beverages more than 45% in the sugar content per litre in the total supply of beverages since 2000 and to reduce the sugar content in certain beverages. For this reason, it has growth the number of drinks without sugar or without added sugar. CONCLUSION: there is an increasing supply and options of lower-sugar and sugar-free beverages.

INTRODUCCIÓN: durante estos últimos años los consumidores han ido variando sus exigencias en cuanto a los alimentos, pero siempre han mantenido como primera premisa la seguridad alimentaria. Dentro de estos avances, cabe destacar la reducción y la eliminación del azúcar y del uso de edulcorantes en bebidas no alcohólicas, lo que ha permitido que estos productos puedan adaptarse a los requerimientos de las organizaciones de salud en lo relativo al contenido de azúcares simples. OBJETIVOS: conocer la evolución de las bebidas no alcohólicas en España durante los últimos 25 años, sobre todo en la reducción de azúcar y en el uso de edulcorantes. MATERIAL Y MÉTODOS: revisión bibliográfica de la literatura científica disponible, además de la legislación al respecto. RESULTADOS: el desarrollo y la innovación en la composición de las bebidas no alcohólicas ha permitido reducir la cantidad de azúcar, lo que ha permitido que, en algún caso, desde el año 2000 se haya reducido en más de un 45% el contenido de azúcar por litro en el total de la oferta de bebidas y haya contenidos más bajos en azúcar en determinadas bebidas, a lo que hay que añadir la existencia cada vez más numerosa de bebidas sin azúcar o sin azúcar añadido. CONCLUSIÓN: cada vez hay mayor oferta y opciones de bebidas con contenidos más bajos de azúcar o sin azúcar.

Purification and characterization of natural Bet v 1 from birch pollen and related allergens from carrot and celery.

Birch pollen allergy is predominantly caused by the major allergen Bet v 1 and can lead to crossreactions with homologous proteins in food. Two major cross-reactive food allergens are Dau c 1 from carrot and Api g 1 from celery, which have never been purified from their natural source. Here, we describe a non-denaturing purification method for obtaining natural Bet v 1, Dau c 1 and Api g 1, comprising of ammonium sulfate precipitation, hydrophobic interaction chromatography and size exclusion chromatography. This method resulted in 98-99% pure isoform mixtures for each allergen. Characterization of these isoform mixtures with Q-TOF MS/MS clearly showed earlier reported isoforms of Bet v 1, Dau c 1 and Api g 1, but also new isoforms. The presence of secondary structure in the three purified allergens was demonstrated via circular dichroism and showed high similarity. The immune reactivity of the natural allergens was compared with recombinant proteins by Western blot and ELISA and showed similar reactivity.

Clinical and molecular characterization of Wilson disease in Spanish patients.

Wilson disease (WD) results when specific mutations occur at the ATP7B gene. The presence of mutations in the ATP7B gene was studied in the coding region and the intron-exon boundaries in 15 WD Spanish patients, and their first-degree relatives when possible. A total of 20 nucleotide sequence changes were detected, 18 missense and two splicing mutations. Six of these variants were classified as disease-causing mutations, five missense, and one splicing; four of them have been previously described (M645R, A1065P, H1069Q, and 3060 + 5G > T), whereas two were novel (P768L and A990P). No mutation was clearly prevalent, although the H1069Q mutation predominated, nor did a good phenotype-genotype correlation exist. The two new mutations described were manifested as an asymptomatic increase in serum transaminases. The remaining 14 changes were classified as polymorphisms and their potential effects on protein function are discussed. The identification of mutations in the ATP7B gene has allowed a conclusive diagnosis to be made of WD in patients presenting neurological phenotype or neurological of hepatic phenotype, who would otherwise not have been diagnosed using classical criteria. WD patients could start chelating treatment earlier on and possibly modify the natural progression of the disease.

Main antimicrobial compounds in table olives.

The inhibitors involved in the lactic acid fermentation of table olives were investigated in aseptic olive brines of the Manzanilla and Gordal varieties. Phenolic and oleosidic compounds in these brines were identified by high-performance liquid chromatography with ultraviolet and electrospray ionization mass spectrometry detection, and several substances were also characterized by nuclear magnetic resonance. Among these compounds, the dialdehydic form of decarboxymethyl elenolic acid linked to hydroxytyrosol showed the strongest antilactic acid bacteria activity, and its presence in brines could explain the growth inhibition of these microorganisms during olive fermentation. However, it was found that the dialdehydic form of decarboxymethyl elenolic acid, identified for the first time in table olives, and an isomer of oleoside 11-methyl ester were also effective against Lactobacillus pentosus and can, therefore, contribute to the antimicrobial activity of olive brines. It must also be stressed that the three new inhibitors discovered in table olive brines exerted a more potent antibacterial activity than the well-studied oleuropein and hydroxytyrosol.

[Severe obstructive sleep apnea syndrome in a toddler]. / Síndrome de apnea obstructiva del sueño infantil de presentación grave.

We report the case of a 3-year-old boy who had experienced intense snoring, frequent awakenings, intense respiratory effort during sleep, and delayed growth starting at the age of 15 months. He underwent adenoidectomy at 18 months. Symptoms initially improved but reappeared 3 months after surgery. He underwent a second adenoidectomy, this time with tonsillectomy, but there was no significant clinical improvement. Polysomnography revealed severe sleep apnea-hypopnea with an apnea-hypopnea index of 45. Continuous positive airway pressure improved sleep quality, although some symptoms, mainly snoring, persisted. A third adenoidectomy was necessary to normalize his breathing pattern during sleep.