A Comparative Study between Onion Peel Extracts, Free and Complexed with ß-Cyclodextrin, as a Natural UV Filter to Cosmetic Formulations.

The growing concern regarding the adverse effects of synthetic UV filters found in sunscreens has spurred significant attention due to their potential harm to aquatic ecosystems and human health. To address this, the present study aimed to extract and microencapsulate sensitive bioactive compounds derived from by-product onion peel (OP) by molecular inclusion using ß-cyclodextrin as the wall material. Identification and quantification of bioactive compounds within the extract were conducted through high-performance liquid chromatography (HPLC-DAD) analysis, revealing quercetin and resveratrol as the primary constituents. The photoprotection capacity, evaluated by the sun protection factor (SPF), revealed a protection factor comparable to the value for a synthetic UV filter. The produced microparticles presented high antioxidant capacity, significant photoprotection capacity, encapsulation efficiency of 91.8%, mean diameter of 31 µm, and polydispersity of 2.09. Furthermore, to comprehensively evaluate the performance of OP extract and its potential as a natural UV filter, five O/W emulsions were produced. Results demonstrated that microparticles displayed superior ability in maintaining SPF values over a five-week period. Photoprotection evaluation-skin reactivity tests revealed that both extract and microparticles absorb UV radiation in other regions of UV radiation, revealing their potential to be used as a natural UV filter to produce a sustainable and eco-friendly value-added sunscreen.

Innovative Approaches for Food: Using Natural Phenolic-Rich Extracts to Produce Value-Added Fresh Pasta.

Cereal-based products, which are rich in carbohydrates, are widely consumed worldwide; however, this type of food lacks other nutrients. Phenolic compounds from natural sources, such as Moringa oleifera, can be incorporated into these products to increase their nutritional and biological value. In this study, a phenolic-rich extract was obtained from M. oleifera leaf powder using a Soxhlet extractor. The extract obtained presented a total phenolic content of 79.0 mg of gallic acid equivalents/g and the ABTS and DPPH assays showed that the extract can act as an anti-oxidant agent, with IC50 values of 205.2 mg/L and 636.0 mg/L, respectively. Afterwards, fresh pasta was produced and the extract was incorporated into the pasta to improve its biological properties and extend its shelf-life. The results demonstrated that the addition of M. oleifera to the fresh pasta increased its anti-oxidant capacity and did not interfere with the cooking properties of the product. Moreover, the fortified pasta presented an increased shelf-life, since the extract conferred protection against microbial contamination for longer periods of time. Therefore, these findings showed that the incorporation of phenolic-rich extracts from natural sources (such as M. oleifera) is a feasible sustainable biotechnological approach to produce value-added cereal-based products.

A Novel Approach in Skin Care: By-Product Extracts as Natural UV Filters and an Alternative to Synthetic Ones.

The cosmetic industry has been focusing on replacing synthetic ingredients with natural ones, taking advantage of their bioactive compounds. This work assessed the biological properties of onion peel (OP) and passion fruit peel (PFP) extracts in topical formulations as an alternative to synthetic antioxidants and UV filters. The extracts were characterized regarding their antioxidant capacity, antibacterial capacity and sun protection factor (SPF) value. Results revealed that the OP extract exhibited better results, which can result from the high concentrations of quercetin, as identified and quantified in HPLC analysis. Afterward, nine formulations of O/W creams were produced with minor changes in the quantity of additives: OP and PFP extract (natural antioxidants and UV filters), BHT (synthetic antioxidant) and oxybenzone (synthetic UV filter). The stability of the formulations was determined for 28 days; it was verified that they remained stable throughout the study period. The assays of the formulations' antioxidant capacity and SPF value revealed that OP and PFP extracts have some photoprotective properties and are excellent sources of antioxidants. As a result, they can be incorporated in daily moisturizers with SPF and sunscreens replacing and/or diminishing the quantities of synthetic ingredients, reducing their negative effects on human health and the environment.

Incorporation of Moringa oleifera Leaf Extract in Yoghurts to Mitigate Children's Malnutrition in Developing Countries.

Moringa oleifera, which is rich in bioactive compounds, has numerous biological activities and is a powerful source of antioxidants and nutrients. Therefore, M. oleifera can be incorporated into food to mitigate children's malnutrition. In this work, the bioactive compounds were extracted from M. oleifera leaf powder by ultrasound-assisted solid-liquid extraction. The antioxidant and antimicrobial activities and the phenolic composition of the extract were evaluated. The extract presented a total phenolic content of 54.5 ± 16.8 mg gallic acid equivalents/g and IC50 values of 133.4 ± 12.3 mg/L for DPPH and 60.0 ± 9.9 mg/L for ABTS. Catechin, chlorogenic acid, and epicatechin were the main phenolics identified by HPLC-DAD. The obtained extract and M. oleifera leaf powder were incorporated into yoghurts and their physicochemical and biological properties were studied. The incorporation of M. oleifera did not impair the yoghurts' stability over eight weeks when compared to both negative and positive controls. The extract presented higher stability regarding syneresis but lower stability regarding TPC compared to the powder. Also, the fortified yoghurts presented higher antioxidant properties than the negative control. These findings highlight the potential use of M. oleifera powder and extract as natural additives to produce fortified foods that can be used in the mitigation of malnutrition.

Response Surface Modeling and Optimization of the Extraction of Phenolic Antioxidants from Olive Mill Pomace.

Bioactive compounds from olive mill pomace (OMP) were extracted through a two-step solid-liquid extraction procedure considering four factors at five levels of a central composite rotatable response surface design. The influence of the process variables time of the primary extraction (2.0-4.0 h), solvent-to-sample ratio during the primary extraction (5.0-10.0 mL/g), time of the secondary extraction (1.0-2.0 h), and the solvent-to-sample ratio during the secondary extraction (3.0-5.0 mL/g) were examined. The content of bioactive compounds was determined spectrophotometrically, and the individual phenolic compounds were evaluated by reserved-phase high-performance liquid chromatography (RP-HPLC). The Derringer's function was used to optimize the extraction process, and the best conditions were found to be 3.2 h for the primary extraction, 10.0 mL/g for the solvent-to-sample ratio and 1.3 h for the secondary extraction associated with a solvent-to-sample ratio of 3.0 mL/g, obtaining a total phenolic content of 50.0 (expressed as mg gallic acid equivalents (GAE)/g dry weight (dw). The response surface methodology proved to be a great alternative for reducing the number of tests, allowing the optimization of the extraction of phenolic antioxidants from OMP with a reduced number of experiments, promoting reductions in cost and analysis time.

Sustainability in Skin Care: Incorporation of Avocado Peel Extracts in Topical Formulations.

The avocado peel is an agro-industrial by-product that has exhibited a massive increase in its production in the last few years. The reuse and valorisation of this by-product are essential since its disposal raises environmental concerns. In the present study, ethanolic extracts of avocado peels of the Hass variety were obtained, for three extraction times (1.5 h, 3 h and 4 h) and analysed for their antioxidant and antibacterial properties. Antioxidant evaluations of the extracts revealed that the extraction time of 1.5 h exhibited the best results amongst the three, with a DPPH inhibition percentage of 93.92 ± 1.29 and an IC50 percentage, the necessary concentration of the extract to inhibit 50% of DPPH, of 37.30 ± 1.00. The antibacterial capacity of the extracts was evaluated and it was revealed that they were able to inhibit the growth and development of bacteria of the Staphylococcus family. The obtained extract was incorporated in two types of cosmetic formulations (oil-in-water and water-in-oil) and their stability was evaluated and compared with formulations containing synthetic preservatives (BHT and phenoxyethanol). The results of the stability evaluation suggest that the avocado peel extract has the potential to be incorporated in both types of emulsions, acting as an antioxidant and antibacterial agent, proving it to be a viable option to reduce/replace the use of synthetic preservatives. Furthermore, the avocado peel extract proved to be more effective and stable in oil-in-water emulsions. These results highlight the possibility of obtaining sustainable cosmetics, significantly reducing the negative impacts on the environment by the incorporation of extracts sourced from the avocado peel, an interesting source of phenolic compounds, an abundant and low-cost by-product.

A Potential Valorization Strategy of Wine Industry by-Products and Their Application in Cosmetics-Case Study: Grape Pomace and Grapeseed.

Grape pomace and grapeseed are agro-industrial by-products, whose inadequate treatment generates socioeconomic and environmental concerns. Nevertheless, it is possible to valorize them by extracting their bioactive compounds, such as antioxidants (phenolic compounds), vitamin E and fatty acids. The bioactive compounds were extracted using solid-liquid extraction. The yields for phenolic compounds were 18.4 ± 0.4% for grape pomace, and 17.4 ± 0.4%, for grapeseed. For the oil, the yields were 13.3 ± 0.2% and 14.5 ± 0.3% for grape pomace and grapeseed. Antioxidant capacity was assessed by the assay with 2,2-diphenyl-1-picrylhydrazyl (DPPH), and showed that phenolic extract has higher antioxidant capacity than the oils. Grape pomace and grapeseed extracts exhibit, correspondingly, values of 90.8 ± 0.8 and 87.5 ± 0.5 of DPPH inhibition and IC50 of 48.9 ± 0.5 and 55.9 ± 0.7 µgextract·mLDPPH-1. The antimicrobial capacity was assessed by the disk diffusion test, and revealed that, phenolic extracts inhibit the growth of Staphylococcus aureus and Staphylococcus epidermidis. The obtained extracts were incorporated in 10 face cream formulations, with slight modifications in quantities of formulation stabilizers. Their stability was studied for 35 days, and this revealed the possibility of incorporating extracts and oils obtained from by-products as antioxidants in cosmetics, and replacing synthetic ones. As a future recommendation, microencapsulation of the extracts should be performed, in order to increase their stability.

Allopurinol for fibromyalgia pain in adults: A randomized controlled trial.

BACKGROUND: Allopurinol is a potent inhibitor of the enzyme xanthine oxidase used in the treatment of hyperuricemia and gout. Because it is well known that purines exert multiple affects on pain transmission, we hypothesized that the inhibition of xanthine oxidase by allopurinol could be a valid strategy to treat pain in humans. This study aimed to compare the analgesic efficacy of oral allopurinol versus placebo as an adjuvant therapy in patients displaying fibromyalgia. METHODS: This randomized, double-blinded, placebo-controlled study included 60 women with the diagnosis of fibromyalgia. Patients were randomly assigned to receive either oral allopurinol 300 mg (n = 31) or placebo (n = 29) twice daily during 30 days. The patients were submitted to evaluation for pain sensitivity, anxiety, depression, and functional status before treatment, and 15 and 30 days thereafter. RESULTS: Oral administration of allopurinol 300 mg twice daily was ineffective in improving pain scores measured by several tools up to 30 days of treatment (P > 0.05). Additionally, no significant effects of allopurinol over anxiety, depressive symptoms, and functional status of fibromyalgia patients were observed in the present study. CONCLUSIONS: Although previous findings indicated that allopurinol could present intrinsic analgesic effects in both animals and humans, this study showed no benefit of the use of oral allopurinol as an adjuvant strategy during 30 days in women displaying fibromyalgia. However, considering previous promising results, new prospective studies are still valid to further investigate allopurinol and more selective purine derivatives in the management of pain syndromes.

Protocol for visits of patients' pets in palliative care in a hospital / Protocolo para la visita de mascotas de pacientes en cuidados paliativos en un hospital / Protocolo para visita do animal de estimação do paciente em cuidados paliativos em um hospital

ABSTRACT Objective To report the experience of the multidisciplinary health team in the construction and implementation of the assistance protocol for pets visiting patients admitted to a palliative care unit. Method This is an experience report about the construction and implementation of a protocol in a university hospital in the South of Brazil by a working group from the multidisciplinary team of the Palliative Care Program and composed of three nurses, a physician, a psychologist, a social worker, a manager, and a nutritionist. The period of construction and implementation of the protocol was from September 2017 to April 2019. Results The construction of the protocol by the multidisciplinary team followed three stages: planning, execution, and implementation, which enabled the release of visits of patients' pets in palliative care. Conclusion The construction of the protocol allowed for the institutionalization of the visit of patients' pets in palliative care in a university hospital, bringing benefits to patients and their families.

RESUMEN Objetivo Informar la experiencia del equipo de salud multiprofesional en la construcción e implementación de un protocolo de atención para visita de mascotas, para los pacientes internados en una unidad de cuidados paliativos. Método Se trata de un informe de experiencia sobre la construcción e implementación de un protocolo en un hospital universitario en el sur de Brasil, realizado por un grupo de trabajo originado a partir del equipo multidisciplinario del Programa de Cuidados Paliativos y compuesto por tres enfermeras, un médico, un psicólogo, un trabajador social, un administrador y un nutricionista. El período de construcción e implementación del protocolo abarca desde septiembre de 2017 hasta abril de 2019. Resultados La construcción del protocolo por la experiencia del equipo multiprofesional siguió tres etapas: planificación, ejecución e implementación, que permitieron la habilitación de las visitas de mascotas de pacientes en cuidados paliativos. Conclusión La construcción del protocolo permitió institucionalizar la visita de mascotas de pacientes en cuidados paliativos en un hospital universitario, brindando beneficios tanto a los pacientes como a sus familias.

RESUMO Objetivo Relatar a experiência da equipe multiprofissional em saúde na construção e implantação do protocolo assistencial para visita dos animais de estimação dos pacientes internados em uma Unidade de Cuidados Paliativos. Método Trata-se de um relato de experiência de uma ação realizada em um hospital universitário do sul do Brasil por um grupo de trabalho originado da equipe multiprofissional do Programa de Cuidados Paliativos, composto por três enfermeiros, um médico, um psicólogo, um assistente social, um administrador e uma nutricionista. O período de construção e implementação do protocolo foi de setembro de 2017 a abril de 2019. Resultados: A construção do protocolo pela equipe multiprofissional seguiu três etapas, planejamento, execução e implementação, e resultou na liberação para visita dos animais de estimação dos pacientes em cuidados paliativos. Conclusão A construção do protocolo permitiu a institucionalização da visita dos animais de estimação dos pacientes em cuidados paliativos em um hospital universitário, trazendo benefícios para os pacientes e seus familiares.

Physical immobilization of particles inspired by pollination.

Biomimetic systems often exhibit striking designs well adapted to specific functions that have been inspiring the development of new technologies. Herein, we explored the remarkable ability of honey bees to catch and release large quantities of pollen grains. Hair spacing and height on bees are crucial for their ability to mechanically fix pollen grains. Inspired by this, we proposed the concept of a micropatterned surface for microparticle entrapment, featuring high-aspect-ratio elastic micropillars spaced to mimic the hairy surface of bees. The hypothesis was validated by investigating the ability of polydimethylsiloxane microfabricated patches to fix microparticles. The geometrical arrangement, spacing, height, and flexibility of the fabricated micropillars, and the diameter of the microparticles, were investigated. Higher entrapment capability was found through the match between particle size and pillar spacing, being consistent with the observations that the diameter of pollen grains is similar to the spacing between hairs on bees' legs. Taller pillars permitted immobilization of higher quantities of particles, consistent with the high aspect ratio of bees' hairs. Our biomimetic surfaces were explored for their ability to fix solid microparticles for drug-release applications, using tetracycline hydrochloride as a model antibiotic. These surfaces allowed fixation of more than 20 mg/cm2 of antibiotic, about five times higher dose than commercialized patches (5.1 mg/cm2). Such bioinspired hairy surfaces could find applications in a variety of fields where dry fixation of high quantities of micrometer-sized objects are needed, including biomedicine, agriculture, biotechnology/chemical industry, and cleaning utensils.

The Quadruple Helix-Based Innovation Model of Reference Sites for Active and Healthy Ageing in Europe: The Ageing@Coimbra Case Study.

Challenges posed by demographic changes and population aging are key priorities for the Horizon 2020 Program of the European Commission. Aligned with the vision of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), the development, exchange, and large-scale adoption of innovative good practices is a key element of the responses required to ensure all European citizens remain as active and healthy as possible as they age. Urged by the need of developing scalable disruptive innovation across Europe, the European Commission and the EIP on AHA created the Reference Sites; local coalition of partners that develop good practices to support AHA. Ageing@Coimbra is an example of how this can be achieved at a regional level. The consortium comprises over 70 institutions that develop innovative practices to support AHA in Portugal. Ageing@Coimbra partners support a regional network of stakeholders that build a holistic ecosystem in health and social care, taking into consideration the specificities of the territories, living environments and cultural resources (2,243,934 inhabitants, 530,423 aged 65 or plus live in the Centre Region of Portugal). Good practices in reducing the burden of brain diseases that affect cognition and memory impairment in older people and tackling social isolation in urban and rural areas are among the top priorities of Ageing@Coimbra. Profiting from the collaborative work of academia, business companies, civil society, and authorities, the quadruple helix of Ageing@Coimbra supports: early diagnosis of frailty and disease; care and cure; and active, assisted, and independent living. This paper describes, as a Community Case Study, the creation of a Reference Site of the EIP on AHA, Ageing@Coimbra, and its impact in Portugal. This Reference Site can motivate other regions to develop innovative formulas to federate stakeholders and networks, building consortia at regional level. This growing movement, across Europe, is inspired by the quadruple helix concept and by the replication of innovative good practices; creating new Reference Sites for the benefit of Citizens.

Phototherapy on the Treatment of Burning Mouth Syndrome: A Prospective Analysis of 20 Cases.

The aim of this study was to report the effect of laser phototherapy (LPT) on the treatment of burning mouth syndrome (BMS). This prospective clinical study reports on preliminary outcomes of twenty volunteers diagnosed with BMS who have undergone the conventional treatment prior to laser phototherapy. LPT consisted of weekly sessions of LPT (660 nm), for a period of 10 weeks. The laser protocol consisted of the following parameters: 40 mW, 10 J cm(2) and 0.4 J per point, irradiation time of 10 s. In all sessions, the burning intensity was evaluated with a 10 cm Visual Analogue Scale (VAS). The burning intensity evaluation by VAS was performed immediately before and after each LPT session. Nonparametric test of Wilcoxon was used for statistical analysis, considering a significance level of 5%. All volunteers reported reduced burning intensity in all sessions when compared to the previous one and reduction in VAS scores by up to 49% in the last clinical session when compared to the first session. When only the VAS baseline of the first session was compared with the consecutive sessions, there was a statistically significant reduction in VAS scores in almost all sessions. The LPT may be an alternative treatment for the relief of oral burning symptoms in patients with BMS.

Effect of low-level laser therapy in the treatment of burning mouth syndrome: a case series.

OBJECTIVE: The aim of this study was evaluate the effect of low-level laser therapy (LLLT) in the treatment of burning mouth syndrome (BMS) patients. BACKGROUND DATA: BMS is a clinical condition characterized by a burning sensation in a morphologically normal oral mucosa, without association with systemic disorders. METHODS: Ten patients with oral burning sensation were included in the study. After careful evaluation of medical history and oral examination, the diagnosis of BMS was established. All patients were submitted to one weekly session of LLLT for 10 weeks. A continuous wavelength of 660 nm, power 40 mW, 20 J/cm(2), 0.8 J/point, with each point irradiated for 10 sec. In all sessions the burning intensity was evaluated with a 10-cm visual analogue scale (VAS), with 0 indicating no symptoms and 10 indicating the worst burning possible. The burning intensity evaluation by VAS was performed immediately before (VAS baseline) and immediately after each LLLT session. The nonparametric Wilcoxon test was used for statistical analysis, considering significance of 5%. RESULTS: All patients reported improvement in all sessions, with reduction in VAS scores by up to 58% in the tenth session. When only the VAS baseline of the first session was compared with the other sessions, there was a statistically significant reduction in VAS scores in the fourth (p=0.03), fifth (p=0.03), sixth (p=0.009), seventh (p=0.003), eighth, ninth, and tenth (all p=0.002) sessions. CONCLUSIONS: LLLT may be an alternative treatment for the relief of oral burning in patients with BMS.

Simultaneous distillation-extraction of high-value volatile compounds from Cistus ladanifer L.

The present paper describes a procedure to isolate volatiles from rock-rose (Cistus ladanifer L.) using simultaneous distillation-extraction (SDE). High-value volatile compounds (HVVC) were selected and the influence of the extraction conditions investigated. The effect of the solvent nature and extraction time on SDE efficiency was studied. The best performance was achieved with pentane in 1 h operation. The extraction efficiencies ranged from 65% to 85% and the repeatability varied between 4% and 6% (as a CV%). The C. ladanifer SDE extracts were analysed by headspace solid phase microextraction (HS-SPME) followed by gas chromatography with flame ionization detection (GC-FID). The HS-SPME sampling conditions such as fiber coating, temperature, ionic strength and exposure time were optimized. The best results were achieved with an 85 microm polyacrylate fiber for a 60 min headspace extraction at 40 degrees C with 20% (w/v) of NaCl. For optimized conditions the recovery was in average higher than 90% for all compounds and the intermediate precision ranged from 4 to 9% (as CV %). The volatiles alpha-pinene (22.2 mg g(-1) of extract), 2,2,6-trimethylcyclohexanone (6.1 mg g(-1) of extract), borneol (3.0 mg g(-1) of extract) and bornyl acetate (3.9 mg g(-1) of extract) were identified in the SDE extracts obtained from the fresh plant material.

Effects of travoprost 0.004% ophthalmic solution, six weeks after its laminated packaging had been removed, in primary open-angle glaucoma: a randomized, controlled, investigator-blinded study.

BACKGROUND: Primary open-angle glaucoma (POAG) is a chronic and progressive optic nerve and retinal nerve fiber layer neuropathy, with characteristic visual field damage. The intraocular pressure (IOP) is typically higher than the level considered statistically normal. Although there is no known cure, appropriate reduction of IOP with hypotensive drugs (eg, the topical prostaglandin analogue travoprost) delays the progression of POAG. Chemical-stability studies of travoprost performed by the manufacturer suggest that the stability of travoprost is maintained beyond the expiration date, which is 6 weeks after the laminated packaging has been opened. OBJECTIVE: The goal of this study was to assess the efficacy and tolerability of travoprost 0.004% ophthalmic solution, 6 to 12 weeks after its expiration date, in patients with POAG. METHODS: This randomized, controlled, investigator-blinded study was conducted at 2 centers in Brazil: the Ophthalmology Department, Federal University of Goiás, Goiânia, and the Ophthalmology Department, Santa Casa de Misericordia Hospital in São José do Rio Preto, Sao Paulo. Patients with POAG (in 1 or both eyes) were randomly assigned to receive travoprost, either from a bottle from which the laminated packaging had been removed and that had been stored at room light and temperature for 6 weeks (ie, after the expiration date; opened group), or from a bottle that had been sealed until first use by the patient (control group). Drug was to be administered, 1 drop in the lower conjunctival sac (in the affected eye[s]), QD between 7 pm and 9 pm, for 6 weeks. IOP was measured at study weeks 0 (baseline), 4, and 6. The 2 treatment groups were compared with regard to hypotensor effect and incidence of adverse events (AEs). RESULTS: : Thirty-one patients completed the study (55 eyes; 28 right and 27 left eyes; 35 eyes of women, 20 eyes of men). The mean (SD) ages of the opened and control groups were 61.8 (13.5) and 62.8 (14.1) years, respectively. Twenty-four patients were included in both treatment groups (ie, 1 eye per group). The baseline IOP was similar between the 2 treatment groups. There was a significant reduction in IOP in both groups at 4 and 6 weeks (both, P < 0.001 vs baseline). However, no significant differences in IOP were found between the 2 treatment groups at any time during the study. Conjunctive hyperemia and a burning sensation in the eye immediately after application were the only AEs reported; the incidence of these was similar between the 2 treatment groups. CONCLUSIONS: In this study of patients with POAG, IOPs and AEs were similar in eyes receiving 6 weeks of treatment with travoprost 0.004% ophthalmic solution, either from bottles from which the laminated packaging had been opened and that had been stored at room light and temperature for 6 weeks (ie, after the expiration date), or from bottles that had been sealed until first use by the patient. These results suggest that travoprost remains effective for at least 12 weeks after the laminated packaging has been opened.

Invaginación intestinal en el niño: análisis de 83 casos

Se estudiaron 83 casos de Invaginación Intestinal tratados en el Hospital Robert REid Cabral de Santo Domingo entre 1978-1987. Se destaca que el 84% de los analizados presentaron signos obstructivos antes del año de edad, y de éstos el 69% sufrió la patología antes de los seis meses de edad. El 67% (56 niños) ingresaron después de transcurrido 48 horas de inicio de los síntomas. A diferencia de lo reportado, la tríada clásica de vómitos, dolor abdominal tipo cólico y rectorragia, no estuviaron presentes en porcentaje significativo. Se hace énfasis en la necesidad de la realización del diagnóstico temprano de la afección con el objeto de evirar lesiones intestinales irreversibles. Se recomienda el uso de la enema de bario como método terapéutico. Todos los pacientes fueron intervenidos quirúrgicamente. La mortalidad encontrada fue de 28% siendo mayor en aquellos a los que se preacticó resección intestinal