Review: freeze concentration technology applied to dairy products.

Freeze concentration is a process of concentrating liquid products by freezing the water content and subsequently removing the so-formed ice crystals from the food system. In dairy processing, this technology offers the advantage of minimizing the heat abuse of sensitive milk components, such as proteins and flavors. It thus provides an opportunity for producing dairy ingredients with enhanced functional and organoleptic qualities. By freeze concentration, skim milk has been concentrated up to 40 wt% total solids (TS) and whole milk up to 44 wt% TS. Lactose and lipids are more concentrated in the ice fraction than in the concentrated fraction. Proteins (casein and whey protein) decrease the ice growth rate and the high viscosity is a limiting factor for the freeze concentration of both skim milk and whole milk. In this study, the most important studies relating to the suspension, block and layer freeze concentration of milk are summarized, analyzing results and indicating how freeze concentration process efficiency of dairy products can be improved.

[Effectiveness and cost of total hip replacement in seven hospitals in Catalonia, Spain]. / Efectividad y costes de la intervención de prótesis total de cadera en siete hospitales de Cataluña.

BACKGROUND: To quantify short-term benefits of total hip replacement, prognostic factors of the outcome, and to assess hospital costs of this surgical procedure in Catalonia, Spain. PATIENTS AND METHODS: Multicentric prospective study in seven hospitals in Catalonia. All patients undergoing this procedure in one year were included. They were evaluated prior to the operation, and six months later. This evaluation involved: clinical assessment, the Hip Pain and Function Scale, the Nottingham Health Profile (NHP), and the EuroQol (EQ-5D), in order to measure cost-utility. Hospital costs were estimated by means of a specific questionnaire. RESULTS: Information was obtained for 332 patients. The mean age was 65 years (range: 27-89 years); 58% were women; the most common diagnosis was arthritis; 59% of patients had associated pathology and 13% presented some type of postoperative complication. The improvement in health status was important according to all instruments. An outcome of "excellent" or "good" was achieved by 70.8% of the patients, in terms of hip function and pain. The factors associated with not achieving an outcome of this level were: associated pathology, complications, diagnoses other than arthritis, and operation carried out in a tertiary hospital. The total cost of the procedure was 838,480 pesetas. This average varied significantly with the cost of the prosthesis, and as a function of the length of stay. The three-year cost-utility of the procedure was estimated as 507,500 pesetas. CONCLUSIONS: Total hip replacement greatly improves the pain, hip function and overall perceived health of the patient. This improvement is greater among patients with a diagnosis of arthritis, with good overall health, operated on by a surgeon experienced in this procedure. The benefit is high in relation to the cost, although there is a margin for improvement, reducing complications, shortening length of stay, and controlling the price of implants.

Elastofibroma dorsi: clinical and pathologic aspects of two cases.

Elastofibroma dorsi is a benign entity that occurs most often in the subscapular area in elderly women. It has been a subject of controversy whether elastofibroma is a true neoplasm or a reactive fibrous lesion that produces abnormal elastic fibers. A biopsy should be performed to rule out sarcoma in all cases, but definitive treatment only requires simple surgical excision. We report two cases of elastofibroma and discuss the most relevant clinical and pathologic aspects.

Hernia through iliac crest defects. A report of four cases.

Herniation of abdominal contents through the donor site in the ilium occurred in 5% of a series of 59 bone grafts. Four patients had this condition at a 7 year follow up, and 2 were repaired with synthetic mesh. Age, gender, obesity and surgical technique are important causative factors. Preventive measures are proposed which have been successful during the past 3 years.

Tuberculosis of the neural arch. A report of four cases.

Four cases of spinal tuberculosis involving the posterior neural elements are reported; all the patients were from Africa. The condition is rare and its incidence may be different in different races. Neural arch involvement is likely to be associated with neurological complications.