Pharmacokinetic-Pharmacodynamic Modeling of Midazolam in Pediatric Surgery.

Midazolam (MDZ) is used for sedation in surgical procedures; its clinical effect is related to its receptor affinity and the dose administered. Therefore, a pharmacokinetic-pharmacodynamic (PK-PD) population model of MDZ in pediatric patients undergoing minor surgery is proposed. A descriptive, observational, prospective, and longitudinal, study that included patients of both sexes, aged 2-17 years, ASA I/II, who received MDZ in IV doses (0.05 mg/kg) before surgery. Three blood samples were randomly taken between 5-120 min; both sedation by the Bispectral Index Scale (BIS) and its adverse effects were recorded. The PK-PD relationship was determined using a nonlinear mixed-effects, bicompartmental first-order elimination model using Monolix Suite™. Concentrations and the BIS were fitted to the sigmoid Emax PK-PD population and sigmoid Emax PK/PD indirect binding models, obtaining drug concentrations at the effect site (biophase). The relationship of concentrations and BIS showed a clockwise hysteresis loop, probably indicating time-dependent protein binding. Of note, at half the dose used in pediatric patients, adequate sedation without adverse effects was demonstrated. Further PK-PD studies are needed to optimize dosing schedules and avoid overdosing or possible adverse effects.

Higiene de manos, su aprendizaje mediante la utilización de medios de enseñanza

Fundamento: mejorar la higiene de las manos de manera eficaz y sostenida se consigue mediante la aplicación de múltiples medidas para abordar diferentes obstáculos, así como barreras conductuales, es por ello que se hace necesario crear medios que permitan su aprendizaje. Objetivo: diseñar medios de enseñanza que contribuyan al aprendizaje de la higiene de manos tanto en estudiantes de Lic. en Enfermería como en la comunidad. Métodos: se desarrolló una investigación cualicuantitativa, durante el período de estudio de junio 2018 a julio 2021. Los escenarios fueron el Círculo Infantil Marineritos del Sur, Escuela Primaria Guerrillero Heroico y la Universidad de Ciencias Médicas en el municipio de Cienfuegos. Se realizaron grupos de discusión en los tres escenarios, de lo cual emergieron las categorías capacitación y medios de enseñanza, que fueron creados y validados por la metodología de Barraza. Resultados: se diseñó una página web, una aplicación para móvil, juegos didácticos para los niños y trípticos. Todos fueron validados satisfactoriamente. Conclusiones: el diseño de medios de enseñanza, sustentados científicamente, se corresponde con las necesidades de los estudiantes la carrera de Licenciatura en Enfermería y de la comunidad para el logro de los conocimientos teóricos y prácticos en la adherencia a la técnica correcta de higiene de manos.

Summary: Introduction: The improvement of effective and sustained hand hygiene is achieved through the application of multiple measures to address different obstacles, as well as behavioral barriers, which is why it is necessary to create means that allow the learning of it, in such a way. In this sense, the objective is to design teaching means that contribute to the learning of hand hygiene both in Nursing students and in the community, Method; a qualitative-quantitative investigation was developed, Results the qualitative phase was evidenced when a discussion group was carried out from which the category training and teaching aids emerged, which allowed the design of a web page, a mobile application, didactic games for children and triptychs, and the quantitative phase when said teaching aids were validated by the Barraza methodology.

Effect of Instant Controlled Pressure Drop (DIC) on Polyphenols, Flavonoids and Antioxidant Capacity of Green Lentils (Lens culinaris).

Instant controlled pressure drop (DIC) is one of the emerging technologies in food processing; it can be used for drying, freezing and the extraction of bioactive molecules without damaging their properties. Legumes, such as lentils, are one of the most consumed foods in the world; however, they are mainly cooked by boiling, which causes the loss of antioxidant compounds. This work evaluated the effect of 13 different DIC treatments (with pressure ranges of 0.1-0.7 MPa and times of 30-240 s) on the content of polyphenols (Folin-Ciocalteu and High Performance Liquid Chromatography HPLC) and flavonoids (2-aminoethyl diphenylborinate) as well as the antioxidant activity (DPPH and TEAC) of green lentils. The DIC 11 treatment (0.1 MPa, 135 s) obtained the best release of polyphenols, which in turn are related to antioxidant capacity. The abiotic stress generated by DIC could lead to the breakdown of the cell wall structure, which favors the availability of antioxidant compounds. Finally, the most efficient conditions for DIC to promote the release of phenolic compounds and maintain antioxidant capacity were found under low pressures (<0.1 MPa) and short times (<160 s).

Influence of Age and Sex on the Pharmacokinetics of Midazolam and the Depth of Sedation in Pediatric Patients Undergoing Minor Surgeries.

Whether age and sex influence the depth of sedation and the pharmacokinetics of midazolam is currently unknown. The influence of age and sex was investigated in 117 children (2 to 17 years) who required intravenous sedation for minor surgery (0.05 mg/kg). Plasma concentrations and sedation effects were simultaneously measured. The measured concentrations were analyzed using a two-compartment model with first-order elimination. Among the age ranges, significant differences were found (p < 0.05) between the volume of distribution (Vd) of the first compartment (V1) and that of the second (V2). With respect to sex, differences in V2 were found between age groups. At the administered dose, in patients younger than 6 years, a profound sedative effect (40-60 BIS) was observed for up to 120 min, while in older children, the effect lasted only half as long. The differences found in the Vd and bispectral index (BIS) in patients younger than 6 years compared to older patients may be due to immature CYP3A activity and body fat content; furthermore, the Vd varies with age due to changes in body composition and protein binding. Patients younger than 6 years require intravenous (IV) doses <0.05 mg/kg of midazolam for deep sedation. Dosage adjustments according to age group are suggested.

Antioxidant Activity and GC-MS Profile of Cardamom (Elettaria cardamomum) Essential Oil Obtained by a Combined Extraction Method-Instant Controlled Pressure Drop Technology Coupled with Sonication.

Cardamom Essential oils are highly demanded because of their antimicrobial, anti-inflammatory, and antioxidant activities. Nonetheless, retrieving quality extracts quickly with efficient energy savings has been challenging. Therefore, green technologies are emerging as possible alternatives. Thus, this study evaluates the yield and quality of the instant controlled pressure drop (DIC) process coupled with ultrasound-assisted extraction (UAE) of cardamom essential oil (CEO). Likewise, the antioxidant activity, chemical profile of CEO, and microstructure of seeds were analyzed. This study analyzed 13 different treatments with varying saturated steam processing temperatures (SSPT), thermal processing times (TPT), and 1 control. The results showed that CEO yield increased significantly by DIC (140 °C and 30 s) and UAE compared to the control (22.53% vs. 15.6%). DIC 2 (165 °C, 30 s) showed the highest DPPH inhibition (79.48%) and the best Trolox equivalent antioxidant capacity (TEAC) by the control with 0.60 uMTE/g. The GC/MS analysis showed 28 volatile constituents, withα-Terpinyl acetate, geranyl oleate, and oleic acid being the most abundant. DIC (140 °C and 30 s) and UAE showed the best yield and chemical profile. The SEM microscopy of untreated seeds revealed collapsed structures before the oil cell layer, which reduced the extraction yield, contrary to DIC-treated seeds, with more porous structures. Therefore, combining innovative extraction methods could solve the drawbacks of traditional extraction methods.

Sex and Age Influence on Association of CYP450 Polymorphism with Midazolam Levels in Critically Ill Children.

Midazolam is a drug that is metabolized by cytochrome P450 (CYP450) enzymes, particularly CYP3A4 and CYP3A5. The present study aimed to determine the sex and age influence on association of CYP450 polymorphism with midazolam levels in critically ill children. Seventy-two DNA samples were genotyped by real-time PCR. Children ≤ five years of age who carry the rs776746 (T) allele in CYP3A5 gene were associated with lower plasma midazolam levels. The concentration median in patients was 0.0 ng/mL, while in patients with the normal (C) allele, it was 438.17 ng/mL (Q25 135.75-Q75 580.24), p = 0.005. The midazolam plasmatic concentration in female patients with the minor (T) allele was 0.0 ng/mL (Q250.00-Q75204.3), while in patients with the normal (C) allele median it was 459.0 ng/mL (Q25296.9-Q75789.7), p = 0.002. Analysis of the dominant model for the rs2740574 variant in CYP3A4 revealed a median of 0.38 L/kg (Q250.02-Q751.5) for the volume of distribution parameter in female patients with the normal T allele, while female patients with the minor C allele showed a median of 18.1 L/kg (Q257.5-Q7528.7) p = 0.02. Our results suggest an altered midazolam metabolism due to the presence the allelic rs2740574 variants of CYP3A4 and rs776746 of CYP3A5, and also the strong influence of age and sex.

Maximization of Sulforaphane Content in Broccoli Sprouts by Blanching.

Broccoli sprouts are a recognized source of health-promoting compounds, such as glucosinolates, glucoraphanin, and sulforaphane (SFN). Maximization of SFN content can be achieved by technological processing. We investigated the effect of blanching conditions to determine the optimal treatment that maximizes sulforaphane content in broccoli sprouts. Broccoli seeds (cv. Traditional) grown under controlled conditions were harvested after 11 days from germination and subjected to different blanching conditions based on a central composite design with temperature and time as experimental factors. Results were analyzed by ANOVA followed by a Tukey test. The optimum conditions were identified through response surface methodology. Blanching increased sulforaphane content compared with untreated sprouts, agreeing with a decrease in total glucosinolates and glucoraphanin content. Temperature significantly affected SFN content. Higher temperatures and shorter immersion times favor glucoraphanin hydrolysis, thus increasing SFN content. The optimum conditions were blanching at 61 °C for 4.8 min, resulting in 54.3 ± 0.20 µmol SFN/g dry weight, representing a 3.3-fold increase with respect to untreated sprouts. This is the highest SFN content reported for sprouts subjected to any treatment so far. The process described in this work may contribute to developing functional foods and nutraceuticals that provide sulforaphane as an active principle.

Effect of Swell-Drying on Mango (Mangifera indica) Drying Kinetics.

Swell-Drying operation (SD) was applied on mangoes to evaluate its effect on drying kinetics: starting accessibility (δW), apparent drying coefficient (Dapp), and time to obtain a final moisture content of 20% d.b (tf = 20% d.b). Swell-drying consisted of (1) submitting fresh mangoes to a first pre-drying stage under Convective Air Drying (CAD) until a moisture content of 37% d.b; (2) applying Instant Controlled Pressure Drop (DIC) treatments on pre-dried mangoes by following a central composite rotatable design (steam pressure: 0.2-0.6 MPa and treatment time: 5 and 55 s); and (3) apply post-drying of mangoes under CAD. In both cases, CAD was performed at 60 °C and airflow of 1 m/s. Results showed that both the treatment time and the steam pressure impacted the Dapp and the δW. By comparing to the control, SD (0.54 MPa and 48 s) increased the Dapp and δW to 12.2 and 2.7 times, respectively. Moreover, SD triggers a significant reduction in post-drying time (tf = 20% d.b), being this of 2.4 h vs. 30.8 h. These results could be linked to the expansion of the internal pores of mangoes generated by the instant autovaporization of residual water triggered by DIC treatment.

A Preliminary Study on the Effect of the Instant Controlled Pressure Drop Technology (DIC) on Drying and Rehydration Kinetics of Maize Kernels (Zea mays L.).

Maize is one of the three worldwide cereal crops with the most outstanding production; however, its postharvest losses range from 2 to 40% due to inadequate harvesting, drying, and storage technologies. This study focuses on the Instant Controlled Pressure Drop technology (DIC) effect on maize kernels' drying and rehydration kinetics. In total, 19 different DIC treatments were carried out on maize kernels (~25% d.b.). The DIC parameters studied were steam pressure (0.1 to 0.4 MPa) and treatment time (10 to 90 s). After DIC treatment, drying kinetics were carried out by Convective Air Drying (CAD) at 50 °C and 0.4 ms-1 airflow. Rehydration kinetics and Water Holding Capacity (WHC) were evaluated at 20 °C. In comparison to CAD samples, DIC (0.4 MPa and 90 s) reduced the drying time from 180 min to ~108 min. Additionally, regarding the rehydration and WHC results, DIC achieved the same moisture content in only 3.5 min that controls achieved after 1 h of rehydration (0.40 g H2O/g dry matter). Moreover, DIC (0.4 MPa and nine cycles of 10 s) increased the WHC 2.3 times compared to the control. In this way, DIC could be a postharvest technology to improve maize kernels' drying operations and functional properties.

Effect of the Instant Controlled Pressure Drop Technology in Cardamom (Elettaria cardamomum) Essential Oil Extraction and Antioxidant Activity.

Green cardamom (Elettaria cardamomum) is an outspread spice native to Asia, which is well appreciated for its sensory characteristics, delicate aroma, and unique taste. Currently, the main cardamom extracts are essential oils (EOs), and regarding current market tendencies, this market is in high growth. For this reason, technologies such as the instant controlled pressure drop (DIC) have been applied to reach higher yields and better quality of EO. Then, this study explores the impact of DIC as a pretreatment before hydrodistillation (HD) on the EO yield and their antioxidant activity. Obtained results showed that the coupling of DIC-HD increased the yield of essential oil and also had a positive impact on their antioxidant capacity. The EO yield of DIC-HD (140 °C and 30 s) was 4.43% vs. 2.52% for control; the AOX of DIC-HD (165 °C and 30 s) was 86% inhibition vs. 57.02% for control, and the TEAC of DIC-HD (140 °C and 30 s) was 1.44 uMTE/g EO vs. 13.66 uMTE/g EO.

What determines the progress of online information access to banking corporate governance practices? The case of Paraguay.

This paper contributes to the lack of longitudinal studies concerning online information access to corporate governance (CG) practices in the banking sector of Latin American countries. In particular, this study aims to analyze the factors that influence information transparency, both mandatory and voluntary, related to CG practices of banks that operate in Paraguay via their websites from 2016 to 2019. Findings indicate the need to improve the level of information available on websites, with disclosure of voluntary information on CG practices being more prevalent than the disclosure of mandatory information. Likewise, banks that operate in Paraguay have made scant "progress" regarding online access to their governance information over the years analyzed. Moreover, the factors "Bank size" and "listed status" positively influence the information transparency regarding CG practices of Paraguayan banks. In contrast, "leverage," "liquidity," "size of the audit firm," and "credit risk rating" are factors that have a negative relation with the extent of CG disclosure.

An Overview on Food Applications of the Instant Controlled Pressure-Drop Technology, an Innovative High Pressure-Short Time Process.

Food processing systematically aims at meeting the needs of consumers who are looking for total high quality and perfect food safety. As the various thermal and non-thermal food preservation technologies often affect the natural properties in terms of sensation, flavor, texture, etc., instant controlled pressure drop (DIC) has been conceived as a relevant, innovative process in this field. DIC uses high saturated steam pressure and short duration to provide a new way to expand biological matrices, improve drying, decontaminate, and extract biologically active compounds, among other attributes. Therefore, this review focuses on describing the applications of DIC technology on a wide range of products such as foods and by-products that have been processed both in the laboratory and on an industrial scale. The application of DIC has shown the possibility of a significant leap in quality improvement and cost reduction in the food industry. DIC reduces the drying time of fruits and vegetables, and improves the extraction of essential oils, vegetable oils, and antioxidant components. It also provides strong decontamination, eliminates vegetative microorganisms and spores, and reduces non-nutritional and allergenic components. Over the past 33 years, this technology has continued to expand its food applications and improve its characteristics on an industrial scale. But there are still many food unit operations that can be taken to the next level with DIC.

Comparative Bioavailability and Pharmacokinetics Between the Solid Form of Metformin vs a Novel Liquid Extemporaneous Formulation in Children.

Metformin pharmacokinetics in a liquid extemporaneous formulation from commercial tablets was determined in paediatric patients. A randomized, transversal clinical trial was conducted in 34 children and adolescents between 7 and 17 years of age. 17 children were randomized to take metformin in the liquid formulation and, after a 1-week wash period, a 500 mg metformin tablet was administered to them. Blood samples were obtained in Whatman 903® cards at 0, 1, 2, 4, 8, 12 and 24 hours. Extraction was made by direct precipitation with acetonitrile (ACN) and methanol, detection by UPLC and tandem mass spectrometry. The method was accurate, precise, selective and linear from 50 to 1000 ng/mL (r = .9982). Comparative pharmacokinetics, tablet vs formulation, were as follows: Cmax 1503.2 ng/mL vs 1521.4, Tmax 1.5 h vs 2.3, and half-life 8.2 vs 7.5 h. The liquid formulation of metformin showed similar pharmacokinetics to the tablet, and the ratios (90% CI) of geometric mean for metformin were 100.63% (89.13-113.6), 98.08% (88.04-109.2), and 97.52% (84.9-112.01), for Cmax, AUC0-t, and AUC 0-∞, respectively. Pharmacokinetics was determined using WinNonlin Pro 3.1 software. The liquid formulation of metformin showed similar pharmacokinetics to the tablet, allowing a more precise dose adjustment and ease of administration.

Acciones educativas de la familia con el escolar durante el confinamiento por la COVID-19 / Family educational actions with schoolers during COVID-19 confinement

Introducción: El confinamiento por la COVID-19 ha generado un desafío en la crianza de los escolares. Objetivo: Examinar el desempeño de acciones educativas de la familia con el escolar durante el confinamiento por la COVID-19. Métodos: Investigación descriptiva, muestreo no probabilístico,112 familias. que cumplían aislamiento social en la comunidad Ramón López Peña, San Cristóbal, Artemisa en 2020. Instrumento utilizado: Escala de acciones educativas de la familia con el escolar durante el confinamiento por la COVID-19, construida y validada por los investigadores con alfa de Cronbach= 0,970). Resultados: Las acciones educativas: cumplir los horarios de alimentación y sueño (70,6 por ciento), distribuir los roles en el cuidado del menor (70,6 por ciento), apoyo emocional (70,6 por ciento), apoyar con las teleclases (70,6 por ciento), siempre se realizaron por las familias con desempeño favorable. Las acciones: ayudar a recuperarse de una emoción negativa (72,7 por ciento), alejar al escolar de las preocupaciones y tensiones del hogar (72,7 por ciento), explicar si no entiende los contenidos o buscar ayuda (72,7 por ciento), casi nunca fueron realizadas por las familias con desempeño desfavorable. Conclusiones: La mayoría de las familias presentaron desempeño favorable de acciones educativas. La dimensión Cuidados del menor fue la mejor expresada. Enseñar al escolar las medidas higiénicas de protección; brindar información a los escolares sobre cómo protegerse; enseñar y practicar formas de saludar y de mantenerse conectados con seres queridos y amigos, fueron las acciones educativas más realizadas por ambos grupos de familia. La complejidad del aprendizaje en casa y el manejo afectivo del niño requieren especial atención(AU)

Introduction: COVID-19 confinement has created a challenge in raising schoolers. Objective: Examine the performance of educational actions of the family with the school during the confinement by COVID-19. Methods: Descriptive research, non-probabilistic sampling, 112 families who complied with social isolation in Ramón López Peña community, San Cristobal, Artemisa province in 2020. Instrument used: Scale of educational actions of the family with school children during confinement by COVID-19, built and validated by researchers with Cronbach´s alpha = 0.970. Results: Educational actions as meeting food and sleep schedules (70.6 percent), distributing roles in child care (70.6 percent), emotional support (70.6 percent), supporting with teleclasses (70.6 percent) were always carried out by families with favorable performance. Actions like helping to recover from negative emotions (72.7 percent), keeping the schooler away from household concerns and tensions (72.7 percent), explaining whether they don't understand the contents or looking for help (72.7 percent) were almost never made by families with unfavorable performance. Conclusions: Most families had a favorable performance in educational actions. The Child Care dimension was the best performed one. Teaching the schoolchildren the hygienic protective measures, provide information to schoolchildren on how to protect themselves, teaching and practicing ways to greet and stay connected with loved ones and friends were the most performed educational actions by both family groups. The complexity of home learning and the child's affective management require special attention(AU)

The rs776746 variant of CYP3A5 is associated with intravenous midazolam plasma levels and higher clearance in critically ill Mexican paediatric patients.

WHAT IS KNOWN AND OBJECTIVE: Midazolam is a drug that is metabolized by cytochrome P450 (CYP450) enzymes, particularly CYP3A4 and CYP3A5. The presence of single-nucleotide polymorphisms (SNPs) in the genes encoding these enzymes, such as CYP3A4*1B which is associated with low enzyme expression and activity and CYP3A5*3, has been associated with decrease in enzymatic activity and reduced drug clearance, with potential effects on drug levels and/or toxicity. The present study was conducted to determine the frequencies of the allelic variants of the CYP3A4 (rs2740574) and CYP3A5 (rs776746) genes and their effects on the plasma levels and clearance of intravenous midazolam in critically ill Mexican paediatric patients. METHODS: Seventy-two DNA samples were genotyped by real-time PCR with TaqMan probes. Plasma midazolam levels were determined at 3 and 24 h post infusion by high-performance liquid chromatography. RESULTS AND DISCUSSION: The allelic variant rs776746 (CYP3A5*3) was associated with high midazolam plasma levels; the median concentration in patients with the normal genotype (CC) <0.01 ng/ml (Q25 0.01-Q75 196.09), whereas patients with the allelic variant (TT+TC) had a median midazolam concentration of 320.3 ng/ml (Q25 37.51-Q75 529.51), p = 0.001. The median pharmacokinetic clearance rates were 0.10 L/kg/h (Q25 0.01-Q75 0.34) in patients with the allelic variant (TT+TC) and 0.03 L/kg/h (Q25 0.002-Q75 0.13) in patients with the normal genotype (CC), p = 0.042. WHAT IS NEW AND CONCLUSION: This is the first study that reports the frequency of the rs776746 polymorphism in critically ill paediatric patients, which is relevant, since carriers of the *1 allele synthesizing a functional enzyme may need higher doses to achieve adequate sedation. Our results show that compared with carriers of the normal allele, patients with the CYP3A5*3 allelic variant (rs776746) had increased plasma midazolam levels at 3 h after infusion discontinuation (320.3 ng/ml) and greater clearance (0.10 L/kg/h) of the drug.

Programa de intervención sobre la comunicación familiar dirigido a padres y madres con hijas adolescentes en conflicto con la ley penal asistidas en la entidad de atención Acarigua II (H) estado Portuguesa / Intervention program on family communication aimed at parents with adolescent daughters in conflict with criminal law assisted in the Acarigua II (H) Portuguesa state care entity

El objetivo fundamental de esta investigación es proponer un programa de intervención sobre la comunicación familiar dirigido a padres y madres con hijas adolescentes en conflicto con la Ley Penal asistidas en la Entidad de Atención Acarigua II (H) Portuguesa; para ello se empleó la metodología cuantitativa bajo la modalidad de Proyecto Factible, desarrollándose las tres primeras partes del proyecto: Diagnóstico, Estudio de Factibilidad y Diseño de la Propuesta. La población objeto de estudio estuvo conformada por veinticinco (25) padres, madres o representantes presentes durante los meses de Octubre 2017-Febrero 2018. Para determinar el modelo de comunicación de padres y madres con hijas adolescentes en conflicto con la ley penal se elaboró un cuestionario autoaplicado de comunicación familiar, el cual fue sometido a juicio de expertos y prueba piloto. Los datos obtenidos fueron tabulados y procesados mediante la estadística descriptiva. El análisis de los datos reveló que el modelo de comunicación predominante fue el nivelador aunque con marcadas fluctuaciones entre los modelos. Se realizó un estudio de factibilidad (estudio de mercado, institucional, social y financiero) confirmando la factibilidad de la propuesta. La misma fue diseñada bajo la modalidad de cinco talleres teóricos ­ prácticos con la finalidad de autoevaluar la forma en que se comunican y de esta forma adquirir nuevas pautas de comunicación con sus hijas adolescentes, principalmente el modelo nivelador(AU)

The main objective of this research is to propose an intervention program on family communication aimed at parents with adolescent daughters in conflict with the Criminal Law assisted in the Acarigua II (H) Portuguese state Care Entity. A quantitative methodology was used under the modality of Feasible Project, developing the first three parts of the project as Diagnosis, Feasibility Study and Design of the Proposal. The population included twenty-five (25) fathers, mothers or representatives present during the months of October 2017-February 2018. To determine the communication model of fathers and mothers with adolescent daughters, a self-administered family communication questionnaire was used which was submitted to expert judgment and a pilot test. The data obtained was tabulated and processed using descriptive statistics. The analysis of the data revealed that the predominant communication model was the leveler although with marked fluctuations between the models. A feasibility study (market, institutional, social and financial study) was carried out confirming the feasibility of the proposal. The program was designed under the modality of five theoretical-practical workshops in order to self-assess the way parents communicate and thus acquire new communication guidelines with their adolescent daughters, mainly at the leveling model(AU)

EEG findings and clinical prognostic factors associated with mortality in a prospective cohort of inpatients with COVID-19.

PURPOSE: Our objective is to describe the most prevalent electroencephalographic findings in COVID-19 hospitalized patients, and to determine possible predictors of mortality including EEG and clinical variables. METHODS: A multicentric prospective observational study in patients with COVID-19 requiring EEG during hospitalization. RESULTS: We found 94 EEG from 62 patients (55 % men, mean age 59.7 ± 17.8 years) were analyzed. Most frequent comorbidity was cardiac (52 %), followed by metabolic (45 %) and CNS disease (39 %). Patients required ICU management by 60 %, with a mortality of 27 % in the whole cohort. The most frequent EEG finding was generalized continuous slow-wave activity (66 %). Epileptic activity was observed in 19 % including non-convulsive status epilepticus, seizures and interictal epileptiform discharges. Periodic patterns were observed in 3 patients (3.2 %). Multivariate analysis found that cancer comorbidity and requiring an EEG during the third week of evolution portended a higher risk of mortality CONCLUSION: We observed that the most prevalent EEG finding in this cohort was generalized continuous slow-wave activity, while epileptic activity was observed in less than 20 % of the cases. Mortality risk factors were comorbidity with cancer and requiring an EEG during the third week of evolution, possibly related to the hyperinflammatory state.

Instant Controlled Pressure Drop as Blanching and Texturing Pre-Treatment to Preserve the Antioxidant Compounds of Red Dried Beetroot (Beta vulgaris L.).

Red beetroot is rich in bioactive compounds such as polyphenols, flavonoids, betaxanthins, betacyanins, among others. According to selected processing methods, the bioaccessibility of these compounds could be either enhanced or decreased. This study evaluated the effect of four different drying conditions: (1) Traditional Drying (TD), (2) Swell Drying (SD), (3) DIC Blanching + Traditional Drying (BTD), and (4) DIC Blanching + Swell Drying (BSD) on the antioxidant content and the antioxidant activity of red beetroots. Obtained results showed that in all the cases, by comparing to Traditional Drying (TD), the coupling of a DIC Blanching pre-treatment to a Swell Drying treatment (BSD) maintained or enhanced the preservation of the Total Phenolic Compounds (TPC), the Total Flavonoids Compounds (TFC), the Betanin Concentration (BC), the Trolox Equivalent Antioxidant Capacity (TEAC), and the Free Radical Scavenging Activity by DPPH (IC50) of red beetroots. Various studies have shown that thanks to the expanded and porous structure triggered by the Swell Drying process, it has been possible to achieve better antioxidants extraction and better whole quality. Hence, by coupling DIC as a blanching-steaming pre-treatment, it was possible to preserve better the antioxidant content and the antioxidant activity of red dried beetroots.

Mutación de protocadherina 19 (PC-DH19), en paciente con epilepsia refractaria / Mutation of protocadherin 19 (PCDH19), in patients with refractory epilepsy

Paciente de 4 años de edad, con epilepsia de difícil manejo, cuya etiología se atribuye a patología autoinmune y que finalmente se diagnostica una mutación de protocadherina (PCDH19). Se discute la fisiopatología, características clínicas, exámenes y los posibles tratamientos.

Four-year-old patient with intractable epilepsy, whose etiology is attributed to autoimmune pathology and who is eventually diagnosed with a protocadherin mutation (PCDH19). Pathophysiology, clinical characteristics, examinations and possible treatments are discussed.