Guía de práctica clínica para el manejo de la neumonía adquirida en la comunidad / Clinical Practice Guideline for the management of community-acquired pneumonia

Resumen La neumonía sigue siendo una de las principales causas de consulta y de hospitalización a la que, además de su un alto impacto en términos de morbilidad y mortalidad, se suma la actual problemática de resistencia a los antimicrobianos, por lo que establecer directrices que permitan su adecuado diagnóstico y tratamiento es de gran importancia para obtener mejores desenlaces clínicos y promover un uso racional de antibióticos en estos pacientes. La presente guía de práctica clínica (GPC) contiene recomendaciones basadas en la evidencia para el diagnóstico y tratamiento de la neumonía adquirida en la comunidad en adultos, las cuales fueron realizadas mediante el proceso de adaptación de GPC basadas en la evidencia para el contexto colombiano.

Abstract Pneumonia continues to be one of the main causes of consultation and hospitalization to which, besides its high impact on morbidity and mortality, the current problem of antimicrobial resistance is added; thus, establishing guidelines that allow its adequate diagnosis and treatment is of great importance to obtain better clinical outcomes and promote a rational use of antibiotics in these patients. This clinical practice guideline (CPG) contains evidence-based recommendations for the diagnosis and treatment of community-acquired pneumonia in adult population; these recommendations were made by means of the process of adaptation of evidence-based CPGs for the Colombian context.

Identification of non-volatile compounds that impact consumer liking of strawberry preserves: Untargeted LC-MS analysis.

Non-volatile compounds that impact the acceptability of strawberry preserves were investigated by untargeted LC-MS flavoromics analysis. Chemical profiles for fifteen strawberry preserves were modeled against consumer liking scores by orthogonal partial least squares (OPLS) with good fit (R2Y = 0.995) and predictive ability (Q2 = 0.918). Four chemical compounds predictive of acceptability were identified, by accurate MS and NMR, as secoisolariciresinol monoglucoside, (+)-isolariciresinol monoglucoside, 1-hexanoyl-phloroglucinol-2-O-ß-d-glucoside, and the novel compound decanoic acid-4-O-ß-d-glucoside. Sensory recombination testing of preserve samples with added levels of the four predictive LC-MS compounds indicated perceivable sensory changes in the flavor profile. Female consumers significantly preferred the recombination preserve with added levels of both predictive GC-MS and LC-MS compounds as compared to the control preserve, demonstrating the applicability of the approach for understanding product liking.

Identification of volatile compounds correlated with consumer acceptability of strawberry preserves: Untargeted GC-MS analysis.

Volatile compounds that impact the acceptability of strawberry preserves were investigated by untargeted GC-MS flavoromics analysis. Chemical profiles for fifteen strawberry preserves were modeled against consumer liking scores by orthogonal partial least squares (OPLS) with good fit (R2Y = 0.998) and predictive ability (Q2 = 0.853). Ten highly predictive compounds were selected, nine of which were identified, and eight of which were quantified using tandem mass spectrometry. Sensory recombination difference testing revealed that the addition of predictive compounds to an average-liked preserve at levels found in the most-liked preserve induced a perceptible difference to frequent consumers of strawberry jams. One of the highly predictive compounds was identified (MS and synthesis) as a novel linalool oxide product 2-methyl-2-vinyl-tetrahydrofuran with a fruity, herbal-minty, piney aroma and a low odor threshold value.

Characterization of odour-active volatiles and sensory analyses of roasted oak (Quercus humboldtii Bonpl) acorns, a coffee substitute / Caracterización de los compuestos activos olfativamente y análisis sensorial de los frutos tostados del roble (Quercus humboldtii Bonpl), como una bebida sustituta de café

Background: Oak acorns are roasted and grounded to produce a powder that is used to prepare a coffee substitute beverage. Objective: To identify the odour-active volatiles of the powder derived from roasted acorns of Quercus humboldtii and to perform a quantitative descriptive analysis (QDA) of its appearance, odour, and taste. Methods: The odour-active volatiles of roasted oak acorn powder were extracted by SDE and analyzed by GC/MS and olfactory analyses (GC/O). Sensorial analyses of this beverage were done by QDA (Quantitative Descriptive Analysis). Results: Nineteen compounds were identified, showing acid, buttery/caramel, smoke/roasted, and fruity odour notes, which are common to those of roasted coffee. Ketones, aldehydes, aliphatic acids, furanic alcohols and pyrazines were identified as relevant for this coffee substitute beverage. The major volatile compounds were furfural, 5-methyl furfural, furfuryl alcohol, and 3-hydroxy-2-butanone, some of them related to the sugar breakdown by heating. Odour attributes characterized by QDA, were in agreement with those detected by GC-O (Gas Chromatography coupled to Olfactometry), but some off-taste notes were detected. Conclusions: The results of molecular sensory approach confirmed that this product resembles coffee; however, QDA analyses showed the presence of undesirable taste. More studies are needed in order to improve the taste quality of this coffee substitute.

Antecedentes: los frutos del roble se tuestan y muelen para producir un polvo que es empleado en la preparación de una bebida sustituta del café. Objetivos: identificar los compuestos volátiles activos olfativamente presentes en el polvo proveniente de los frutos tostados de Quercus humboldtii; así como llevar a cabo un análisis cuantitativo descriptivo (QDA) de la apariencia, olor y sabor de este polvo. Métodos: os compuestos volátiles activos olfativamente del polvo de los frutos tostados del roble se extrajeron por DES y se analizaron por CG-EM y análisis olfativo (CG-O). La caracterización sensorial de esta bebida sustituta de café fue realizada mediante el empleo de QDA. Resultados: se identificaron diecinueve compuestos y se evidenció la presencia de notas de olor como manteca/caramelo, ahumado/tostado y frutal, similares a las encontradas en el café tostado. Los componentes mayoritarios identificados para este sustituto de café fueron cetonas, aldehídos, ácidos alifáticos, alcoholes furánicos y pirazinas. Los compuestos mayoritarios detectados fueron furfural, 5-metil furfural, alcohol furfurílico y 3-hidroxi-2-butanona, algunos de ellos relacionados con la descomposición térmica de azúcares. Los atributos de olor caracterizados por QDA fueron similares a los detectados por CG-O, aunque se detectaron algunas notas de sabor desagradable. Conclusiones: los resultados del molecular sensory approach confirmaron que este producto se parece al café; sin embargo el QDA mostró la presencia de un sabor desagradable. Estudios adicionales son necesarios para mejorar la calidad del sabor de este sustituto de café.

Spermidine Derivatives in Lulo (Solanum quitoense Lam.) Fruit: Sensory (Taste) versus Biofunctional (ACE-Inhibition) Properties.

The bitterness in lulo (Solanum quitoense Lam.) fruit is increased during processing (juicing or drying). To identify the bitter-active compounds, the ethanolic fruit pulp extract was subjected to RP-18 solid-phase extraction, and then sensory-guided fractionated by HPLC. Two spermidine derivatives, N(1),N(4),N(8)-tris(dihydrocaffeoyl)spermidine and N(1),N(8)-bis(dihydrocaffeoyl)spermidine, were isolated and their structures confirmed by analysis of their HPLC-ESI/MS and (1)H and (13)C NMR data. The N(1),N(4),N(8)-tris(dihydrocaffeoyl)spermidine was synthesized and used as an authentic sample to unequivocally confirm the structure of this compound and to quantitate it in both fresh and dried fruit. In silico analyses demonstrated that spermidine derivatives identified in lulo pulp exhibited a strong ACE-I (angiotensin I-converting enzyme) inhibitory activity. Subsequently, these results were confirmed by in vitro analyses and showed the potential use of lulo fruit pulp as an ingredient of functional foods related to the prevention of blood hypertension.

Chemical and sensory comparison of fresh and dried lulo (Solanum quitoense Lam.) fruit aroma.

The odour-active volatile compounds of lulo fruit (Solanum quitoense Lam.) were isolated by solvent extraction followed by solvent-assisted flavour evaporation (SAFE). GC-O and GCMS analyses as well as quantitation by internal standard method showed that (Z)-3-hexenal, ethyl butanoate, 3-sulphanylhexyl acetate, and ethyl hexanoate were key aroma compounds in this fruit. Other odorants with relevance because their contribution (high OAVs) to the overall aroma were 4-hydroxy-2,5-dimethyl-3(2H)-furanone, methyl benzoate, (E)-2-hexenal, and hexanal. Lulo fruit pulp in presence of maltodextrin DE-20 was dried by using four different types of drying methods: hot air-drying (HD), spray drying (SD), lyophilisation (LD), and ultrasonic convective hot air-drying (HUD). LD sample exhibited the highest sensory rank (lulo-like) in comparison with fresh fruit pulp. Hot-air drying processes (HD and HUD) changed adversely the aroma of lulo fruit pulp.