A qualitative metasummary of detransition experiences with recommendations for psychological support.

Objective: The main goal of this article is to identify areas of psychotherapeutic work with detransitioners, that is, individuals who stop or reverse a gender transition, given the scarcity of information and resources. Methods: We conducted a systematic review and metasummary of qualitative data published until April 2023. Data were extracted, grouped, and refined to conform meta-findings. Results: The database search yielded 845 records, of which 15 comprising 2689 people who detransitioned were included in the review. A total of 582 findings were extracted, resulting in 34 meta-findings with frequencies ≥ 15 %. Two main thematic areas with several subthemes were identified. The theme "Gender transition" included "Perspectives" and "Emotions." The theme "Gender detransition" included "Driving factors," "Challenges" (a. Social and emotional difficulties, b. Lack of support and understanding, c. Negative healthcare experiences, d. Detransphobia, and e. Identity concerns), "Needs," "Growth and evolution," and "Identity and future." Based on these meta-findings, we advance broad recommendations for supporting detransitioners in their various emotional, social, and identity needs. Conclusions: Detransitioners are diverse in their experiences and perspectives and face significant challenges. Emotional validation with a focus on personal strengths and meanings, treatment of concurrent psychological issues, development of social networks, and support of identity exploration are key aspects of psychotherapeutic work with this population.

Gender detransition: A critical review of the literature.

Gender detransition is the act of stopping or reversing the social, medical, and/or administrative changes achieved during a gender transition process. It is an emerging phenomenon of significant clinical and social interest.

Destransición de género: Una revisión crítica de la literatura / Gender detransition: a critical review of the literature

Introducción. La destransición de género es el acto de detenero revertir los cambios sociales, médicos y/o administrativos conseguidos durante un proceso de transición de género. Se trata de un fenómeno emergente de gran interés a nivel clínico y social. Método. Se condujo una búsqueda sistemática en siete bases de datos entre 2010 y 2022, se rastrearon manualmente las referencias de los artículos y se consultaron libros especializados. Se realizó un análisis cuantitativo y de contenido. Resultados. Se incluyeron 138 registros, 37% correspondientes a estudios empíricos y 38,4% publicados en 2021. Se identifican al menos ocho términos para hacer referencia a la destransición, con diferencias en sus definiciones. La prevalencia difiere en función del criterio utilizado, siendo menor para la destransición/arrepentimiento (0-13,1%) que para la descontinuación de la asistencia/tratamiento médico (1,9%-29,8%),y menor para la destransición/arrepentimiento tras cirugía (0-2,4%) que para la destransición/arrepentimiento tras tratamiento hormonal (0-9,8%). Se describen más de 50 factores psicológicos, médicos y socioculturales que influyen en la decisión de destransicionar, así como 16 factores predictores/asociados a la destransición. No se encuentran guías de abordaje sanitario ni legislativo. Los debates actuales se centran en los interrogantes sobre la naturaleza de la disforia de género y el desarrollo de la identidad, el papel de los profesionales con respecto al acceso a los tratamientos médicos y el impacto de las destransiciones sobre la futura accesibilidad a dichos tratamientos. Conclusiones. La destransición de género es una realidad compleja, heterogénea, poco estudiada y escasamente comprendida. Se requiere un abordaje y estudio sistemático que permita comprender su prevalencia real, implicaciones y manejo a nivel sanitario. (AU)

Introduction. Gender detransition is the act of stoppingor reversing the social, medical, and/or administrative changesachieved during a gender transition process. It is an emergingphenomenon of significant clinical and social interest.Methods. We systematically searched seven databasesbetween 2010 and 2022, manually traced article references,and consulted specialized books. Quantitative and contentanalyses were carried out.Results. We included 138 registers, 37% of which were empirical studies and 38.4% of which were published in 2021. Atleast eight terms related to detransition were identified, withdifferences in their definitions. Prevalence estimates differ according to the criteria used, being lower for detransition/regret (0-13.1%) than for discontinuation of care/medical treatment (1.9%-29.8%), and for detransition/regret after surgery(0-2.4%) than for detransition/regret after hormonal treatment (0-9.8%). More than 50 psychological, medical, and sociocultural factors influencing the decision to detransition and16 predictors/associated factors are described. No health orlegal guidelines are found. Current debates focus on the nature of gender dysphoria and identity development, the role ofprofessionals in accessing medical treatments, and the impactof detransition on future access to these treatments.Conclusions. Gender detransition is a complex, heterogeneous, under-researched, and poorly understood reality. Asystematic study and approach to the topic is needed to understand its prevalence, implications, and management from a healthcare perspective. (AU)

Methyl Jasmonate and Nanoparticles Doped with Methyl Jasmonate affect the Cell Wall Composition of Monastrell Grape Skins.

The structural composition of the cell wall of grape skins is related to the cell wall integrity and subsequent extraction of the different compounds that are contained inside vacuoles and also the cell wall breakdown products. Different reports have established that methyl jasmonate (MeJ) produces changes in the composition of the grape skin cell wall. The use of elicitors to promote the production of secondary metabolites in grapes has been studied in several reports; however, its study linked to nanotechnology is less developed. These facts led us to study the effect of methyl jasmonate (MeJ) and nanoparticles doped with MeJ (nano-MeJ) on the cell walls of Monastrell grapes during three seasons. Both treatments tended to increase cell wall material (CWM) and caused changes in different components of the skin cell walls. In 2019 and 2021, proteins were enlarged in both MeJ and nano-MeJ-treated grapes. A general decrease in total phenolic compounds was detected with both treatments, in addition to an increment in uronic acids when the grapes were well ripened. MeJ and nano-MeJ produced a diminution in the amount of cellulose in contrast to an increase in hemicellulose. It should be noted that the effects with nano-MeJ treatment occurred at a dose 10 times lower than with MeJ treatment.

Empirically supported affirmative psychological interventions for transgender and non-binary youth and adults: A systematic review.

Research suggests that transgender and non-binary (TGNB) individuals experience lower levels of psychological well-being than the general population. Although practice recommendations and guidelines exist, there is a paucity of studies evaluating the effects of psychological interventions on this group. This systematic review aimed to synthesize and analyze existing empirical affirmative psychological interventions for TGNB individuals to assess their efficacy. Eight databases (PubMed, Web of Science, PsycINFO, Scopus, LILACS, Cochrane, ProQuest, Google Scholar) were searched from January 2010 to June 2022 to identify relevant studies. Included studies needed to be randomized controlled trials, quasi-experimental, or uncontrolled pre-post. Twenty-two articles were included, of which eight had TGNB participants only, two had mixed samples with separated outcome data for TGNB participants, and 12 had mixed samples with no disaggregated data. Experimental designs, participant samples, assessed variables, and type of interventions varied widely across studies, thus preventing comparisons. Overall results suggest improvements in psychological distress, depression, anxiety, suicidality, substance-related risk behaviors, coping skills/emotion regulation, stress appraisal, self-esteem, self-acceptance, social support, minority stress, resilience, hope, positive identity, and identity acceptance, although conclusions are limited by moderate-to-high risk of bias. Future research should implement more consistent and rigorous methodological designs to assess and compare intervention efficacy.

Effects of Methyl Jasmonate and Nano-Methyl Jasmonate Treatments on Monastrell Wine Volatile Composition.

The application of methyl jasmonate (MeJ) as an elicitor to enhance secondary metabolites in grapes and wines has been studied, but there is little information about its use in conjunction with nanotechnology and no information about its effects on wine volatile compounds. This led us to study the impact of nanoparticles doped with MeJ (Nano-MeJ, 1mM MeJ) on the volatile composition of Monastrell wines over three seasons, compared with the application of MeJ in a conventional way (10 mM MeJ). The results showed how both treatments enhanced fruity esters in wines regardless of the vintage year, although the increase was more evident when grapes were less ripe. These treatments also achieved these results in 2019 in the cases of 1-propanol, ß-phenyl-ethanol, and methionol, in 2020 in the cases of hexanol and methionol, and in 2021, but only in the case of hexanol. On the other hand, MeJ treatment also increased the terpene fraction, whereas Nano-MeJ, at the applied concentration, did not increase it in any of the seasons. In summary, although not all families of volatile compounds were increased by Nano-MeJ, the Nano-MeJ treatment generally increased the volatile composition to an extent similar to that obtained with MeJ used in a conventional way, but at a 10 times lower dose. Therefore, the use of nanotechnology could be a good option for improving the quality of wines from an aromatic point of view, while reducing the necessary dosage of agrochemicals, in line with more sustainable agricultural practices.

Productiveness and Berry Quality of New Wine Grape Genotypes Grown under Drought Conditions in a Semi-Arid Wine-Producing Mediterranean Region.

One alternative for adapting viticulture to high temperatures and the scarcity of water is the development of new varieties adapted to such conditions. This work describes six new genotypes, derived from "Monastrell" × "Cabernet Sauvignon" (MC16, MC19, MC72, MC80) and "Monastrell" × "Syrah" (MS104, MS49) crosses, grown under deficit irrigation and rainfed conditions in a semi-arid wine-producing area (Murcia, southeastern Spain). The effect of genotype, year, and irrigation treatment on the phenological, productiveness, morphological, and grape quality data was evaluated. The study material was obtained and selected as part of a breeding program run by the Instituto Murciano de Investigación y Desarollo Agrario y Medioambiental (IMIDA). The results obtained show that under rainfed conditions, the values for productive variables decreased, while those referring to the phenolic content increased. Notable variation in the parameters evaluated was also seen for the different genotypes studied. The behavior of the genotypes MC80 and MS104 under rainfed conditions was noteworthy. In addition to maintaining very adequate yields, phenolic contents, must pH, and total acidity values, MC80 fell into the best 'phenolic quality group' and MS104 returned a low º°Baumé value, ideal for the production of low-alcohol-content wines. These genotypes could favor the development of sustainable quality viticulture in dry and hot areas.

Effect of Methyl Jasmonate Doped Nanoparticles on Nitrogen Composition of Monastrell Grapes and Wines.

Nitrogen composition on grapevines has a direct effect on the quality of wines since it contributes to develop certain volatile compounds and assists in the correct kinetics of alcoholic fermentation. Several strategies can be used to ensure nitrogen content in grapes and one of them could be the use of elicitors such as methyl jasmonate. The use of this elicitor has been proven to be efficient in the production of secondary metabolites which increases the quality of wines, but its use also has some drawbacks such as its low water solubility, high volatility, and its expensive cost. This study observes the impact on the amino acid and ammonium composition of must and wine of Monastrell grapes that have been treated with methyl jasmonate (MeJ) and methyl jasmonate n-doped calcium phosphate nanoparticles (MeJ-ACP). The first objective of this study was to compare the effect of these treatments to determine if the nitrogenous composition of the berries and wines increased. The second aim was to determine if the nanoparticle treatments showed similar effects to conventional treatments so that the ones which are more efficient and sustainable from an agricultural point of view can be selected. The results showed how both treatments increased amino acid composition in grapes and wines during two consecutive seasons and as well as the use of MeJ-ACP showed better results compared to MeJ despite using less quantity (1 mM compared to 10 mM typically). So, this application form of MeJ could be used as an alternative in order to carry out a more efficient and sustainable agriculture.

Aromatic Characterization of New White Wine Varieties Made from Monastrell Grapes Grown in South-Eastern Spain.

The aromatic profile of a wine is one of the main characteristics appreciated by consumers. Due to climate change, vineyards need to adapt to new conditions, and one of the strategies that might be followed is to develop new white varieties from Monastrell and other cultivars by means of intervarietal crosses, since white varieties are a minority in south-eastern Spain. Such crosses have already been obtained and have been seen to provide quality white wines of high acidity and with a good aromatic composition. To confirm this, a quantitative analysis was carried out during two vintages (2018 and 2019) in order to study and compare the volatile composition of Verdejo (V) wine with the aromatic composition of several wines made from different crosses between Cabernet Sauvignon (C), Syrah (S), Tempranillo (T), and Verdejo (V) with Monastrell (M), by means of headspace SPME-GC-MS analysis. Wine volatile compounds (alcohols, volatile acids, ethyl esters, terpenes, norisoprenoids, and two other compounds belonging to a miscellaneous group) were identified and quantified using a HS-SPME-GS-MS methodology. An additional sensory analysis was carried out by a qualified tasting panel in order to characterize the different wines. The results highlighted how the crosses MT103, MC69, and MC180 showed significant differences from and better quality than the Verdejo wine. These crosses produced higher concentrations of several aromatic families analyzed, which was supported by the views of the tasting panel, thus confirming their excellent aromatic potential as cultivars for producing grapes well adapted to this area for making white wines.

Variaciones de la ecocardiografía tras la cirugía bariátrica. Derivación biliopancreática vs. gastrectomía vertical / Variations in echocardiography after bariatric surgery. Biliopancreatic diversion vs. vertical gastrectomy

INTRODUCCIÓN: la obesidad se ha convertido en un problema de salud a nivel mundial de primera magnitud por su relación con la morbimortalidad cardiovascula. Así, la cirugía bariátrica se plantea como una de las soluciones principales para la corrección del exceso de peso y, consecuentemente, la mejoría de las cardiopatías asociadas. OBJETIVO: comparar la gastrectomía vertical (GV) con la derivación biliopancreática de tipo Scopinaro (DBP) para observar la repercusión, desde el punto de vista ecocardiográfico, de los cambios que se producen en la estructura cardiaca tras la cirugía. Además, evaluar el resultado quirúrgico en función de la escala BAROS. MATERIAL Y MÉTODOS: se recogieron los resultados de la ecocardiografía incluida en el estudio preoperatorio de los pacientes candidatos a cirugía bariátrica de nuestro hospital, intervenidos en un periodo de 2 años (de enero 2014 a diciembre 2015), junto a los datos antropométricos y de comorbilidad. Estos se compararon con los resultados postoperatorios medidos a los 3 años de la cirugía. RESULTADOS: finalmente se seleccionaron 26 pacientes (13 GV y 13 DBP), con una edad media de 42 años. GV: IMC inicial de 44,6 ± 17,1; IMC final de 31,8 ± 111,3 (p < 0,01). DBP: IMC inicial de 48,1 ± 14,2; IMC final de 32,7 ± 110,4 (p < 0,01). Ecocardiografía: función sistólica normal: 100% vs. 92%; función diastólica normal: 88,5% vs. 69,2%; sin valvulopatía: 80% vs. 69%; aurícula izquierda normal: 76,9% vs. 73,1% (p > 0,05); HTA: 38% vs. 19% (p < 0,05), en el preoperatorio y postoperatorio, respectivamente. CONCLUSIONES: no se encontraron diferencias significativas entre los dos grupos estudiados con técnicas diferentes, si bien pudo encontrarse un ligero deterioro de la función diastólica en ambos grupos. Las comorbilidades asociadas a la obesidad mejoraron en ambos grupos y el grado de evaluación de la cirugía fue positivo. La escasa variación de la ecocardiografía hace replantearse su uso sistemático en el preoperatorio de estos pacientes por el bajo índice coste-beneficio

INTRODUCTION: obesity has become a worldwide health problem due to its relationship with cardiovascular morbimortality, thus bariatric surgery is considered as one of the main solutions for the correction of excess weight and, consequently, the improvement of its associated heart diseases. OBJECTIVE: to compare vertical gastrectomy (VG) and biliopancreatic diversion (BPD) by observing echocardiographic characteristics both before and after surgery, as well as to evaluate surgical outcome in terms of the BAROS scale. METHODS: results were collected from the echocardiographic testing requested for the preoperative study of patients who underwent surgery over the course of 24 months (from January 2014 to December 2015), as well as their anthropometric data. These were compared with postoperative parameters measured at 3 years after surgery. RESULTS: finally, 26 patients were selected (13 VG and 13 BPD) with a mean age of 42 yrs. VG: initial BMI: 44.6 ± 17.1; final BMI: 31.8 ± 111.3 (p < 0.01); BPD: initial BMI: 48.1 ± 114.2; final BMI: 32.7 ± 110.4 (p < 0.01). Echocardiography: normal systolic function: 100% vs 92%; normal diastolic function: 88.5% vs 69.2%; no valvulopathy: 80% vs 69%; normal left atrium: 76.9% vs 73.1% (p > 0.05); HTA: 38.5% vs 19.2% (p < 0.05), preoperatively and postoperatively, respectively. CONCLUSIONS: no significant differences were found between the two groups studied with different techniques, although a slight deterioration in diastolic function was found in both groups. The comorbidities associated with obesity improved in both groups, and the surgery was scored as positive. The scant variation revealed by echocardiography prompts to reconsider its systematic preoperative use in these patients given the low cost-benefit ratio

[Variations in echocardiography after bariatric surgery. Biliopancreatic diversion vs vertical gastrectomy]. / Variaciones de la ecocardiografía tras la cirugía bariátrica. Derivación biliopancreática vs. gastrectomía vertical.

INTRODUCTION: Introduction: obesity has become a worldwide health problem due to its relationship with cardiovascular morbimortality, thus bariatric surgery is considered as one of the main solutions for the correction of excess weight and, consequently, the improvement of its associated heart diseases. Objective: to compare vertical gastrectomy (VG) and biliopancreatic diversion (BPD) by observing echocardiographic characteristics both before and after surgery, as well as to evaluate surgical outcome in terms of the BAROS scale. Methods: results were collected from the echocardiographic testing requested for the preoperative study of patients who underwent surgery over the course of 24 months (from January 2014 to December 2015), as well as their anthropometric data. These were compared with postoperative parameters measured at 3 years after surgery. Results: finally, 26 patients were selected (13 VG and 13 BPD) with a mean age of 42 yrs. VG: initial BMI: 44.6 ± 7.1; final BMI: 31.8 ± 11.3 (p < 0.01); BPD: initial BMI: 48.1 ± 14.2; final BMI: 32.7 ± 10.4 (p < 0.01). Echocardiography: normal systolic function: 100% vs 92%; normal diastolic function: 88.5% vs 69.2%; no valvulopathy: 80% vs 69%; normal left atrium: 76.9% vs 73.1% (p > 0.05); HTA: 38.5% vs 19.2% (p < 0.05), preoperatively and postoperatively, respectively. Conclusions: no significant differences were found between the two groups studied with different techniques, although a slight deterioration in diastolic function was found in both groups. The comorbidities associated with obesity improved in both groups, and the surgery was scored as positive. The scant variation revealed by echocardiography prompts to reconsider its systematic preoperative use in these patients given the low cost-benefit ratio.

INTRODUCCIÓN: Introducción: la obesidad se ha convertido en un problema de salud a nivel mundial por su relación con la morbimortalidad cardiovascular. La cirugía bariátrica se plantea como una de las soluciones para la corrección del exceso de peso y mejoría de las cardiopatías asociadas. Objetivo: comparar la gastrectomía vertical con la derivación biliopancreática de tipo Scopinaro para observar la repercusión de los cambios que se producen en la estructura cardiaca tras la cirugía. Además, evaluar el resultado quirúrgico en función de la escala BAROS. Material y métodos: se recogieron los resultados de la ecocardiografía incluida en el estudio preoperatorio de los pacientes candidatos a cirugía bariátrica de nuestro hospital, intervenidos en un periodo de 2 años, junto a los datos antropométricos y de comorbilidad. Estos se compararon con los resultados postoperatorios medidos a los 3 años de la cirugía. Resultados: finalmente se seleccionaron 26 pacientes (13 GV y 13 DBP), con una edad media de 42 años. GV: IMC inicial de 44,6 ± 7,1; IMC final de 31,8 ± 11,3 (p < 0,01). DBP: IMC inicial de 48,1 ± 14,2; IMC final de 32,7 ± 10,4 (p < 0,01). Ecocardiografía: función sistólica normal: 100% vs. 92%; función diastólica normal: 88,5% vs. 69,2%; sin valvulopatía: 80% vs. 69%; aurícula izquierda normal: 76,9% vs. 73,1% (p > 0,05); HTA: 38% vs. 19% (p < 0,05), en el preoperatorio y postoperatorio, respectivamente. Conclusiones: no se encontraron diferencias significativas entre los dos grupos estudiados con técnicas diferentes, si bien pudo encontrarse un ligero deterioro de la función diastólica en ambos grupos. Las comorbilidades asociadas a la obesidad mejoraron en ambos grupos y el grado de evaluación de la cirugía fue positivo. La escasa variación de la ecocardiografía hace replantearse su uso sistemático en el preoperatorio de estos pacientes por el bajo índice coste-beneficio.

Study of aromatic profile of different crosses of Monastrell white wines.

BACKGROUND: Aromatic compounds are responsible for the final quality of wines. A semi-quantitative analysis was carried out during two consecutive seasons aiming to determine the volatile composition of 12 new white crosses obtained between Monastrell (M) and other varieties, such as Cabernet Sauvignon (C), Syrah (S) and Tempranillo (T) (MC10, MC180, MC9, MC69, MS30, MS33, MS82, MT103, MT19, MV11, MV67 and MV7), using a methodology based on gas chromatography-solid phase microextraction-mass spectrometry. RESULTS: On the one hand, 30 aromatic compounds were identified belonging to different chemical groups (alcohols, acids, terpenes, norisoprenoids and esters). The results showed how some crosses presented significant differences with respect to their parental. For example, in 2016, Monastrell and Cabernet Sauvignon showed high concentration of alcohols, acids and some terpenes, whereas the corresponding crosses showed a predominance of aromas belonging to esters. In 2017, as a result of edaphoclimatic conditions, the white crosses had higher concentrations of esters and acids. In addition, Monastrell and Cabernet Sauvignon showed similar concentrations of alcohols compared to 2016. On the other hand, sensorial analyses confirmed these results, so that mint and peppermint aromas and a fresh quality were detected in MC69 wine, especially in 2016, and fruity and acid aromas were detected in MC180 wine, which gave it a wide ranging complexity and aromatic potential. CONCLUSION: The present study reports the first investigation of the volatile composition and sensory characteristics of directed crosses white wines obtained from Monastrell and other varieties, such as Cabernet Sauvignon, Syrah, Tempranillo and Verdejo. The results obtained indicate that the use of some of these white crosses could be a good option for growing them in this Mediterranean area as a result of the contribution of a good quality in the wine aroma. © 2019 Society of Chemical Industry.

National Trend in Laparoscopic Gastrectomy for Gastric Cancer: Analysis of the National Register in Chile.

INTRODUCTION: The laparoscopic approach for the treatment of gastric cancer has many advantages. However, outside Asia there are few large case series. AIM: To evaluate postoperative morbidity, long-term survival, changes in indication, and the results of laparoscopic gastrectomy. METHODS: We included all patients treated with a laparoscopic gastrectomy from 2005 to 2014. We compared results across 2 time periods: 2005-2011 and 2012-2014. Median follow-up was 39 months. RESULTS: Two hundred and eleven patients underwent a laparoscopic gastrectomy (median age 64 years, 55% male patients). In 135 (64%) patients, a total gastrectomy was performed. Postoperative morbidity occurred in 29%. A significant increase in the indication of laparoscopic surgery for stages II-III (32 vs. 45%; p = 0.04) and higher lymph node count (27 vs. 33; p = 0.002) were observed between the 2 periods. The 5-year overall survival was 72%. According to the stage, the 5-year overall survival was 85, 63, and 54% for stage I, II, and III respectively (p < 0.001). CONCLUSIONS: There was an acceptable rate of postoperative complications and the long-term survival was in accordance with the disease stage. There was a higher indication of laparoscopic surgery in stages II-III disease, and higher lymph node count in the latter period of this study.

Impact of phenylalanine and urea applications to Tempranillo and Monastrell vineyards on grape amino acid content during two consecutive vintages.

Nitrogen plays a key role in the fermentation and secondary metabolites formation. The aim was to study the influence of vine nitrogen applications on grape amino acid composition. Nitrogen sources applied to Tempranillo and Monastrell grapevines were phenylalanine and urea, during two seasons. Results showed that the application of these compounds had little effect on grape amino acid composition, regardless of variety and vintage. This could be due to the fact that vineyards did not present nitrogenous requirements. Thus, variety was the determining factor in Asp, Glu, Gln, Cit, Met, Gly, Gaba, Val, Ile, and Leu while season was the factor that most affected Thr, Arg, Ala, and Lys due its implication on berry ripening. The concentration of the remaining amino acids was influenced by two or three of the factors studied. Therefore, when the vineyard has adequate nitrogen nutritional status, grape amino acid content was determined by variety and vintage.

Elicitors used as a tool to increase stilbenes in grapes and wines.

Two preharvest treatments (methyl jasmonate or cell wall yeast) of grapevines (Monastrell and Tempranillo) were applied during two vintages (2014 and 2015) to check whether these elicitors enhanced stilbene accumulation in berries at the moment of harvest and in the corresponding wines elaborated with them. The main objective was checking the effect of treatment, variety and year on stilbene composition due to the interesting health-related properties of these compounds in both grapes and wines. The results pointed to inter-varietal and inter-annual differences, and that the treatments generally enhanced the stilbene composition of grapes and, particularly, of wines. The increase was more evident in Monastrell variety than in Tempranillo variety and in their wines more than their grapes during 2014 vintage but not during 2015 vintage.

Transumbilical single-incision laparoscopic sleeve gastrectomy.

BACKGROUND: Sleeve gastrectomy has become an established primary bariatric surgical technique. Its relatively lower complexity has made it eligible to be performed by single-incision laparoscopy (single-incision laparoscopic sleeve gastrectomy, SILSG). The aim of this paper is to present our SILSG technique and surgical outcomes and demonstrate that SILSG is a safe and feasible procedure using conventional laparoscopic instruments. METHODS: All patients who underwent SILSG since December 2012 in our institution were analyzed. The operative technique involved creation of a transumbilical incision and the introduction of a GelPoint device with four trocars. Rigid instruments were used in all patients. Gastric transection was performed 4 cm proximal to the pylorus and calibrated with a 36-Fr bougie. Hemostasis of the staple line was achieved with metallic clips. RESULTS: A total of 74 patients underwent SILSG. Their mean age and body mass index were 34.2 ± 9.2 years and 34.0 ± 3.2 kg/m(2) (range 30.0-42.7 kg/m(2)), respectively. The mean operative time was 48 ± 10 min. No reoperations or deaths occurred. One patient developed portal vein thrombosis. The mean length of hospital stay was 2.4 ± 2.0 days. The cosmetic result was satisfactory in all patients. CONCLUSIONS: SILSG is a safe and feasible procedure when performed with the technique described herein. This technique allows for the use of conventional laparoscopic instruments and reasonable operative times. The main benefit of the procedure is an excellent cosmetic result with virtually no visible scars.

Influence of cold pre-fermentation treatments on the major volatile compounds of three wine varieties.

The volatile compounds of wines made from three grape varieties (Monastrell, Cabernet Sauvignon and Syrah) using three pre-fermentation techniques (grape freezing, dry-ice and cold maceration) and a control treatment were measured. The different winemaking practices, which are intended to increase the aromatic properties of wines, produced results that depended on the variety concerned. For example, freezing the Cabernet Sauvignon and Syrah grapes produced different results compared with the respective controls, whereas few changes were found on freezing the Monastrell wine. Differences were significant in the case of some volatile compounds. Linear discriminant analysis allowed some grouping of the varieties at sampling but not of the pre-fermentation techniques used.

Transumbilical laparoscopic Roux-en-Y gastric bypass with hand-sewn gastrojejunal anastomosis.

Single-port laparoscopic surgery has undergone significant development over the past 5 years. Single port is used in various procedures, including bariatric surgery. The aim of this paper is to describe a surgical technique for gastric bypass with a transumbilical approach (transumbilical gastric bypass-TUGB) with hand-sewn gastrojejunostomy, in selected patients who may be benefited by a better cosmetic result. The procedure begins with a transumbilical vertical incision. We use the GelPOINT single-port device and a 5-mm assistant trocar in the left flank (in the first two cases, a 2-mm subxiphoid liver retractor was used). A gastric pouch is made and calibrated with a 36-Fr bougie. The gastrojejunal anastomosis is performed by hand-sewing in two layers. A Roux-en-Y with a biliary limb of 50 cm and an alimentary limb of 120 cm is performed with a stapler. Three women were subjected to TUGB. The women were aged 28, 31, and 42 years; they had body mass indexes of 40.3, 33, and 38.2; and the operating times were 150, 200, and 150 min, respectively. The first two women underwent a Roux-en-Y gastric bypass (RYGB), and the last woman underwent a RYGB with a resection of the stomach remnant. There were no conversions to open or multitrocar techniques. No complications or deaths occurred. The three patients were satisfied with the cosmetic result. The technique described for TUGB is a feasible procedure for surgeons who have previous experience with the transumbilical approach.

Transumbilical sleeve gastrectomy with an accessory lateral port: surgical results in 237 patients and 1-year follow-up.

BACKGROUND: The transumbilical approach has recently been shown to be safe for several surgical procedures. Case series of sleeve gastrectomy (SG) with a transumbilical approach (TUSG) has been reported with various techniques. The objective of this report is to present the technique, surgical results, and 1-year follow-up results of simplified TUSG using rigid instruments. METHODS: All of the patients who had undergone SG since July 2010 were offered a transumbilical approach. The operative technique involves a transumbilical incision and the introduction of a SILS® or GelPoint® multiport and a 5-mm metallic accessory trocar laterally in the left flank. Rigid instruments were used in all patients. Gastric transection was made 4-5 cm proximal to the pylorus, calibrated with a 36-Fr bougie. Selected hemostasis to the staple line was achieved with metallic clips. RESULTS: A total of 237 patients underwent TUSG. Patient body mass index ranged from 30 to 46 kg/m(2). The mean operative time was 49.5 ± 14.9 min. Six patients presented with early complications, including hemoperitoneum in three cases, antral leak in one case, intestinal perforation in one case, and portal vein thrombosis in one case. Conversion to the multitrocar technique was required in one patient. There were no mortalities. The mean length of hospital stay was 2.2 ± 1 days. The cosmetic result was satisfactory for all of the patients. CONCLUSIONS: TUSG is a safe and feasible procedure using the described technique. The insertion of a 5-mm assistance trocar simplifies the procedure, allowing the use of rigid instruments.