Eosinophilic cholecystitis in children: Case series.

INTRODUCTION: Eosinophilic cholecystitis (EC) is rarely seen in the pediatric population. Most of the available literature comes from adult patients, while only anecdotal cases have been reported in children. OBJECTIVE: To describe the clinical course, management, and outcomes of all EC cases treated at a children's hospital. MATERIAL AND METHODS: All cholecystectomy specimens obtained between 2011 and 2017 were retrospectively reviewed. EC was diagnosed when more than 90% of the inflammatory cells in the gallbladder wall were eosinophils, whereas lymphoeosinophilic cholecystitis (LEC) was diagnosed when the percentage of eosinophils was between 50 and 90. We analyzed all clinical aspects of patients with EC and LEC. RESULTS: We identified and reviewed 134 cholecystectomy specimens. Of them, 8 (6.0%) were classified as EC, and 3 (2.2%) as LEC. The mean age at presentation was 12.6 (2-17) years. The female-to-male ratio was 1.5/1. One patient had a history of hereditary spherocytosis, and 3 patients had systemic eosinophilia. All patients presented with clinical and radiological signs of acute cholecystitis and underwent cholecystectomy. Acute cholecystitis was confirmed by histopathology in all cases. All cases of EC and LEC had cholelithiasis. None of the patients required additional treatment. All patients recovered uneventfully. CONCLUSIONS: EC is rarely seen in children, it does not have a specific clinical presentation, and it is always associated with cholelithiasis. The diagnosis is made postoperatively by histopathology. All patients in our study presented with acute cholecystitis. TYPE OF STUDY: Retrospective review. LEVEL OF EVIDENCE: Level IV.

Erratum to "Phenolic profile, in vitro antimicrobial activity and antioxidant capacity of Vaccinium meridionale Swartz pomace" [Heliyon 6 (5) (May 2020) e03845].

[This corrects the article DOI: 10.1016/j.heliyon.2020.e03845.].

Phenolic profile, in vitro antimicrobial activity and antioxidant capacity of Vaccinium meridionale swartz pomace.

Berries of Vaccinium meridionale Swartz contain a variety of phytochemicals, which are believed to account for their bioactive properties. The potential of Vaccinium meridionale Swartz pomace as a source of bioactive compounds was investigated. The dietary fiber (DF) content was assessed by the AOAC method, phenolic compounds were characterized and quantified via HPLC-PDA and UPLC-QTOF-MS. The in vitro antibacterial activity was tested against Gram-positive and Gram-negative bacteria. The antioxidant properties were assessed by the ORAC and the ABTS assays. The DF content was 52.4 ± 3.7%, phenolic compounds comprised anthocyanins (ACNs) (747.6 ± 167.5 mg cyanidin-3-glucoside/100 g FW), hydroxycinammic acids (HCAs) (229.2 ± 68.4 mg chlorogenic acid equivalents/100 g FW), flavonols (335.0 ± 139.5 rutin equivalents/100 g FW), and procyanidins (PACs) (140.9 ± 33.3 mg cocoa procyanidin equivalents/100 g FW). Staphylococcus aureus was more sensitive than E. coli. The ORAC value was 250.0 ± 32.0 µmol TE/g fresh weight (FW). Results suggest that the residue from V. meridionale S. can be utilized to obtain valuable nutraceuticals for the development of functional foods.

Eye lens radiation exposure in paediatric interventional treatment of retinoblastoma.

Retinoblastoma represents 3% of cancers in children under fifteen years of age. The standard paediatric treatment for saving the affected eye is supraselective intra-arterial chemotherapy performed in interventional rooms. In order to address the radiation toxicity due to the angiography, the aim of this study was to determine the typical dose value corresponding to the procedure, estimate the paediatric patients' eye lens dose and study the relationship between dose indicators and dose to the lens. An automatic dose management software was installed in two interventional rooms to obtain the distribution of the dose indicators kerma-area product and reference-point air kerma, getting a typical value 16 Gy·cm2 and 130 mGy, respectively (n = 35). The eye lens dose estimates were obtained with photoluminescent dosimeters placed on the patient's eyelids. In the left eye, the entrance surface air kerma was 44.23 ± 2.66 mGy, and 12.72 ± 0.89 mGy in the right eye (n = 10). There was a positive correlation between dose to the lens per procedure and dose indicators, with R2 > 0.65 for both eyes. Based on this information, the threshold for the onset of radiation-induce cataracts (500 mGy) will be exceeded if the treatment is performed for more than 8 sessions.

Grado en que se alcanzan los objetivos de control en pacientes con diabetes de tipo 2 en diferentes grupos poblacionales / Level at which control objectives are reached in patients in different population groups with type 2 diabetes

Introducción. Existe evidencia del elevado riesgo macro- y microvascular de los pacientes con diabetes. El objetivo de este estudio era determinar el grado de control en pacientes con diabetes de tipo 2 en diferentes grupos poblacionales. Material y métodos. Diseño: estudio descriptivo transversal; emplazamiento: Atención Primaria. Servicio Madrileño de Salud, Madrid. Año: 2014. Participantes: pacientes mayores de 14 años con diagnóstico de diabetes de tipo 2. Número de participantes: n=6.674. Mediciones principales: variables sobre el grado de control (HbA1c, tensión arterial sistólica [TAS], tensión arterial diastólica [TAD], cLDL) y variables sobre características del paciente (demográficas, otros FRCV, complicaciones). Resultados. La media de edad de los pacientes con HbA1c controlada fue de 67,8 vs. 62,9 años en los no controlados (p<0,001). Los pacientes con diagnóstico de hipertensión arterial (HTA) tenían un porcentaje de control mayor con respecto a los no diagnosticados en HbA1c, TAS, TAD y cLDL: 51 vs. 37%; 62 vs. 43%; 75 vs. 47% y 57 vs. 44%, respectivamente; con diagnóstico de dislipidemia: 51 vs. 39%; 60 vs. 49%; 70 vs. 56% y 56 vs. 46%. Con diagnóstico de macroangiopatía: 46 vs. 45%; 58 vs. 54%; 71 vs. 62% y 15 vs. 60%. Todas las diferencias eran estadísticamente significativas (p<0,001). Más del 50% de los pacientes sin diagnóstico de HTA tenían TAS>140mmHg o TAD>90mmHg. Más del 25% de los pacientes con HTA o dislipidemia y cifras no controladas no recibían tratamiento farmacológico. Conclusión. El control era mejorable en todos los grupos, sobre todo en los jóvenes y en los pacientes con riesgo cardiovascular especialmente elevado por la presencia de otros FRCV o de macroangiopatía. Un porcentaje importante de pacientes con cifras de TA y de cLDL no controladas no estaban diagnosticados de HTA o dislipidemia ni recibían tratamiento farmacológico (AU)

Introduction. There is evidence of increased macro- and micro-vascular risk in diabetic patients. The objective of this study was to determine the level of control in patients in different population groups with type 2 diabetes. Material and methods. Design. Descriptive cross-sectional study. Location: Primary care. Madrid Health Service. Year: 2014. Subjects: Patients over 14 years with type 2 diabetes. Number of patientes: n=6674. Measurements. Variables on the degree of control (HbA1c, systolic blood pressure [SBP], diastolic blood pressure [DBP], LDL-c) and variables on patient characteristics (demographic, other cardiovascular risk factors, complications). Results. The mean age of patients with controlled HbA1c was 67.8 years vs. 62.9 years in the uncontrolled (P<.001). Patients diagnosed with hypertension have a higher percentage of control with respect to the undiagnosed in HbA1c, SBP, DBP and LDL-c: 51 vs. 37%, 62 vs. 43%, 75 vs. 47% and 57 vs. 44% respectively; diagnosed with dyslipidaemia: 51 vs. 39%, 60 vs. 49%, 70 vs. 56% and 56 vs. 46%. With a diagnosis of macroangiopathy: 46 vs. 45%, 58 vs. 54%, 71 vs. 62% and 15 vs. 60%. All differences were statistically significant (P<.001). Over 50% of patients without a diagnosis of hypertension had an SBP> 140mmHg or DBP> 90mmHg. Over 25% of patients with hypertension or DL and uncontrolled levels were not receiving drug treatment. Conclusion. Control was improved in all groups, especially in younger patients, with particularly high cardiovascular risk by the presence of other cardiovascular risk factors or macroangiopathy. A significant percentage of patients with uncontrolled BP and cLDL were not diagnosed or receiving drug treatment (AU)

Polyphenolic composition and antioxidant activity of açai (Euterpe oleracea Mart.) from Colombia.

Berries of Colombian Euterpe oleracea Mart. were analyzed for total phenolic content (TPC), anthocyanin (ACN) content, and antioxidant activity. Additionally, reversed-phase ultra-high performance liquid chromatography with photodiode array detection (RP-UHPLC-PDA) and heated electrospray ionization (HESI) multistage mass spectrometry (MS(n)) were used to determine the composition of phenolic compounds. Anthocyanin content was 0.57±0.39mg cyanidin-3-glucoside/g fresh weight (FW) and TPC was 6.07±2.17mg gallic acid equivalent (GAE)/g FW. The ABTS radical scavenging activity was 3.1±1.3µmol Trolox equivalents (TE)/100g FW, whereas the DPPH value was 2693.1±332.8µmol TE/100g FW. Overall, results show that Colombian açai has a more diverse polyphenolic profile and higher antioxidant activity than Brazilian açai. This information could be useful in authentification procedures to differentiate Brazilian açai from Colombian açai when used as an alternative for the supply of this fruit during the time of shortage in Brazil.

[Level at which control objectives are reached in patients in different population groups with type 2 diabetes]. / Grado en que se alcanzan los objetivos de control en pacientes con diabetes de tipo 2 en diferentes grupos poblacionales.

INTRODUCTION: There is evidence of increased macro- and micro-vascular risk in diabetic patients. The objective of this study was to determine the level of control in patients in different population groups with type 2 diabetes. DESIGN: Descriptive cross-sectional study. LOCATION: Primary care. Madrid Health Service. Year: 2014. SUBJECTS: Patients over 14 years with type 2 diabetes. Number of patientes: n=6674. MEASUREMENTS: Variables on the degree of control (HbA1c, systolic blood pressure [SBP], diastolic blood pressure [DBP], LDL-c) and variables on patient characteristics (demographic, other cardiovascular risk factors, complications). RESULTS: The mean age of patients with controlled HbA1c was 67.8 years vs. 62.9 years in the uncontrolled (P<.001). Patients diagnosed with hypertension have a higher percentage of control with respect to the undiagnosed in HbA1c, SBP, DBP and LDL-c: 51 vs. 37%, 62 vs. 43%, 75 vs. 47% and 57 vs. 44% respectively; diagnosed with dyslipidaemia: 51 vs. 39%, 60 vs. 49%, 70 vs. 56% and 56 vs. 46%. With a diagnosis of macroangiopathy: 46 vs. 45%, 58 vs. 54%, 71 vs. 62% and 15 vs. 60%. All differences were statistically significant (P<.001). Over 50% of patients without a diagnosis of hypertension had an SBP> 140mmHg or DBP> 90mmHg. Over 25% of patients with hypertension or DL and uncontrolled levels were not receiving drug treatment. CONCLUSION: Control was improved in all groups, especially in younger patients, with particularly high cardiovascular risk by the presence of other cardiovascular risk factors or macroangiopathy. A significant percentage of patients with uncontrolled BP and cLDL were not diagnosed or receiving drug treatment.

Grado de control de factores de riesgo cardiovascular en pacientes con diabetes con y sin enfermedad cardiovascular / Control of cardiovascular risk factors among patients with diabetes with and without cardiovascular disease

Introducción. Existe evidencia de los beneficios de alcanzar objetivos cardiovasculares en diabetes. Objetivo. Conocer la distribución de los niveles de riesgo cardiovascular en los pacientes con diabetes y las intervenciones clínicas que reciben. Diseño. Estudio descriptivo transversal. Emplazamiento. SERMAS (Madrid) 2010. Participantes. Todos los pacientes con diagnóstico registrado de DM, n = 41.096. Mediciones principales. Pacientes en prevención secundaria o primaria, grado de control metabólico y de cada uno de los factores de riesgo cardiovascular, intervenciones clínicas farmacológicas y no farmacológicas. Además, variables del paciente y del profesional. Resultados. Un 21,5% (IC del 95%, 21,1%-21,9%) en prevención secundaria (muy alto riesgo cardiovascular). De ellos, tenía hemoglobina glucosilada controlada el 31% (IC del 95%, 30,1%-32%), PA controlada el 49,9% (IC del 95%, 48,8%-50,9%) y cLDL controlado el 39,4% (IC del 95%, 38,4%-40,4%). Solo 8,9% (IC del 95%, 8,3%-9,5%) tenía bien controladas glucosilada, la PA y el cLDL, y el 19,8% (IC del 95%, 19%-20,6%) no tenía buen control de ninguna. El 23,6% (IC del 95%, 23,2%-24%) de los que tenían PA no controlada tenía fármacos antihipertensivos. Estaban mejor controlados los pacientes mayores de 70 años y los que pertenecían a centro urbano o con presión asistencial no elevada. Conclusión. En pacientes con diabetes con riesgo cardiovascular muy elevado (en prevención secundaria) menos de la mitad de los mismos tenía un buen control de factores de riesgo cardiovascular (PA y cLDL). Se encontró asociación con el mejor control el ser mayor de 70 años, la menor presión asistencial y el pertenecer a centro urbano. Por todo esto, parece razonable la elaboración de estrategias para favorecer un control exhaustivo de los factores de riesgo cardiovascular en pacientes con diabetes en prevención secundaria (AU)

Introduction. There is evidence that cardiovascular goals are beneficial in diabetes. Objective. To determine the distribution of cardiovascular risk levels in patients with diabetes and the clinical interventions they have received. Design. Descriptive cross-sectional study. Setting. SERMAS (Madrid) 2010. Subjects. All patients with diabetes. (n = 41,096). Main measurements. Patients in primary or secondary prevention, metabolic and cardiovascular risk factors control, pharmacological and non-pharmacological interventions. Patient and professional variables. Results. Around one-fifth (21.5%) (95%CI: 21.1% -21.9%) in secondary prevention (very high cardiovascular risk). HbA1c was under control in 31% (95%CI: 30.1%-32%), with 49.9% (95%CI: 48.8%-50.9%) with BP under control, and 39.4% (95% CI: 38.4%-40.4%) with LDL controlled. Only 8.9% (95%CI: 8.3%-9.5%) had a well-controlled HdA1c, BP and LDL, and in 19.8% (95%CI: 19%-20.6%) none of these were under control. Of those with an uncontrolled BP, 23.6% (95% CI: 23.2%-24%) had antihypertensive drugs. There was better control in patients older than 70 years, and those who lived in an urban center, or a lower number of patients per day. Conclusion. In diabetic patients with very high cardiovascular risk (secondary prevention), just half of them had good control of cardiovascular risk factors (BP and LDL). An association was found between better control and older than 70, urban center or lower number of patients per day. This suggests developing strategies to promote a comprehensive control of cardiovascular risk factors in diabetic patients in secondary prevention (AU)

Identification of phenolic compounds in petals of nasturtium flowers (Tropaeolum majus) by high-performance liquid chromatography coupled to mass spectrometry and determination of oxygen radical absorbance capacity (ORAC).

The contents and profile of polyphenols were analyzed in edible petals of nasturtium flowers (Tropaeolum majus) of three colors, and their oxygen radical absorbance capacities (ORAC) were compared. Three primary anthocyanins (ACNs) and 15 non-ACN phenolic compounds including hydroxycinammic acids (HCAs) and flavonoids (myricetin, quercetin, and kaempferol derivatives) were detected. Anthocyanin concentration was within 31.9 ± 21.7 and 114.5 ± 2.3 mg cyanidin-3-glucoside (cy-3-glu)/100 g fresh weight (FW) in yellow and red petals, respectively. The concentration of HCAs varied between 33.3 ± 7.1 and 235.6 ± 8.1 mg chlorogenic acid equivalents/100 g FW for red and yellow flowers, respectively. Red flowers had the highest level of flavonoids (315.1 ± 2.4 mg myricetin equivalents/100 g FW) and the highest ORAC radical-scavenging activity. These results show the diversity and abundance of polyphenolic compounds in nasturtium flowers, which could be the basis for applications in functional foods, cosmetics, and pharmaceuticals.

[Control of cardiovascular risk factors among patients with diabetes with and without cardiovascular disease]. / Grado de control de factores de riesgo cardiovascular en pacientes con diabetes con y sin enfermedad cardiovascular.

INTRODUCTION: There is evidence that cardiovascular goals are beneficial in diabetes. OBJECTIVE: To determine the distribution of cardiovascular risk levels in patients with diabetes and the clinical interventions they have received. DESIGN: Descriptive cross-sectional study. SETTING: SERMAS (Madrid) 2010. SUBJECTS: All patients with diabetes. (n=41,096). MAIN MEASUREMENTS: Patients in primary or secondary prevention, metabolic and cardiovascular risk factors control, pharmacological and non-pharmacological interventions. Patient and professional variables. RESULTS: Around one-fifth (21.5%) (95%CI: 21.1% -21.9%) in secondary prevention (very high cardiovascular risk). HbA1c was under control in 31% (95%CI: 30.1%-32%), with 49.9% (95%CI: 48.8%-50.9%) with BP under control, and 39.4% (95% CI: 38.4%-40.4%) with LDL controlled. Only 8.9% (95%CI: 8.3%-9.5%) had a well-controlled HdA1c, BP and LDL, and in 19.8% (95%CI: 19%-20.6%) none of these were under control. Of those with an uncontrolled BP, 23.6% (95% CI: 23.2%-24%) had antihypertensive drugs. There was better control in patients older than 70 years, and those who lived in an urban center, or a lower number of patients per day. CONCLUSION: In diabetic patients with very high cardiovascular risk (secondary prevention), just half of them had good control of cardiovascular risk factors (BP and LDL). An association was found between better control and older than 70, urban center or lower number of patients per day. This suggests developing strategies to promote a comprehensive control of cardiovascular risk factors in diabetic patients in secondary prevention.

Asociación entre indicadores de proceso medidos sobre historia electrónica y resultados intermedios en salud, en pacientes con diabetes / Relationship between process indicators measured using electronic records and intermediate health outcomes in patients with diabetes

Objetivo. Determinar, en diabetes, si la medición sobre historia electrónica de cada indicador de proceso del SERMAS se asocia a resultados intermedios en salud. Método. Estudio descriptivo transversal efectuado en el Área 1 de AP Madrid.en el año 2010. Los participantes fueron pacientes con diabetes (n = 16.652). Variables independientes: indicadores institucionales de proceso (cartera de servicios) y dependientes. Resultados intermedios: cifras controladas de HbG, TA, LDL, tabaco y peso; detección de complicaciones. Potencialmente confusoras: edad y sexo, tipo y tiempo de evolución, comorbilidad, fármacos y variables del profesional. Resultados. El 55,9% (IC 95%: 55,1-56,7%) tenía cifras controladas de HbG. El registro de los siguientes indicadores de proceso se asoció con un aumento de la probabilidad de alcanzar resultados intermedios: revisión de antecedentes familiares, personales, estilo de vida, adherencia, tratamiento, medición de HbG, peso, TA, consejo sobre tabaco, ECG, índice tobillo-brazo, creatinina y fondo de ojo. El rango de OR fue desde 1,15 (IC 95%: 1,01-1,32) a 2,05 (IC 95%: 1,76-2,39). En otros criterios no se encontró asociación: clasificación DM, medición de glucemia, revisión del plan de cuidados, medición de IMC, LDL y microalbuminuria. Conclusiones. En diabetes se encontró asociación entre los indicadores de proceso del Sermas, medidos sobre historia electrónica, y un aumento del 20-50% de la probabilidad de alcanzar resultados intermedios en salud (con excepciones). Parece recomendable mantener la medición de proceso y resultado, incorporar la medición de otros resultados intermedios, incorporar otras intervenciones de impacto, priorizar las mejoras de actividad o de registro en criterios de proceso de baja realización y alto impacto y modificar los indicadores sin asociación con resultados(AU)

Objective. To study relationship between institutional process indicators (measured using electronic records) and intermediate outcomes of patients with diabetes. Method. Cross-sectional epidemiological study. Setting Primary care health district 1. Madrid. 2010. Patients: all patients with diabetes; n = 16.652. Main measures variables. Independent. Institutional process indicators. Dependent. Intermediate outcomes: GHb, BP, LDL, tobacco and weight within target limits and detected complications. Confounding. Age, gender, type and years for DM, co-morbidity, drugs and professional variables. Results. GHb of 55,9% (SE 0,4) of patients was within target limits. Bivariate analysis and multivariate logistic regression showed that the recording of some process indicators was associated with an increase in the probability to achieve targets in intermediate outcomes: reviewing personal and family history, lifestyle and drug therapy, creatinine, GHb, BP and weight measurement, smoking advice, EKG, ankle-arm index, and eye examination. OR were from 1,15 (CI95%:1,01-1,32) to 2,05 (CI95%:1,76-2,39). Relationship among other indicators and higher probability to achieve targets was not found: classification, reviewing care plan, glucose, BMI, LDL and microalbuminury measurement. Conclusions. In diabetes, a lot of institutional process indicators measured on electronic records was associated with increase of probability to achieve targets in intermediate outcomes. It suggests to maintain process and outcome measurement, to include other outcomes, to include other interventions, to prioritize improvements in process indicators that show low performance and high impact and to keep out or to change process indicators that relationship was not found(AU)

[Relationship between process indicators measured using electronic records and intermediate health outcomes in patients with diabetes]. / Asociación entre indicadores de proceso medidos sobre historia electrónica y resultados intermedios en salud, en pacientes con diabetes.

OBJECTIVE: To study relationship between institutional process indicators (measured using electronic records) and intermediate outcomes of patients with diabetes. METHOD: Cross-sectional epidemiological study. Setting Primary care health district 1. Madrid. 2010. PATIENTS: all patients with diabetes; n = 16.652. Main measures variables. Independent. Institutional process indicators. Dependent. Intermediate outcomes: GHb, BP, LDL, tobacco and weight within target limits and detected complications. Confounding. Age, gender, type and years for DM, co-morbidity, drugs and professional variables. RESULTS: GHb of 55.9% (SE 0,4) of patients was within target limits. Bivariate analysis and multivariate logistic regression showed that the recording of some process indicators was associated with an increase in the probability to achieve targets in intermediate outcomes: reviewing personal and family history, lifestyle and drug therapy, creatinine, GHb, BP and weight measurement, smoking advice, EKG, ankle-arm index, and eye examination. OR were from 1,15 (CI 95%: 1.01-1.32) to 2.05 (CI 95%: 1.76-2.39). Relationship among other indicators and higher probability to achieve targets was not found: classification, reviewing care plan, glucose, BMI, LDL and microalbuminury measurement. CONCLUSIONS: In diabetes, a lot of institutional process indicators measured on electronic records was associated with increase of probability to achieve targets in intermediate outcomes. It suggests to maintain process and outcome measurement, to include other outcomes, to include other interventions, to prioritize improvements in process indicators that show low performance and high impact and to keep out or to change process indicators that relationship was not found.

Significado de las vivencias de niños y niñas afectados por el VIH/SIDA, adscritos a un centro de atención y apoyo / Meaning of the live experiences of children suffering of HIV/AIDS, care for a support center

Esta investigación de corte cualitativo con diseño fenomenológico, buscó a través de los talleres lúdicos, la observación participante y la entrevista semiestructurada, comprender el significado de las vivencias de niños y niñas de 7 a 16 años de edad afectados por el VIH/SIDA, adscritos a un centro de atención y apoyo para el VIH/SIDA, entendiendo la vivencia como el resultado de la relación del sujeto con los diversos objetos y eventos que constituyen los aspectos dinámicos de su mundo y que componen su historia. Los significados de estos niños/as acerca de la vivencia de estar afectados por el VIH/SIDA giran en torno al señalamiento, la discriminación, el ser portador social del virus, miedo de revelar la condición en la escuela por el rechazo que puede causarles, la no satisfacción de sus demandas ontológicas por su institucionalización y la resignificación de sus vivencias que los lleva a tener conductas preventivas y ser educadores de la enfermedad.

This qualitative research with a phenomenological design, searched throughout playful workshops, partaker observation and semi-structured interview, understand the meaning of the experiences of children from 7 to 16 years old affected by HIV/AIDS, care for a support center for HIV/AIDS. Understanding the experience as the result of the subject's relationship with the different objects and events that constitute the dynamic aspects of their world and that comprise their story. The meanings of these children on the experience of being affected by HIV/AIDS revolve around tagging, discrimination, carrying the virus socially, fear to reveal the condition at school that can cause rejection, the failure to meet their ontological demands for their institutionalization and the significance of their experiences that leads to preventive behaviors and develop educators of the disease.

Determination of carotenoids, total phenolic content, and antioxidant activity of Arazá (Eugenia stipitata McVaugh), an Amazonian fruit.

The fruit of Arazá (Eugenia stipitata McVaugh) native to the Colombian Amazon is considered a potentially economically valuable fruit for the Andean economy due to its novel and unique taste. The fruit has an intense yellow color, but its chemical composition and properties have not been well studied. Here we report the identification and quantitation of carotenoids in the ripe fruit using high performance liquid chromatography (HPLC) with photodiode array detector (PDA) and atmospheric pressure chemical ionization (APcI) mass spectrometry (MS/MS). The qualitative carotenoid profile of the fruit according to maturity stage was also observed. Furthermore, antioxidant activity of the peel and pulp were assessed using the ferric reducing ability of plasma (FRAP), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and 1,1-diphenyl-2-picrylhydrazyl (DPPH) methods, in addition to chemical indexes and total phenolic content. Multiple carotenoids were identified in the peel and pulp including four xanthophylls (free and esterified as their mono and diesters) and two carotenes. One of the xanthophylls was tentatively identified as zeinoxanthin, while the others were identified as lutein, zeaxanthin, and ß-cryptoxanthin. Carotenes included α-carotene and ß-carotene. The total carotenoid content was significantly higher in the peel (2484 ± 421 µg/100 g FW) than in the pulp (806 ± 348 µg/100 g FW) with lutein, ß-cryptoxanthin, and zeinoxanthin as the major carotenoid components. The unique carotenoid composition of this fruit can differentiate it from other carotenoid-rich fruits and perhaps be useful in authentication procedures. Overall, results from this study suggest that Colombian Arazá may be a good edible source of carotenoids important in retinal health as well as carotenoids with provitamin A activity. Therefore, Arazá fruit can be used as a nutraceutical ingredient and in production of functional foods in the Colombian diet.

Antioxidant activity, total phenolics content, anthocyanin, and color stability of isotonic model beverages colored with Andes berry (Rubus glaucus Benth) anthocyanin powder.

The stability of anthocyanin (ACN) freeze-dried powders from Andes berry (Rubus glaucus Benth) as affected by storage, addition of maltodextrin as a carrier agent, and illumination was evaluated in isotonic model beverages. The ethanolic ACN extract was freeze dried with and without maltodextrin DE 20. Isotonic model beverages were colored with freeze-dried ACN powder (FDA), freeze-dried ACN powder with maltodextrin (MFDA), and red nr 40. Beverages were stored in the dark and under the effect of illumination. Half life of the ACNs, changes in color, total phenolics content (TPC), and antioxidant activity were analyzed for 71 d. Addition of maltodextrin and absence of light stabilized the color of beverages and improved ACN and TPC stability during storage. The antioxidant activity of the beverages was higher when they were colored with MFDA and highly correlated with ACN content. There was no correlation between antioxidant activity and TPC. It is concluded that addition of maltodextrin DE 20 as a carrier agent during freeze-drying improves the color and stability of nutraceutical antioxidants present in Andes berry extract. This suggests a protective enclosing of ACNs within a maltodextrin matrix with a resulting powder that could serve as a supplement or additive to naturally color and to enhance the antioxidant capacity of isotonic beverages.

STABILITY OF ANTHOCYANINS FROM Rubus glaucus AND Solanum betaceum Cav.dark-red strain AS AFFECTED BY TEMPERATURE, STORAGE AND WATER ACTIVITY / Efecto de la temperatura, almacenamiento y la actividad de agua sobre la estabilidad de antocianinas de Rubus glaucus y Solanum betaceum Cav.dark-red strain

The stability of sprayed-dried microencapsulated anthocyanins from Andes berry (Rubus glaucus) and Tamarillo (Solanum betaceum), as affected by storage time, water activity (Aw) and temperature was compared. The fruits were osmotically dehydrated with ethanol and the anthocyanin extract was microencapsulated with maltodextrin DE 20 by spray drying. Half life of the anthocyanins; changes in color, total phenolics, and antioxidant activity of the powders, were analyzed during storage at two different temperatures ( 25 °C and 40 °C) and two Aw levels (0.20 and 0.35). A decrease in monomeric anthocyanin was observed in both samples. The half life of the Andes berry pigments ranged between 11 and 32 days while the half life of the tamarillo pigments ranged between 9 and 21 days. A darkening effect occurred in both samples as a result of storage time. The antioxidant activity decreased while the phenolic content increased with time. Antioxidant activity of Andes berry samples was highly correlated with anthocyanin content and total phenolic content while the antioxidant activity of tamarillo samples was highly correlated with total phenolic content. These results would be useful in developing applications for spray-dried anthocyanins as powdered food-grade colorants.

Se comparó el efecto del tiempo de almacenamiento, la temperatura y la actividad de agua (Aw) sobre la estabilidad de antocianinas microencapsuladas de Mora de Castilla (Rubus glaucus) y tamarillo (Solanum betaceum). Las frutas se sometieron a deshidratación osmótica con etanol y el extracto antociánico se microencapsuló con maltodextrina ED 20 por atomización. La vida media de las antocianinas; los cambios en color, fenoles totales y actividad antioxidante se analizaron durante el almacenamiento a dos temperaturas ( 25 °C y 40 °C) y dos niveles de Aw (0,20 y 0,35). Se observó una disminución de la antocianina monomérica en las dos muestras. La vida media de los pigmentos de mora de Castilla varió entre 11 y 32 días, mientras que la vida media de los pigmentos del tamarillo varió entre 9 y 21 días. Hubo oscurecimiento de las muestras como resultado del tiempo de almacenamiento. La actividad antioxidante de las dos muestras dismi-nuyó, mientras que el contenido fenólico aumentó con el tiempo. La actividad antioxi-dante de las muestras de mora de Castilla presentó una alta correlación con los con-tenidos de antocianinas y fenoles totales mientras que la actividad antioxidante de las muestras de tamarillo se correlacionó con el contenido de fenoles totales. Estos resultados son útiles en el desarrollo de aplicaciones de antocianinas microencapsu-ladas como colorantes alimenticios.

Determination of anthocyanins, total phenolic content, and antioxidant activity in Andes Berry (Rubus glaucus Benth).

Anthocyanins, total phenolic content, ascorbic acid content, and the antioxidant activity were determined in extracts of Andes berry fruit (Rubus glaucus Benth). Anthocyanis (ACNs) were isolated and characterized by means of high-performance liquid chromatography (HPLC) with photodiode array detection and electro spray ionization/mass spectrometry (PDA-ESI/MS/MS) analysis. The anthocyanin (ACN) content was 45 mg/100 g FW. The isolated anthocyanins were characterized as cyanidin 3-sambubioside, cyanidin 3-glucoside, cyanidin 3-xylorutinoside, cyanidin 3-rutinoside, pelargonidin 3-glucoside, and pelargonidin 3-rutinoside. The ascorbic acid content was 10.1 mg/100 g FW. The total phenolic content as determined by the Folin-Ciocalteau method was 294 mg GAE/100 g FW while the antioxidant activity as measured by ABTS(.) (+) radical scavenging capacity and ferric reducing antioxidant power (FRAP) was 2.01 and 4.50 mmol TE/100 g FW or 8.22 mmoles ferric iron reduced/100 g FW, respectively. The high phenolic content and antioxidant capacity of Andes berry suggest that this fruit could be a rich source of natural pigments, nutraceuticals, and natural antioxidants.

Nongenomic regulation of glutamatergic neurotransmission in hippocampus by thyroid hormones.

Thyroid hormones (THs) are well known for their genomic effects but recently attention has focused also on their nongenomic actions as rapid modulators of membrane receptors. Here we show that thyroxine (T4) and 3,3',5'-l-triiodothyronine (T3) rapidly decrease N-methyl-d-aspartate (NMDA)-evoked currents in rat hippocampal cultures with potency in the micromolar range. The effect is not mediated by glutamate or glycine binding sites as an increase in agonist or glycine concentration does not alter TH potencies. Furthermore THs' effect on NMDA receptors is independent of voltage and of subunit composition. The mechanism of THs' antagonistic effect does not involve PKC phosphorylation of NMDA receptors since neither blocking nor stimulating PKC changed THs' modulation. T3, but not T4, inhibits also kainate-evoked currents in hippocampal neurons in culture. In hippocampal pyramidal neurons in slice, T3, but not T4, significantly reduced the frequency of miniature excitatory postsynaptic currents (mEPSCs) without affecting their amplitude and decay. In cultured rat cortical neurons THs prevented glutamate-induced neuronal death at concentrations similar to those effective on glutamatergic receptors. Taken together our data show for the first time that THs can rapidly affect ionotropic glutamatergic receptors in hippocampal neurons, an effect that could have an important role in their modulation of brain function in physiological and pathological states.

Endovascular repair of descending thoracic aortic aneurysm via midsternotomy and without extracorporeal circulation.

A 68-year-old man with peripheral vascular disease and associated risk factors, was diagnosed by CT-scan and aortography with an atherosclerotic descending thoracic aortic aneurysm. The patient was treated by successful endovascular grafting of the aneurysm using a midsternotomy incision and the insertion of a thoracic stent-graft through a T-Dacron tube sutured in the ascending aorta, without the aid of cardiopulmonary bypass.

Hipertensión portal prehepática como complicación tardía del trasplante hepático pediátrico / Prehepatic portal hypertension after pediatric liver transplantion

Algunos niños sometidos a trasplante hepático (TH) desarrollan a largo plazo hipertensión portal prehepática (HPP) y plantean problemas hasta ahora poco conocidos; muchas de las lecciones aprendidas con el manejo de estos enfermad pueden tener además aplicación fuera del trasplante. Objetivos: 1. Analizar la incidencia y factores de riesgo de HPP tras TH. 2, Valorar los resultados con los diferentes tratamientos utilizados. Material y métodos. Estudio retrospectivo sobre 164 niños que sobrevivieron más de un año tras TH. Análisis univariante de posibles factores de riesgo asociados a multivariante (regresión logística) para aquéllos que en el análisis univariante tuvieron significación. Se analizan otros factores asociados y las indicaciones y resultados de dos tipos de tratamiento: dilatación neumática percutánea y shunt quirúrgico (esplenorrenal y meso-portal o shunt de Rex). Resultados. Nueve niños desarrollaron Hpp sintomática (hemorrágica en 8, ascitis en 1), asociada en 2 a trastorno linfoproliferativo postrasplante y a estenosis biliar anastomótica en uno. La edad al primer trasplante (menores de un año), peso (menores de 10 Kg) y necesidad de retrasplante fueron en el análisis univariante las variables asociadas con riesgo incrementado de HPP. Fueron casi significativas el diagnóstico (atresia biliar), y el grado de urgencia del TH. En el análisis multivariante, la necesidad de retrasplantes es la única variable independiente que incrementa el riesgo (riesgo relativo; 4,5 intervalo de confianza 95 por ciento: 1,29-18,87). Al diagnóstico, tres caos mostraron estenosis portal, y ausencia de permeabilidad con trasformación cavernomatosa de la porta en cinco. La hPP fue ocasionada en un caso por desconexión de vena esplénica ( que de momento no requiere tratamiento); los tres casos de estenosis portal fueron dilatados con éxito por abordaje percutáneo, y los dos de los 5 casos de trombosis portal han sido derivados quirúrgicamente; uno mediante shunt esplenorrenal y otro mediante shunt de Rex (primer caso realizado en España); los restantes tres casos están estables y pendientes de solución quirúrgica. La función hepática es normal en los 9 casos. Conclusiones. La HPP puede complicar a largo plazo en pronóstico del TH pediátrico. Diagnosticada en fase de estenosis portal, la dilatación neumática es el tratamiento de elección, debiendo ser tratados los restantes quirúrgicamente. En estos casos, el shunt más fisiológico y la mejor opción es el de Rex (AU)