Muffin-Type Bakery Product Based on Mexican Mesquite (Prosopis spp.) Flour: Texture Profile, Acceptability, and Physicochemical Properties.

In this research, muffin-type bakery products were developed based on wheat flour (WF) and mesquite flour (MF) in the following proportions: WFMF 90:10, WFMF 75:25, and WFMF 50:50. The products were characterized based on various properties in which it was possible to observe that the water activity (aw) did not show a significant change with the increase in the concentration of MF. In addition, the increase in the concentration of MF modified the sensory properties (color, odor, flavor, texture, and acceptance), further decreasing the luminosity and increasing the values of the a* and b* coordinates. Moreover, in the texture profile analysis, it was found that the increase in the MF concentration increased hardness, fracturability, and gumminess and decreased adhesiveness and cohesiveness. All the previously mentioned changes were more evident in the WFMF50:50 and, to a lesser degree, in WFMF75:25. In general, in most evaluations realized, the WFMF90:10 treatment was the most similar to the control (without MF). However, WFMMF75:25 provided a higher protein and fiber content and a lower fat content. Finally, it is possible to use the flour obtained from the mesquite fruit to make bakery products since it is an important source of food due to the wide distribution of mesquite in the country.

Production and Characterization of Biocomposite Films of Bacterial Cellulose from Kombucha and Coated with Chitosan.

The purpose of this research is to produce and characterize bacterial cellulose (BC) films coated with chitosan (BC-CH). BC films were produced in a fermentation medium based on Camellia sinensis tea and dextrose (12 days at 25 °C) and subsequently treated with coating-forming solutions (CFSs) based on chitosan (BC-CH 0.5%, BC-CH 1.0%, and BC-CH 1.5%). As a result, the FTIR spectra of BC and BC-CH 1.5% showed the main characteristic bands of cellulose and chitosan. In the physicochemical characterization of the films, it was found that the incorporation of the chitosan coatings did not affect the thickness; however, it decreased the luminosity (L*) and increased redness (a*), yellowness (b*), and opacity (75.24%). Additionally, the light absorption properties in the UV-Vis range were improved. Furthermore, the application of the CFSs increased: the solubility (64.91%), the antimicrobial activity against S. aureus (6.55 mm) and E. coli (8.25 mm), as well as the antioxidant activity (57.71% and 24.57% free radical scavenging activity), and the content of total phenols (2.45 mg GAE/g). Finally, our results suggest that the BC-CH films developed in the present study show a potential application as active packaging material for food.

Repeated loss of variation in insect ovary morphology highlights the role of development in life-history evolution.

The number of offspring an organism can produce is a key component of its evolutionary fitness and life history. Here we perform a test of the hypothesized trade-off between the number and size of offspring using thousands of descriptions of the number of egg-producing compartments in the insect ovary (ovarioles), a common proxy for potential offspring number in insects. We find evidence of a negative relationship between egg size and ovariole number when accounting for adult body size. However, in contrast to prior claims, we note that this relationship is not generalizable across all insect clades, and we highlight several factors that may have contributed to this size-number trade-off being stated as a general rule in previous studies. We reconstruct the evolution of the arrangement of cells that contribute nutrients and patterning information during oogenesis (nurse cells), and show that the diversification of ovariole number and egg size have both been largely independent of their presence or position within the ovariole. Instead, we show that ovariole number evolution has been shaped by a series of transitions between variable and invariant states, with multiple independent lineages evolving to have almost no variation in ovariole number. We highlight the implications of these invariant lineages on our understanding of the specification of ovariole number during development, as well as the importance of considering developmental processes in theories of life-history evolution.

Cerebellar gangliocytoma as a cause of fluctuating hearing loss.

Cerebellar lesions could be a cause of fluctuating hearing loss, due to the increase of intracranial pressure by partially or complete blocking of the Foramen of Luschka. Patients with intracranial hypertension may present audio-vestibular symptoms. Fluctuating sensorineural hearing loss may be the manifestation of different inner ear disorders such as Meniere's disease (MD), immune-mediated inner ear disease (IMIED), otosyphilis, and labyrinthine fistula including semicircular canal dehiscence. A rare mechanism involved in the fluctuating hearing loss is the increase in cerebrospinal fluid (CSF) pressure, that may be caused by a cerebellar tumor. A 51-year-old female presented a 2-year history of left ear fluctuating hearing loss and tinnitus, with fluctuations among the day, and normal otoscopy. Several audiometries showed a left ear moderate sensorineural hearing loss in low frequencies (Figure 1). The patient underwent a cerebral magnetic resonance imaging (MRI) (Figure 2). She was treated with three courses of systemic steroids showing improvement of symptoms during the treatment. However, the symptoms always returned when corticotherapy was interrupted. The patient was given two intratympanic steroids cycles combined with hydrochlorothiazide/ amiloride hydrochloride. The cerebral MRI described a left cerebellar focal lesion diagnosed as a cerebellar gangliocytoma. After receiving the second intratympanic steroids, cycle combined with systemic ameride showed a significant improvement of audition. Between the several causes of fluctuating hearing loss, a cerebellar gangliocytoma is a very rare disease, which needs a high degree of suspicion and otorhinolaryngologists should be familiar with this entity since patients may present with audiological and vestibular symptoms.

Malignancy risk of sonographically benign appearing purely solid adnexal masses in asymptomatic postmenopausal women.

OBJECTIVE: To assess the natural history of benign appearing purely solid ovarian lesions in asymptomatic postmenopausal women. METHODS: Retrospective observational cohort study comprising 99 women (mean age, 58.2 years, ranging from 50 to 77 years) diagnosed as having a purely solid ovarian lesion at transvaginal ultrasound between April 2001 and October 2015. Inclusion criteria were as follows: asymptomatic postmenopausal women with a well-defined purely solid ovarian lesion with International Ovarian Tumor Analysis color score 1 or 2, without ascites and/or signs of carcinomatosis. Clinical, sonographic, biochemical (CA-125), and histologic data (in case of surgery) were retrieved for analysis. Patients who were managed conservatively were assessed by transvaginal sonography every 6 months for a minimum of a year. In case of bilateral lesions we used the largest one for analysis. RESULTS: Five women (5.1%) had bilateral lesions. Mean size of the lesion was 2.9 cm (range, 1.0-7.8 cm). Most lesions were homogeneous (96.0%). Acoustic shadowing was present in 59.6% of cases. International Ovarian Tumor Analysis color score was 1 in 77.8% and 2 in 22.2% of the cases, respectively. Median CA-125 was 10.8 IU/mL (range, 3.0-403.0 IU/mL). Forty-two women underwent surgery after diagnosis (histologic diagnoses were as follows: fibroma (n = 26), fibrothecoma (n = 5), dermoid (n = 3), Brenner tumor (n = 3), endometrioma (n = 2), thecoma (n = 1), primary invasive cancer (n = 2). One case of invasive cancer CA-125 was 403.0 IU/mL and in the other case CA-125 was 6.0 IU/mL. They both were stage 1. Fifty-seven women were managed with serial follow-up. With a median follow-up time of 36 months (range, 12-142 months) all these lesions had no change and women remain asymptomatic. Considering all 99 cases the risk of malignancy is 2% (95% CI, 0.1-7.5). CONCLUSIONS: The risk of malignancy of benign appearing purely solid adnexal masses in asymptomatic postmenopausal women is low. Conservative management of these lesions might be an option.

Hospital costs associated with nosocomial infections in a pediatric intensive care unit / Coste asociado a la infección nosocomial en una unidad de cuidados intensivos pediátricos

Objective: To estimate the additional cost attributable to nosocomial infection (NI) in a pediatric intensive care unit (PICU) and related factors. Methods: A prospective cohort study was conducted in all children admitted to the PICU of a tertiary-care pediatric hospital between 2008 and 2009. Descriptive and bivariate analyses were conducted of total direct costs due to PICU stay and medical procedures in patients with and without NI. A log-linear regression model was performed to determine the factors associated with higher total cost. Results: A total of 443 patients were studied and the prevalence of NI was 11.3%. The difference in the median total cost was €30,791.4 per patient between groups with and without NI. The median cost of PICU length of stay in patients with NI was almost eight times higher than the median cost of patients without NI. In patients with NI, the highest costs related to medical procedures were associated with antibiotics, enteral and parenteral feeding, and imaging tests. In the multivariate model, the factors associated with higher cost were infection, the performance of cardiovascular surgery, urgent admission, a higher pediatric risk mortality score, and the presence of immunosuppression. By contrast, older children and those with surgical admission generated lower cost. Conclusions: NI was associated with an increase in total cost, which implies that the prevention of these infections through specific interventions could be cost-effective and would help to increase the safety of healthcare systems (AU)

Objetivo: El objetivo del estudio es estimar el coste adicional atribuible a la infección nosocomial (IN) en una Unidad Pediátrica de Cuidados Intensivos (UCIP) y sus factores asociados. Método: estudio de cohortes prospectivo de todos los pacientes ingresados en una UCIP de tercer nivel entre 2008 y 2009. Se realizó un análisis descriptivo y bivariante del coste total asociados a estancia en UCIP y procedimientos en pacientes con y sin IN. Mediante regresión lineal múltiple, se estimaron los factores asociados al incremento del coste total. Resultados: se estudiaron 443 pacientes, la incidencia de IN fue 11,3%. La diferencia de las medianas en el coste total fue de 30.791,4€ por paciente entre los grupos con y sin IN. El coste mediano de la estancia de pacientes con IN fue casi ocho veces mayor que el coste mediano de los pacientes sin IN. En pacientes con IN, el coste asociado a procedimientos más elevado fue el de antibióticos, nutrición enteral y parenteral y pruebas de imagen. En el modelo multivariante los factores asociados con un mayor coste fueron: presencia de infección nosocomial, cirugía cardiovascular, tipo ingreso urgente, mayor índice pronóstico de mortalidad al ingreso y la presencia de inmunosupresión. Por el contrario, los de mayor edad y aquellos ingresados por cirugía presentaron un menor coste. Conclusiones: La IN está asociada al incremento del coste total, lo que implica que la prevención de estas infecciones mediante intervenciones específicas podría resultar costo-efectiva, redundando en sistemas de salud más seguros (AU)

Esteroides asociados a inmunoglobulina intravenosa en el tratamiento del Síndrome de Stevens-Johnson y necrólisis epidérmica tóxica / Steroids associated with intravenous immunoglobulin in the treatment of Stevens-Johnson syndrome and toxic epidermal necrolysis

Introducción: La necrólisis epidérmica tóxica (NET) y el síndrome de Stevens-Johnson (SSJ) son reacciones cutáneas raras, graves y potencialmente mortales asociadas principalmente al uso de medicamentos; sin embargo, se ha señalado la posible relación entre el SSJ con la infección por Mycoplasma pneumoniae o herpes. El tratamiento consiste en la suspensión del fármaco y cuidados de soporte. No existe tratamiento específico que haya demostrado eficacia. Se ha propuesto el uso de inmunoglobulina intravenosa debido a su potencial anti-Fas in vitro, aunque sus efectos reportados no son concluyentes. Objetivo: Describir la respuesta a inmunoglobulina intravenosa en el tratamiento del SSJ/NET en el Hospital de Especialidades Centro Médico Nacional Siglo XXI. Material y métodos: Se realizó un estudio descriptivo retrospectivo en pacientes con SSJ/NET del servicio de Medicina Interna que recibieron inmunoglobulina intravenosa (IV) en el período de marzo de 2008 y abril de 2014. Resultados: Siete pacientes recibieron de 1-3 g/kg de inmunoglobulina IV, 5 mujeres (87.7%) y 1 hombre (14.2%). Todos se relacionaron con ingesta de fármacos, trimetoprim/sulfametoxazol en el 28.5% de los casos. El 71.4% presentó fiebre, 85.7% presentó afección mayor al 10% de la superficie corporal, 100% presentó afección de 2 o más mucosas y 42.8% requirió manejo avanzado de la vía aérea. La estancia hospitalaria promedio fue de 32 días. No ocurrieron defunciones. Una mujer presentó hipertensión asociada a la infusión de inmunoglobulina, así como cefalea, y otra paciente desarrolló neumonía nosocomial. Conclusiones: La respuesta a inmunoglobulina IV fue satisfactoria logrando abortar la progresión del cuadro en 5 pacientes, 85.7% de los casos, sin efectos adversos relevantes(AU)

Background: Toxic epidermal necrolysis (TEN) and Stevens -Johnson syndrome (SJS) are rare but serious and potentially lifethreatening adverse cutaneous drug reactions. However, a possible relationship between SJS with Mycoplasma pneumoniae infection or herpes has been noted. Treatment consists of drug discontinuation and supportive care as there is no specific therapy that has shown efficacy. Intravenous immunoglobulins have been tested as a consequence of the anti-Fas in vitro potential, although its reported effects are inconclusive. Objective: To describe the response to intravenous immunoglobulin in the management of SJS / TEN in Hospital de Especialidades Centro Médico Nacional SXXI. Material and methods: A retrospective descriptive study was conducted in patients with SJS / TEN in the service of Internal Medicine who received intravenous immunoglobulin (IVIG) from March 2008 until April 2014. Results: Seven patients received 1-3 g/ kg IV immunoglobulin, 5 females (87.7 %) and 1 male (14.2 %), all related to ingestion of drugs, trimethoprim/ sulfamethoxazole in 28.5 % of cases. 71.4% had fever, 85.7 % had skin involvement of greater than 10% of the body surface , 100 % had involvement of 2 or more mucous and 42.8 % required advanced airway management . The average hospital stay was 32 days. No deaths occurred. A woman has hypertension associated with immunoglobulin infusion and headache, and another patient developed nosocomial pneumonia Conclusions: Response to IV immunoglobulin was satisfactory as it was associated with cessation of skin and mucosal detachment in 85.7 % of cases without significant adverse effects.

Hospital costs associated with nosocomial infections in a pediatric intensive care unit.

OBJECTIVE: To estimate the additional cost attributable to nosocomial infection (NI) in a pediatric intensive care unit (PICU) and related factors. METHODS: A prospective cohort study was conducted in all children admitted to the PICU of a tertiary-care pediatric hospital between 2008 and 2009. Descriptive and bivariate analyses were conducted of total direct costs due to PICU stay and medical procedures in patients with and without NI. A log-linear regression model was performed to determine the factors associated with higher total cost. RESULTS: A total of 443 patients were studied and the prevalence of NI was 11.3%. The difference in the median total cost was €30,791.4 per patient between groups with and without NI. The median cost of PICU length of stay in patients with NI was almost eight times higher than the median cost of patients without NI. In patients with NI, the highest costs related to medical procedures were associated with antibiotics, enteral and parenteral feeding, and imaging tests. In the multivariate model, the factors associated with higher cost were infection, the performance of cardiovascular surgery, urgent admission, a higher pediatric risk mortality score, and the presence of immunosuppression. By contrast, older children and those with surgical admission generated lower cost. CONCLUSIONS: NI was associated with an increase in total cost, which implies that the prevention of these infections through specific interventions could be cost-effective and would help to increase the safety of healthcare systems.

Removal of chromium and lead by a sulfate-reducing consortium using peat moss as carbon source.

The effect of pre-treated peat moss on the ability of a sulfate-reducing microbial consortium to remove chromium and lead in solution was evaluated. The most active bacterial community (235.7 mmol H2S/g VSS) was selected from among eight consortia. The peat moss was pre-treated with different HCl concentrations and contact times. The best combination of treatments was 20% HCl for 10 min. The constant substrate affinity Ks was 740 mg COD/L and the ratio COD/SO4(2-) was 0.71. At pH 5, higher production of biogenic sulfide was observed. The up-flowpacked bed bioreactor operated at a flow of 8.3 mL/min for 180 h to obtain removal efficiency (by sulfate-reducing activity) of 90% lead and 65% chromium. It is important to consider that peat moss is a natural adsorbent that further influences the removal efficiency of metal ions.