Quality of a powdered grapefruit product formulated with biopolymers obtained by freeze-drying and spray-drying.

Freeze-drying and spray-drying are two techniques used to produce dehydrated food products. Both techniques are easy to use and offer high sensory, nutritive value, and functional quality to foods. However, both processes become difficult for foods with high sugar and acid content, such as fruits. This is because these products, once dehydrated, moisten quickly, causing a change in their physical properties, mainly in the mechanical aspects related to the start of a caking phenomenon. Therefore, incorporating high molecular weight biopolymers that act as facilitators or processors, prevent the structural collapse of the product. The aim of this study was to select the best process, between freeze-drying or spray-drying, to obtain a powdered grapefruit product with the higher quality. The impact of the biopolymers used to stabilize the powdered product was also tested. The properties analyzed were the solubility, wettability, hygroscopicity, porosity, and color of the powder together with the flow behavior, both in air and water. The results of this study show that using the freeze-drying technique, products have a better flow behavior, greater porosity, and a color more like fresh grapefruit. Biopolymers, especially when in combination, have a positive effect on the quality parameters studied. PRACTICAL APPLICATION: The results of this study allow freeze-drying to be proposed as a process to obtain a grapefruit product with better properties, both powdered and rehydrated, than that obtained by spray-drying. On the other hand, although the incorporation of biopolymers is necessary to facilitate the process and stabilize the product, no significant differences have been found between the different formulations tested, although it seems that their combination favours some of the properties of the powder, such as solubility, hygroscopicity, wetting time and dispersibility.

Dihydroagarofuranoid Sesquiterpenes as Acetylcholinesterase Inhibitors from Celastraceae Plants: Maytenus disticha and Euonymus japonicus.

Natural cholinesterase inhibitors have been found in many biological sources. Nine compounds with agarofuran (epoxyeudesmane) skeletons were isolated from seeds and aerial parts of Maytenus disticha and Euonymus japonicus. The identification and structural elucidation of compounds were based on spectroscopic data analyses. All compounds had inhibitory acetylcholinesterase (AChE) activity. These natural compounds, which possessed mixed or uncompetitive mechanisms of inhibitory activity against AChE, may be considered as models for the design and development of new naturally occurring drugs for management strategies for neurodegenerative diseases. This is the first report of these chemical structures for seeds of M. disticha.

A new isoxazolic compound acts as alpha7 nicotinic receptor agonist in human umbilical vein endothelial cells.

Recent evidence suggests that the alpha7 nicotinic acetylcholine receptors (alpha7 nAChRs) participate in the development of angiogenesis and could be a new endothelial target for revascularization in therapeutic angiogenesis. It has been shown that in human umbilical vein endothelial cells (HUVECs) alpha7 nAChR agonists increase the intracellular calcium concentration ([Ca2+]i), thus inducing proliferation and vessel formation which are important stages of angiogenesis. In the present study we evaluated the effect of new isoxazole compounds on the cytosolic Ca2+ signal in HUVECs using the fluorescent Ca2+ indicator Fluo-3AM and probing the involvement of alpha7 nAChR by means of pharmacological tools. HUVECs expressed mainly alpha7 nAChR, since there was no significant difference in the increase in [Ca2+]i induced by nicotine, a non-selective nicotinic agonist, in relation to choline, a selective alpha7 nAChR agonist. The increase in [Ca2+]i induced by 1 mM choline was inhibited significantly (p = 0.014) in cells which had been pre-incubated for 15 min with methyllycaconitine (MLA), a selective alpha7 nAChR antagonist. The studied compounds 1, 2, and 3 induced an increase in [Ca2+]i in a dose-dependent manner. Compound 1 at 10 microM induced a greater increase in [Ca2+]i than compounds 2 and 3. The increase in [Ca2+]i induced by compound 1 was significantly inhibited by MLA (p = 0.013) and completely inhibited by mecamylamine, a non-selective nAChR antagonist, indicating that the isoxazolic compound 1 acts as an alpha7 nAChR agonist.

Antioxidant activity of bioactive extracts obtained from rhizomes of Cyperus digitatus Roxb / Actividad antioxidante de extractos obtenidos a partir de rizomas de Cyperus digitatus Roxb

Members of the family Cyperaceae such as Cyperus alopecuroides, Cyperus articulatus, Cyperus scariosus and Cyperus rotundus possess significant amount of studies about their antioxidant activities and other properties. Nevertheless, the plant Cyperus digitatus belonging to the genus Cyperus lacks of studied about any kind of intrinsic activity. Different extracts and fractions were obtained from the rhizomes of Cyperus digitatus, and a Phytochemical screening and the content of phenols and flavonoids and the antioxidant properties (FRAP, DPPH and beta-Carotene bleaching) were quantified in each of theextracts and fractions. Of all the extracts obtained, the BE and AqE extracts showed the best antioxidant potential, meanwhile, none of the fractions obtained from the EAE extract show a relevant activity.

Los miembros de la familia Cyperaceae, tales como Cyperus alopecuroides, Cyperus articulatus, Cyperus scariosus y Cyperus rotundus poseen una cantidad significativa de estudios sobre sus actividades antioxidantes y otras propiedades. Sin embargo, la planta Cyperus digitatus perteneciente al género Cyperus carece de estudio de cualquier tipo de actividad intrínseca. Razón por la cual se estudió sus propiedades antioxidantes (FRAP, DPPH y blanqueamiento del beta-caroteno), cuantificación de contenido fenolico y flavonoides totales en extractos y fracciones obtenidos de los rizomas de Cyperus digitatus, y un perfil fitoquímico. De todos los extractos obtenidos, BE y AqE mostraron el mejor potencial antioxidante, por otra parte ninguna de las fracciones obtenidas a partir del extracto EAE mostro una actividad relevante.

Host selection and probing behavior of the poplar aphid Chaitophorus leucomelas (Sternorrhyncha: Aphididae) on two poplar hybrids with contrasting susceptibility to aphids.

Poplars are frequently attacked by aphids. The differential susceptibility of poplar hybrids to the aphid Chaitophorus leucomelas Koch (Sternorrhyncha: Aphididae) has been described, but the mechanism underlying this pattern is unknown. This work tested the hypothesis that poplar resistance to this aphid is associated with the presence of volatiles and secondary plant compounds that affect host selection and feeding behavior. This hypothesis was tested by studying the host choice and feeding behavior of C. leucomelas on two poplar hybrids with contrasting susceptibilities to this aphid ([Populus trichocarpa Torrey & Gray x Populus deltoides Bartram ex Marshall] x P. deltoides [TD x D], and [P. trichocarpa x Populus maximowiczii Henry] x [P. trichocarpa x P. maximowiczii] [TM x TM]). The results showed that C. leucomelas rejected leaves of the TM x TM hybrid and did not prefer odors from either hybrid. Electronic monitoring of the probing behavior of C. leucomelas suggested the involvement of antifeedant factors in the TM x TM hybrid. In addition, the chemical characterization of volatiles, epicuticular waxes, and internal phenols of leaves from both poplar hybrids revealed that TM x TM had a higher abundance of monoterpenes, sesquiterpenes, n-alkanes, and phenols. These results are discussed in terms of their contribution to poplar breeding programs aimed at enhancing insect resistance.

New diterpenes from Azorella spinosa.

Two new diterpenes,2-acetoxy-13-hydroxy-mulin-11-ene and 2-acetoxy-mulin-11, 13-diene,have been isolated from the aerial parts of Azorella spinosa and their structures determined by spectroscopic and conventional chemical methods. Furthermore, 2, 13-dihydroxy-mulin-11-ene was obtained using a basic hydrolysis of the first compound. Two diterpenes reported for other Azorella species have also been found, namely mulinolic acid and 13beta-hydroxyazorellane, as well as the triterpene lactone of ursolic acid,quercetin, and 7-hydroxycoumarin. The compounds were evaluated using antibacterial, antioxidant and enzymatic assays; no significant activity was detected.

Effect of tomato industrial processing (different hybrids, paste, and pomace) on inhibition of platelet function in vitro, ex vivo, and in vivo.

Cardiovascular disease (CVD) is the leading cause of death worldwide. Healthy eating is among its safeguards, especially the daily intake of fruits and vegetables. In this context it has been shown that tomato (Solanum lycopersicum) presents antiplatelet activity. In the present study, we evaluated in vitro antiplatelet activity of fresh hybrid tomato process (nine hybrids: Apt 410, H 9888, Bos 8066, Sun 6366, AB3, HMX 7883, H 9665, H 7709, and H 9997), paste and its by-product of industrial processes (pomace). We assessed antiplatelet activity ex vivo and bleeding time in rats that ingested 0.1 and 1.0 g/kg of pomace each day. In studies in vitro, no significant differences in antiplatelet activity was observed in fresh tomato hybrids. Furthermore, the agro-industrial process did not affect the antiplatelet activity of paste and pomace. Likewise, pomace intake of 1.0 g/kg per day prolonged bleeding time and reduced ex vivo platelet aggregation in rats. The data obtained indicate that tomato has one or more compounds that caused antiplatelet activity. Regular consumption of tomato and its industrial derivatives could be part of a CVD prevention regimen.

Synthetic isoxazole as antiplatelet agent.

Abstract Nine synthetic isoxazoles were evaluated as antiplatelet agents and studied the possible mechanism of more active compound. The initial screening was evaluating all compounds against platelet aggregation assays. The most active compound was isoxazole 8 showing an inhibition of platelet aggregation around 70%. In subsequent experiments, ADP and collagen were used as agonists to explore the possible inhibitory mechanisms of isoxazole 8 in platelet aggregation and secretion. We reported the effect of isoxazole 8 for reducing the expression of inflammatory markers, such as soluble CD40 ligand (sCD40L) and soluble P-selectin (sP-selectin), on activated platelets. Of this form, an inhibition of sCD40L and sP-selectin can prevent the onset of an atherosclerotic lesion.

Isoxazoles: synthesis, evaluation and bioinformatic design as acetylcholinesterase inhibitors.

OBJECTIVES: Inhibition of acetylcholinesterase (AChE) is a common treatment for early stages of Alzheimer's disease. In this study, nine isoxazoles derivatives were tested for their in-vitro AChE activity. The molecular docking showed the interaction of the compounds with the active site. METHODS: The isoxazoles were synthesized using 1,3-dipolar cycloaddition in the presence of sodium hypochlorite. They were also isolated and characterized by spectroscopic methods. The in-vitro activity was measured by an adapted version of Ellman's assay. KEY FINDINGS: The isoxazoles are described as inhibitors of AChE. The most potent compound in the series exhibited a moderate inhibitory activity (50% inhibitory concentration = 134.87 µm). The design of new compounds was created by using the RACHEL module of the SYBYL software. CONCLUSIONS: Our research provided enough evidence of the efficacy of isoxazoles as AChE inhibitors. The isoxazoles were synthesized and evaluated as inhibitors of AChE. The docking study based on a novel series of complexes isoxazole with AChE from Electroporus electricus has demonstrated that the ligand bind is similar to the compounds used as reference. To find new candidates with the isoxazole core that act as inhibitors of AChE, part of the structure of the compound 9 was used for de-novo design. Molecular docking models of the ligand-AChE complexes suggest that the compound 10 is located on the periphery of the AChE active site.

Synthesis of bistetrahydroquinolines as potential anticholinesterasic agents by double Diels-Alder reactions.

The tetrahydroquinoline ring system is a unit found in many biologically active natural products and pharmacologically relevant therapeutic agents. A new series of bistetrahydroquinolines (bis-THQs) was synthesized using imino Diels-Alder reactions between dialdehydes, anilines and N-vinyl-2-pyrrolidone (NVP). The notable features of this procedure are mild reaction conditions, greater selectivity and good yields of products. In addition, the inhibitory activity against acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) of some selected derivatives is reported. The feasible binding modes of these active compounds, within AChE and BuChE binding sites, were predicted by molecular docking experiments and their binding affinity was estimated by means of free energy calculations through the MM-GBSA approximation.

Protective Mechanisms of S. lycopersicum Aqueous Fraction (Nucleosides and Flavonoids) on Platelet Activation and Thrombus Formation: In Vitro, Ex Vivo and In Vivo Studies.

The purpose of this research was to investigate mechanisms of antiplatelet action of bioactive principle from S. lycopersicum. Aqueous fraction had a high content of nucleosides (adenosine, guanosine, and adenosine 5'-monophosphate) by HPLC analysis. Also aqueous fraction presented flavonoids content. Aqueous fraction inhibited platelet activation by 15 ± 6% (P < 0.05). Fully spread of human platelets on collagen in the presence of aqueous fraction was inhibited from 15 ± 1 to 9 ± 1 µ m(2) (P < 0.001). After incubation of whole blood with aqueous fraction, the platelet coverage was inhibited by 55 ± 12% (P < 0.001). Platelet ATP secretion and aggregation were significantly inhibited by the aqueous fraction. At the same concentrations that aqueous fraction inhibits platelet aggregation, levels of sCD40L significantly decreased and the intraplatelet cAMP levels increased. In addition, SQ22536, an adenylate cyclase inhibitor, attenuated the effect of aqueous fraction toward ADP-induced platelet aggregation and intraplatelet level of cAMP. Platelet aggregation ex vivo (human study) and thrombosis formation in vivo (murine model) were inhibited by aqueous fraction. Finally, aqueous fraction may be used as a functional ingredient adding antiplatelet activities (nucleosides and flavonoids) to processed foods.

Protective mechanisms of guanosine from Solanum lycopersicum on agonist-induced platelet activation: role of sCD40L.

In the past 30 years, only three natural products have been sources of new drugs with antiplatelet activity. In this study, we have demonstrated for the first time that guanosine from Solanum lycopersicum possesses antiplatelet (secretion, spreading, adhesion and aggregation) activity in vitro and inhibition of platelet inflammatory mediator of atherosclerosis (sCD40L). According to ADP-induced platelet aggregation inhibiting, the total extract residue was fractionated by liquid chromatography/phase separation, affording an aqueous fraction. This fraction was subjected to repeated permeation over Sephadex LH-20 and semi-preparative TLC. The isolated compound finally obtained was identified as guanosine on the basis of its UV-spectra, HPLC and 1H-NMR data. Guanosine concentration dose-dependently (1 to 4 mmol/L) inhibited platelet secretion and aggregation induced by ADP and collagen. Spread of human platelets on collagen in the presence of guanosine was fully inhibited. After incubation of whole blood with guanosine, the platelet adhesion and aggregation under flow conditions was inhibited concentration dependently (0.2 to 2 mmol/L). At the same concentrations that guanosine inhibits platelet aggregation, levels of sCD40L were significantly decreased. Guanosine is thus likely to exert significant protective effects in thromboembolic-related disorders by inhibiting platelet aggregation.

Antioxidant and Antiplatelet Activities in Extracts from Green and Fully Ripe Tomato Fruits (Solanum lycopersicum) and Pomace from Industrial Tomato Processing.

The consumption of fruits and vegetables is accepted to be one of the strategies to reduce risk factors for these diseases. The aim of this study was to examine potential relationships between the antioxidant and the antiplatelet activities in green mature and fully ripe (red) tomatoes and of lycopene-rich byproducts of tomato paste processing such as pomace. The total phenol content of tomato components was the highest in peels, pulp, and in the mucilaginous myxotesta covering the tomato seeds with values 36.9 ± 0.8, 33.3 ± 00.5, and 17.6 ± 0.9 mg GAE/100 g, respectively (P < 0.05). Tomato peels had the highest antioxidant activity, both, as measured by the FRAP (46.9 ± 0.9 µ mol Fe(+2)/g, P < 0.05) and the DPPH assays (97.4 ± 0.2%, 1000 µ g/mL, P < 0.05). Pomace extracts showed the highest antiplatelet activity induced by ADP, collagen, TRAP-6, and arachidonic acid. While the maturation stage of the tomato fruit affected the antioxidant effect, antiplatelet activity was independent of fruit ripeness. Finally, based on the present results, tomato and its byproducts may be considered as a valuable source of antioxidant and antiplatelet activities.

Determination of antibacterial, antioxidant, antiplatelet and inhibition of cholinesterase activities from the methanolic extracts of Azorella species (Apiaceae) / Determinación de la actividad antibacteriana, antioxidante, antiagregante plaquetaria e inhibición de la colinesterasa a partir de los extractos metanólicos de especies Azorella (Apiaceae)

In this study, we investigated the potential antibacterial, antioxidant and anti-platelet activities and the inhibition of cholinesterase from the methanolic extracts obtained from aerial parts of the two species of Azorella: A. spinosa (Constitution, Chile) and A. monantha (Torres del Paine, Enladrillado and Paso Vergara). All extracts showed only moderate inhibitory activity on acetylcholinesterase (AChE), the most active extract with IC50 = 27ug/mL was A. spinosa. Inhibition of platelet aggregation induced by ADP presented maximal aggregation to 70 and 57 percent on extracts of A. spinosa and A. monantha (Paso Vergara), respectively. The most active extract with antioxidant effect was A. spinosa with IC50 of 28.72ug/mL. Antibacterial activity of the extract on Escherichia coli, Pseudomonas aeruginosa and Acinetobacter baumannii was not present. The extracts of A. spinosa and A. monantha (Paso Vergara) presented the best results on the activities that were evaluated.

En este estudio se investigó las potenciales actividades antibacteriana, antioxidante, antiplaquetaria e inhibición de la colinesterasa de extractos metanólicos a partir de las partes aéreas de dos especies de Azorella: A. spinosa (Constitución, Chile) y A. monantha (Torres del Paine, Enladrillado y Paso Vergara). Todos los extractos mostraron actividad inhibidora moderada solamente sobre acetilcolinesterasa (AChE), siendo el más activo el extracto de A. spinosa con IC50= 27ug/mL. La inhibición de la agregación plaquetaria inducida por ADP presentó máxima agregación al 70 y 57 por ciento sobre los extractos de A. spinosa y A. monantha (Paso Vergara) respectivamente. El extracto más activo con efecto antioxidante fue el de A. spinosa con un IC50 de 28,72ug/mL,). No se presentó actividad antibacteriana de ningún extracto sobre Escherichia coli, Pseudomonas aeuroginosa y Acinetobacter baumannii. Los extractos de A. spinosa y A. monantha (Paso Vergara) presentan los mejores resultados sobre las actividades evaluadas, lo que permite el estudio bioguiado de los metabolitos presentes en estos extractos.

Bioassay-Guided Isolation and HPLC Determination of Bioactive Compound That Relate to the Antiplatelet Activity (Adhesion, Secretion, and Aggregation) from Solanum lycopersicum.

In seeking the functionality of foodstuff applicable to medicine, ripe tomato fruits were found to show an antiplatelet activity. Therefore, the bioactive compound was isolated, structurally identified, and studied for an inhibitory effects on platelet adhesion, secretion, and aggregation. The concentration of adenosine in ripe tomato fruits (pulp and skin extracts) and its processing by-products (paste and pomace) was determined by reversed-phase high-performance liquid chromatography (HPLC). According to platelet aggregation inhibition induced by ADP, the total extract residual was fractionated by liquid-liquid separation, obtaining aqueous, ethyl acetate and petroleum ether extracts. The aqueous extract was subjected to repeated permeation over sephadex LH-20 and semipreparative TLC. The isolate finally obtained was identified as adenosine on the basis of ESI-MS, (1)H NMR, HPLC, and UV spectra. Adenosine concentration dependently (2.3-457 µM) platelet aggregation inhibited induced by ADP. Also, adenosine present inhibition of platelet secretion and thrombus formation under flow conditions. The quantitative HPLC analysis revealed significant amounts of adenosine in ripe tomato fruits and its processing by-products. From these results, extracts/fractions of ripe tomato fruits and their processing by-products may be referred to as functional food and functional ingredients containing a compound that inhibits platelet function with a potent preventive effect on thrombus formation, as those that occur in stroke.

Biological activity of isoflavonoids from Azorella madreporica.

Four isoflavones, isolated from the whole plant of Azorella madreporica, were identified as angustone C (1), alpinumisoflavone (2), licoisoflavone A (3) and isolupalbigenin (4) by spectroscopic studies. The compounds were evaluated for antibacterial and gastroprotective activities. This is the first time that isoflavonoids have been reported in this genus.

Clinical predictors of prosthesis-patient mismatch after aortic valve replacement for aortic stenosis.

OBJECTIVE: We sought to ascertain predictors of Patient Prosthesis Mismatch, an independent predictor of mortality, in patients with aortic stenosis using bioprosthetic valves. METHOD: We analyzed 2,107 sequential surgeries. Patient Prosthesis Mismatch was calculated using the effective orifice area of the prosthesis divided by the patient's body surface area. We defined nonsignificant, moderate, and severe Patient Prosthesis Mismatch as effective orifice area indexes of .0.85 cm(2)/m, 0.85-0.66 cm(2)/m(2), and <0.65 cm(2)/m(2), respectively. RESULTS: A total of 311 bioprosthetic patients were identified. The incidence of nonsignificant, moderate, and severe Patient Prosthesis Mismatch was 41%, 42, and 16%, respectively. Severe Patient Prosthesis Mismatch was significantly more prevalent in females (82%). In severe Patient Prosthesis Mismatch, the perfusion and the crossclamp times were considerably lower when compared with nonsignificant Patient Prosthesis Mismatch and moderate Patient Prosthesis Mismatch. Patients with severe Patient Prosthesis Mismatch had a significantly higher likelihood of spending time in the intensive care unit and a significantly longer length of stay in the hospital. Body surface area was not different in severe Patient Prosthesis Mismatch when compared with nonsignificant Patient Prosthesis Mismatch. In-hospital mortality in patients with nonsignificant, moderate, and severe Patient Prosthesis Mismatch was 2.3%, 6.1%, and 8%, respectively. Minimally invasive surgery was significantly associated with moderate Patient Prosthesis Mismatch in 49% of the patients, but not with severe Patient Prosthesis Mismatch. CONCLUSION: Severe Patient Prosthesis Mismatch is more common in females, but not in those with minimal available body surface area. Though operative times were shorter in these patients, intensive care unit and hospital lengths of stay were longer. Surgeons and cardiologists should be cognizant of these clinical predictors and complications prior to valve surgery.

Fractions of aqueous and methanolic extracts from tomato (Solanum lycopersicum L.) present platelet antiaggregant activity.

Cardiovascular disease (CVD) is the leading cause of death worldwide. Its prevention emphasizes three aspects: not smoking, physical activity and a healthy diet. Recently, we screened the antithrombotic activity of a selected group of fruits and vegetables. Among them, tomato showed an important effect. The aim of this study was to evaluate and characterize the platelet antiaggregatory activity of tomato (Solanum lycopersicum L.). For this, we obtained aqueous and methanolic tomato extracts and evaluated the effect of pH (2 and 10) and temperature (22, 60 and 100°C) on this activity. Furthermore, in order to isolate the antiaggregant principle, we separated tomato extracts into several fractions (A-D) by size exclusion chromatography. In addition, we evaluated the platelet antiaggregating activity ex vivo in Wistar rats. Aqueous and methanolic extracts of tomato treated at 22, 60 and 100°C and pH 2 and 10 still inhibited platelet aggregation (in vitro). Moreover, it was noted that one of the fractions (fraction C), from both aqueous and methanolic extracts, presented the highest activity (∼70% inhibition of platelet aggregation) and concentration dependently inhibited platelet aggregation significantly compared with control (P < 0.05). These fractions did not contain lycopene but presented two peaks of absorption, at 210 and 261 nm, compatible with the presence of nucleosides. In rats treated with tomato macerates, a mild platelet antiaggregating effect ex vivo was observed. Further studies are required to identify the molecules with platelet antiaggregating activity and antiplatelet mechanisms of action.

Antifungal activity of tetrahydroquinolines against some phytopathogenic fungi.

Seven synthetic tetrahydroquinolines with different substitution patterns were obtained by an imino Diels-Alder condensation reaction and were evaluated against phytopathogenic fungi. Compounds with a methoxy group showed interesting activity against Cladosporium cladosporoides with a MIC value of 13.75 microg/mL

Clinical predictors of prosthesis-patient mismatch after aortic valve replacement for aortic stenosis

OBJECTIVE: We sought to ascertain predictors of Patient Prosthesis Mismatch, an independent predictor of mortality, in patients with aortic stenosis using bioprosthetic valves. METHOD: We analyzed 2,107 sequential surgeries. Patient Prosthesis Mismatch was calculated using the effective orifice area of the prosthesis divided by the patient's body surface area. We defined nonsignificant, moderate, and severe Patient Prosthesis Mismatch as effective orifice area indexes of .0.85 cm²/m, 0.85-0.66 cm²/m², and <0.65 cm²/m², respectively. RESULTS: A total of 311 bioprosthetic patients were identified. The incidence of nonsignificant, moderate, and severe Patient Prosthesis Mismatch was 41 percent, 42, and 16 percent, respectively. Severe Patient Prosthesis Mismatch was significantly more prevalent in females (82 percent). In severe Patient Prosthesis Mismatch, the perfusion and the crossclamp times were considerably lower when compared with nonsignificant Patient Prosthesis Mismatch and moderate Patient Prosthesis Mismatch. Patients with severe Patient Prosthesis Mismatch had a significantly higher likelihood of spending time in the intensive care unit and a significantly longer length of stay in the hospital. Body surface area was not different in severe Patient Prosthesis Mismatch when compared with nonsignificant Patient Prosthesis Mismatch. In-hospital mortality in patients with nonsignificant, moderate, and severe Patient Prosthesis Mismatch was 2.3 percent, 6.1 percent, and 8 percent, respectively. Minimally invasive surgery was significantly associated with moderate Patient Prosthesis Mismatch in 49 percent of the patients, but not with severe Patient Prosthesis Mismatch. CONCLUSION: Severe Patient Prosthesis Mismatch is more common in females, but not in those with minimal available body surface area. Though operative times were shorter in these patients, intensive care unit and hospital lengths of stay were longer. Surgeons and cardiologists should be cognizant of these clinical predictors and complications prior to valve surgery.