Characterization of mating type on aroma production and metabolic properties wild Kluyveromyces marxianus yeasts.

Kluyveromyces marxianus yeasts represent a valuable industry alternative due to their biotechnological potential to produce aromatic compounds. 2-phenylethanol and 2-phenylethylacetate are significant aromatic compounds widely used in food and cosmetics due to their pleasant odor. Natural obtention of these compounds increases their value, and because of this, bioprocesses such as de novo synthesis has become of great significance. However, the relationship between aromatic compound production and yeast's genetic diversity has yet to be studied. In the present study, the analysis of the genetic diversity in K. marxianus isolated from the natural fermentation of Agave duranguensis for Mezcal elaboration is presented. The results of strains in a haploid and diploid state added to the direct relationship between the mating type locus MAT with metabolic characteristics are studied. Growth rate, assimilate carbohydrates (glucose, lactose, and chicory inulin), and the production of aromatic compounds such as ethyl acetate, isoamyl acetate, isoamyl alcohol, 2-phenylethyl butyrate and phenylethyl propionate and the diversity in terms of the output of 2-phenylethanol and 2-phenylethylacetate by de novo synthesis were determinate, obtaining maximum concentrations of 51.30 and 60.39 mg/L by ITD0049 and ITD 0136 yeasts respectively.

Safety and complications of percutaneous tracheostomy in a cohort of 800 mixed ICU patients.

Percutaneous tracheostomy is used primarily to assist weaning from mechanical ventilation in the intensive care unit. We report our experiences of 800 such procedures performed in the intensive care unit by a collaborative team (critical care and ENT specialists). Most procedures (85.6%) were performed by residents supervised by the intensive care unit staff. Complications occurred in 32 patients (4%). Intraprocedural complications occurred in 17 patients (2.1%), early postprocedural complications in six (0.75%), and late postprocedural complications in nine (1.1%). No deaths were directly related to percutaneous tracheostomy. The incidence of complications was greater in percutaneous tracheostomy performed by the residents during their initial five attempts compared to their later attempts (9.2% vs 2.6%, p < 0.05). The low incidence of complications indicates that bedside percutaneous tracheostomy can be performed safely as a routine procedure in daily care of intensive care unit patients.

[The administration of 20 ppm of inhaled nitric oxide produces a faster response than the inhalation of 5 ppm in adult respiratory distress syndrome]. / La administración de 20 ppm de óxido nítrico inhalado produce una respuesta más rápida que la inhalación de 5 ppm en el síndrome de distrés respiratorio del adulto.

OBJECTIVES: To compare the effects of 5 and 20 ppm of nitric oxide, evaluating time until response for each dose, in patients with adult respiratory distress syndrome (ARDS). PATIENTS AND METHODS: The study was prospective, controlled and random. Fifteen patients assigned to two groups received either 5 ppm (8 patients) or 20 ppm (7 patients) from November 96 to July 97. The main variables analyzed were PaO2/FiO2 and pulmonary vascular resistance index. We also studied etiology, severity of pulmonary damage as reflected by the Lung Injury Score, age, sex, Apache II prognostic score and exitus. Outcome was considered good if PaO2/FiO2 increased and/or pulmonary vascular resistance index decreased by more than 30% from the initial level (before inhalation of nitric oxide). RESULTS: The mean lung injury score was 2.9 +/- 0.4 and the two groups were homogeneous. Time until response to nitric oxide was significantly less in the 20 ppm group. Both PaO2/FiO2 and pulmonary vascular resistance index improved significantly in both groups whereas Qs/Qt improved only in the 20 ppm group. We also found that cardiac index and oxygen transport increased, the latter significantly only in the 20 ppm group. NO2 formation was less than 2 ppm and methemoglobin levels did not rise above 2%. CONCLUSIONS: Inhaled nitric oxide significantly improves oxygenation and decreases pulmonary vascular resistance without altering systemic vascular resistance during treatment of ARDS. The final outcomes were similar for both doses, but the 20 ppm dose produced a significantly faster response as well as a significant decrease in Qs/Qt.

La administración de 20 ppm de óxido nítrico inhalado produce una respuesta más rápida que la inhalación de 5 ppm en el síndrome de distrés respiratorio del adulto / An inhaled nitric oxide dose of 20 ppm produces a faster response than 5 ppm in adult respiratory distress syndrome

Objetivos. Comparar los efectos respectivos de 5 y 20 partes por millón (ppm) evaluando el tiempo de respuesta de ambas dosis, en pacientes con síndrome de distrés respiratorio del adulto.Métodos. El estudio fue prospectivo, controlado y aleatorio. Se estudió a 15 pacientes divididos en dos grupos, que recibían dosis de 5 ppm (grupo 5 ppm: 8 pacientes) o bien de 20 ppm (grupo 20 ppm: 7 pacientes), entre noviembre de 1996 y julio de 1997. Las variables principales analizadas fueron el índice PaO2/FiO2 y el índice de resistencias vasculares pulmonares. También se estudiaron la etiología, la gravedad de la lesión pulmonar según la Lung Injury Score (LIS), la edad, el sexo, el índice pronóstico APACHE II y la mortalidad. Se consideró resultado positivo el aumento del PaO2/FiO2 y/o la disminución del índice de resistencias vasculares pulmonares en más del 30 por ciento de los valores previos a la inhalación de NO.Resultados. El valor medio del LIS fue de 2,9 ñ 0,4. Los dos grupos eran homogéneos. El tiempo de respuesta al NO fue significativamente inferior en el grupo 20 ppm. Tanto el PaO2/FiO2 como el índice de resistencias vasculares pulmonares mejoraron significativamente en los dos grupos, y el Qs/Qt sólo en el grupo 20 ppm. También se observó aumento en el índice cardíaco y transporte de O2, que fue significativo sólo en el grupo 20 ppm. La formación de NO2 fue inferior a 2 ppm y la metahemoglobina no superó el 2 por ciento.Conclusiones. La inhalación de NO produjo mejoría significativa en la oxigenación y disminuyó significativamente las resistencias vasculares pulmonares, sin alterar las resistencias vasculares sistémicas, durante el tratamiento del síndrome de distrés respiratorio del adulto. Los efectos finales de ambas dosis fueron similares, pero las dosis de 20 ppm produjeron una respuesta significativamente más temprana y una disminución del Qs/Qt también significativa (AU)

[Comparative study of percutaneous tracheotomy and conventional surgical tracheotomy in patients with prolonged intubation]. / Estudio comparativo entre la traqueotomía percutánea y la traqueotomía convencional quirúrgica en pacientes con intubación prolongada.

BACKGROUND: Percutaneous tracheotomy (PT) has become an alternative to conventional surgical tracheotomy (CST) in recent years. Our aim was to compare the advantages and disadvantages of the two techniques in our intensive care unit (ICU). PATIENTS AND METHODS: Two patient groups were compared. Sixty underwent PT and 47 underwent CST, and all were admitted to the ICU between May 1995 and August 1997. PT was performed in 49 by way of progressive dilations, and 11 were performed by Griggs' method using a dilator. Variables studied were age, sex, reason for admission, APACHE II upon admission to the ICU, duration of technique, and immediate and late complications. Statistical analysis was provided by applying a Student t test to contrast quantitative variables and a chi-squared test to compare proportions. RESULTS: The following variables were significantly different. APACHE II upon admission was 18 +/- 5 in the PT group and 15 +/- 6 in the CST group (p < 0.002). Duration of the procedure was 15 +/- 4 minutes in the PT group and 36 +/- 11 in the CST group (p < 0.005). Complications after tracheotomy in PT group patients consisted of 1 false line during a change of cannula and 1 late tracheoesophageal fistula. Complications in the CST group included 16 episodes of slight bleeding, 9 stoma infections, 3 cases of pneumothorax, 2 of bad scarring of the stoma and 1 late fistula (p < 0.005). Time of follow-up was 41 to 76 days for PT patients and 32 to 51 days for CST patients. CONCLUSIONS: PT is a fast, simple procedure that is easy to manage and requires fewer resources (operating theater, personnel and equipment) and causes fewer medium-term complications than does CST.

[Traumatic bilateral chylothorax (author's transl)]. / Quilotórax bilateral traumático.

A case is presented of a bilateral chylothorax caused by rupture of the thoracic duct, secondary to a closed traumatism of the thorax in a polytraumatized patient, and produced by a mechanism of hyperextension of the dorsal segment of the vertebral column. Considerations are made with reference to the anatomy of the thoracic duct, the rupture mechanism, diagnosis, complications and treatment. The chylothorax could not be distinguished clinically and by simple radiology from the traumatic hemothorax. The preliminary diagnosis will be made according to the macroscopic appearance of the drained fluid, and the definite diagnosis by the analytical and histopathologic characteristics of the same fluid. The lymphographic examination reveals the exact point of the lesion. The immediate complications are related to the respiratory insufficiency due to the occupation of the pleural space, and under a long period of time undernutrition provoked by the loss of fats and proteins. The treatment of choice is based upon the early drainage of the chylothorax and on the absolute suppression of the oral intake, establishing a complete parenteral feeding during at least 15 days. Afterwards oral diet can be initiated with a gradual increase in its quantity and always without fat content, while at the same time the parenteral nutrition is reduced. Following this protocol a great number of ruptures of the thoracic duct can be corrected, achieving a spontaneous closure of the duct. In the cases in which this not occur, at the end of 15 days it would be advisable to perform a surgical operation according to the Lampson's ligature technique.