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Rev. colomb. anestesiol ; 50(4): e204, Oct.-Dec. 2022. tab, graf
Artigo em Inglês | LILACS-Express | LILACS | ID: biblio-1407948


Abstract Introduction: The ventilator-induced lung injury (VILI) depends on the amount of energy per minute transferred by the ventilator to the lung measured in Joules, which is called mechanical power. Mechanical power is a development variable probably associated with outcomes in ventilated patients. Objective: To describe the value of mechanical power in patients with SARS-CoV-2 infection and ventilated for other causes and its relationship between days of mechanical ventilation, length of stay in the intensive care unit (ICU), and mortality. Methods: A multicenter, analytical, observational cohort study was conducted in patients with SARS-CoV-2 infection who required invasive mechanical ventilation and patients ventilated for other causes for more than 24 hours. Results: The cohort included 91 patients on mechanical ventilation in three tertiary care centers in the city of Pereira, Colombia. The average value of the mechanical power found was 22.7 ± 1 Joules/ min. In the subgroup of patients with SARS-CoV-2 infection, the value of mechanical power was higher 26.8 ± 9 than in the subgroup of patients without a diagnosis of SARS-CoV-2 infection 18.2 ± 1 (p <0.001). Conclusions: Mechanical power is an important variable to consider during the monitoring of mechanical ventilation. This study found an average value of mechanical power of 22.7 ± 1 Joules/min, being higher in patients with SARS-CoV-2 infection related to longer days of mechanical ventilation and a longer stay in the ICU.

Resumen Introducción: La lesión pulmonar inducida por la ventilación mecánica (LPIVM) depende, entre otras variables, de la cantidad de energía -medida en Joules- por unidad de tiempo transferida desde el ventilador al paciente, también llamada poder mecánico. El poder mecánico es una variable de desarrollo, posiblemente asociada a los desenlaces en pacientes sometidos a ventilación. Objetivo: Describir el valor del poder mecánico en pacientes con infección por SARS-CoV-2 y ventilados por otras causas y la relación entre días de ventilación mecánica, estancia en la UCI y mortalidad. Métodos: Estudio multicéntrico, analítico y observacional de cohorte realizado en pacientes con diagnóstico de infección por SARS-CoV-2 que requirieron soporte ventilatorio mecánico invasivo y pacientes ventilados por otras causas, durante más de 24 horas. Resultados: La cohorte incluyó 91 pacientes que recibieron ventilación mecánica en 3 centros de tercer nivel de la ciudad de Pereira, Colombia. El valor promedio del poder mecánico obtenido fue 22,7 ± 1 Joules/min. En el grupo de pacientes con infección por SARS-CoV-2 el valor obtenido fue mayor (26,8 ± 9), comparado con el grupo de pacientes sin infección por SARS-CoV-2 (18,2 ± 1) (p <0,001). Conclusiones: El poder mecánico es una variable importante a tener en cuenta en el monitoreo de la ventilación mecánica. El presente estudio encontró un valor promedio de poder mecánico de 22,7±1 Joules/min, siendo mayor en los pacientes con infección por SARS-CoV-2 en relación con más días de ventilación mecánica y estancia en UCI más prolongada.

Intensive Care Med Exp ; 10(1): 55, 2022 Dec 30.
Artigo em Inglês | MEDLINE | ID: mdl-36581716


BACKGROUND: The respiratory system's static compliance (Crs) and airway resistance (Rrs) are measured during an end-inspiratory hold on volume-controlled ventilation (static method). A numerical algorithm is presented to calculate Crs and Rrs during volume-controlled ventilation on a breath-by-breath basis not requiring an end-inspiratory hold (dynamic method). METHODS: The dynamic method combines a numerical solution of the equation of motion of the respiratory system with frequency analysis of airway signals. The method was validated experimentally with a one-liter test lung using 300 mL and 400 mL tidal volumes. It also was validated clinically using airway signals sampled at 32.25 Hz stored in a historical database as 131.1-s-long epochs. There were 15 patients in the database having epochs on volume-controlled ventilation with breaths displaying end-inspiratory holds. This allowed for the reliable calculation of paired Crs and Rrs values using both static and dynamic methods. Epoch mean values for Crs and Rrs were assessed by both methods and compared in aggregate form and individually for each patient in the study with Pearson's R2 and Bland-Altman analysis. Figures are shown as median[IQR]. RESULTS: Experimental method differences in 880 simulated breaths were 0.3[0.2,0.4] mL·cmH2O-1 for Crs and 0[- 0.2,0.2] cmH2O·s· L-1 for Rrs. Clinical testing included 78,371 breaths found in 3174 epochs meeting criteria with 24[21,30] breaths per epoch. For the aggregate data, Pearson's R2 were 0.99 and 0.94 for Crs and Rrs, respectively. Bias ± 95% limits of agreement (LOA) were 0.2 ± 1.6 mL·cmH2O-1 for Crs and - 0.2 ± 1.5 cmH2O·s· L-1 for Rrs. Bias ± LOA median values for individual patients were 0.6[- 0.2, 1.4] ± 0.9[0.8, 1.2] mL·cmH2O-1 for Crs and - 0.1[- 0.3, 0.2] ± 0.8[0.5, 1.2] cmH2O·s· L-1 for Rrs. DISCUSSION: Experimental and clinical testing produced equivalent paired measurements of Crs and Rrs by the dynamic and static methods under the conditions tested. CONCLUSIONS: These findings support to the possibility of using the dynamic method in continuously monitoring respiratory system mechanics in patients on ventilatory support with volume-controlled ventilation.

PLoS One ; 17(12): e0277333, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36548225


BACKGROUND: Research priorities in Antimicrobial Stewardship (AMS) have rapidly evolved in the last decade. The need for a more efficient use of antimicrobials have fueled plenty of studies to define the optimal duration for antibiotic treatments, and yet, there still are large areas of uncertainty in common clinical scenarios. Pseudomonas aeruginosa has been pointed as a priority for clinical research, but it has been unattended by most randomized trials tackling the effectiveness of short treatments. The study protocol of the SHORTEN-2 trial is presented as a practical example of new ways to approach common obstacles for clinical research in AMS. OBJECTIVE: To determine whether a 7-day course of antibiotics is superior to 14-day schemes for treating bloodstream infections by P. aeruginosa (BSI-PA). METHODS: A superiority, open-label, randomized controlled trial will be performed across 30 Spanish hospitals. Adult patients with uncomplicated BSI-PA will be randomized to receive a 7 versus 14-day course of any active antibiotic. The primary endpoint will be the probability for the 7-day group of achieving better outcomes than the control group, assessing altogether clinical effectiveness, severe adverse events, and antibiotic exposure through a DOOR/RADAR analysis. Main secondary endpoints include treatment failure, BSI-PA relapses, and mortality. A superiority design was set for the primary endpoint and non-inferiority for treatment failure, resulting in a sample size of 304 patients. CONCLUSIONS: SHORTEN-2 trial aligns with some of the priorities for clinical research in AMS. The implementation of several methodological innovations allowed overcoming common obstacles, like feasible sample sizes or measuring the clinical impact and unintended effects. TRIAL REGISTRATION: EudraCt: 2021-003847-10; NCT05210439.

Infecções por Pseudomonas , Sepse , Adulto , Humanos , Pseudomonas aeruginosa , Antibacterianos/uso terapêutico , Infecções por Pseudomonas/tratamento farmacológico , Resultado do Tratamento , Sepse/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto
Molecules ; 27(23)2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36500472


The main by-product generated from the olive oil two-phase extraction system, or alperujo, is undoubtedly a rich source of bioactive components, among which phenolics are one of the most important. The evolution of four of its main phenolics: hydroxytyrosol (HT), hydroxytyrosol 4-ß-d-glucoside (Glu-HT), 3,4-dihydroxyphenylglycol (DHPG) and tyrosol (Ty) was studied over two seasons and in ten oil mills under similar climatological and agronomic conditions, for the first time using organic extraction and high-performance liquid chromatography (HPLC-DAD) determination. The results show that HT (200-1600 mg/kg of fresh alperujo) and Ty (10-570 mg/kg) increase, while DHPG (10-370 mg/kg) decreases only in the last month of the season and Glu-HT (1400-0 mg/kg) decreases drastically from the beginning. This evolution is similar between different seasons, with a high correlation between Glu-HT, HT, and Ty. On the other hand, it has been verified that a mixture of alperujos from all the oil mills, which is what the pomace extractor receives, is a viable source of a liquid fraction which is rich in the phenolics studied through organic extractions and especially after the application of a thermal treatment, obtaining values of 4.2 g/L of HT, 0.36 g/L of DHPG, and 0.49 g/L of Ty in the final concentrated liquid fraction.

Olea , Álcool Feniletílico , Azeite de Oliva/análise , Glucosídeos , Resíduos Sólidos/análise , Álcool Feniletílico/química , Fenóis/análise , Olea/química
PLoS One ; 17(11): e0277340, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36346782


Due to the high prevalence of patients attending with urinary tract infection (UTI) symptoms, the use of flow-cytometry as a rapid screening tool to avoid unnecessary cultures is becoming a widely used system in clinical practice. However, the recommended cut-points applied in flow-cytometry systems differ substantially among authors, making it difficult to obtain reliable conclusions. Here, we present FlowUTI, a shiny web-application created to establish optimal cut-off values in flow-cytometry for different UTI markers, such as bacterial or leukocyte counts, in urine from patients with UTI symptoms. This application provides a user-friendly graphical interface to perform robust statistical analysis without a specific training. Two datasets are analyzed in this manuscript: one composed of 204 urine samples from neonates and infants (≤3 months old) attended in the emergency department with suspected UTI; and the second dataset including 1174 urines samples from an elderly population attended at the primary care level. The source code is available on GitHub ( The web application can be executed locally from the R console. Alternatively, it can be freely accessed at FlowUTI provides an easy-to-use environment for evaluating the efficiency of the urinary screening process with flow-cytometry, reducing the computational burden associated with this kind of analysis.

Infecções Urinárias , Idoso , Lactente , Recém-Nascido , Humanos , Citometria de Fluxo , Infecções Urinárias/microbiologia , Urinálise , Contagem de Leucócitos , Software
Antioxidants (Basel) ; 11(10)2022 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-36290637


The growing interest in natural compounds is helping to improve the management of agro-industrial by-products such as the date seed as sources of such compounds. In this work, the application of a hydrothermal treatment at 160 and 180 °C for 60 min was studied to achieve the solubilization of its phenolic components and sugars in order to obtain biologically active extracts. The percentage of phenols and total sugars in the final extracts were very similar, at 45 and 25% for the 160 and 180 °C treatments, respectively. The treatment at a higher temperature allowed greater solubilization of other components. The antioxidant activity was measured as free-radical scavenging capacity. For the DPPH• method, expressed as EC50, the results were 0.34 and 0.37 mg/L, the TEAC values for the ABTS• method were 6.61 and 3.28 mg/g dried extract, and the values obtained by the ORAC method were 12.82 and 9.91 mmol Trolox/g dried extract, for 160 and 180 °C, respectively. All these values are higher than those of other plant extracts and extracts obtained using the whole date. Therefore, the date seed is a very important source of phenols, and through thermal and chromatographic processes, it is possible to obtain extracts with high antioxidant activity.

Enferm. infecc. microbiol. clín. (Ed. impr.) ; 40(8): 441-444, Oct. 2022. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-210274


Introducción: Este artículo describe la planificación efectuada para adecuar la capacidad diagnóstica de grandes volúmenes de RT-PCR de SARS-CoV-2. Métodos: El análisis y predicción del flujo de trabajo incluyó el número de RT-PCR desde el inicio de la pandemia, con 31.971 registros. La planificación de la capacidad y de las opciones diagnósticas se planteó en base a los posibles escenarios derivados de las predicciones efectuadas. Resultados: De acuerdo con las predicciones obtenidas, se optó por una solución automatizada basada en el empleo de robots OT-2 (Opentrons) para configurar un flujo de trabajo reproducible, que logró una capacidad de procesamiento de 5.640 muestras/día, con un tiempo de respuesta de cuatro horas. Conclusiones: El análisis y predicción del flujo de trabajo, unido al empleo de plataformas basadas en OT-2, proporciona una infraestructura robusta que permite atender con éxito las demandas de pruebas que exige esta pandemia.(AU)

Introduction: In the present manuscript we describe the planning carried out in our hospital to adapt our diagnostic capability to perform large numbers of SARS-CoV-2 RT-PCR. Methods: The analysis and prediction of workflow included the number of RT-PCR per week from the beginning of the pandemic, with a total of 31971 determinations. The planning phase was developed based on the different scenarios previously predicted. Results: According to the predictions obtained, an automated custom solution was chosen, based on the use of the OT-2 open-source liquid-handling robots (Opentrons), to design a reproducible workflow that achieved a production capacity of 5640 samples/day, with a time of response of four hours per procedure. Conclusions: The analysis and prediction of workflow, along with the use of the robotic platforms OT-2, provided a robust structure to deal with the high demand of determinations that this pandemic requires.(AU)

Humanos , Vírus da SARS , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Reação em Cadeia da Polimerase , Pandemias , Fluxo de Trabalho , Robótica , Previsões , Técnicas e Procedimentos Diagnósticos , Testes Imediatos , Microbiologia , Doenças Transmissíveis
Rev. argent. cardiol ; 90(3): 188-193, ago. 2022. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1407142


RESUMEN Introducción: La cirugía de revascularización miocárdica (CRM) ha modificado la evolución natural de los pacientes con enfermedad de tronco de la arteria coronaria izquierda (TCI). En nuestro medio es escasa la información relacionada con el seguimiento a mediano y largo plazo de los pacientes intervenidos. Objetivo: Evaluar la implicancia de la enfermedad del TCI en la evolución alejada de los pacientes intervenidos con CRM, y conocer la mortalidad e incidencia de infarto de miocardio (IAM) y/o accidente cerebrovascular (ACV). Resultados: El seguimiento se completó en 438 pacientes (95,6%) con una mediana de 58 meses [Rango intercuartilo (RIC) 35-88 meses]. La sobrevida actuarial fue a 10 años del 91,8% para toda la población, sin diferencias significativas entre el grupo TCI (91,57%) vs. el grupo no TCI (91,86%), HR 1,008, IC95% 0,38-2,65, p=0,98. En el análisis multivariado se encontraron como predictores de mortalidad alejada la fracción de eyección ventricular izquierda preoperatoria (HR 0,95, IC 95% 0,93-0,97, p<0,001), la edad (HR 1,1, IC 95% 1,04-1,13, p< 0,001) y la prioridad no electiva de la cirugía (HR = 3,71; IC 95%: 1,3-10,35; p = 0,01). La sobrevida libre de IAM fue del 96,8% (TCI 94% vs. no TCI 97,4%, p= 0,8) y la libertad de ACV fue del 98% (TCI 97,8% vs. no TCI 98,1%, p= 0,8). Conclusión: En los pacientes sometidos a CRM, la presencia de enfermedad del TCI no incrementó la tasa de eventos duros (muerte, IAM y ACV) en el seguimiento alejado. Los resultados obtenidos en esta serie de pacientes son similares a los publicados en la bibliografía internacional utilizada para desarrollar las guías de revascularización miocárdica.

ABSTRACT Background: Coronary artery bypass grafting (CABG) has modified the natural evolution of patients with left main coronary artery (LMCA) disease. There is little information in our setting regarding the mid- and long-term follow-up of operated patients. Objective: The aim of this study was to evaluate the implication of LMCA disease in the long-term evolution of patients operated on with CABG, and to assess the mortality and incidence of myocardial infarction (AMI) and/or stroke. Results: Follow-up was completed in 438 patients (95.6%) with a median of 58 months [interquartile range (IQR) 35-88 months]. Actuarial survival at 10 years was 91.8% for the entire population, with no significant differences between the LMCA group (91.57%) vs. the non-LMCA group (91.86%), HR 1,008 95% CI 0.38-2.65, p=0.98. In multivariate analysis, preoperative left ventricular ejection fraction (HR = 0.95; 95% CI 0.93-0.97; p < 0.001), age (HR 1.1, 95% CI 1.04-1.13, p<0.001) and non-elective priority of surgery (HR=3.71; 95% CI 1.3-10.35; p=0.01) were independent predictors of long-term mortality. AMI-free survival was 96.8% (LMCA 94% vs. non-LMCA 97.4%, p=0.8) and freedom from stroke was 98% (LMCA 97.8% vs. non-LMCA 98.1 %, p=0.8). Conclusion: In patients undergoing CABG, the presence of LMCA disease did not increase the rate of hard events (death, AMI, and stroke) at the long-term follow-up. The results obtained in this series of patients are similar to those published in the international literature used to develop myocardial revascularization guidelines.

Small ; 18(34): e2202648, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35900063


The enhanced safety, superior energy, and power density of rechargeable metal-air batteries make them ideal energy storage systems for application in energy grids and electric vehicles. However, the absence of a cost-effective and stable bifunctional catalyst that can replace expensive platinum (Pt)-based catalyst to promote oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) at the air cathode hinders their broader adaptation. Here, it is demonstrated that Tin (Sn) doped ß-gallium oxide (ß-Ga2 O3 ) in the bulk form can efficiently catalyze ORR and OER and, hence, be applied as the cathode in Zn-air batteries. The Sn-doped ß-Ga2 O3 sample with 15% Sn (Snx =0.15 -Ga2 O3 ) displayed exceptional catalytic activity for a bulk, non-noble metal-based catalyst. When used as a cathode, the excellent electrocatalytic bifunctional activity of Snx =0.15 -Ga2 O3 leads to a prototype Zn-air battery with a high-power density of 138 mW cm-2 and improved cycling stability compared to devices with benchmark Pt-based cathode. The combined experimental and theoretical exploration revealed that the Lewis acid sites in ß-Ga2 O3 aid in regulating the electron density distribution on the Sn-doped sites, optimize the adsorption energies of reaction intermediates, and facilitate the formation of critical reaction intermediate (O*), leading to enhanced electrocatalytic activity.

Rev. colomb. anestesiol ; 50(2): e300, Jan.-June 2022. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1376820


Abstract CoVID-19-associated infection leads to a pathology of yet unknown clinical behavior, confronting the clinician with various challenges. An extensive search was conducted based on review articles on SARS-CoV-2 infection and studies including mechanical ventilation management strategies in order to complete this narrative review. Evidenced-based treatment for SARS-CoV2 infection is still in the works. We have some tools from our knowledge from past experiences indicating that a step-wise management approach should be used, without neglecting other joint therapeutic measures for improved clinical outcomes of a condition with a high mortality. The current recommendations indicate that patients with severe acute respiratory failure due to SARS-CoV-2 should be managed with protective mechanical ventilation measures. No strong evidence is yet available on the individualization of mechanical ventilation therapy according to phenotypes.

Resumen La infección asociada a COVID-19 produce una patología de comportamiento aún desconocido, planteándole diversos desafíos al clínico. Para esta revisión narrativa se llevó a cabo una extensa búsqueda basada en artículos de revisión sobre la infección por SARS-CoV-2 y estudios que incluían estrategias de manejo con ventilación mecánica. El tratamiento basado en evidencia para la infección por SARS-CoV2 todavía está en desarrollo. Tenemos algunas herramientas basadas en nuestros conocimientos de experiencias en el pasado que indican que se debe usar un abordaje escalonado, sin descuidar otras medidas terapéuticas conjuntas para mejorar los desenlaces clínicos de una condición con una elevada mortalidad. Las actuales recomendaciones indican que los pacientes con falla respiratoria aguda por SARS-CoV-2 deben manejarse con medidas de protección con ventilación mecánica. Aún no tenemos una sólida evidencia sobre la individualización del tratamiento con ventilación mecánica, de acuerdo a los distintos fenotipos.

Enferm Infecc Microbiol Clin (Engl Ed) ; 40(8): 441-444, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35624065


INTRODUCTION: In the present manuscript we describe the planning carried out in our hospital to adapt our diagnostic capability to perform large numbers of SARS-CoV-2 RT-PCR. METHODS: The analysis and prediction of workflow included the number of RT-PCR per week from the beginning of the pandemic, with a total of 31971 determinations. The planning phase was developed based on the different scenarios previously predicted. RESULTS: According to the predictions obtained, an automated custom solution was chosen, based on the use of the OT-2 open-source liquid-handling robots (Opentrons), to design a reproducible workflow that achieved a production capacity of 5640 samples/day, with a time of response of four hours per procedure. CONCLUSIONS: The analysis and prediction of workflow, along with the use of the robotic platforms OT-2, provided a robust structure to deal with the high demand of determinations that this pandemic requires.

COVID-19 , SARS-CoV-2 , COVID-19/diagnóstico , Teste para COVID-19 , Técnicas de Laboratório Clínico/métodos , Humanos , Pandemias , Reação em Cadeia da Polimerase Via Transcriptase Reversa , SARS-CoV-2/genética
BMJ Open ; 12(2): e051187, 2022 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-35115349


OBJECTIVE: Successful clinical trials are subject to recruitment. Recently, the REJUVENATE trial, a prospective phase 2a open-label, single-arm interventional clinical trial conducted within the Innovative Medicines Initiative-supported Combatting Bacterial Resistance in Europe-Carbapenem Resistance project, was published, with 85% of the recruitment performed in Spain. We analysed the recruitment success in this trial by establishing a model of recruitment practice. METHODS: A descriptive qualitative study was performed from May 2016 to October 2017 at 10 participating Spanish centres. Data were extracted from: (1) feasibility questionnaires to assess the centre's potential for patient enrolment; (2) delegation of responsibility records; (3) pre-screening records including an anonymised list of potentially eligible and (4) screening and enrolment records. A descriptive analysis of the features was performed by the participating centre. Pearson's and Spearman's correlation coefficients were calculated to determine factors of recruitment success. RESULTS: The highest recruitment rate was observed in Hospitals 3 and 6 (58.8 and 47.0 patients per month, respectively). All the study teams were multidisciplinary with a median of 15 members (range: 7-22). Only Hospitals 3, 5 and 6 had dedicated nursing staff appointed exclusively to this study. Moreover, in those three hospitals and in Hospital 9, the study coordinator performed exclusive functions as a research planner, and did not assume these functions for the other hospitals. The univariate analysis showed a significant association between recruitment success and months of recruitment (p=0.024), number of staff (p<0.001), higher number of pharmacists (p=0.005), infectious disease specialists (p<0.001), the presence of microbiologist in the research team (p=0.018) and specifically dedicated nursing staff (p=0.036). CONCLUSIONS: The existence of broad multidisciplinary teams with staff dedicated exclusively to the study as well as the implementation of a well-designed local patient assessment strategy were the essential optimisation factors for recruitment success in Spain. TRIAL REGISTRATION NUMBER: NCT02655419; EudraCT 2015-002726-39; analysis of pre-screened patients.

Aztreonam , Compostos Azabicíclicos , Humanos , Estudos Prospectivos , Espanha , Inquéritos e Questionários
Food Chem ; 378: 131983, 2022 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-35032801


The formation of the molecule 4,5-dihydroxy-2-cyclopenten-1-one (DHCP) from the thermal treatment of pectin-containing foods was investigated in small-scale laboratory preparation of sterilized vegetable puree (carrot, zucchini and tomato) and fruit puree (peach and mixture of pear and apple) and in commercial baby foods. DHCP attracts attention due to its cytotoxicity as well as potential antiviral and anti-inflammatory effects. However, its effects and the difficulty of its identification in food are mediated in part by the formation of Michael adducts of DHCP with amino acids. The results revealed that DHCP reacted efficiently with cysteine and glutathione, and to a lesser extent with histidine. Mass spectrometry analysis confirmed the formation of adducts of DHCP with amino acids in a model system, being in a real food system difficult to investigate. However, these formed adducts are of potential interest, although it is not known whether they are safe, bioactive or reversible.

Frutas , Verduras , Aminoácidos , Ciclopentanos , Alimentos Infantis
Antioxidants (Basel) ; 10(12)2021 Nov 23.
Artigo em Inglês | MEDLINE | ID: mdl-34942961


The aim of this research was to investigate the interaction of phenols and pectic polysaccharides during the olive oil extraction process. For this, pectin was extracted from fresh olive fruits and compared to the pectin isolated from the paste resulting from the extraction of the olive oil after milling with malaxation at 30 °C/30 min and subsequent centrifugation of the olive paste from the same lot of olive fruits in a system called ABENCOR (AB). The results indicate that these interactions were enhanced during the olive oil extraction process. In addition, the resulting AB extracts exhibited high antioxidant activity (ORAC) and strong antiproliferative activity in vitro against colon carcinoma Caco-2 cell lines compared to olive fruit extracts. The polyphenols associated mainly with the acidic pectin substance, with a higher content in AB extracts, seem to be responsible for these activities, and appear to maintain their activities in part after complexation. However, even in olive fruit extracts with smaller amounts of phenols in their compositions, pectic polysaccharides may also be involved in antioxidant and antiproliferative activities.

Rev. argent. cardiol ; 89(6): 494-500, dic. 2021. tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1407083


RESUMEN Introducción: El reemplazo quirúrgico de la válvula aórtica (REEAO) en pacientes con valvulopatía aórtica grave sintomática, es el tratamiento definido como el de referencia. Sin embargo, el implante valvular aórtico transcatéter (TAVI) se posiciona actualmente como una alternativa en pacientes de diferentes riesgos según los scores internacionales. Algunas guías consideran al TAVI como el procedimiento preferible en los pacientes añosos. Objetivos: Conocer el riesgo y resultados de morbimortalidad del REEAO en pacientes adultos clasificados según la edad en mayores de 75 años, o de 75 años o menos. Material y métodos: Estudio retrospectivo sobre 228 pacientes consecutivos intervenidos mediante REEAO entre el 1 de enero de 2011 y el 31 de diciembre de 2020 por valvulopatía aórtica grave sintomática. Del total de pacientes operados, 46 (16%) eran mayores de 75 años (Grupo 1, G1) y 182 pacientes (84%) tenían 75 años o menos (Grupo 2, G2). Se excluyeron pacientes con enfermedad coronaria concomitante, endocarditis bacteriana u otras valvulopatías asociadas. Resultados: Los pacientes del G1 tenían mayor riesgo de morbimortalidad quirúrgica analizado por scores de riesgo validados: ArgenSCORE de 1,55 (RIC 0,99-3,33) vs 1,08 (RIC 0,68-2,23), p = 0,02 y STS score de 2,33 (RIC 1,57-3,23) vs. 0,94 (RIC 0,721,44), p = 0,0001, con respecto al G2; no se encontraron en cambio diferencias significativas en el EuroSCORE II : 2,37 (RIC 1,19-3,61) vs. 1,83 (RIC 1,16-3,04), p = 0,2. La mortalidad registrada global fue del 1,7% (G1: 2,1% vs. G2: 1,6% , p NS); no se observaron accidente cerebrovascular (ACV) ni infarto agudo de miocardio (IAM) perioperatorios. Conclusiones: La escasa presentación de muerte, ACV e IAM sugiere que el tratamiento seleccionado para estos pacientes fue adecuado, con excelentes resultados sin diferencias entre los dos grupos etarios.

ABSTRACT Background: Surgical aortic valve replacement (SAVR) is the reference treatment in patients with symptomatic severe aortic valve disease. However, according to international scores, transcatheter aortic valve implantation (TAVI) is currently an alternative in different risk patients, and some guidelines consider TAVI as a preferable procedure in elderly patients. Objectives: The aim of this study was to assess SAVR morbidity and mortality risk and results in adult patients, classified according to age as >75 years or ≤75 years. Methods: A retrospective study was performed on 228 consecutive patients undergoing SAVR between January 1, 2011 and December 31, 2020 for symptomatic severe aortic valve disease. Among the total number of patients operated on, 46 (16%) were >75 years (Group 1, G1) and 182 (84%) were ≤75 years (Group 2, G2). Patients with concomitant coronary heart disease, bacterial endocarditis or other associated valve diseases were excluded from the analysis. Results: Group 1 patients had greater risk of surgical morbidity and mortality analyzed by validated risk scores: ArgenSCORE 1.55 (IQR 0.99-3.33) vs 1.08 (IQR 0.68-2.23), p = 0.02 and STS score 2.33 (IQR 1.57-3.23) vs. 0.94 (IQR 0.72-1.44), p = 0.0001, with respect to G2, while no significant differences were found for EuroSCORE II: 2.37 (IQR 1.19-3.61) vs. 1.83 (IQR 1.163.04), p = 0.2. Overall mortality was 1.7% (G1: 2.1% vs. G2: 1.6%, p=NS), with no perioperative stroke or acute myocardial infarction (AMI). Conclusions: The low number of deaths, stroke and AMI observed suggests that the selected treatment for these patients was adequate, with excellent results and without significant differences between these two age groups.