Effect of high-pressure treatment and storage temperature on top-quality (Montanera) Iberian dry-cured pork sausages (chorizo).

The stability after hydrostatic high pressure (HHP) (600 MPa/8 min/10 °C) and 180 days of storage at 4 and 20 °C was evaluated on Iberian dry-cured pork sausages (chorizo) packaged sliced or as half-pieces from pigs raised outdoors. Microbiological, physical-chemical, oxidative, and sensory changes were analyzed. The evolution of mesophilic aerobic and molds and yeasts counts was different in the half and sliced packaged pork sausages after processing and during storage. Sliced and half-packaged pork sausages had instrumental color stability after HHP and during storage. TBA-RS values were quite stable in both products. Protein oxidation values of pork sausage in half-products were increased by at 20 °C. In sliced pork sausage, both HPP and 20 °C storage favored the development of protein oxidation at the end of storage. In the sensory analysis, the sliced product developed more rancidity than the half-pieces during the storage. Therefore, the storage temperature has great importance for the preservation of dry-cured pork sausages, the increases of protein oxidation, and rancidity could reduce the shelf-life at these conditions. The presentation of the product is also relevant when HHP is applied, and this would also compromise the stability of the product when it is stored at room temperature. PRACTICAL APPLICATION: Chorizo is a traditional dry-fermented pork sausage that is generally considered to be microbiologically safe. However, the initial contamination of the raw materials, and some processes, such as the slicing or packaging, can compromise the safety of these products. Additionally, packaged dry-cured sausages require long shelf-life, and although they are normally stored at refrigeration temperature; sometimes, they are preserved at room temperature. The application of hydrostatic high pressure could increase the safety of dry-cured meat products even when they are stored at room temperature. Initial characteristics of each type of pork sausage could determine their technological behavior during processing or during storage under different conditions.

Oral health in children with acute lymphoblastic leukaemia: before and after chemotherapy treatment.

AIM: To evaluate changes in the oral health status of children under the age of 14 years with acute lymphoblastic leukaemia (ALL) attending a cancer centre before and after chemotherapy treatment. MATERIALS AND METHODS: A total of 32 children with ALL without distinction of gender were selected for study. The oral cavity of the patients was evaluated before the induction stage and 17 days later. Clinical evaluation of the submandibular, submental, and cervical lymph nodes was performed. Saliva samples were collected during the early morning hours. Bacterial plaque was assessed by using the Silness and Löe plaque index (SLPI) and gingiva status was evaluated with the gingival Löe and Silness index (GLSI). The WHO toxicity oral scale was used to record the degree of oral mucositis. The resulting data were analysed with McNemar's test, t test (for related samples), and Wilcoxon test. RESULTS: There were statistically significant differences for palpable lymph nodes, paleness of oral mucosa, and ecchymoseis, respectively, P ≤ 0.000, P = 0.03, and P = 0.01, with these manifestations decreasing significantly after treatment. Incipient gingivitis had frequencies of 71.9% and 75% before and after treatment, respectively. The mean SLPI score declined significantly from 1.16 ± 0.52 (before treatment) to 0.56 ± 0.36 (after treatment) (P < 0.000); salivary flow increased significantly from 0.54 ± 0.34 to 1.22 ± 1.07 after chemotherapy treatment (P < 0.00). Oral mucositis was present in 24 children (75%) with a 1-2 severity level. CONCLUSIONS: After chemotherapy treatment, there were changes in the oral conditions of children with ALL. Some manifestations decreased after treatment, whereas in others increased.

Intraoperative assessment of carotid endarterectomy.

In our experience intraoperative arteriography in carotid endarterectomy is very effective in detecting residual small lesions after surgery. There were no neurosurgical complications due to arteriography. The interpretation of the surgical results is objective since the criteria are the same as those used to assess preoperative arteriography. Different intraoperative assessment methods to control carotid endarterectomy are also analysed.

Abdominal aortic aneurysms. Results of surgical treatment.

One hundred and twenty-one aneurysms of the abdominal aorta were operated on during a ten year period (1971-1981). Elective surgery was carried out in 89 patients (73.5%). Thirty-two patients were operated on for impending or frank rupture. Most of the patients treated electively had no symptoms on admission. The mortality of this group of patients was 6.7% (6 patients). All the patients treated as emergencies had acute abdominal or back pain. Six cases presented with shock and acute renal failure. The hospital mortality was high in this group of 11 patients (34.3%). Nine of them were operated on because of suspected rupture but this was not confirmed at operation. Only one patient in this group died after the operation (11.1%). The hospital mortality of the 23 patients with ruptured aneurysms was 43.4% (10 patients). Six of them died in the operating room. While elective surgery carries an acceptable mortality, the emergency procedure involves a high risk. All the aneurysms must be resected electively in spite of the absence of symptoms.

Iliac arteriovenous fistula as a complication of lumbar disc surgery. Report of two cases and review of literature.

Vascular lesions following surgery of the lumbar disc are very infrequent, and exceptionally an arteriovenous fistula can developed. An important proportion of the reported cases were previously diagnosed as deep venous thrombosis, because this kind of pathology was not suspected. Postsurgical arteriovenous fistula produces severe haemodynamic disturbances, and congestive heart failure will develop if they are left to their natural course without intervention. Arteriovenous fistula should be suspected in the post-operative period of the lumbar disc surgery if congestive heart failure appears, accompanied by swelling of one or both lower limbs. Early surgery is the treatment of choice in order to prevent the congestive heart failure, and to preserve the normal function of the lower extremities. The technical choice seems to be the closure of the orifice of the fistula through the arterial lumen, together with appropriate arterial reconstruction.

[Analysis of withdrawal from noninvasive mechanical ventilation in patients with obesity-hypoventilation syndrome. Medium term results]. / Análisis de la retirada de la ventilación mecánica no invasiva en pacientes con síndrome de hipoventilación-obesidad. Resultados a medio plazo.

OBJECTIVE: To evaluate the possibility of cessation of noninvasive mechanical ventilation or noninvasive positive pressure ventilation (NPPV) treatment in patients with obesity-hypoventilation syndrome (OHS). MATERIAL AND METHODS: A study was carried out on 22 OHS patients who had received NPPV for a minimum of 1 year. Prior to evaluation of the cessation of ventilatory support, all patients underwent the following tests: diurnal and nocturnal arterial blood gases, nocturnal oximetry, nocturnal cardiorespiratory polygraphy, and lung function tests. Based on the results obtained, 12 patients who met the NPPV cessation criteria were selected. This group was liberated from ventilatory support for 3 months. At the end of this period, all of the tests initially carried out were repeated on all patients and the results were compared with those obtained at the time of NPPV cessation. RESULTS: Three months after liberation from NPPV, no significant variations were observed in arterial blood gases or in lung function tests in comparison with the values found at the time of cessation. In terms of individual development, only 1 patient showed blood gas deterioration requiring a return to NPPV. In 7 cases, a polygraph showed obstructive sleep apnea syndrome (OSAS), 4 at the time of cessation and 3 at the follow-up examination carried out at the end of the 3 months. Finally, in 4 patients the respiratory situation remained stable, with no significant variations in the tests done before or after cessation of NPPV. CONCLUSIONS: The majority of the OHS patients who receive prolonged treatment with NPPV continue to be stable 3 months after liberation from ventilatory support. A high percentage of these patients can be seen to have OSAS once the hypercapnia situation is corrected.

Coronary steal syndrome.

A patient who suffered recurrent myocardial ischaemia and cerebrovascular symptoms 56 months after a quadruple coronary bypass is reported. Three coronary arteries had been bypassed using reversed saphenous vein and the other using the left internal mammary artery (IMA). Coronary angiography demonstrated patency of al bypasses but the presence of an obstruction of the left subclavian artery proximal to the origin of the left IMA, with angiographic criteria of the steal syndrome. The patient's symptoms were relieved by bypass from the left common carotid artery to the distal left subclavian artery. The pathophysiology, diagnosis, prevention and treatment of coronary steal syndrome are discussed.