RESUMEN
The banana is a tropical fruit characterized by its composition of healthy and nutritional compounds. This fruit is part of traditional Ecuadorian gastronomy, being consumed in a wide variety of ways. In this context, unripe Red Dacca banana samples and those submitted to different traditional Ecuadorian heating treatments (boiling, roasting, and baking) were evaluated to profile their phenolic content by ultra-high-performance liquid chromatography coupled to high-resolution mass spectrometry (UHPLC-HRMS) and the antioxidant activity by ORAC, ABTS, and DPPH assays. A total of sixty-eight phenolic compounds were identified or tentatively identified in raw banana and treated samples, highlighting the content in flavonoids (flavan-3-ols with 88.33% and flavonols with 3.24%) followed by the hydroxybenzoic acid family (5.44%) in raw banana samples. The total phenolic compound content significantly decreased for all the elaborations evaluated, specifically from 442.12 mg/100 g DW in fresh bananas to 338.60 mg/100 g DW in boiled (23.41%), 243.63 mg/100 g DW in roasted (44.90%), and 109.85 mg/100 g DW in baked samples (75.15%). Flavan-3-ols and flavonols were the phenolic groups most affected by the heating treatments, while flavanones and hydroxybenzoic acids showed higher stability against the heating treatments, especially the boiled and roasted samples. In general, the decrease in phenolic compounds corresponded with a decline in antioxidant activity, evaluated by different methods, especially in baked samples. The results obtained from PCA studies confirmed that the impact of heating on the composition of some phenolic compounds was different depending on the technique used. In general, the heating processes applied to the banana samples induced phytochemical modifications. Even so, they remain an important source of bioactive compounds for consumers.
RESUMEN
IMPORTANCE: The effect of high-flow oxygen therapy vs conventional oxygen therapy has not been established in the setting of severe COVID-19. OBJECTIVE: To determine the effect of high-flow oxygen therapy through a nasal cannula compared with conventional oxygen therapy on need for endotracheal intubation and clinical recovery in severe COVID-19. DESIGN, SETTING, AND PARTICIPANTS: Randomized, open-label clinical trial conducted in emergency and intensive care units in 3 hospitals in Colombia. A total of 220 adults with respiratory distress and a ratio of partial pressure of arterial oxygen to fraction of inspired oxygen of less than 200 due to COVID-19 were randomized from August 2020 to January 2021, with last follow-up on February 10, 2021. INTERVENTIONS: Patients were randomly assigned to receive high-flow oxygen through a nasal cannula (n = 109) or conventional oxygen therapy (n = 111). MAIN OUTCOMES AND MEASURES: The co-primary outcomes were need for intubation and time to clinical recovery until day 28 as assessed by a 7-category ordinal scale (range, 1-7, with higher scores indicating a worse condition). Effects of treatments were calculated with a Cox proportional hazards model adjusted for hypoxemia severity, age, and comorbidities. RESULTS: Among 220 randomized patients, 199 were included in the analysis (median age, 60 years; n = 65 women [32.7%]). Intubation occurred in 34 (34.3%) randomized to high-flow oxygen therapy and in 51 (51.0%) randomized to conventional oxygen therapy (hazard ratio, 0.62; 95% CI, 0.39-0.96; P = .03). The median time to clinical recovery within 28 days was 11 (IQR, 9-14) days in patients randomized to high-flow oxygen therapy vs 14 (IQR, 11-19) days in those randomized to conventional oxygen therapy (hazard ratio, 1.39; 95% CI, 1.00-1.92; P = .047). Suspected bacterial pneumonia occurred in 13 patients (13.1%) randomized to high-flow oxygen and in 17 (17.0%) of those randomized to conventional oxygen therapy, while bacteremia was detected in 7 (7.1%) vs 11 (11.0%), respectively. CONCLUSIONS AND RELEVANCE: Among patients with severe COVID-19, use of high-flow oxygen through a nasal cannula significantly decreased need for mechanical ventilation support and time to clinical recovery compared with conventional low-flow oxygen therapy. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04609462.
Asunto(s)
COVID-19/complicaciones , Intubación Intratraqueal/estadística & datos numéricos , Terapia por Inhalación de Oxígeno/métodos , Oxígeno/uso terapéutico , Insuficiencia Respiratoria/terapia , Anciano , Anciano de 80 o más Años , COVID-19/terapia , Enfermedad Crítica/mortalidad , Enfermedad Crítica/terapia , Femenino , Humanos , Unidades de Cuidados Intensivos , Intubación Intratraqueal/efectos adversos , Masculino , Persona de Mediana Edad , Terapia por Inhalación de Oxígeno/instrumentación , Respiración Artificial , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/mortalidad , SARS-CoV-2 , Factores de Tiempo , Resultado del TratamientoRESUMEN
BACKGROUND AND AIMS: Familial Hypercholesterolemia (FH) is characterized by elevated LDL-cholesterol (LDL-C) and high atherosclerosis risk. The impact of different dietary patterns on atherosclerosis biomarkers has been poorly studied in FH. This study verified the association of adherence to a Mediterranean diet with biomarkers of dyslipidemia and low-grade inflammation in molecularly proven FH adults from Brazil (BR) and Spain (SP). METHODS AND RESULTS: In this cross-sectional study adherence to the Mediterranean diet was assessed by a validated score and generalized estimating equations were used to evaluate its association with plasma LDL-C, apolipoprotein-B (ApoB) and high sensitivity C-reactive protein (hs-CRP) concentrations. We included 92 (mean age 45 years, 58.7% females) and 98 FH individuals (mean age 46.8 years, 60.2% females) respectively from BR and SP. FH causing variants did not differ between countries. LDL-C, ApoB and hs-CRP concentrations were higher in BR than in SP: 179 (135-250) and 161 (133-193) mg/dL; 141 (109-181) and 103 (88-134) mg/dL; and 1.6 (0.8-4.0) and 0.8 (0.4-1.5) mg/L respectively (all p < 0.001). Most of BR had low adherence (n = 77, 83.7%), while the majority of SP were divided into moderate (n = 35, 35.7%) and strong adherence to the Mediterranean diet (n = 37, 37.8%), p < 0.001. There was a significant inverse association of adherence to the Mediterranean diet score with higher LDL-C, ApoB, and hs-CRP after adjusting for socio economic parameters, caloric and fatty acid intakes as well as pharmacological lipid lowering therapies. CONCLUSIONS: Higher adherence to a Mediterranean diet was associated with better dyslipidemia and low-grade inflammation profiles in FH.
Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Dieta Saludable , Dieta Mediterránea , Hiperlipoproteinemia Tipo II/dietoterapia , Mediadores de Inflamación/sangre , Inflamación/prevención & control , Lípidos/sangre , Cooperación del Paciente , Conducta de Reducción del Riesgo , Adulto , Biomarcadores/sangre , Brasil/epidemiología , Enfermedades Cardiovasculares/sangre , Enfermedades Cardiovasculares/diagnóstico , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Conducta Alimentaria , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Hiperlipoproteinemia Tipo II/sangre , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/epidemiología , Inflamación/sangre , Inflamación/diagnóstico , Inflamación/epidemiología , Masculino , Persona de Mediana Edad , Valor Nutritivo , Factores Protectores , Medición de Riesgo , España/epidemiología , Factores de Tiempo , Resultado del TratamientoRESUMEN
Microcirculatory dysfunction plays a pivotal role in the pathogenesis of severe sepsis and septic shock; hence, microcirculation blood flow monitoring has gained increasing attention. However, microcirculatory imaging is still investigational in human sepsis and has not yet been incorporated into routine clinical practice for several reasons, including the difficult interpretation of microcirculation imaging data, difficulty to draw a parallel between sublingual microcirculation imaging and organ microcirculation dysfunction, as well as the absence of microvessel dysfunction parameters defining sequential microcirculatory changes from the early to late stages of the disease, which could aid in the context of therapeutic approaches and of prognostic parameters. The purpose of this review was to bridge the experimental abdominal organ microvascular derangement kinetics and clinical aspects of microcirculatory findings in the early phase of severe sepsis/septic shock.
Asunto(s)
Microcirculación , Sepsis/fisiopatología , Animales , Arteriolas/fisiopatología , Arteriolas/ultraestructura , Velocidad del Flujo Sanguíneo , Modelos Animales de Enfermedad , Infecciones por Escherichia coli/complicaciones , Humanos , Microscopía por Video , Ratas , Sepsis/etiología , Circulación Esplácnica , Vénulas/fisiopatología , Vénulas/ultraestructura , Vísceras/irrigación sanguíneaRESUMEN
PURPOSE: To analyze in vivo the architecture of clear corneal incisions (CCIs) for phacoemulsification using optical coherence tomography (OCT). SETTING: Anterior Segment Department, Asociacion Para Evitar la Ceguera en Mexico, Hospital Dr Luis Sanchez Bulnes, Mexico. METHODS: A prospective masked study analyzed 20 unsutured CCIs placed superiorly and created in a uniplanar fashion with a 3.2 mm slit-angled metal keratome. All wounds were evaluated with a retinal OCT model 1, 3, and 30 days postoperatively. Intraocular pressure (IOP) and incision leakage were checked. The architecture was described according to the angle of incidence, apposition of the epithelial and endothelial margins, and wound sealing. RESULTS: No leakage was detected. The angle varied from 33 to 85 degrees; angles greater than 75 degrees were done by a surgeon in training. Wound apposition at the epithelial margin was achieved in all cases. In contrast, imperfect apposition of the endothelial margin was seen in 45% of incisions on day 1 and in 15% on day 30. Incomplete sealing of the wound was seen by OCT in 25% of cases at 24 hours and persisted in 10% of all cases at 1 month. This gaping occurred on the endothelial side and never translated to the epithelial margin. No statistical correlation was found between gaping and the angle of the incision, IOP variations, or surgeon experience. CONCLUSIONS: Although in vivo CCIs caused minor anatomic imperfections, they were clinically stable independent of incision angle, IOP variation, and surgeon experience. Incision stability may be related to careful wound construction, epithelial viability, stromal edema, and efficient endothelial pumping.
Asunto(s)
Córnea/patología , Córnea/cirugía , Facoemulsificación/métodos , Tomografía de Coherencia Óptica , Cicatrización de Heridas , Femenino , Fluorofotometría , Humanos , Presión Intraocular , Implantación de Lentes Intraoculares , Masculino , Estudios Prospectivos , Tonometría OcularRESUMEN
Se reportan las complicaciones de 72 enfermos con resecciones pulmonares, durante el período de 1995 a 1999 en el Hospital Clinicoquirúrgico "Comandante Manuel Fajardo". El 61,1 porciento fue por resecciones regladas (lobectomías y neumonectomías) y el resto atípicas. La mortalidad quirúrgica fue de 4,1 porciento y la morbilidad del 11,1 porciento. Las complicaciones más frecuentes fueron la neumonía y la sepsis de la herida, observada en el 2,7 porciento. La fístula bronquial se presentó en un enfermo (1,3 porciento)(AU)
The complications of 72 patients with pulmonary resections performed at Comandante Manuel Fajardo Clinical and Surgical Hospital from 1995 to 1999 are reported. 61.1 percent of the complications were due to segmental resections (lobectomies and neuronectomies) and the rest were atypical. Surgical mortality was 4.1 percent and morbidity 11.1 percent. The most frequent complications were pneumonia and wound sepsis, which were observed in 2.7 percent. A patient had bronchial fistula (1.3 percent)(AU)
Asunto(s)
Humanos , Neumonectomía/métodos , Complicaciones Posoperatorias/epidemiología , Procedimientos Quirúrgicos Pulmonares/efectos adversos , Enfermedades Pulmonares/cirugía , Neoplasias Pulmonares/complicaciones , Neumotórax/cirugía , Complicaciones Posoperatorias/mortalidadRESUMEN
Se presentan 2 enfermos con cáncer epidermoide de esófago torácico, tercio inferior, considerado irresecable en la intervención quirúrgica por presentar infiltración del tronco celiaco. Se realiza bypass gástrico tubular a expensa de la gastroepiploica derecha (técnica de Postlethwait) con buenos resultados
Asunto(s)
Derivación Gástrica/métodos , Neoplasias EsofágicasRESUMEN
Se muestra en este estudio los resultados obtenidos en el tratamiento a 42 enfermos de cáncer de esófago, de ellos, fueron resecables el 40,0 porciento, al que se le realizó diferentes procederes quirúrgicos. Al resto de los pacientes, excepto uno, se les colocó un tubo protésico transluminal por el método de tracción, previa colocación de un tubo nasogástrico a través de la estenosis tumoral. La morbimortalidad obtenida en esta casuística resultó aceptable para este tipo de entidad(AU)
Asunto(s)
Humanos , Neoplasias Gástricas/cirugía , Cardias/cirugía , Neoplasias Esofágicas/cirugía , Resultado del Tratamiento , Cuidados PaliativosRESUMEN
Se presenta un enfermo con leiomiosarcoma retroperitoneal con una supervivencia de 26 meses tratado con 4 intervenciones abdominales, las 3 primeras con resección total del tumor que no impidieron las recidivas que lo condujeron a la muerte. Se destacan características particulares y la mala evolución de este enfermo a pesar de cirugías exeréticas y complejas(AU)
Asunto(s)
INFORME DE CASO , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Retroperitoneales/cirugía , Leiomiosarcoma/cirugía , Recurrencia Local de Neoplasia/cirugíaRESUMEN
Se presenta un enfermo con leiomiosarcoma retroperitoneal con una supervivencia de 26 meses tratado con 4 intervenciones abdominales, las 3 primeras con resección total del tumor que no impidieron las recidivas que lo condujeron a la muerte. Se destacan características particulares y la mala evolución de este enfermo a pesar de cirugías exeréticas y complejas
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Leiomiosarcoma , Recurrencia Local de Neoplasia , Neoplasias RetroperitonealesRESUMEN
Se muestra en este estudio los resultados obtenidos en el tratamiento a 42 enfermos de cáncer de esófago, de ellos, fueron resecables el 40,0 porciento, al que se le realizó diferentes procederes quirúrgicos. Al resto de los pacientes, excepto uno, se les colocó un tubo protésico transluminal por el método de tracción, previa colocación de un tubo nasogástrico a través de la estenosis tumoral. La morbimortalidad obtenida en esta casuística resultó aceptable para este tipo de entidad
Asunto(s)
Humanos , Cuidados Paliativos , Cardias , Neoplasias Esofágicas , Neoplasias Gástricas , Resultado del TratamientoRESUMEN
Between 1980 to 1989 all the records of patients with slipped capital femoral epiphysis (SCFE) from the University Children Hospital in San Juan, Puerto Rico were Reviewed. This was done in an effort to assess the outcome of patients affected with SCFE admitted to University Pediatric Hospital. Comparison with other populations already studied showed no significant differences regarding patients age, weight, side effected, bilaterality and response to current standard surgical methods of treatment.
Asunto(s)
Humanos , Masculino , Femenino , Lactante , Preescolar , Niño , Adolescente , Epífisis Desprendida/cirugía , Cabeza Femoral , Cabeza Femoral/cirugía , Cabeza Femoral , Epífisis Desprendida , Estudios de Seguimiento , Articulación de la Cadera , Articulación de la Cadera/cirugía , Hispánicos o Latinos , Puerto Rico , Estudios RetrospectivosRESUMEN
El presente trabajo de rehabilitación clínica, muestra el accionar de un equipo multidisciplinario, cuya finalidad es la rehabilitación de pacientes con deficiencias congénitas terminales de los miembros [amputados congénitos]. Mostramos la metodología de trabajo seguida, con 295 pacientes, con compromiso de miembros superiores y/o inferiores, atendidos en la unidad de amputados del Instituto Nacional de Rehabilitación Psicofísica entre 1960 y 1986 inclusive. Los resultados obtenidos, satisfactorios, muestran, no obstante, cierto grado de deserción, que nos habla de una mala comprensión social y sanitaria del problema del discapacitado. Preconizamos por lo tanto, la imprescindible necesidad de: trabajo en equipo, derivación precoz, equipamiento temprano por medio de una receta magistral de la prótesis, adecuado entrenamiento en el uso de la misma. Para posibilitar la metodología expuesta, anteriormente, será necesario la amplia difusión de la problemática que nos ocupa.
Asunto(s)
Amputados , RehabilitaciónRESUMEN
El presente trabajo de rehabilitación clínica, muestra el accionar de un equipo multidisciplinario, cuya finalidad es la rehabilitación de pacientes con deficiencias congénitas terminales de los miembros [amputados congénitos]. Mostramos la metodología de trabajo seguida, con 295 pacientes, con compromiso de miembros superiores y/o inferiores, atendidos en la unidad de amputados del Instituto Nacional de Rehabilitación Psicofísica entre 1960 y 1986 inclusive. Los resultados obtenidos, satisfactorios, muestran, no obstante, cierto grado de deserción, que nos habla de una mala comprensión social y sanitaria del problema del discapacitado. Preconizamos por lo tanto, la imprescindible necesidad de: trabajo en equipo, derivación precoz, equipamiento temprano por medio de una receta magistral de la prótesis, adecuado entrenamiento en el uso de la misma. Para posibilitar la metodología expuesta, anteriormente, será necesario la amplia difusión de la problemática que nos ocupa. (AU)