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Surgical treatment of complex intestinal atresia is challenging. Moreover, multiple surgical techniques have been described to treat these congenital malformations. As no single/universal technique is useful for every patient, individualized surgical treatment for these complex cases is mandatory. Isolated apple peel atresia (type IIIb), in coexistence with other types of atresia, is a rare event with a poor functional prognosis, which is difficult to treat surgically. Furthermore, the ability to achieve good surgical results becomes more difficult in resource-limited health facilities, such as the Hospital Pediatrico Moctezuma (Mexico City). The objective of this case report of two full-term female newborns with isolated apple peel atresia and an apple peel malformation with distal type IV atresia is to describe the successful surgical technique used in these patients and how to deal with certain postsurgical complications.

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This paper proposes to apply a postharvest environmental stress to red apples, Malus domestica, variety Red Delicious in order to increase the polyphenols compounds (PP) content in their peels. The possibility of enhancing extractable PP provides a useful alternative for the use of discarded crops in the food industry. A great increase in PP was observed in response to light damage produced by the environmental stress applied in this work. Flavonols > anthocyanins > flavanols > dihydrochalcones > phenolic acids is the order in PP content. The interaction of the extracted PP from unstressed and stressed apple peels with beta-lactoglobulin (ß-LG) was characterized. A PP/ß-LG complex which was formed with one single binding site in the protein was determined. The interaction was spontaneous and enthalpy driven. PP extracted from unstressed samples had greater affinity for the protein than PP extracted from stressed samples, possibly due to the polar characteristic of anthocyanins. The results of this last study could provide a better understanding of the interaction between PP and ß-LG to incorporate them into functional foods.

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Background: Apple pomace is a by-product of the fruit juice industry and comprises peel, seed, stem, and pulp tissues. This by-product contains dietary fibers, polyphenols, vitamins, and organic acids that can benefit human health and have a high potential as a dietary source. Baked products are well-known food types to humans and have a key role in feeding people worldwide. Nowadays, enriched products such as bread, cakes, and biscuits are available in stores. Different studies worldwide have been done about applying the by-products of the fruit juice industry in the bakery. Objective: This research aimed to evaluate apple peel (APE) and pulp (APU) powders separately as a partial substitute for wheat flour in cake production. Methods: Apple peel and pulp separately produced as the residual wastes of juicing were dried for 3 hours in oven (60°C). The dried pulp and peel were ground and sieved using a 60 µm mesh. In this research, chemical and physicochemical analyses were performed according to AACC (Approved Methods of the American Association of Cereal Chemists) and standard food analysis methods. Textural characteristic was analyzed by a texture analyzer (Brookfield CT3-10 Kg, US) equipped with an aluminum probe. Results: Different levels of APE and APU powders (10%, 20%, and 30 %) were used to enrich the cakes. The ash content, fat content, water adsorption capacity, and oil absorption capacity of the wheat flour were lower than APU and APE, whereas the moisture content, protein content, bulk density, and pH showed a reverse trend. Adding APU and APP to the cake formula increased total dietary fiber (TDF) from 4.14 % in the control sample to 27.71 % in the sample with 30 % apple peel powder (APE-30). The highest a* colorimetric parameter (redness) in the cake core was 3.82 in the APE-30 sample. The addition of APE and APU significantly increased the hardness, gumminess, and chewiness of the samples (p<0.05). APE-10 samples could improve the nutritional properties of the cakes without significant reduction (p>0.05) in overall acceptance compared to the control sample. Conclusion: The results of this research demonstrated that a partial replacement of the wheat flour with apple pulp and peel significantly increased the dietary fibers, especially insoluble dietary fiber, compared to the control sample. Apple pulp and apple peel powders had the potential for use in cake making as a good source of dietary fibers

Antecedentes: la pulpa de manzana es un subproducto de la industria del jugo de frutas y se compone de tejidos de cáscara, semillas, tallo y pulpa. Este subproducto contiene fibra dietética, polifenoles, vitaminas y ácidos orgánicos que pueden ser beneficiosos para la salud humana y tienen un alto potencial como fuente dietética. Los productos horneados son de tipos de alimentos bien conocidos para los seres humanos y son clave en la alimentación de las personas de todo el mundo. Hoy en día, los productos enriquecidos como pan, pasteles y galletas están disponibles en las tiendas. Se han hecho diferentes estudios en todo el mundo sobre la aplicación del subproducto de la industria del jugo de frutas en la panadería. Objetivo: El propósito de esta investigación fue evaluar los polvos de cáscara de manzana (APE) y pulpa (APU) como sustituto parcial de la harina de trigo en la producción de pasteles. Métodos: Cáscaras de manzana y pulpa producidas por separado como desechos residuales de jugos, se secaron durante 3 horas en el horno (60 °C). La pulpa seca y la cáscara fueron molidas y tamizadas usando una malla de 60 micras. En esta investigación el análisis químico y físico-químico realizado de acuerdo con el AACC (Aprobado Métodos de la Asociación Americana de Químicos del Cereales) y los métodos estándar de análisis de alimentos. La característica textural fue analizada por el analizador de textura (Brookfield CT3-10 Kg, US) equipado con una sonda de aluminio. Resultados: Se utilizaron diferentes niveles de polvos APE y APU (10, 20 and 30 %) para enriquecer los pasteles. La capacidad de absorción de ceniza, grasa, agua y aceite de la harina de trigo fue menor que la APU y APE, mientras que la humedad, la proteína, la densidad a granel y el pH mostraron una tendencia inversa. Además, APU y APE en fórmula de pastel, aumentaron la fibra dietética total (TDF) de 4.14 % en la muestra de control a 27.71 % en la muestra con un 30 % de polvo de pelar de manzana (APE-30). El parámetro más alto a* colorimétrico en núcleo de pastel fue de 3.82 (enrojecimiento) en la muestra APE-30. La adición de APE y APU aumentó significativamente la dureza, gomosidad y masticabilidad de las muestras (p<0.05). Las muestras de APE-10 podrían mejorar las propiedades nutricionales de los pasteles sin reducción significativa (P<0.05) en aceptación general, en comparación con la muestra de control. Conclusión: Los resultados de este estudio demostraron que un reemplazo parcial de la harina de trigo por pulpa de manzana y cáscara aumentó significativamente la fibra dietética especialmente la insoluble, cuando se compara con la muestra de control. La pulpa en polvo y la cáscara de manzana tienen el potencial de uso en la fabricación de pasteles como una buena fuente de fibra dietética.

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BACKGROUND: Gastroschisis is a closure defect of the abdominal wall classified as complex when it presents with necrosis, volvulus, or atresia of the gastrointestinal tract. Jejunoileal atresia is caused by abnormal closure, discontinuity, or narrowing of the intestine. Apple Peel or type IIIb is the rarest presentation, with an incidence of 1.3 per 10,000 live births. In addition to presenting a high mortality rate. PRESENTATION OF CASE: We present a preterm newborn patient of 30 weeks with a diagnosis of gastroschisis and jejunoileal atresia type IIIB. The congenital wall defect was closed in the first surgical stage, and he was then taken at four weeks to correct the atresia. In the second surgery, we found a difference in intestinal calibers of 8:1, and the surgical team decides to perform remodeling of the proximal sac with a mechanical stapler and perform anastomosis using the Santulli technique. On day 6 of life, enteral feeding began through a nutrition tube localized under intestinal anastomosis with progressive nutritional increase. Subsequently, intermittent and progressive occlusion of the stoma was performed, leading the patient to a definitive surgical closure one month later. CONCLUSIONS: The mortality rate for gastroschisis and complex intestinal atresia is high. Advances in prenatal diagnosis, neonatal intensive care, and proper surgical correction are crucial to improving survival rates. The Santulli procedure is a surgical alternative for intestinal atresias with a caliber discrepancy greater than 4 to 1 or when the characteristics of the distal part do not allow a primary anastomosis to be performed.

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The Cunninghamella echinulata PA3S12MM fungus is a great producer of invertases in a growth medium supplemented by apple peels. The enzyme was purified 4.5 times after two chromatographic processes, and it presented a relative molecular mass of 89.2 kDa. The invertase reached maximum activity at pH of 6 and at 60°C, in addition to presenting stability in alkaline pH and thermal activation at 50°C. The enzymatic activity increased in the presence of Mn2+ and dithiothreitol (DTT), while Cu2+ and Z2+ ions inhibited it. Also, DTT showed to protect enzymatic activity. The apparent values for Km , Vmáx , and Kcat for the sucrose hydrolysis were, respectively, 173.8 mmol/L, 908.7 mmol/L min-1 , and 1,388.79 s-1 . The carbohydrate content was of 83.13%. The invertase presented hydrolytic activity over different types of glycosidic bonds, such as α1 â†” 2ß (sucrose), α1 â†’ 4 (polygalacturonic acid), α1 â†’ 4 and α1 â†’ 2 (pectin), and α1 â†” 1 (trehalose), indicating that the enzyme is multifunctional. Thus, the biochemical properties showed by the C. echinulata PA3S12MM suggest a broad industrial application, such as in the biomass hydrolysis or in the food industry. PRACTICAL APPLICATIONS: Invertases are hydrolytic enzymes employed in several industrial sectors. Given their great importance for the economy and several industrial sectors, there is a growing interest in microorganisms producing this enzyme. The analysis of the biochemical properties of invertase in C. echinulata PA3S12MM suggest applications in the food industry. Due to its increased hydrolytic activity, the hydrolysis process of the sucrose may employ invertase for the production of invert sugar. The stability at alkaline pH suggests an application in the development of enzymatic electrodes for the quantification of sucrose in food and beverage. The multifunctional activity may work in the biomass hydrolysis or saccharification of by-products for the extraction of fermentable sugars. The high level of invertase N-linked glycosylation of invertase grants this enzyme thermal stability at high temperatures, in addition to resistance against the action of proteases, which are desirable characteristics for the application of this enzyme in industrial processes.

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Introducción: las duplicidades digestivas son entidades raras que se pueden presentar asociadas a otras malformaciones.Presentación del caso: recién nacida, con diagnóstico prenatal de imagen quística abdominal a las 25 sem de edad gestacional, que comenzó con regurgitaciones en las primeras 24 h de vida. Se realizaron estudios de imágenes y se corroboró imagen quística abdominal, no dependiente del tracto genitourinario; así como malformación digestiva de tipo de atresia intestinal. Se realizó tratamiento quirúrgico de esta última y de la tumoración. Se llegó a diagnóstico de certeza de duplicidad digestiva mediante estudios microscópicos, por anatomía patológica. La paciente fue dada de alta a los 30 días de vida con lactancia materna y curva de ganancia de peso estable.Conclusiones: dentro de los diagnósticos diferenciales de las imágenes quísticas intraabdominales en el recién nacido están: los quistes de ovarios, los quistes mesentéricos y las duplicidades digestivas, en orden de aparición, según frecuencia(AU)

Introduction: digestive duplications are rare diseases that may occur in association with other malformations.Case presentation: a female newborn with prenatal diagnosis of abdominal cyst image at 25 weeks of gestational age, who presented with regurgitations in her first 24 hours of life. Imaging studies were performed in which an abdominal cyst, not depending on the genitourinary tract, was confirmed in addition to an intestinal atressia-type abdominal malformation. The latter and the tumor were surgically removed. The final diagnosis, based on microscopic studies through pathological anatomy, was digestive duplication. The patient was discharged at her 30 days of age on breastfeeding and with stable weight gain curve.Conclusions: among the differential diagnoses of intraabdominal cyst images in the newborn are: ovary cysts, mesenteric cysts and digestive duplications in order of occurrence by frequency(AU)

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BACKGROUND: This study assessed the extraction efficiency of ursolic (UA) and oleanolic acids (OA), as well as the total phenols in aqueous and hydroethanolic extracts of dry apple peels at room temperature. MATERIALS AND METHODS: AFTER RUNNING PRELIMINARY ASSAYS ON DECOCTIONS AND TINCTURES (ETHANOL: water 7:3 v/v), the extracts from dried apple (cv. Fuji) peels were obtained by static maceration over varied intervals (2 to 180 days). The UA and OA content in the extracts was quantified by High Performance Liquid Chromatography with Diode Array Detection (HPLC-DAD) with a reversed phase column and isocratic elution (CH3CN/H2O/H3PO4) against calibration curves (R(2) > 0.9995). The total phenol content in the extracts was evaluated spectrophotometrically at 760 nm using the Folin-Ciocalteau method referencing gallic acid. RESULTS: UA and OA in the hydroethanolic extracts ranged from 3.63-6.12 mg/g and 2.12-3.30 mg/g, corresponding to 1.72-3.07 and 1.00-1.66 mg/g in the raw material, respectively. Higher values of triterpene acid content corresponded to maceration periods of 10 or 30 days. The residual phenol and polyphenol content ranged from 6.97 to 11.6 mg/g. The UA and OA yields, as well as the total phenol content, versus the maceration time were plotted in Control Charts within confidence intervals (95%) and were unaffected during the assayed period. CONCLUSION: Apple peel tinctures from 10% solids obtained at room temperature exhibited the highest content of triterpene acids when employing a maceration period of 10 to 30 days. Extracts prepared using this procedure contained an average of 7.33 mg/g of total triterpene acids and 10.6 mg/g phenolic compounds. These results establish supporting data for apple peel tinctures and their derived phytopharmaceuticals that are standardized on the ursolic-oleanolic acid content.

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Apple-peel atresia (or Type-IIIb intestinal atresia) is an unusual type of jejunoileal atresia. They present with jejunal atresia near the ligament of Treitz and a foreshortened small bowel. Many surgical options have been used, but the optimal method of repair remains unclear. We present a case of a newborn with apple-peel intestinal atresia managed by enteroplasty for intestinal lengthening and primary anastomosis.

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