Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Tecnologías emergentes para la conservación de alimentos sin calor

Not available&lt;br&gt;&lt;br&gt;Se han investigado los principios básicos de tres tecnologías emergentes para pasteurizar y esterilizar alimentos sin empleo del calor Mediante numerosos estudios se ha comprobado la efectividad de los campos eléctricos pulsantes de alta intensidad (CEPAI), los pulsos de luz (PL) y los campos magnéticos oscilantes (CMO) en la destrucción de microorganismos y enzimas de sistemas alimentarios. En la inactivación microbiana por CEPA!, el blanco principal es la membrana celular que, al ser sometida a campos eléctricos de alta intensidad, se hace permeable formando huecos o poros cuyo tamaño se incrementa a medida que aumenta la intensidad del campo eléctrico o el tiempo de tratamiento o se reduce la resistencia iónica del medio de pulsación. Por otra parte, los PL inducen reacciones fotoquímicas y fototérmicas en los alimentos, causando la muerte de gran cantidad de microorganismos, especialmente en productos alimenticios envasados. Los CMO producen simulación o inhibición en el crecimiento y reproducción de los microorganismos, un simple pulso de intensidad de 5-10 teslas y frecuencias de 5-500 kHz es suficiente para reducir el número de microorganismos en un mínimo de 2 ciclos logarítmicos. Se ha comprobado que estas tecnologías alargan la vida de anaquel de diversos productos alimenticios y pueden ser consideradas como sustitutos parciales de los procesos convencionales de pasteurización y esterilización de alimentos por tratamientos térmicos

Infuencia del tratamiento térmico y la humedad en la calidad de los geles de surimi de tilapia

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Effect of milk treatment on acidification, physicochemical characteristics, and probiotic cell counts in low fat yogurt

The effect of milk treatment (heat, high hydrostatic pressure - HHP, or combined heat and HHP) on acidification, physicochemical characteristics, and probiotic cell counts in low fat yogurt was studied. All samples were analyzed for fermentation time, pH, titratable acidity, total solids, water-holding capacity, syneresis, Hunter L*, a*, and b* values, Streptococcus thermophilus, Lactobacillus delbrueckii ssp bulgaricus, L. acidophilus, and Bifidobacterium longum. The application of HHP combined with thermal treatment resulted in yogurt gels with attractive physicochemical characteristics and high water-holding capacity. In addition to this, the milk treatment did not affect the probiotic bacteria growth. The balance of strains in the starter culture and level of inoculation influenced the yogurt fermentation and properties. The use of combined heat and HHP to treat milk before yogurt fermentation could be an alternative process for obtaining high quality, additive-free healthy products

Pressurization of some starches compared to heating: Calorimetric, thermo-optical and X-ray examination

Starch suspensions (30%), from pea and corn samples, with amylose (AML) contents ranging from 28% to 75%, were pressurized between 150 and 650 MPa for 30 min at room temperature. Differential scanning calorimetry (DSC), assisted by thermo-optical polarized microscopy (TPM) and X-ray diffractometry (XRD), was used to demonstrate the difference between pressure-gelatinization and heat gelatinization. The higher amylose content made the starch more resistant to pressure-induced gelatinization. Normal corn (28% AML) and pea starches (35% AML) partially gelatinized at 400 MPa and up, however pressurization produced low-quality gels with granular structure. Conversely, high amylose corn starches (55% and 70% AML) did not gelatinize at all (even at 650 MPa), although the starch suspensions underwent slight increases in viscosity. Retrogradation occurred either concurrently or immediately after pressurization as opposed to long-term thermal retrogradation. XRD revealed that a second scan produced vitrification and possible resistant starch formation in gelatinized/gelled starches. © 2008 Elsevier Ltd. All rights reserved.Partial funding from CICYT (Project MAT2004-00496) is acknowledgedPeer Reviewe