Rodríguez-Suárez

La anemia perioperatoria constituye un factor independiente de riesgo de mor- bimortalidad postoperatoria. Sin embargo, persisten barreras conceptuales, logísticas y administrativas que dificultan la implementación generalizada de protocolos para su manejo. El coordinador del proyecto convocó a un grupo multidisciplinar de 8 profesionales para elab- orar un documento de consenso sobre el manejo de la anemia perioperatoria, en base a una serie puntos claves (PCs) relativos a su prevalencia, consecuencias, diagnóstico y tratamiento. Estos PCs fueron evaluados utilizando una escala Likert de 5 puntos, desde ‘‘totalmente en desacuerdo [1]’’ a ‘‘totalmente de acuerdo [5]’’. Cada PC se consideró consensuado si recibía una puntuación de 4 o 5 por al menos 7 participantes (>75%). A partir de los 36 PCs consensuados, se construyeron algoritmos diagnóstico-terapéuticos que pueden facilitar la implementación de programas de identificación precoz y manejo adecuado de la anemia perioperatoria, adaptados a las características de las instituciones hospitalarias de nuestro paísFunding for open access charge: Universidad de Málaga / CBU

Vinegar production from fruit concentrates: effect on volatile composition and antioxidant activity

Vinegar stands as a highly appreciated fermented food product due to several functional properties and multiple applications. This work focuses on vinegar production from fruit wines derived from fruit concentrates, to attain a food product with nutritional added value. Four fruit vinegars (orange, mango, cherry and banana), were produced and characterized, with total acidities of 5.3 ± 0.3% for orange, 5.6 ± 0.2% for mango, 4.9 ± 0.4% for cherry and 5.4 ± 0.4% for banana. Acetification showed impact on aroma volatiles, mainly related to oxidative reactions. Minor volatiles associated with varietal aroma were identified, monoterpenic alcohols in orange vinegar, esters in banana vinegar, C13-norisoprenoids in cherry vinegar and lactones in mango vinegar, indicating fruit vinegars differentiated sensory quality. Total antioxidant activity analysis by FRAP, revealed fruit vinegars potential to preserve and deliver fruit functional properties. Antioxidant activity of fruit vinegars, expressed as equivalents of Fe2SO4, was of 11.0 ± 1.67 mmol L1 for orange, 4.8 ± 0.5 mmol L1 for mango, 18.6 ± 2.33 mmol L1 for cherry and 3.7 ± 0.3 mmol L1 for banana. Therefore, fruit vinegars presented antioxidant activity close to the reported for the corresponding fruit, and between 8 and 40 folds higher than the one found in commercial cider vinegar, demonstrating the high functional potential of these novel vinegar products.Authors would like to acknowledge the financial funding of: FruitVinegarDRINK QREN Project (Ref. 23209), Project "BioInd-Biotechnology and Bioengineering for improved Industrial and Agro-Food processes, REF. NORTE-07-0124-FEDER-000028" Co-funded by the Programa Operacional Regional do Norte (ON.2 - O Novo Norte), QREN, FEDER and the FCT Strategic Project Pest OE/EQB/LA0023/2013. Authors would also like to acknowledge the participation of Mendes Goncalves S.A. and Frulact S.A. staff, for the active input, which led to the work basis and rationale.info:eu-repo/semantics/publishedVersio

Comparative study of the biochemical changes and volatile compound formations during the production of novel whey-based kefir beverages and traditional milk kefir

Cheese whey (CW) and deproteinised cheese whey (DCW) were investigated for their suitability as novel substrates for the production of kefir-like beverages. Lactose consumption, ethanol production, as well as organic acids and volatile compounds formation, were determined during CW and DCW fermentation by kefir grains and compared with values obtained during the production of traditional milk kefir. The results showed that kefir grains were able to utilise lactose from CW and DCW and produce similar amounts of ethanol (7.8–8.3 g/l), lactic acid (5.0 g/l) and acetic acid (0.7 g/l) to those obtained during milk fermentation. In addition, the concentration of higher alcohols (2-methyl-1-butanol, 3-methyl-1-butanol, 1-hexanol, 2-methyl-1-propanol, and 1-propanol), ester (ethyl acetate) and aldehyde (acetaldehyde) in cheese whey-based kefir and milk kefir beverages were also produced in similar amounts. Cheese whey and deproteinised cheese whey may therefore serve as substrates for the production of kefir-like beverages similar to milk kefir.The authors acknowledge the financial support from Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior (CAPES), CAPES-GRICES and Lactogal for supplying cheese whey powder

Volatile fingerprinting differentiates diverse-aged craft beers

Supplementary data to this article can be found online at https:// doi.org/10.1016/j.lwt.2019.03.044.Beer ageing on wood is a complex and difficult to control process involving several reactions and compounds. Difficulties in understanding the underlying phenomena often lead to empirical and unpredictable processes and heterogeneous products. This work resorts to volatile fingerprinting along with multivariate analysis as tools to differentiate and highlight differences in beers derived from diverse production processes. Volatile composition of beers originating from barrel ageing processes and unaged beer were analyzed by GC-MS. The collected data was processed by principal component analysis, which allowed the evaluation of relations between samples and volatile compounds. Beers were distinguished by clusters comprising different groups of volatiles. Beer with the longest period in barrel was in the cluster with the most volatiles. Beer produced by resident barrel microbiota fermentation was characterized by presence of Brettanomyces sp. metabolites. Beer aged in barrel by a shorter time period showed characteristic content of ethyl esters and oak extractives. Beer produced in inox vat and beer fermented in barrel with pitching of S. cerevisiae appeared in the same cluster, relating with fermentative esters. Volatile fingerprinting was a viable approach to characterize and distinguish the analyzed beers, providing relevant information regarding the impact of production methodologies in volatile composition.This work had funding support of the Portuguese Foundation for Science and Technology (FCT) under the scope of the strategic funding of UID/BIO/04469/2019 unit and COMPETE 2020 (POCI-01-0145 FEDER-006684) and BioTecNorte operation (NORTE-01-0145-FEDER000004) funded by the European Regional Development Fund under the scope of Norte2020 – Programa Operacional Regional do Norte. Fermentum –EngenhariadasFermentações Lda.also participated incofunding and supplying materials for this work. Authors would like to thank Mr. Paulo Coutinho and Quinta do Portal for supplying the oak barrels used in this work.info:eu-repo/semantics/publishedVersio

Evolution of the use of corticosteroids for the treatment of hospitalised COVID-19 patients in Spain between March and November 2020: SEMI-COVID national registry

Objectives: Since the results of the RECOVERY trial, WHO recommendations about the use of corticosteroids (CTs) in COVID-19 have changed. The aim of the study is to analyse the evolutive use of CTs in Spain during the pandemic to assess the potential influence of new recommendations. Material and methods: A retrospective, descriptive, and observational study was conducted on adults hospitalised due to COVID-19 in Spain who were included in the SEMI-COVID- 19 Registry from March to November 2020. Results: CTs were used in 6053 (36.21%) of the included patients. The patients were older (mean (SD)) (69.6 (14.6) vs. 66.0 (16.8) years; p < 0.001), with hypertension (57.0% vs. 47.7%; p < 0.001), obesity (26.4% vs. 19.3%; p < 0.0001), and multimorbidity prevalence (20.6% vs. 16.1%; p < 0.001). These patients had higher values (mean (95% CI)) of C-reactive protein (CRP) (86 (32.7-160) vs. 49.3 (16-109) mg/dL; p < 0.001), ferritin (791 (393-1534) vs. 470 (236- 996) µg/dL; p < 0.001), D dimer (750 (430-1400) vs. 617 (345-1180) µg/dL; p < 0.001), and lower Sp02/Fi02 (266 (91.1) vs. 301 (101); p < 0.001). Since June 2020, there was an increment in the use of CTs (March vs. September; p < 0.001). Overall, 20% did not receive steroids, and 40% received less than 200 mg accumulated prednisone equivalent dose (APED). Severe patients are treated with higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%. Conclusions: Patients with greater comorbidity, severity, and inflammatory markers were those treated with CTs. In severe patients, there is a trend towards the use of higher doses. The mortality benefit was observed in patients with oxygen saturation </=90%

Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

Dynamic simulation of a biomass domestic boiler under thermally thick considerations

A biomass combustion model with a thermally thick approach is presented and applied to the simulation of a commercial biomass domestic boiler. A subgrid scale model is used to divide the particles into several grid points, each representing one of the different combustion stages. These grid points determine the variables of the solid phase located in the packed bed calculated as a porous zone with a volume-averaged approach. The combustion model is coupled with a fuel-feeding model based on Lagrangian trajectories of particles. Those are transformed into solid phase variables as soon as they reach the packed bed, allowing the numerical model to simulate the transient behavior of such a system. This methodology is here applied to a 27-kW boiler operating in stable conditions with two feeding systems: one in which the particle feeding rate is kept constant in time and another in which the feeding rate varies randomly through time. The behavior of such a boiler is better understood thanks to the completeness of the model here presented, whose results are also compared to experimental measurements. The CFD model gives reasonably good predictions of the heat transferred, the flue gas temperature, the excess air coefficient and CO2 emissions, as well as the fluctuations of the boiler when the feeding rate is not constant. However, the model underestimates unburnt species like CO, probably due to the oversimplified gas reaction mechanisms employed in the simulation

Lipedematous scalp. A rare entity in the pediatric ageLipedema de cuero cabelludo: una entidad infrecuente en pediatría.

Lipedematous scalp is an uncommon entity of unknown etiology, rarely described in the pediatric age. It is characterized by boggy thickening of the scalp predominantly located at the vertex and occiput, which acquires a cotton-like consistency. This condition is palpable rather than visible. It is a casual finding because it is usually asymptomatic, although it may involve alopecia, pruritus, or dysesthesia. We report a 10-year-old girl with lipedematous scalp without alopecia. Sonographic and MRI findings confirmed the diagnosis of lipidematous scalp.  El lipedema de cuero cabelludo o cuero cabelludo lipedematoso es una entidad infrecuente y de etiología desconocida, rara vez descrita en la edad pediátrica. Se caracteriza por un engrosamiento difuso y de tacto esponjoso del tejido celular subcutáneo localizado principalmente en vértex y occipucio. Suele ser un hallazgo casual dado que habitualmente cursa de forma asintomática, aunque puede asociar alopecia, prurito o disestesias. Presentamos el caso de una niña de 10 años de edad con lipedema de cuero cabelludo sin alopecia asociada. Los hallazgos ecográficos y de resonancia magnética confirmaron el diagnóstico de lipedema de cuero cabelludo