Resistencia a biocidas de diferentes cepas de escherichia coli

Los biocidas son herramientas de gran importancia para controlar la transmisión de microorganismos patógenos a través de la cadena alimentaria. En el presente estudio se ha determinado la resistencia a siete biocidas en una colección de nueve cepas de Escherichia coli, incluyendo cepas verotoxigénicas y cepas portadoras de resistencia a beta-lactámicos. Los biocidas más eficaces fueron triclosan, hexadecilpiridinio y cetrimida, seguido del cloruro de benzalconio. No se encontraron diferencias significativas entre las cepas verotoxigénicas y/o productoras de beta lactamasas de amplio espectro en cuanto a sensibilidad a los biocidas mencionados.Biocides have great relevance in the control of transmission of foodborne microbes through the food chain. In the present study, resistance to seven biocides was investigated among a collection of nine Escherichia coli strains, including verotoxigenic and beta-lactamase producers. The most effective biocides were triclosan, hexadecylpyridinium chloride and cetrimide, followed by benzalkonium chloride. Verotoxigenic and beta-lactamase producing strains did not show significant differences in their sensitivities to biocides compared to the other strains tested

Bioconservación de alimentos cárnicos

Las bacteriocinas, así como las cepas bacterianas que las producen, han sido ampliamente estudiadas para la conservación de los alimentos por métodos naturales (bioconservación). En productos cárnicos (abarcando toda la gama, desde la materia prima hasta productos elaborados) se han desarrollado numerosos estudios empleando bacteriocinas como nisina, pediocinas y otras, bien solas o aplicadas con otros antimicrobianos (como ácidos orgánicos o agentes quelantes) o tratamientos (como el calor, las altas presiones o la luz pulsada) para la inactivación de bacterias patógenas o alterantes. Los resultados de muchos de estos tratamientos son bastante prometedores, como por ejemplo el empleo de bacteriocinas como recubrimientos protectores en salchichas. Las cepas de bacterias lácticas seleccionadas por su capacidad productora de bacteriocinas ofrecen buenas perspectivas como cultivos protectores, pero sobre todo como cultivos iniciadores en la elaboración de productos cárnicos fermentados, mejorando la seguridad microbiológica de los mismos. El empleo de cultivos iniciadores bacteriocinogénicos con propiedades funcionales definidas abre nuevas vías para la innovación y el desarrollo de nuevos productos cárnicos fermentados.Bacteriocins as well as their producer strains have been widely investigated for application in natural food preservation processes (biopreservation). Numerous studies have been carried out on application of bacteriocins such as nisin, pediocin and others in different types of meat products, either singly or in combination with other antimicrobials (such as organic acids or chelating agents) or treatments (such as heat, pulsed light or high hydrostatic pressure). Many of the results reported are highly promising, like for example the application of bacteriocins in edible coatings for sausages. Bacteriocin-producing lactic acid bacteria are also interesting, in view of their possible applications as protective cultures or as starter cultures in fermented meat products, increasing the product safety. Bacteriocin-producing starter cultures with additional functional properties open new possibilities for innovation and development of new fermented meat products

Recomendaciones basadas en la evidencia del grupo andaluz para la reflexión e investigación en nutrición (Garin) para el manejo del paciente con síndrome de intestino corto

In order to develop evidence-based recommendations and expert consensus for the nutritional management of patients with short bowel syndrome (SBS), we conducted a systematic literature search using the PRISMA methodology plus a critical appraisal following the GRADE scale procedures. Pharmacological treatment with antisecretory drugs, antidiarrheal drugs, and somatostatin contributes to reducing intestinal losses. Nutritional support is based on parenteral nutrition; however, oral intake and/or enteral nutrition should be introduced as soon as possible. In the chronic phase, the diet should have as few restrictions as possible, and be adapted to the SBS type. Home parenteral nutrition (HPN) should be individualized. Single-lumen catheters are recommended and taurolidine should be used for locking the catheter. The HPN’s lipid content must be greater than 1 g/kg per week but not exceed 1 g/kg per day, and omega-6 fatty acids (ω6 FAs) should be reduced. Trace element vials with low doses of manganese should be used. Patients with chronic SBS who require long-term HPN/fluid therapy despite optimized treatment should be considered for teduglutide treatment. All patients require a multidisciplinary approach and specialized follow-up. These recommendations and suggestions regarding nutritional management in SBS patients have direct clinical applicability

Regular insulin added to total parenteral nutrition vs subcutaneous glargine in non-critically ill diabetic inpatients, a multicenter randomized clinical trial: INSUPAR trial

Background: There is no established insulin regimen in T2DM patients receiving parenteral nutrition. Aims: To compare the effectiveness (metabolic control) and safety of two insulin regimens in patients with diabetes receiving TPN. Design: Prospective, open-label, multicenter, clinical trial on adult inpatients with type 2 diabetes on a non-critical setting with indication for TPN. Patients were randomized on one of these two regimens: 100% of RI on TPN or 50% of Regular insulin added to TPN bag and 50% subcutaneous Gl. Data were analyzed according to intention-to-treat principle. Results: 81 patients were on RI and 80 on GI. No differences were observed in neither average total daily dose of insulin, programmed or correction, nor in capillary mean blood glucose during TPN infusion (165.3 +/- 35.4 in RI vs 172.5 +/- 43.6 mg/dL in GI; p = 0.25). Mean capillary glucose was significantly lower in the GI group within two days after TPN interruption (160.3 +/- 45.1 in RI vs 141.7 +/- 43.8 mg/dL in GI; p = 0.024). The percentage of capillary glucose above 180 mg/dL was similar in both groups. The rate of capillary glucose <= 70 mg/dL, the number of hypoglycemic episodes per 100 days of TPN, and the percentage of patients with non-severe hypoglycemia were significantly higher on GI group. No severe hypoglycemia was detected. No differences were observed in length of stay, infectious complications, or hospital mortality. Conclusion: Effectiveness of both regimens was similar. GI group achieved better metabolic control after TPN interruption but non-severe hypoglycemia rate was higher in the GI group. (C) 2019 The Author(s). Published by Elsevier Ltd

Recommendations of the GARIN group for dietary managing of patient with chronic kidney disease

[ES] Introducción y objetivos: en el tratamiento dietético de los pacientes con enfermedad renal crónica (ERC) existen muchas áreas de incertidumbre. El grupo de trabajo GARIN tiene como objetivo defi nir su posición en este campo. Material y métodos: revisión bibliográfi ca previa y reunión presencial en la que se discutieron y contestaron preguntas específi cas sobre el tema. Resultados: la actuación terapéutica debe ser individualizada y atendiendo al grado de enfermedad renal que presente el paciente y a sus comorbilidades. En cuanto a la terapia médica nutricional, nuestro grupo propone tres niveles diferentes de actuación, en los que las recomendaciones de ingesta proteica, fi bra, ácidos grasos o potasio son distintas. Además, sugerimos utilizar el concepto ratio fósforo/proteína en el ajuste de la dieta del paciente con ERC. Damos recomendaciones en cuanto al tratamiento en diabetes y en suplementación artifi cial. Conclusiones: estas recomendaciones aportan respuestas concretas sobre cuestiones comunes en la asistencia a pacientes con ERC.[EN] Background and objectives: by means of this update, the GARIN working group aims to defi ne its position regarding the dietary treatment of patients with chronic kidney disease (CKD). In this area there are many aspects of uncertainty. Material and methods: bibliographical review and specifi c questions in advance were discussed and answered at a meeting in the form of conclusions. Results: the therapeutic action must be individualized and taking into account the degree of renal failure that the patient presents and their comorbidities. Regarding nutritional medical therapy, our group proposes three different levels of action, in which the recommendations of protein intake, fi ber, fatty acids or potassium are different. In addition, we suggest using the phosphorus/protein ratio concept in adjusting the diet of the patient with CKD. We give recommendations regarding treatment in diabetes and artifi cial supplementation. Conclusions: these recommendations about dietary issues in patients with CKD can add value to clinical work.Nestlé Health Nutrition cubrió todos los gastos de transporte y de alquiler de salones para las sesiones físicas, pero no ha tomado parte en el desarrollo, diseño o manuscrito del artículo

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

Dietary α‐Linolenic Acid, Marine ω‐3 Fatty Acids, and Mortality in a Population With High Fish Consumption: Findings From the PREvención con DIeta MEDiterránea (PREDIMED) Study

Background: Epidemiological evidence suggests a cardioprotective role of α‐linolenic acid (ALA), a plant‐derived ω‐3 fatty acid. It is unclear whether ALA is beneficial in a background of high marine ω‐3 fatty acids (long‐chain n‐3 polyunsaturated fatty acids) intake. In persons at high cardiovascular risk from Spain, a country in which fish consumption is customarily high, we investigated whether meeting the International Society for the Study of Fatty Acids and Lipids recommendation for dietary ALA (0.7% of total energy) at baseline was related to all‐cause and cardiovascular disease mortality. We also examined the effect of meeting the society's recommendation for long‐chain n‐3 polyunsaturated fatty acids (≥500 mg/day). Methods and Results: We longitudinally evaluated 7202 participants in the PREvención con DIeta MEDiterránea (PREDIMED) trial. Multivariable‐adjusted Cox regression models were fitted to estimate hazard ratios. ALA intake correlated to walnut consumption (r=0.94). During a 5.9‐y follow‐up, 431 deaths occurred (104 cardiovascular disease, 55 coronary heart disease, 32 sudden cardiac death, 25 stroke). The hazard ratios for meeting ALA recommendation (n=1615, 22.4%) were 0.72 (95% CI 0.56–0.92) for all‐cause mortality and 0.95 (95% CI 0.58–1.57) for fatal cardiovascular disease. The hazard ratios for meeting the recommendation for long‐chain n‐3 polyunsaturated fatty acids (n=5452, 75.7%) were 0.84 (95% CI 0.67–1.05) for all‐cause mortality, 0.61 (95% CI 0.39–0.96) for fatal cardiovascular disease, 0.54 (95% CI 0.29–0.99) for fatal coronary heart disease, and 0.49 (95% CI 0.22–1.01) for sudden cardiac death. The highest reduction in all‐cause mortality occurred in participants meeting both recommendations (hazard ratio 0.63 [95% CI 0.45–0.87]). Conclusions: In participants without prior cardiovascular disease and high fish consumption, dietary ALA, supplied mainly by walnuts and olive oil, relates inversely to all‐cause mortality, whereas protection from cardiac mortality is limited to fish‐derived long‐chain n‐3 polyunsaturated fatty acids. Clinical Trial Registration URL: http://www.Controlled-trials.com/. Unique identifier: ISRCTN35739639

Late Holocene deposits distribution and structuration ¡n the Bay of Cádiz

Late Holocene deposits characterization in the Bay of Cádiz has been carry out by means of a high resolution seismic profiles grid. Sedimentaiy cover distribution allows to distinguish two different sectors in the external bay: a) eastern sector, with a thick sedimentary infill, composed of three major depocenters with a NNW-SSE direction; and b) western sector, with a thinner sedimentary cover which increases progressively towards the continental shelf. This Holocene sedimentary cover is composed of three seismic units: 1) unit a: sigmoida-oblique progradational configuration; 2) unit b: sigmoidal progradational configuration; and 3) unit c: aggradational superficial unit that is only present in the western sector of the Ba

Recommendations Based on Evidence by the Andalusian Group for Nutrition Reflection and Investigation (GARIN) for the Pre- and Postoperative Management of Patients Undergoing Obesity Surgery

In order to develop evidence-based recommendations and expert consensus for nutrition management of patients undergoing bariatric surgery and postoperative follow-up, we conducted a systematic literature search using PRISMA methodology plus critical appraisal following the SIGN and AGREE-II procedures. The results were discussed among all members of the GARIN group, and all members answered a Likert scale questionnaire to assess the degree of support for every recommendation. Patients undergoing bariatric surgery should be screened preoperatively for some micronutrient deficiencies and treated accordingly. A VLCD (Very Low-Calorie Diet) should be used for 4-8 weeks prior to surgery. Postoperatively, a liquid diet should be maintained for a month, followed by a semi-solid diet also for one month. Protein requirements (1-1.5 g/kg) should be estimated using adjusted weight. Systematic use of specific multivitamin supplements is encouraged. Calcium citrate and vitamin D supplements should be used at higher doses than are currently recommended. The use of proton-pump inhibitors should be individualised, and vitamin B12 and iron should be supplemented in case of deficit. All patients, especially pregnant women, teenagers, and elderly patients require a multidisciplinary approach and specialised follow-up. These recommendations and suggestions regarding nutrition management when undergoing bariatric surgery and postoperative follow-up have direct clinical applicability.Funding for the face-to-face meeting and the translation into English was provided by NESTLE HEALTHCARE.Ye