Antioxidant activity of hydroxytyrosol in frankfurters enriched with n-3 polyunsaturated fatty acids

8 páginas,6 tablas.The capacity of hydroxytyrosol (HXT) to inhibit lipid oxidation in cooked pork meat batter, oil-in-water emulsions and potential functional frankfurters formulated with a healthier oil combination (as animal fat replacer) was studied during chilling storage, and its effect compared with those produced by synthetic antioxidants (BHA/BHT). Although efficiency varied, HXT was an effective antioxidant during chilling storage in the three food matrices studied. In general the order of inhibition capacity of HXT against lipid oxidation (thiobarbituric acid-reactive substances-TBARS) was cooked meat batter > oil-in-water emulsion > frankfurters, whereas in the case of BHA/BHT (with lower inhibitory activity than HXT) it was cooked meat batter > oil-in-water emulsion, and there was no antioxidative effect in frankfurters. Whereas significant correlations were established between lipid oxidation (TBARS) and antioxidative capacity measured by photochemiluminescence (PCL) in frankfurters supplemented with HXT and BHA/BHT, no significant correlations were found between ferric reducing/antioxidant power assay (FRAP) and TBARS and PCL.This research was supported by the projects AGL2008-04892- CO3-01 and Consolider Ingenio 2010: CARNISENUSA (CSD2007- 00016).Peer reviewe

Preeclampsia severa de aparición temprana: características clínico epidemiológicas en la unidad de cuidados intensivos materno del INMP agosto del 2014 a setiembre del 2018

Objective: to acknowledge the pathological, clinical and epidemiological characteristics of early-onset severe preeclampsia and late-onset severe preeclampsia in patients admitted in the maternal intensive care unit (MICU) of the maternal perinatal national institute (INMP). Methods: We develop a comparative transversal descriptive study. Clinical charts were reviewed from August first of 2014 until September thirty of 2018 getting 332 charts of early-onset preeclampsia and 325 charts of the late-onset type. Results: The mean age of the patients with early-onset severe preeclampsia was 27.84 years (IC 26.88- 28.81) (p: 0.72), the mean for hospital stay was higher in the patients with the early-onset type (p: 0.006). The new born showed statistical difference in weight (p=0.000), height (p=0.000) and the APGAR score was lower in the early-onset group (p=0.000). We did not found difference statistically significative between early-onset severe preeclampsia and eclampsia (p=0.481). Conclusion: we did not found differences between early onset preeclampsia and eclampsia. New born had lower weight, height and APGAR score in the early-onset group than in the late-onset group.Objetivo: conocer las características epidemiológicas clínicas y patológicas de la Preeclampsia severa (PES) de aparición temprana y la PES de aparición tardía de pacientes admitidas a la Unidad de Cuidados Intensivos Maternos (UCIM) del Instituto Nacional Materno Perinatal (INMP). Material y métodos: se realizó un estudio descriptivo transversal comparativo en el que se revisaron las historias clínicas desde EL primero de agosto del 2014 hasta el 30 de Setiembre del 2018 obteniendo 332 registros de pacientes con PES de aparición Temprana y 325 registros de pacientes con PES de aparición tardía.Resultados: La edad promedio de las pacientes con diagnóstico de PES de aparición temprana fue 27.84 años [IC 26.88- 28.81 (p: 0.72)], el promedio de estancia hospitalaria fue mayor en las pacientes con PES de aparición temprana (p 0.006). Los recién nacidos mostraron diferencias significativas con respecto al peso (p= 0.000), la talla (p= 0.000); el APGAR al minuto fue significativamente menor en el grupo de aparición temprana (p=0.000). No se encuentra diferencia significativa entre la PES de aparición temprana y la eclampsia (p=0.481). Conclusión: No observamos diferencias significativas entre PES de aparición temprana y eclampsia. Los recién nacidos, presentan peso, talla y APGAR menores en el grupo de aparición temprana que el grupo de aparición tardía

Utilidad del score SOFA en la predicción de muerte materna en la UCI materna del INMP

Objective:  To compare the SOFA score at admission and 24 hours and evaluate its usefulness in predicting maternal death. Materials and methods: A cross-sectional descriptive study of patients admitted to the Maternal ICU of the INMP was carried out from August 2014 to July 2019. Parametric and non-parametric tests were applied according to a previous evaluation of normality and a statistical significance p<0.05. Statistical analysis was performed using the statistical package STATA version 13. Results: The mean age corresponds to 28.32 years. The mean gestational age corresponded to 31.33 weeks; The mean hospital stay was 4.52 days. The area under the curve for SOFA at entry was 0.8818 and the area under the curve for SOFA at 24 hours was 0.9755.     P=0.1225. No significant differences were found between them. It was determined that the best cut-off point corresponds to a Score of 6 with a sensitivity that corresponds to 89.29% and a specificity of 79.13%. Conclusions: The SOFA Score adapts well to obstetric patients admitted to Maternal Intensive Care settings, maintaining a cut-off of 6 for admission SOFA with good sensitivity and specificity. (89.29%, 79.13%). The SOFA score is useful in maternal ICU environments and it should be used in our country.Objetivo: Comparar el score SOFA al ingreso y a las 24horas, y evaluar su utilidad en la predicción de la muerte materna. Materiales y métodos: Se realizó un estudio descriptivo de tipo transversal de las pacientes admitidas a la UCI Materna del INMP desde agosto del 2014 a Julio del 2019. Se aplicaron pruebas paramétricas o no paramétricas según evaluación previa de normalidad y se usó una significación estadística p<0.05. El análisis estadístico se realizó utilizando el paquete estadístico STATA versión 13. Resultados: La media de la edad corresponde a 28.32 años. La media de la edad gestacional correspondió a 31.33 semanas; La media de la estancia hospitalaria fue de 4.52 días. El area bajo la curva para el SOFA al ingreso fue de 0.8818 y el area bajo la curva del SOFA a las 24horas fue de 0.9755. P=0.1225. No se encontraron diferencias significativas entre ellas. Se determinó que el mejor punto de corte corresponde a un Score de 6 con una sensibilidad que corresponde a 89.29% y una especificidad de 79.13%. Conclusiones: El Score SOFA se adapta bien a las pacientes obstétricas admitidas en los ambientes de Cuidados Intensivos Materno, manteniendo un corte de 6 para el SOFA de ingreso con una buena sensibilidad y especificidad. (89.29%, 79.13%). El Score SOFA es útil para ser usado en ambientes de UCI y además debe sugerirse su uso en toda UCI obstétrica de nuestro país

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Agente de carga a base de konjac y partículas de hidrogel como nuevos sistemas de incorporación de aceites en productos cárnicos

El objetivo general trazado en esta esta memoria consistió en el diseño y desarrollo de derivados cárnicos con mejor composición lipídica mediante procesos de reformulación encaminados a la obtención de productos más saludables. Para ello se eligieron dos sistemas de lípidos estructurados aceites con una composición lipídica más saludable, dotados de propiedades sólidas o viscosas, escasamente empleados agente de carga de aceite a base de konjac y partículas de hidrogel.La utilización de un agente de carga estabilizando una mezcla de aceites de oliva, lino y pescado se ensayó como estrategia en el desarrollo de salchichas tipo frankfurt y de hamburguesas, aplicando procesos de reformulación encaminados a la reducción de grasa y a la mejora del perfil de ácidos grasos. Para ello, dicho agente de carga se empleó en la sustitución de grasa animal de los productos: a) 19,1por ciento en salchichas tipo frankfurt sustitución parcial y b 6,8 y 13,4por ciento sustitución parcial y total, respectivamente)en hamburguesas. Además en el caso de las hamburguesas se evaluó el efecto de los métodos de cocción (plancha y fritura) sobre los componentes mayoritarios y el perfil lipídico.Por otro lado, el empleo de partículas de hidrogel encapsulando aceite de pescado, se estudió como estrategia de desarrollo dirigida a la mejora del perfil lipídico en productos tipo gel/emulsión (sistema modelo y salchichas tipo frankfurt enriquecidos en AGP n3 de cadena larga EPA y DHA. En primer lugar se evaluó su estabilidad oxidativa como ingredientes, sometidos a condiciones de procesado propias de los productos tipo gel/emulsión, posteriormente se determinó la estabilidad oxidativa en una matriz cárnica básica (sistema modelo) formulada con tales partículas, y finalmente se estudió su incorporación 23,5 por ciento en salchichas tipo frankfurt. En ambos planteamientos se analizaron los efectos de la reformulación y la conservación en refrigeración sobre las propiedades nutricionales, tecnológicas, sensoriales y vida útil de los productos.Los resultados obtenidos señalan que el uso de agente de carga como estrategia de reformulación en salchichas tipo frankfurt y hamburguesas dio lugar a la obtención de productos con contenido reducido en grasa, y con perfil lipídico más en línea con los objetivos nutricionales. Esto es, disminuyendo el contenido en AGS incrementando los AGP n3. En relación a los métodos de cocción en hamburguesas plancha y fritura si bien estos afectaron la composición, no implicaron una alteración sobre las proporciones relativas de ácidos grasos de los productos reformulados. En general, la aplicación de esta estrategia permitió la obtención de derivados cárnicos con adecuada viabilidad tecnológica y sensorial, sin más limitaciones en términos de vida útil que las propias de un derivado cárnico de naturaleza análoga. Por otra parte, el empleo de las partículas de hidrogel presentó una notable mejora sobre la estabilidad oxidativa de este material lipídico, tanto como ingrediente, como formando parte de una matriz cárnica. El enriquecimiento en EPA y DHA de salchichas tipo frankfurt a través del empleo de partículas de hidrogel conllevó a la obtención de productos con perfil lipídico mejorado y con un aporte significativamente alto de AGP n-3, conformado principalmente por n3 de cadena larga. La aplicación de esta estrategia de reformulación no condicionó las propiedades tecnológicas y sensoriales ni la vida útil. Cabe destacar que los cambios de composición ocasionados permitieron dotar a los productos de distintas declaraciones nutricionales y de propiedades saludables, en consonancia con lo establecido por el Reglamento 1924/2006 del Parlamento Europeo. Como conclusión general se puede señalar que la aplicación de lípidos estructurados como nuevos sistemas de estabilización de aceites abren nuevas posibilidades dentro de las estrategias de reformulación dirigidas a la producción de derivados cárnicos saludables

Síndrome HELLP: resultado materno fetal. Unidad de cuidados intensivos materno del Instituto Nacional Materno Perinatal

Objective. Know clinical and pathological epidemiologic characteristics from HELLP Syndrome of admitted patients in the Maternal Intensive Care Unit from INMP. Materials and methods. Clinical histories from admitted patients in the Maternal Intensive Care Unit from INMP since August of 2014 to August 31st of 2016 were checked out. Furthermore, 502 records: 49 record of patients with HELLP Syndrome y 452 records of patients with preeclampsia diagnostic were included.Objetivo. conocer las características epidemiológicas clínicas y patológicas del Síndrome HELLP de pacientes admitidas a la UCIM del INMP. Materiales y métodos. se revisaron las historias clínicas de las pacientes admitidas a la Unidad de Cuidados Intensivos Materno del INMP, desde agosto del año 2014 hasta el 31 de agosto del año 2016. Ademas, se incluyeron 502 registros; 49 registros de pacientes con diagnóstico de síndrome HELLP y 452 registros de pacientes con diagnóstico de preeclampsia