Almidones de Cáscara de Yuca (Manihot Esculenta) y Papa (Solanum Tuberosum) para Producción de Bioplásticos: Propiedades Mecánicas y Efecto Gelatinizante

  Los productos biodegradables basados en materias primas agrícolas ocupan un gran espacio en las investigaciones para el desarrollo y mejoramiento de bioplástico a base de almidón que presentan propiedades similares a los plásticos convencionales. El objetivo de este trabajo consistió en describir la gelatinización y propiedades mecánicas de bioplásticos extraídos de almidones tanto de cáscaras de yuca (Manihot esculenta) como de cáscaras de papa (Solanum tuberosum). A partir de una revisión bibliográfica literaria complementada con aproximadamente 86 artículos científicos se logró comprobar que la gelatinización de estos residuos en función de sus propiedades fisicoquímicas y funcionales, mejoran sus propiedades mecánicas, además la adición de sustancias poliméricas sintéticas y naturales, plastificantes, materiales de relleno, aditivos, agentes acoplantes, agentes desestructurantes y agua otorgaron las propiedades mecánicas necesarias para trabajar como un termoplástico. Si bien ambos almidones presentan propiedades mecánicas viables para la elaboración de biopolímeros, se logra concluir que el almidón de cáscara de papa puede alcanzar un bioplástico con mejores propiedades mecánicas debido a que presenta gránulos más esféricos y regulares, los cuales pueden formar estructuras moleculares más estables, así como su alto contenido de amilosa favorece en la gelatinización y logra que la fuerza de tensión presente un incremento en comparación al almidón de cáscara de yuca.   Palabra clave: Almidón, gelatinización, papa, propiedades mecánicas, yuca.   Abstract Biodegradable products based on agricultural raw materials occupy a large space in research for the development and improvement of starch-based bioplastics that have properties similar to conventional plastics. The objective of this work was to describe the gelatinization and mechanical properties of bioplastics extracted from starches both from cassava peels (Manihot esculenta) and potato peels (Solanum tuberosum). From a literary bibliographic review complemented with approximately 86 scientific articles. it was possible to verify that the gelatinization of these residues based on their physicochemical and functional properties, improves their mechanical properties. Moreover, the addition of synthetic and natural polymeric substances, plasticizers, fillers, additives, coupling agents, destructuring agents, and water will give the necessary mechanical properties to work as a thermoplastic. Although both starches have viable mechanical properties for the production of biopolymers, it is possible to conclude that potato peel starch can achieve a bioplastic with better mechanical properties due to the fact that it presents more spherical and regular granules, which can form more stable molecular structures; as well as, its high amylose content favors gelatinization and achieves an increase in the tensile strength compared to cassava shell starch.  Keywords: Gelatinization, mechanical properties, yucca, potato, starch

Optimal surgical timing after post-infarction ventricular septal rupture

Background: Ventricular septal rupture (VSR) following acute myocardial infarction (AMI) is a dan-gerous condition. Surgical VSR closure is the definitive therapy, but there is controversy regarding the surgical timing and the bridging therapy between diagnosis and intervention. The objective of this study is to analyze the ideal time of surgical repair and to establish the contribution of mechanical circulatory support (MCS) devices on the prognosis. Methods: We designed an observational, retrospective, multicenter study, selecting all consecutive patients with post-AMI VSR between January 1, 2008 and December 31, 2018, with non-exclusion criteria. The main objective of this study was to analyze the optimal timing for surgical repair of post-AMI VSR. Second- ary endpoints were to determine which factors could influence mortality in the patients of the surgical group. Results: A total of 141 patients were included. We identified lower mortality rates with an odds ratio of 0.3 (0.1 & ndash;0.9) in patients operated on from day 4 compared with the surgical mortality in the first 24 hours after VSR diagnosis. The use of MCS was more frequent in patients treated with surgery, par- ticularly for intra-aortic balloon pump (IABP; 79.6% vs. 37.8%, p < 0.001), but also for veno-arterial extracorporeal membrane oxygenation (VA-ECMO; 18.2% vs. 6.4%, p = 0.134). Total mortality was 91.5% for conservative management and 52.3% with surgical repair (p < 0.001). Conclusions: In our study, we observed that the lowest mortality rates in patients with surgical repair of post-AMI VSR were observed in patients operated on from day 4 after diagnosis of VSR, compared to earlier interventions. (Cardiol J 2022; 29, 5: 773 & ndash;781

Optimal surgical timing after post-infarction ventricular septal rupture

Background: Ventricular septal rupture (VSR) following acute myocardial infarction (AMI) is a dangerous condition. Surgical VSR closure is the definitive therapy, but there is controversy regarding the surgical timing and the bridging therapy between diagnosis and intervention. The objective of this study is to analyze the ideal time of surgical repair and to establish the contribution of mechanical circulatory support (MCS) devices on the prognosis. Methods: We designed an observational, retrospective, multicenter study, selecting all consecutive patients with post-AMI VSR between January 1, 2008 and December 31, 2018, with non-exclusion criteria. The main objective of this study was to analyze the optimal timing for surgical repair of post-AMI VSR. Secondary endpoints were to determine which factors could influence mortality in the patients of the surgical group. Results: A total of 141 patients were included. We identified lower mortality rates with an odds ratio of 0.3 (0.1–0.9) in patients operated on from day 4 compared with the surgical mortality in the first 24 hours after VSR diagnosis. The use of MCS was more frequent in patients treated with surgery, particularly for intra-aortic balloon pump (IABP; 79.6% vs. 37.8%, p &lt; 0.001), but also for veno-arterial extracorporeal membrane oxygenation (VA-ECMO; 18.2% vs. 6.4%, p = 0.134). Total mortality was 91.5% for conservative management and 52.3% with surgical repair (p &lt; 0.001). Conclusions: In our study, we observed that the lowest mortality rates in patients with surgical repair of post-AMI VSR were observed in patients operated on from day 4 after diagnosis of VSR, compared to earlier interventions

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Cardiac arrest as a manifestation of unknown Type V glycogenosis: a case report

Few cases have been reported to date, in which a massive rhabdomyolysis causes a cardiac arrest in a male adult suffering from undiagnosed McArdle disease. Veno-arterial extracorporeal membrane oxygenation and cytokine adsorption filter (CytoSorb®) were required to reach a complete and successful recovery.Cardiac arrestCytoSorb®ECMOExercise intoleranceMyoglobinuriaMyophosphorylase deficiencyRenal failureRhabdomyolysi

Consideraciones sobre el abordaje invasivo de la cardiopatía isquémica y estructural durante el brote de coronavirus COVID-19.: Documento de consenso de la Asociación de Cardiología Intervencionista y la Asociación de Cardiopatía Isquémica de la Sociedad Española de Cardiología

The current COVID-19 outbreak is forcing healthcare workers to continuously reconsider the proper indications for cardiac catheterization. Human and material resources optimization, infection prevention for patients and healthcare workers, and transfer times force a rethink of the previously established protocols. This article is a consensus statement of the Interventional Cardiology Association and the Ischemic Heart Disease Association of the Spanish Society of Cardiology, and aims to provide information to healthcare workers on the indications of diagnostic or therapeutic cardiac catheterization during the current COVID-19 pandemic.El brote actual de COVID-19 está obligando a los profesionales sanitarios a replantear de forma continua las indicaciones de cateterismo cardiaco. La optimización de recursos materiales y humanos, la prevención de contagios a profesionales y pacientes, así como la gestión de los tiempos de traslado, hace totalmente necesario reformular los protocolos previamente establecidos. El presente texto es un documento de consenso de la Asociación de Cardiología Intervencionista y la Asociación de Cardiopatía Isquémica y Cuidados Agudos Cardiovasculares de la Sociedad Española de Cardiología que pretende dar información al personal sanitario sobre las indicaciones de cateterismo diagnóstico o terapéutico durante la pandemia actual de COVID-19

Efectos potenciales del cambio global en la fisiología de los pingüinos antárticos

Barbosa, Andrés ... et. al.-- IX Simposio de Estudios Polares del Comité Español del Scientific Committee on Antarctic Research (SCAR), 5-7 September 2018, Madrid, España.-- 1 pageEl cambio global es uno de los factores ambientales más notables en la Península Antártica. Entre los distintos componentes que lo determinan se encuentra el cambio climático, la contaminación y la introducción de especies invasoras. En las últimas décadas la variación de las temperaturas ha producido profundos cambios ambientales tanto en el medio físico como en la biota de esta región. Los pingüinos antárticos constituyen el 80% de la biomasa de vertebrados del ecosistema antártico y junto con su posición en la parte alta de la cadena trófica les confiere el papel de centinelas del ecosistema al reflejar en su biología muchos de los cambios que se producen en el ambiente. Durante los últimos 15 años se están desarrollando un conjunto de proyectos dentro del macroproyecto PINGUCLIM cuyos objetivos están dirigidos a identificar los posibles efectos que el cambio global puede producir en la fisiología de los pingüinos antárticos. Paraello se ha llevado a cabo una aproximación a tres escalas, una a largo plazo para determinar dichos potenciales efectos, otra a corto plazo para la descripción de información básica y la identificación de los mecanismos que puedan explicar dichos efectos,y una geográfica que aprovechando las diferencias ambientales existentes a lo largo de la península antártica permita entender los cambios esperables. Con toda la información obtenida se ha construido un marco de efectos potenciales en cascada que relaciona los cambios ambientales ya producidos o esperables con distintos aspectos de la biología de los pingüinos. En esta comunicación se presentarán los resultados obtenidos a lo largo de estos años en aspectos tales como la dieta, ingestión de componentes esenciales como antioxidantes, presencia y efectos de parásitos/patógenos, respuesta inmunitaria, estrés oxidativo, presencia y efectos de contaminantesPeer Reviewe