Tipo de corte y cloruro de calcio sobre la conservación del maxaje (Cucumis anguria L) mínimamente procesado

The minimum processing of the maxixe (Cucumis anguria L), alia the practicality with the expansion of the market of consumption of this olerícola. Thus, the objective of this work was to evaluate the effects of the cut and the application of the associated calcium chloride on the post-harvest quality of cv. Valenciano minimally processed. The fruits were collected, selected and submitted to two types of cuts: slices and slices and later immersed in solution containing calcium chloride in the concentrations of: distilled water (control), 1, 2, 3 and 4%. The samples were conditioned in a refrigerator at 8 ± 2 ° C for a period of eight days and evaluated every two days for loss of mass, firmness, total soluble solids, titratable acidity, pH, total chlorophyll content and presence of gum. The slice cut had a lower effect on the quality of the samples, especially when related to mass loss and firmness during the storage period. The immersion in solution containing calcium chloride is efficient in preserving the physico-chemical and sensorial aspects of the samples, and the concentration of 4% was more efficient in controlling the metabolic changes due to the senescence process.O processamento mínimo do maxixe (Cucumis anguria L), alia a praticidade com a ampliação do mercado de consumo desta olerícola. Assim, o objetivo desse trabalho foi avaliar os efeitos do corte e da aplicação do cloreto de cálcio associado na qualidade pós-colheita de maxixes cv. Valenciano minimamente processados. Os frutos foram coletados, selecionados e submetidos a dois tipos de cortes: fatias e em rodelas e posteriormente imersos em solução contendo cloreto de cálcio nas concentrações de: água destilada (controle), 1, 2, 3 e 4%. As amostras foram acondicionadas em refrigerador a 8±2°C por um período de oito dias, e avaliados a cada dois dias quanto à perda de massa, firmeza, sólidos solúveis totais, acidez titulável, pH, teor de clorofila total e presença de goma. O corte em rodelas causou menor efeito sobre a qualidade das amostras, principalmente quando relacionado a perda de massa e na firmeza durante o período de armazenamento. A imersão em solução contendo cloreto de cálcio é eficiente em preservar os aspectos físico-químicos e sensoriais das amostras, sendo que a concentração de 4%, mostrou-se mais eficiente em controlar as alterações metabólicas decorrentes do processo de senescência.El procesamiento mínimo del maxixe (Cucumis anguria L), combina la practicidad con la ampliación del mercado de consumo de esta olerícola. Así, el objetivo de este trabajo fue evaluar los efectos del corte y de la aplicación del cloruro de calcio asociado en la calidad post-cosecha de maxixes cv. Valenciano minimamente procesados. Los frutos fueron recolectados, seleccionados y sometidos a dos tipos de cortes: rebanadas y en rodajas y posteriormente inmersos en solución conteniendo cloruro de calcio en las concentraciones de: agua destilada (control), 1, 2, 3 y 4%. Las muestras fueron acondicionadas en refrigerador a 8 ± 2 ° C durante un período de ocho días, y se evaluaron cada dos días en cuanto a la pérdida de masa, firmeza, sólidos solubles totales, acidez titulable, pH, contenido de clorofila total y presencia de goma . El corte en rodajas causó menor efecto sobre la calidad de las muestras, principalmente cuando se relacionó con la pérdida de masa y la firmeza durante el período de almacenamiento. La inmersión en solución que contiene cloruro de calcio es eficiente en preservar los aspectos físico-químicos y sensoriales de las muestras, siendo que la concentración del 4%, se mostró más eficiente en controlar los cambios metabólicos resultantes del proceso de senescencia

FISIOLOGIA PÓS-COLHEITA DO CAMU-CAMU TRATADO COM DIFERENTES FONTES E DOSES DE RADIAÇÃO

Por se tratar de um fruto climatérico, o camu-camu (Myrciaria dúbia (H.B.K.) McVaugh) apresenta uma rápida deterioração em temperatura ambiente, sendo atribuída à elevada taxa respiratória o aumento da produção de etileno e a perda de água. Assim, o presente trabalho tem por objetivo avaliar os efeitos de diferentes doses de radiação gama e ultravioleta C na fisiologia e conservação pós-colheita in natura do camu-camu. Os frutos foram mantidos sob refrigeração por 21 dias a 10°C e avaliados a cada três dias sobre as seguintes variáveis: perda de massa fresca, firmeza do fruto, sólidos solúveis, acidez titulável, pH, vitamina C e antocianinas. O experimento foi conduzido em um delineamento inteiramente casualizado em esquema fatorial 5x8, com cinco repetições. Na avaliação físico-química, somente a variável pH não apresentou diferença significativa na interação dos fatores tratamentos e dias de armazenamento. O uso da radiação gama e ultravioleta C não comprometeu a qualidade pós-colheita do camu-camu in natura e a dose de 1,0 de ambas as fontes mostram-se mais eficientes em manter a conservação durante o período de armazenamento

Síndrome compartimental após extravasamento de contraste: Compartment syndrome after contrast extravasation

Introdução: A síndrome compartimental decorrente do extravasamento de contraste pode ter diversas complicações, merecendo atenção para que seja evitada ou uma vez instaurada, tratada. Apresentação do caso: Paciente do sexo feminino, 65 anos de idade, ex-tabagista, hipertensa e portadora de doença aterosclerótico vascular periférica, em uso de Losartana e AAS. Sofreu queda sobre membro superior esquerdo e foi submetida à Tomografia Computadorizada com contraste iodado que extravasou ocasionando náusea, episódios de vômito e dor, edema, parestesia e prurido local, sendo diagnosticada com síndrome compartimental e tratada com fasciotomia. Discussão: A síndrome compartimental decorre do aumento da pressão em um compartimento osteofascial fechado, diversas podem ser as etiologias da compressão dentre elas o extravasamento de contraste iodado usado em Tomografias Computadorizadas, provocando de alterações cutâneas e comprometendo elementos vasculares, nervos e músculos levando a prejuízo tecidual, demandando intervenção rápida para diminuir a extensão dos agravos através da Fasciotomia associada a aspiração do contraste. Conclusão: A Síndrome compartimental causada por extravasamento de contraste iodado pode ter desfechos locais e sistêmicos severos, assim que feito seu diagnóstico deve ter abordagem definitiva o quanto antes para minimizar suas complicações

Síndrome de Patau: Patau syndrome

Introdução: A Síndrome de Patau, ou trissomia do 13, é um distúrbio autossômico. A principal causa dessa síndrome é a não disjunção do cromossomo 13 durante a primeira divisão meiótica e sua incidência é cerca de 1:20.000 a 25.000. Apresentação do caso: Paciente do sexo feminino,37 anos de idade, natural e procedente de Goiânia/Go,casada e dona de casa.G3P2A0C0 com 33 semanas e 2 dias de gestação.Admitida no hospital das Clínicas de Goiânia com quadro de sangramento vaginal em pequena quantidade e dor em baixo ventre há 2 horas.Negou comorbidades, tabagismo, etilismo e uso de drogas ilícitas. Discussão: A Síndrome de Patau está relacionada a várias malformações, sendo as principais do trato gastrointestinal, sistema nervoso central e cardiopatias. Certas anomalias ou malformações são incompatíveis com a vida, mas alguns casos de trissomia parcial do cromossomo 13 podem ter sobrevida mais longa. Portadores dessa anomalia costumam vir a óbito devido a complicações cardiorrespiratórias. A idade materna avançada é o principal fator de risco. O diagnóstico dessa síndrome pode ser feito por ultrassom obstétrico de qualidade. Conclusão: Logo, nota-se que é primordial que as mulheres realizem o pré-natal adequado. E caso apresentem os fatores de risco é importante o aconselhamento genético pré-natal e pré-concepcional para que a mulher e o feto tenham a assistência adequada

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Report of rare case of dermatofibrosarcoma protuberans in the buccal mucosa: review of diagnostic, histopathological and immunohistochemical criteria

Dermatofibrosarcoma protuberans (DFSP) is an uncommon intermediate-grade soft tissue sarcoma. The tumor is found preferentially on the trunk, whereas the head and neck region are affected in only 10% to 15% of cases. We report the case of a 44-year-old woman with a 5-month history of an asymptomatic, firm, yellow nodule in the mucosa of the right cheek measuring 2.5 cm. The clinical diagnosis was lipoma and an excisional biopsy was obtained. Histopathological analysis revealed a proliferation of spindle-shaped mesenchymal cells arranged in interlacing fascicles amidst fibrous stroma. Low mitotic activity (2 mitoses per field) and deep cell infiltration into adipose tissue were observed. These features led to the histopathological diagnosis of a malignant low-grade mesenchymal cell tumor. Immunohistochemical analysis revealed negative staining for α-SMA, S-100, and Bcl-2, but positive staining for Ki-67 (18%) and strong and diffuse staining for CD34. These findings were compatible with the diagnosis of DFSP. Only two cases of DFSP in the oral cavity, both involving the cheek mucosa, have been described so far, highlighting the rarity of the present case

Report of rare case of dermatofibrosarcoma protuberans in the buccal mucosa: review of diagnostic, histopathological and immunohistochemical criteria

Dermatofibrosarcoma protuberans (DFSP) is an uncommon intermediate-grade soft tissue sarcoma. The tumor is found preferentially on the trunk, whereas the head and neck region are affected in only 10% to 15% of cases. We report the case of a 44-year-old woman with a 5-month history of an asymptomatic, firm, yellow nodule in the mucosa of the right cheek measuring 2.5 cm. The clinical diagnosis was lipoma and an excisional biopsy was obtained. Histopathological analysis revealed a proliferation of spindle-shaped mesenchymal cells arranged in interlacing fascicles amidst fibrous stroma. Low mitotic activity (2 mitoses per field) and deep cell infiltration into adipose tissue were observed. These features led to the histopathological diagnosis of a malignant low-grade mesenchymal cell tumor. Immunohistochemical analysis revealed negative staining for α-SMA, S-100, and Bcl-2, but positive staining for Ki-67 (18%) and strong and diffuse staining for CD34. These findings were compatible with the diagnosis of DFSP. Only two cases of DFSP in the oral cavity, both involving the cheek mucosa, have been described so far, highlighting the rarity of the present case

Paediatric COVID-19 mortality: a database analysis of the impact of health resource disparity

Background The impact of the COVID-19 pandemic on paediatric populations varied between high-income countries (HICs) versus low-income to middle-income countries (LMICs). We sought to investigate differences in paediatric clinical outcomes and identify factors contributing to disparity between countries.Methods The International Severe Acute Respiratory and Emerging Infections Consortium (ISARIC) COVID-19 database was queried to include children under 19 years of age admitted to hospital from January 2020 to April 2021 with suspected or confirmed COVID-19 diagnosis. Univariate and multivariable analysis of contributing factors for mortality were assessed by country group (HICs vs LMICs) as defined by the World Bank criteria.Results A total of 12 860 children (3819 from 21 HICs and 9041 from 15 LMICs) participated in this study. Of these, 8961 were laboratory-confirmed and 3899 suspected COVID-19 cases. About 52% of LMICs children were black, and more than 40% were infants and adolescent. Overall in-hospital mortality rate (95% CI) was 3.3% [=(3.0% to 3.6%), higher in LMICs than HICs (4.0% (3.6% to 4.4%) and 1.7% (1.3% to 2.1%), respectively). There were significant differences between country income groups in intervention profile, with higher use of antibiotics, antivirals, corticosteroids, prone positioning, high flow nasal cannula, non-invasive and invasive mechanical ventilation in HICs. Out of the 439 mechanically ventilated children, mortality occurred in 106 (24.1%) subjects, which was higher in LMICs than HICs (89 (43.6%) vs 17 (7.2%) respectively). Pre-existing infectious comorbidities (tuberculosis and HIV) and some complications (bacterial pneumonia, acute respiratory distress syndrome and myocarditis) were significantly higher in LMICs compared with HICs. On multivariable analysis, LMIC as country income group was associated with increased risk of mortality (adjusted HR 4.73 (3.16 to 7.10)).Conclusion Mortality and morbidities were higher in LMICs than HICs, and it may be attributable to differences in patient demographics, complications and access to supportive and treatment modalities

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable