Truffles are a well-known worldwide product mainly appreciated by their unique aroma, which is composed by more than 50 volatile compounds. However, to this day, no one has accomplished to find the ...aromatic key that evokes the real aroma of truffles for its use as food flavoring. Among them, black truffle was selected for extraction with supercritical fluids using CO2 as solvent recovering natural truffle aroma fraction. To achieve the optimal extraction ratio, time, pressure and grapeseed oil addition to the separators were evaluated. Aroma from black truffle powder, extracts obtained, and residual cakes fractions were characterized by headspace gas chromatography-spectrometry and olfactometry techniques. The results indicated that optimal extraction conditions were 30 MPa for 3 h. Also, grapeseed oil addition enhanced trapping some key truffle aromatic compounds as 2,3-butanodione, 2-methyl-1-butanol, octanal and dimethyl disulphide. Olfactometry study showed the aromatic profile of the extracts indicating the molecules ethyl pentanoate (fruity), 1-hexen-3-one (metallic) and ethyl hexanoate (fruity) as the main compounds of extracts samples. For the first time, a natural truffle aroma has been obtained using low-value truffles. After aromatic extraction, carbohydrates, proteins, and phenolic compounds were analysed within the residues, showing a potential source of bioactive compounds.
Display omitted
•SFE-CO2 (30 MPa, 3 h) generated enrich odor fractions from black truffle.•Grapeseed oil addition into the separators helped to trap key volatile compounds.•A total of 91 volatile and 36 odor compounds were detected by HS-GC-MS and CG-O.•The bioactive compounds from truffle were not affected after SFE extraction.
Urinary tract infections (UTI) are common in emergency departments (ED), and at least 15% of them are bacteremic. However, there are few data on how to predict which patients are at high risk of ...developing bacteremic UTI (b-UTI). We performed a retrospective observational cohort study including patients diagnosed with UTI who were admitted to the ED of a tertiary-care hospital in Spain. We included only those patients in whom blood cultures were performed. A nomogram for b-UTI was developed as visualizations of a logistic regression model. Two hundred and thirteen patients with UTI were finally included, 108 of them developed b-UTI (50.7%). The mean age was 60.5 ± 21.4 years. A previous urologic disease was present in 45.5%, 12 out of 213 patients (5.6%) had a urologic tumor (10.2% in b-UTI group vs. 1% in non b-UTI,
p
= 0.003), and 4.2% were kidney transplant recipients. In a multivariate analysis, variables associated with b-UTI were: solid organ malignancy (OR 3.19; CI 95% 1.01–10.03,
p
= 0.04), elevated neutrophil count (more than 80% of neutrophils) (OR 5.84; CI 95% 2.13–15.99,
p
= 0.0006), elevated C reactive protein (OR 1.046; CI 95% 1.006–1.087,
p
= 0.022), and pyuria (presence of ≥50 white cells per high-power field of urine) (OR 4.43; CI 95% 1.94–10.11,
p
= 0.0004). The presence of solid tumor, elevated neutrophil count, elevated C reactive protein, and pyuria are independent risk factors that could be useful in anticipating the development of bacteremia in patients with UTI seen in the ED.
Many meta-analyses usually omit the number needed to treat, or perform the calculation incorrectly, despite its importance in clinical decision-making. Accordingly, we will explain in an easily ...understandable way how to perform this procedure to assess the clinical relevance of the intervention.
The expressions of the Cochrane Library and the concepts of clinical relevance and evidence-based medicine were applied. Simple cutoff points were also established to facilitate the task of interpreting results. The method was applied to two published meta-analyses to illustrate its application to real cases (treatment nonadherence).
In the first example, with a risk in the control group ranging from 0.22 to 0.70, sending mobile phone messages to remind chronic patients to take their medication is clinically relevant with a high degree of evidence. For the second example (single-pill regimen in patients suffering from hypertension and/or dyslipidemia after 6 months), the range of the assumed control risk was between 0.28 and 0.57.
The constructed algorithm could be applied to published meta-analyses or incorporated systematically in all meta-analyses with these characteristics.
•Meta-analyses of randomized clinical trials (RCTs) have the highest degree of evidence to assess an intervention.•In meta-analyses, the relative risk/odds ratio is usually provided, omitting the number needed to treat (NNT).•We propose a simple method to compute the NNT/relative risk reduction in a meta-analysis of RCTs.•The method has been applied to a practical case to facilitate its understanding.•By following our proposal, we can determine the clinical relevance of an intervention.
Background
The cell cycle checkpoint G1/S, dependent on cyclin-dependent kinase (CDK) 4 amplification/overexpression and retinoblastoma phosphorylation, is altered in most anaplastic ...oligodendrogliomas (AOs).
Objective
We aimed to evaluate the efficacy of palbociclib, an oral inhibitor of CDK4/6 with proven efficacy in breast cancer, in patients with AO. The primary endpoint was progression-free survival at 6 months.
Patients and Methods
We conducted a multicenter, open-label, phase II trial evaluating the efficacy and safety of palbociclib in patients with AO who progressed on radiotherapy and chemotherapy with histologically and molecularly confirmed grade 3 oligodendroglioma and conserved retinoblastoma protein (pRb) expression by immunohistochemistry. Patients were treated with palbociclib (125 mg/day) for 3/1 weeks on/off.
Results
Overall, 34 patients were enrolled across 10 hospitals in the Spanish Group of Neuro-Oncology (GEINO) study. The study was stopped early owing to the lack of efficacy, with 74% of evaluable patients progressing within 6 months, which was insufficient to consider palbociclib as an active drug in this population. Within the median follow-up of 12 months, the median progression-free survival was 2.8 months 95% confidence interval (CI) 2.6–3.1 and the median overall survival was 32.1 months (95% CI 5.1–59.2). There were no partial or complete responses; only 13 patients (38%) achieved stable disease as the best response. Palbociclib was well tolerated, with neutropenia (grade 3 or higher: 58.8%) and thrombocytopenia (grade 3 or higher: 14.7%) as the most common adverse events (AEs). Both AEs had no significant impact.
Conclusion
Despite the good tolerance, palbociclib monotherapy did not show favorable efficacy against recurrent AO.
Trial Registration
This study is registered with ClinicalTrials.gov, identifier NCT0253032 (retrospectively registered on 21 August 2015).
Sweet cherry trees (Prunus avium L.) are susceptible to a range of diseases, but there have been no studies to date about the viral infection of sweet cherry trees in Spain. To determine the ...phytosanitary status of Spanish sweet cherry plantations, the incidence and leaf symptoms induced by Prune dwarf (PDV), Prunus necrotic ringspot (PNRSV) and Apple chlorotic leaf spot (ACLSV) viruses were investigated during 2009. Young leaf samples were taken from 350 sweet cherry trees, corresponding to 17 cultivars, and were analysed by double antibody sandwich enzyme-linked immunosorbent assay (DAS-ELISA). To associate the leaf symptoms with the virus, 50 mature leaves from each infected tree were visually inspected during the summer. The ELISA results revealed that 72 % of sweet cherry trees were infected by at least one of the viruses. PDV occurred in all sampled cultivars and presented the highest infection rate, followed by ACLSV and PNRSV. A high number of trees showed asymptomatic, in both single and mixed infections. The leaf symptoms associated with the viruses involved generalized chlorosis around the midvein (PDV), chlorotic and dark brown necrotic ringspots on both secondary veins and intervein regions (PNRSV), chlorotic and reddish necrotic ringspots (ACLSV) and generalized interveinal chlorosis (PDV-PNRSV).
•Bimodal wave of COVID-19 infection occurs in many European countries, including Spain.•Adults with acute lymphoblastic leukemia (ALL) had similar poor outcome in the two infection waves, despite an ...increase in health care resources against COVID-19 infection.•The main prognostic factor for ALL survival was the presence of comorbidities prior to COVID-19 infection.
SARS-CoV-2 infection has bimodal distribution in Europe with a first wave in March to June 2020 and a second in September 2020 to February 2021. We compared the frequency, clinical characteristics and outcomes of adults with acute lymphoblastic leukemia (ALL) and infection in the first vs. second pandemic waves in Spain.
In this prospective study the characteristics of ALL and COVID-19 infection, comorbidities, treatment and outcome in the two periods were compared. The study ended when vaccination against SARS-CoV-2 was implemented in Spain.
Twenty eight patients were collected in the first wave and 24 in the second. The median age was 46.5 years (range 20–83). Patients from the first wave had a trend to more severe ALL (higher frequency of patients under induction or submitted to transplantation or under immunosuppressive therapy). No significant differences were observed in need for oxygen support, intensive care unit (ICU) requirement, days in ICU and time to COVID-19 infection recovery. Seventeen patients (33%) died, with death attributed to COVID infection in 15 (29%), without significant differences in the 100 day overall survival (OS) probabilities in the two waves (68% ± 17% vs. 56% ± 30%). The only prognostic factor for OS identified by was the presence of comorbidities at COVID-19 infection (HR: 5.358 95% CI: 1.875- 15.313).
The frequency and mortality of COVID-19 infection were high in adults with ALL, without changes over time, providing evidence in favor of vaccination priority for these patients.
The characteristics and outcome of ALL in adults with COVID-19 infection in the first two waves of the pandemic in Spain were compared. The frequency and mortality of COVID-19 infection were high in adults with ALL, without changes over time. Comorbidities at COVID-19 infection was the only prognostic factor for survival.
Background and aims:
Oxidative stress (OS) induces the production of fibroblast growth factor 21 (FGF21). Previous data have revealed that FGF21 protects cells from OS injury and death, making it a ...potential therapeutic option for many diseases with increased OS. However, the association of this growth factor with OS markers in humans with chronic kidney disease (CKD) remains unknown. This study aims to evaluate the association of serum FGF21 with serum total antioxidant capacity (TAC) and oxidized low-density lipoproteins (OxLDL) in subjects in different stages of kidney disease.
Methods:
This is a cross-sectional study that included 382 subjects with different stages of CKD, irrespective of type 2 diabetes (T2D) diagnosis. Associations of serum FGF21 with OxLDL, TAC, sex, age, body mass index (BMI), fasting plasma glucose, estimated glomerular filtration rate (eGFR), T2D, and smoking, were evaluated through bivariate and partial correlation analyses. Independent associations of these variables with serum FGF21 were evaluated using multiple linear regression analysis.
Results:
Serum FGF21 was significantly and positively correlated with age (r = 0.236), TAC (lnTAC) (r = 0.217), and negatively correlated with eGFR (r = −0.429) and male sex (r = −0.102). After controlling by age, sex, BMI, T2D, smoking, and eGFR; both TAC and OxLDL were positively correlated with FGF21 (r = 0.117 and 0.158 respectively, p < 0.05). Using multiple linear regression analysis, eGFR, male sex, T2D, OxLDL, and TAC were independently associated with serum FGF21 (STDβ = −0.475, 0.162, −0.153, 0.142 and 0.136 respectively; p < 0.05 for all) adjusted for age, BMI, smoking, and fasting plasma glucose.
Conclusion:
A positive association between serum FGF21 and OS has been found independently of renal function in humans. Results from the present study provide novel information for deeper understanding of the role of FGF21 in OS in humans with CKD and T2D; mechanistic studies to explain the association of serum FGF21 with oxidative stress in CKD are needed.
Linezolid resistance is extremely uncommon in Staphylococcus aureus.
To report an outbreak with linezolid and methicillin-resistant S. aureus (LRSA) in an intensive care department and the effective ...control measures taken.
Outbreak study of consecutive critically ill patients colonized and/or infected with LRSA at an intensive care department of a 1000-bed tertiary care university teaching hospital in Madrid, Spain. Patients were placed under strict contact isolation. Daily updates of outbreak data and recommendations for the use of linezolid were issued. Extensive environmental sampling and screening of the hands of health care workers were performed.
Linezolid use and clinical and epidemiological characteristics and outcomes using minimal inhibitory concentrations, pulsed-field gel electrophoresis, and polymerase chain reaction of LRSA isolates.
Between April 13 and June 26, 2008, 12 patients with LRSA were identified. In 6 patients, LRSA caused ventilator-associated pneumonia and in 3 patients it caused bacteremia. Isolates were susceptible to trimethoprim-sulfamethoxazole, glycopeptides, tigecycline, and daptomycin. Genotyping identified 1 predominant clone and 3 other types. Cfr-mediated linezolid resistance was demonstrated in all isolates. Potential hospital staff carriers and environmental samples were negative except for one. Six patients died, 5 of them in the intensive care unit, with 1 death attributed to LRSA infection. Linezolid use decreased from 202 defined daily doses in April 2008 to 25 defined daily doses in July 2008. Between July 2008 and April 2010, no new cases have been identified in the weekly surveillance cultures or diagnostic samples.
The first clinical outbreak, to our knowledge, with LRSA mediated by the cfr gene developed at our center, was associated with nosocomial transmission and extensive usage of linezolid. Reduction of linezolid use and infection-control measures were associated with the termination of the outbreak.
Biomimetic carbonate–hydroxyapatite (HA) nanocrystals have been synthesized by using the sitting drop vapor diffusion technique, for the first time. The method consists of diffusing vapors of an ...aqueous solution of NH4HCO3 through drops containing an aqueous mixture of (CH3COO)2Ca and (NH4)2HPO4 in order to increase slowly their pH. This synthesis has been performed in a crystallization mushroom, a glass device developed for protein and small molecules crystallization. The concentrations of the reagents, the final pH and the crystallization time have been optimized to produce pure carbonate–HA as a single phase. X‐Ray diffraction, Fourier transformed infrared spectroscopy, and transmission electron microscopy have been utilized to characterize the synthesized carbonated substituted HA crystals which display nanometric dimensions, plate‐like morphology, and low crystallinity degree, closely resembling the inorganic phase of bones, teeth, and many pathological calcifications. This novel method may prove to be suitable for the study of the interactions and/or the co‐crystallization of hydroxyapatite with minute amounts of biomolecules, polymers, or drugs.
Carbonate–hydroxyapatite nanocrystals have been produced by using the sitting drop vapor diffusion technique, for the first time. The method consists of diffusing gases from an aqueous solution of NH4HCO3 through drops containing an aqueous mixture of (CH3COO)2Ca and (NH4)2HPO4, in order to increase slowly their pH and to dope the precipitate with carbonate. This method is simple and controllable, and may prove to be suitable for the study of the interactions and/or the co‐crystallization of hydroxyapatite with minute amounts of biomolecules, polymers or drugs.
Abstract Objective The goal of this study was to investigate clinical findings, ictal semiology, and results of video/electroencephalography (video/EEG), and magnetoencephalography (MEG) in patients ...with startle epilepsy and normal brain MRI. Methods Four patients (mean age 12.5 years) with startle epilepsy were investigated with MRI, video/EEG, and MEG. Results Epilepsy diagnosis was established in childhood, and all had spontaneous and reflex seizures. Reflex seizures were triggered by sudden, unexpected sounds and tactile stimuli. The neurological examinations and MRIs were normal. MEG recordings showed focal epileptiform activity. An ictal MEG was obtained in one patient. Source modeling yielded dipole sources in right central frontal region. Conclusion The present study demonstrates that the origin of epileptiform activity in startle epilepsy can be localized in brain areas associated with supplementary motor seizures, even in patients with normal brain MRI. MEG adds complementary information to the localization of epileptiform activity and can be useful in planning invasive studies in cases evaluated for epilepsy surgery.
PDF
