Correlación entre saturación venosa, ruptura de anastomosis y formación de fístulas en pacientes con trauma abdominal en el Hospital Occidente de Kennedy

El manejo del trauma abdominal supone el reto de realizar una anastomosis o sutura intestinal en pacientes comprometidos hemodinámicamente. La decisión de cirugía de control de daños ante la presencia de acidosis, hipotermia y coagulopatía es evidente, sin embargo la situación no siempre es tan clara. En individuos con trauma se desarrollan cambios moleculares e inflamatorios por inadecuado balance entre aporte y demanda de oxígeno, que afectan el proceso de reparación de los tejidos con el riesgo de aparición de fístulas. Una forma rápida y práctica de detectar esta hipoperfusión es midiendo la saturación venosa de oxígeno (SVO2) y el Lactato Sérico. OBJETIVOS: Establecer correlación entre los valores de SVO2 transoperatorio y la aparición de fístulas intestinales en pacientes intervenidos por trauma abdominal. MATERIALES Y METODOS: Estudio de cohorte prospectivo que analiza diferentes variables en relación con la aparición de fistulas en pacientes con trauma abdominal que requieren suturas en el tracto gastrointestinal, haciendo énfasis en los niveles de SVO2. RESULTADOS: Los pacientes con falla anastomótica, presentaron un promedio de SVO2 más baja (60.0% ± 2.94%), versus los no fistulizados (69.89% ± 7.21%) (p =0.010). Todos los pacientes de la cohorte expuesta (SVO2<65%), presentaron dehiscencia de la anastomosis (RR =39.8, IC95%: 2.35,659.91, p<0.001, Test exacto de Fisher). El valor predictivo positivo de la saturación (<65%) fue de 57.14% (IC 95%: 13.34%, 100%) y el valor predictivo negativo fue de 100% (IC 95%:81.75%, 100%). La sensibilidad fue de 100% (IC 95%:87.50%, 100%) y especificidad de 91.89% (IC 95%: 81.75%, 100%). En el análisis bivariante determinó que el índice de trauma abdominal, el nivel de hemoglobina y el requerimiento de transfusión de glóbulos rojos, son factores de riesgo directamente relacionados con la falla de la anastomosis en pacientes con trauma abdominal CONCLUSIONES: - Hay una fuerte relación entre la falla en la reparación intestinal y SVO2 < 65%. - El pronóstico de una anastomosis intestinal está directamente relacionada con el estado hemodinámico y la perfusión tisular al momento de la intervención quirúrgica. - El nivel de SVO2 puede apoyar al cirujano en la decisión de realizar o no una reparación en víscera hueca al momento de intervención quirúrgica en un paciente con trauma abdominal.

Vigilancia tecnológica de los tres principales productos agrícolas base de alimentación y cultivados en Brasil y Argentina

La seguridad agroalimentaria debe ser prioridad para los gobiernos de Brasil y Argentina, debido a que deben garantizar la producción y el abastecimiento de los alimentos básicos para las futuras generaciones, entendido como alimentos básicos aquellos que más se consumen, ya sea en su forma original o por medio de sus subproductos, estos productos son el trigo, el maíz y el arroz. El garantizar la producción y el abastecimiento de estos productos en el corto y largo plazo, implica entender cuáles de los procesos productivos aplicados en la realización de los productos base de alimentación no son compatibles con el medio ambiente, generando impactos negativos sobre este. Estos impactos ambientales generados a partir de la agricultura, son identificados como el uso excesivo de recursos naturales entre ellos el agua, así como su contaminación por agentes toxico como los agroquímicos y fertilizantes. Asimismo, el uso de estos agentes tóxicos, genera la infertilidad de los suelos afectando directamente la producción en el largo plazo. Entender los impactos ambientales, implica desarrollar estrategias transversales que le permitan a los garantizar un desarrollo sostenible a lo largo de todo el ciclo del producto; estas estrategias deben estar acompañadas por un rendimiento y eficiencia de los cultivos, de nada sirve implementar estrategias compatibles con el medio ambiente si no se cumple con el principal objetivo de la producción de estos producto, que es garantizar el abastecimiento y alimentación para las generaciones presentes y futuras.

La ideología del Buen Vivir: la metamorfosis de una «alternativa al desarrollo» en desarrollo de toda la vida

El objetivo del documento es analizar el concepto y estrategias oficiales del Buen Vivir a través del filtro de las principales definiciones de ideología (de Marx y Engels, Lenin, Lukács, Gramsci Manheim, Freud, Marcuse, Althusser, Lacan y Žižek) con el fin de contrastar el discurso del Buen Vivir (recogido en la Constitución de la República de 2008, los Planes Nacionales para el Buen Vivir 2009-13 y 2013-17, y en la publicística y discursos oficiales mantenidos sobre el tema por parte de las máximas autoridades políticas del Ecuador) con la orientación y resultados de las políticas públicas diseñadas e implementadas supuestamente para alcanzarlo. El trabajo contiene dos hipótesis. La principal es que el concepto de Buen Vivir, a la vez que recupera un conjunto de principios y aspiraciones propios de la tradición multicultural del Ecuador, incorpora una buena parte de las definiciones de ideología (como falsa conciencia, programa movilizador, utopía-ilusión-fantasía, discurso hegemónico) y, por tanto, asume un significado ideológico análogo al que los defensores del Buen Vivir achacan al desarrollo económico. La segunda hipótesis, subordinada a la anterior, es que el concepto de Buen Vivir, en su dimensión ideológica plural, es funcional a un modelo económico primario exportador (antitético a los principios del Buen Vivir) y se ha utilizado para consolidar el apoyo a la verdadera utopía desarrollista y modernizadora de los gobiernos de Rafael Correa: un proceso de desarrollo basado en la staple theory, que debe culminar en una diversificación de la estructura productiva del país por ahora inédita.

Enhancing the selenium content of bovine milk through alteration of the form and concentration of selenium in the diet of the dairy cow

Since estimated dietary selenium intake in the UK has declined steadily from around 60 mug day(-1) in 1975 to 34 mug day(-1) in 1997, there is a need to increase selenium intake from staple foods such as milk and milk products. An experiment was therefore done to investigate the relationship between dietary source and concentration of selenium and the selenium content of bovine milk. In a 3 x 3 factorial design, 90 mid-lactation Holstein dairy cows were supplemented over 8 weeks with either sodium selenite (S), a chelated selenium product (Selenium Metasolate(TM)) (C) or a selenium yeast (Sel-plex(TM)) (Y) at three different dietary inclusion levels of 0.38 (L), 0.76 (M) and 1.14 (H) mg kg(-1) dry matter (DM). Significant increases in milk selenium concentration were observed for all three sources with increasing inclusion level in the diet, but Y gave a much greater response (up to +65 mug l(-1)) than the other two sources of selenium (S and C up to +4 and +6 mug l(-1) respectively). The Y source also resulted in a substantially higher apparent efficiency of transfer of selenium from diet to milk than S or C. Feeding Y at the lowest dietary concentration, and thus within the maximum level permitted under EU regulations, resulted in milk with a selenium concentration of 28 mug l(-1). If the selenium concentration of milk in the UK was increased to this value, it would, at current consumption rates, provide an extra 8.7 mug selenium day(-1), or 11 and 14% of daily recommended national intake for men and women respectively. (C) 2004 Society of Chemical Industry.

Effect of dietary phytate and microbial phytase on mineral and trace element bioavailability- a literature review

Phytic acid (PA) is the main phosphorus storage compound in cereals, legumes and oil seeds. In human populations where phytate-rich cereals such as wheat, maize and rice are a staple food, phytate may lead to mineral and trace element deficiency. Zinc appears to be the trace element whose bioavailability is most influenced by PA. Furthermore, several studies in humans as well as in monogastric animals clearly indicate an inhibition of non-haem iron absorption at marginal iron supply due to phytic acid. In fact PA seems to be, at least partly, responsible for the low absorption efficiency and high incidence of iron deficiency anaemia evident in most developing countries, where largely vegetarian diets are consumed Microbial phytases have provided a realistic means of improving mineral availability from traditionally high-phytate diets. In fact it has been consistently shown that Aspergillus phytases significantly enhance the absorption of calcium, magnesium and zinc in pigs and rats. Furthermore there are a few studies in humans indicating an improvement of iron bioavailability due to microbial phytase.

Strigolactone analogues induce suicidal seed germination of Striga spp. in soil

Striga hermonthica and Striga asiatica are obligate root parasites that cause serious problems in the production of staple cereal crops in Africa. Because of the high levels of infestation, there is an urgent need to control these weeds. A potentially useful control option is depletion of the soil seed bank by suicidal germination, which involves germination of the seeds in the absence of host plants. Suicidal germination is often mentioned in the literature, but not considered realistic, because of the alleged untimely decomposition of the stimulants in the soil, despite the fact that some encouraging results were reported around 1980. The alleged instability has prevented active research in this direction for the past 20–25 years. Five newly designed synthetic germination stimulants were investigated as candidates for suicidal germination. An important issue is the persistence of these stimulants in soil. Packets with Striga spp. seeds were put in pots with soil and then treated with aqueous solutions of the stimulants. All five compounds induced germination under these conditions, with percentages varying between 18% and 98% depending on stimulant and species. There were no noticeable signs of decomposition of the stimulants. The best performing stimulant is derived from 1-tetralone. We conclude that synthetic strigolactones analogues have excellent prospects for use in combating parasitic weeds. Further testing will be needed to evaluate whether such prospects can be realised in the field.

The interval and indoor playmaking

Although early modern acting companies were adept at using different kinds of venue, performing indoors imposed a significant change in practice. Since indoor theatres required artificial lighting to augment the natural light admitted via windows, candles were employed; but the technology was such that candles could not last untended throughout an entire performance. Performing indoors thus introduced a new component into stage practice: the interval. This article explores what extant evidence (such as it is) might tell us about the introduction of act breaks, how they may have worked, and the implications for actors, audiences and dramatists. Ben Jonson's scripting of the interval in two late plays, The Staple of News and The Magnetic Lady, is examined for what it may suggest about actual practice, and the ways in which the interval may have been considered integral to composition and performance is explored through a reading of Middleton and Rowley's The Changeling. The interval offered playwrights a form of structural punctuation, drawing attention to how acts ended and began; actors could use the space to bring on props for use in the next act; spectators might use the pause between acts to reflect on what had happened and, perhaps, anticipate what was to come; and stage-sitters, the evidence indicates, often took advantage of the hiatus in the play to assert their presence in the space to which all eyes naturally were drawn.

Acute ingestion of beetroot bread increases endothelium-independent vasodilation and lowers diastolic blood pressure in healthy men: a randomized controlled trial

Dietary nitrate, from beetroot, has been reported to lower blood pressure (BP) by the sequential reduction of nitrate to nitrite and further to NO in the circulation. However, the impact of beetroot on microvascular vasodilation and arterial stiffness is unknown. In addition, beetroot is consumed by only 4.5% of the UK population, whereas bread is a staple component of the diet. Thus, we investigated the acute effects of beetroot bread (BB) on microvascular vasodilation, arterial stiffness, and BP in healthy participants. Twenty-three healthy men received 200 g bread containing 100 g beetroot (1.1 mmol nitrate) or 200 g control white bread (CB; 0 g beetroot, 0.01 mmol nitrate) in an acute, randomized, open-label, controlled crossover trial. The primary outcome was postprandial microvascular vasodilation measured by laser Doppler iontophoresis and the secondary outcomes were arterial stiffness measured by Pulse Wave Analysis and Velocity and ambulatory BP measured at regular intervals for a total period of 6 h. Plasma nitrate and nitrite were measured at regular intervals for a total period of 7 h. The incremental area under the curve (0-6 h after ingestion of bread) for endothelium-independent vasodilation was greater (P = 0.017) and lower for diastolic BP (DBP; P = 0.032) but not systolic (P = 0.99) BP after BB compared with CB. These effects occurred in conjunction with increases in plasma and urinary nitrate (P < 0.0001) and nitrite (P < 0.001). BB acutely increased endothelium-independent vasodilation and decreased DBP. Therefore, enriching bread with beetroot may be a suitable vehicle to increase intakes of cardioprotective beetroot in the diet and may provide new therapeutic perspectives in the management of hypertension.

The consumer acceptance of novel vegetable-enriched bread products as a potential vehicle to increase vegetable consumption

Currently UK fruit and vegetable intakes are below recommendations. Bread is a staple food consumed by ~95% of adults in western countries. In addition, bread provides an ideal matrix by which functionality can be delivered to the consumer in an accepted food. Therefore, enriching bread with vegetables may be an effective strategy to increase vegetable consumption. This study evaluated consumer acceptance, purchase intent and intention of product replacement of bread enriched with red beetroot, carrot with coriander, red pepper with tomato or white beetroot (80g vegetable per serving of 200g) compared to white control bread (0g vegetable). Consumers (n=120) rated their liking of the breads overall, as well as their liking of appearance, flavour and texture using nine-point hedonic scales. Product replacement and purchase intent of the breads was rated using five-point scales. The effect of providing consumers with health information about the breads was also evaluated. There were significant differences in overall liking (P<0.0001), as well as liking of appearance (P<0.0001), flavour (P=0.0002) and texture (P=0.04), between the breads. However, the significant differences resulted from the red beetroot bread which was significantly (P<0.05) less liked compared to control bread. There were no significant differences in overall liking between any of the other vegetable-enriched breads compared with the control bread (no vegetable inclusion), apart from the red beetroot bread which was significantly less liked. The provision of health information about the breads did not increase consumer liking of the vegetable-enriched breads. In conclusion, this study demonstrated that vegetable-enriched bread appeared to be an acceptable strategy to increase vegetable intake, however, liking depended on vegetable type.

Manipulation of lipids in animal-derived foods: can it contribute to public health nutrition?

Foods derived from animals are an important source of nutrients for humans. Concerns have been raised that due to their SFA content, dairy foods may increase the risk of cardiometabolic disease. Prospective studies do not indicate an association between milk consumption and increased disease risk although there are less data for other dairy foods. SFA in dairy products can be partially replaced by cis-MUFA through nutrition of the dairy cow although there are too few human studies to conclude that such modification leads to reduced chronic disease risk. Intakes of LCn-3 FA are sub-optimal in many countries and while foods such as poultry meat can be enriched by inclusion of fish oil in the diet of the birds, fish oil is expensive and has an associated risk that the meat will be oxidatively unstable. Novel sources of LCn-3 FA such as kirll oil, algae, and genetically modified plants may prove to be better candidates for meat enrichment. The value of FA-modified foods cannot be judged by their FA composition alone and there needs to be detailed human intervention studies carried out before judgements concerning improved health value can be made. Practical applications: The amount and FA composition of dietary lipids are known to contribute to the risk of chronic disease in humans which is increasing and becoming very costly to treat. The use of animal nutrition to improve the FA composition of staple foods such as dairy products and poultry meat has considerable potential to reduce chronic risk at population level although judgements must not be based simply on FA composition of the foods.

Agricultural innovations at a Late Iron Age oppidum: archaeobotanical evidence for flax, food and fodder from Calleva Atrebatum, UK

The development of oppida in the late first millennium BC across north-western Europe represents a major change in settlement form and social organisation. The construction of extensive earthwork systems, the presence of nucleated settlement areas, long-distance trade links and the development of hierarchical societies have been evidenced. These imply that changes in the style and organisation of agriculture would have been required to support these proto-urban population centres. Hypotheses of the subsistence bases of these settlements, ranging from a reliance on surplus arable production from local rural settlements, to an emphasis on pastoral activities, are here reviewed and grounded against a wider understanding of the expansion of agriculture in the Late Iron Age. These agricultural models have not been previously evaluated. This paper presents archaeobotanical data from six well fills from large-scale excavations at Late Iron Age and Early Roman Silchester, a Late Iron Age territorial oppidum and subsequent Roman civitas capital located in central-southern Britain. This is the first large-scale study of waterlogged plant macrofossils from within a settlement area of an oppidum. Waterlogged plant macrofossils were studied from a series of wells within the settlement. An assessment of taphonomy, considering stratigraphic and contextual information, is reported, followed by an analysis of the diverse assemblages of the plant remains through univariate analysis. Key results evidence animal stabling, flax cultivation, hay meadow management and the use of heathland resources. The staple crops cultivated and consumed at Late Iron Age and Early Roman Silchester are consistent with those cultivated in the wider region, whilst a range of imported fruits and flavourings were also present. The adoption of new oil crops and new grassland management shows that agricultural innovations were associated with foddering for animals rather than providing food for the proto-urban population. The evidence from Silchester is compared with other archaeobotanical datasets from oppida in Europe in order to identify key trends in agricultural change.

Patterns of food acquisition in Brazilian households and associated factors: a population-based survey

Objective: To identify food acquisition patterns in Brazil and relate them to the sociodemographic characteristics of the household. Design: A cross-sectional national Household Budget Survey (HBS). Principal component factor analysis was used to derive food patterns (factors) on the basis of the acquisition of food classified into thirty-two food groups. Setting: The source of data originates from the 2002-2003 HBS carried out by the Brazilian Institute of Geography and Statistics between June 2002 and July 2003 using a representative sample of all Brazilian households. Subject: A total of 48 470 households allocated into 443 strata of households that were geographically and socio-economically homogeneous as a study unit. Results: We identified two patterns of food acquisition. The first, named `dual`, was characterized by dairy, fruit, fruit juice, vegetables, processed meat, soft drinks, sweets, bread and margarine, and by inverse correlations with Brazilian staple foods. In contrast, the second pattern, named `traditional`, was characterized by rice, beans, manioc, flour, milk and sugar. The `dual` pattern was associated with higher household educational level, income and the average age of adults on the strata, whereas the `traditional` presented higher loadings in less-educated households and in the rural setting. Conclusions: Dietary patterns described here suggest that policies and programmes to promote healthy eating need to consider that healthy and non-healthy foods may be integral in the same pattern.

Fibroelastic Components of the Vesicourethral Junction of Rats in the Aging Process

The vesicourethral junction comprising the vesical trigone, is relevant in setting and positioning of the urinary bladder, along with the vesical neck, fixed by lateral ligaments of the bladder and tendinous arch of the pelvis fascia. Namely, the puboprostatic ligament (men) and the pubovesical (women). The circular set elastic fibers in this junction are important and valuable in the elasticity and plasticity of the area, allowing quick expansion and withdrawal with the flow of urine, and associated to smooth muscle tissue and nerve control form an important collective to maintain urinary continence. The objective of the present study is to describe the elastic system in the vesicouretral junction in relation to aging and its involvement in the states of urinary continence and incontinence, as well as the study of the vesicouretral junction in various age groups while evaluating with electron transmission microscopy. To carry out the study, 12 Wistar rats were used, divided into groups: neonate (4 animals), adult group (4 animals) and aged group (4 animals). Electron transmission microscopy with use of tanic acid technique associated to glutaraldehyde fixation, satisfactorily showed the extreme structural differences between mature elaunin and oxytalan fibers present between intercelular spaces and bundles of collagen fibers. The phases of elastogenesis in neonate animals and degradation of the elastic system of older animals were also evaluated.

Crosslinking of Poly(N-vinyl-2-pyrrolidone) in the Coating of Cotton Yarn

Coating of cotton yarn is employed in the textile industry to increase the mechanical resistance of the yarns and resistance to vibration, friction, impact, and elongation, which are some of the forces to which the yarn is subjected during the weaving process. The main objective of this study is to investigate the usage of a synthetic hydrophilic polymer, poly(N-vinyl-2-pyrrolidone) (PVP), to coat 100% cotton textile yarn, aiming to give the yarn a temporary mechanical resistance. For the improvement of the mechanical resistance of the yarn, the following crosslinking processes of PVP were investigated: UV-C (ultraviolet) radiation, the Fenton and photo-Fenton reactions, and sensitized UV-C radiation. The influence of each crosslinking process was determined through tensile testing of the coated yarns. The results indicated that the best crosslinking process employed was UV-C radiation; increasing the mechanical resistance of the yarn up to 44% if compared with the pure cotton yarn, that is, without polymeric coating and crosslinking. POLYM. ENG. SCI., 51:445-453, 2011. (C) 2010 Society of Plastics Engineers

Opportunistic vertebrate predation by the Squirrel Glider Petaurus Norfolcensis

The Squirrel Glider Petaurus norfolcensis is classified as an exudivore/insectivore feeder, with staple dietary items including insects, insect exudates and plant exudates. During a study of the foraging ecology of the species in northern Victoria, an adult female glider was observed to harass a nesting Common Bronzewing Phaps chalcoptera, ultimately removing the bird before consuming eggs within the nest. A description of this observation is provided and vertebrate predation by the Squirrel Glider is discussed in relation to other published accounts. Vertebrate predation by the Squirrel Glider is considered infrequent and opportunistic, but may provide an additional protein and energy source for lactating females.