Hein Keating (pizzachalk57)

The abundance of publications of COVID-19-induced chilblains has resulted in a confusing situation. This is a prospective single-institution study from 15 March to 13 May 2020. Thirty-two patients received PCR nasopharyngeal swabs. Of these, 28 patients had a thoracic CT-scan, 31 patients had blood and urine examinations, 24 patients had skin biopsies including immunohistochemical and direct immunofluorescence studies, and four patients had electron microscopy. COVID-19-induced chilblains are clinically and histopathologically identical to chilblains from other causes. Although intravascular thrombi are sometimes observed, no patient had a systemic coagulopathy or severe clinical course. The exhaustive clinical, radiological, and laboratory work-up in this study ruled-out other primary and secondary causes. Electron microscopy revealed rare, probable viral particles whose core and spikes measured from 120 to 133 nm within endothelium and eccrine glands in two cases. This study provides further clinicopathologic evidence of COVID-19-related chilblains. Negative PCR and antibody tests do not rule-out infection. Chilblains represent a good prognosis, occurring later in the disease course. No systemic coagulopathy was identified in any patient. Patients presenting with acral lesions should be isolated, and chilblains should be distinguished from thrombotic lesions (livedo racemosa, retiform purpura, or ischemic acral necrosis). This study provides further clinicopathologic evidence of COVID-19-related chilblains. Negative PCR and antibody tests do not rule-out infection. Chilblains represent a good prognosis, occurring later in the disease course. No systemic coagulopathy was identified in any patient. Patients presenting with acral lesions should be isolated, and chilblains should be distinguished from thrombotic lesions (livedo racemosa, retiform purpura, or ischemic acral necrosis).This study investigated the changes of lipids during the industrial preparation of noodle dough and dried noodles, including the hydration, sheeting, and drying processes. The results showed that industrial processing markedly influenced the stability of lipids during the preparation of dried noodles. The contents of total free fatty acids, polyunsaturated fatty acids, and free lipids were reduced, while peroxide values increased during the hydration and sheeting processes, showing the instability of lipids. The increase in lipid oxidation may have been due to the activation of lipoxygenase. Although its activity declined by 45.7% in the hydration process compared to that of the native wheat flour (198.5 ± 20.4 U/g/min), the residue activity should have been high enough to oxidize lipids. Interestingly, lipase activity remained relatively stable. In addition, an obvious increase of carbon-centered free radicals was observed during the entire processing. In conclusion, the industrial processing, especially the hydration process, markedly changed the lipid profile and promoted lipid oxidation during the preparation of dried noodles. PRACTICAL APPLICATION The present study showed the positive relationship between endogenous lipid degrading enzymes and the degradation of lipids and elucidated the role of industrial processing on lipid stability in noodle dough and dried noodles. The results of the present study will also help us to understand more about the sensory quality of dried noodles during preparation, as well as to develop high quality of wheat-based food products.Sudden unexpected death due to pneumothoraces caused by spontaneous rupture of bilateral pulmonary bullae is rare. This article reports the case of a 16-year-old girl who experienced this rare phenomenon without any precipitating factors. The patient did not have a history of chest pains or smoking but experienced chest tightness in the early morning and collapsed and died 4 h later. Autopsy identified the cause of death to be bilateral pneumot