Abstract Symbiotic fermented kinds of milk are products with probiotic microorganisms and a simultaneous prebiotic effect. The presence of fibers or oligosaccharides causes it. This work aimed to evaluate and model fermented milk beverage production with probiotic microorganisms and in situ Galactooligosaccharides (GOS) synthesis. GOS enzymatic production was maximized through the mathematical model, and finally, the mathematical prediction was experimentally validated. For this purpose, the enzymatic kinetics of GOS production from Aspergillus oryzae β-galactosidase enzyme was experimentally evaluated for different initial lactose concentrations (30%, 35%, and 40% w/v) and enzyme/lactose ratio (R: 0.2%, 0.4%, and 0.6%). In addition, the fermentative kinetics of lactic acid and biomass production were evaluated using the probiotic strain Lactobacillus acidophilus. The parameters correlation for both models was then performed. A unified model determined the process conditions that maximize GOS concentration in the fermented milk beverage. According to the model, the operating values that maximized the GOS production were 40% of initial lactose, R: 0.15%, 20 min of enzymatic reaction, and 17 h of fermentative reaction. The final fermented milk drink showed a GOS content of 2.9 g/portion of 200 g, guaranteeing the recommended daily values of the prebiotic with the consumption of two servings. effect it (GOS synthesis finally validated purpose βgalactosidase β galactosidase 30%, 30 (30% 35 35% 40 w/v wv w v enzymelactose R (R 02 0 2 0.2% 04 4 0.4% 0.6%. 06 0.6% . 6 0.6%) addition acidophilus performed 015 15 0.15% reaction 1 29 9 2. gportion g portion servings 30% 3 (30 0.2 0.4 0.6 01 0.15 (3 0. 0.1 (

Background: acute respiratory distress syndrome is an acute multicausal hypoxemic insufficiency that is frequent in the intensive care units and has a high mortality. Objective: to determine the incidence and mortality of acute respiratory distress syndrome in the intensive care unit of Dr. Eduardo Agramonte Piña Teaching Pediatric Hospital in Camagüey. Methods: a descriptive, retrospective, observational study was conducted. The medical histories of the patients admitted in the intensive care unit between December 1993 and December 2003, were reviewed. These patients matched the diagnostic criteria of acute respiratory distress syndrome, according to the American-European consensus of 1994. Results: during the study period, 4438 children were admitted. The 3, 6 % of the patients matched the diagnostic criteria; the 76, 6 % of them because of direct pulmonary problems and the 23, 4 % because of indirect pulmonary problems. The 47, 4 % of the patients were admitted with an oxygenation index lower than 15. The global mortality was of 36, 7 % and the most affected age group was 7-11 years old. Conclusions: it was found that the incidence and mortality of acute respiratory distress syndrome in the intensive care unit of Dr. Eduardo Agramonte Piña Teaching Pediatric Hospital in Camagüey has a parallel behavior to other institutions of similar characteristics.

Fundamento: el síndrome de dificultad respiratoria aguda es una insuficiencia aguda hipoxémica multicausal, frecuente en los servicios de terapia intensiva y con elevada mortalidad. Objetivo: determinar la incidencia y mortalidad del síndrome de dificultad respiratoria aguda en la unidad de cuidados intensivos del Hospital Pediátrico Universitario Dr. Eduardo Agramonte Piña de la ciudad de Camagüey. Métodos: se realizó un estudio observacional retrospectivo y descriptivo. Se revisaron los expedientes clínicos de los pacientes ingresados en la unidad de cuidados intensivos entre diciembre de 1993 a diciembre de 2013, que cumplieran los criterios diagnósticos del síndrome de dificultad respiratoria aguda según el consenso americano-europeo de 1994. Resultados: en el período de estudio ingresaron 4 438 niños de los cuales el 3,6 % cumplieron los criterios diagnósticos, el 76,6 % de ellos por causa pulmonar directa y el 23,4 % por causa indirecta. El 47,4 % de los pacientes ingresó con un índice de oxigenación menor de 15. La mortalidad global fue de 36,7 % y el grupo de edad más afectado fue el de 7-11 años. Conclusiones: se constató que la incidencia y la mortalidad del síndrome de dificultad respiratoria aguda en la unidad de cuidados intensivos del Hospital Pediátrico Universitario Dr. Eduardo Agramonte Piña, tiene un comportamiento afín con otras instituciones de características similares.