Effect of different dietary arachidonic, eicosapentaenoic, and docosahexaenoic acid content on selected immune parameters in gilthead sea bream (Sparus aurata).

The increasing replacement of fish oil (FO) by vegetable oils (VO) in aquafeeds for marine carnivorous species may lead to modifications of the dietary arachidonic (ARA), eicosapentaenoic (EPA) and docosahexaenoic (DHA) levels and ratios that may compromise the fish immune status. Therefore, this study aimed to assess how different dietary ratios of ARA, EPA, and DHA modulate the immune response of gilthead sea bream juveniles. For that purpose, four isoproteic and isolipidic plant-based diets were formulated to include different dietary Long-Chain-Polyunsaturated Fatty Acids (LC-PUFA) ratios (%DM): Diet A (2.0% ARA: 0.2% EPA: 0.1% DHA); Diet B (1.0% ARA: 0.4% EPA: 0.4% DHA); Diet C (0% ARA: 0.6% EPA: 0.6% DHA); Diet D (0% ARA: 0.3% EPA: 1.5% DHA). Fish were fed the experimental diets for 56 days and then the haematological profile, humoral innate immune parameters, and expression of immune-related genes in the gut were determined. Our results showed that fish fed diet B exhibited an increase in the monocyte numbers, alternative complement activity, and bactericidal activity against Photobacterium damselae compared to the values found in fish fed other diets. Contrarily, peroxidase, antiproteases, and proteases activity and nitric oxide levels were not affected by the dietary treatments. Immune-related gene expression in the distal intestine did not show differences between dietary treatments. Overall, a diet with a balanced n-6 (ARA) and n-3 (EPA+DHA) LC-PUFA ratio seemed to better modulate the fish innate immune response, thus better preparing the fish innate immune system against potential immunological insults.

Oxidative status and intestinal health of gilthead sea bream (Sparus aurata) juveniles fed diets with different ARA/EPA/DHA ratios.

The present work assessed the effects of dietary ratios of essential fatty acids, arachidonic (ARA), eicosapentaenoic (EPA) and docosahexaenoic acid (DHA), on liver and intestine oxidative status, intestinal histomorphology and gut microbiota of gilthead sea bream. Four isoproteic and isolipidic plant-based diets were formulated containing a vegetable oil blend as the main lipid source. Diets were supplemented with ARA/EPA/DHA levels (%DM) equivalent to: 2%:0.2%:0.1% (Diet A); 1.0%:0.4%:0.4% (Diet B); 0%:0.6%:0.6% (Diet C); 0%:0.3%:1.5% (Diet D) and tested in triplicate groups for 56 days. Lipid peroxidation was higher in fish fed diets C and D while no differences were reported between diets regarding total, oxidized, and reduced glutathione, and oxidative stress index. Glutathione reductase was higher in fish fed diet A than diets C and D. No histological alterations were observed in the distal intestine. Lower microbiota diversity was observed in intestinal mucosa of fish fed diet C than A, while diets C and D enabled the proliferation of health-promoting bacteria from Bacteroidetes phylum (Asinibacterium sp.) and the absence of pathogenic species like Edwardsiella tarda. Overall, results suggest that a balance between dietary ARA/EPA + DHA promotes gilthead sea bream juveniles' health however higher dietary content of n-3 LC-PUFA might limited the presence of microbial pathogens in intestinal mucosa.

Local immune response of two mucosal surfaces of the European seabass, Dicentrarchus labrax, fed tryptophan- or methionine-supplemented diets.

Immune responses relies on an adequate provision of multiple nutrients that sustain the synthesis of key effector molecules. These needs are depicted in the already reported increase of circulating free amino acids in fish under stressful conditions. Since aquaculture and the inherent fish welfare are an emergent call, the immunomodulatory effects of amino acids on gut- and skin-associated lymphoid tissues of the European seabass (Dicentrarchus labrax) were studied under unstressed conditions and after an inflammatory insult. To achieve this goal, fish were distributed in duplicate tanks (fifteen fish per tank) and were fed for 14 days with methionine or tryptophan-supplemented diets at 2× dietary requirement level (MET and TRP, respectively) or a control diet meeting the amino acids requirement levels (CTRL). Afterwards, samples of skin and posterior gut were collected from 6 fish per dietary treatment for the assessment of the immune status while the remaining animals were intraperitoneally-injected with inactivated Photobacterium damselae subsp. piscicida and subsequently sampled either 4 or 24 h post-injection. The immune status of both mucosal surfaces was poorly affected, although a tryptophan effect was denoted after bacterial inoculation, with several immune-related genes up-regulated in the gut at 4 h post-injection, which seems to suggest a neuroendocrine-immune systems interaction. In contrast, skin mucosal immunity was inhibited by tryptophan dietary supplementation. Regarding methionine, results were often statistically non-significant, though increasing trends were denoted in a few parameters. Overall, dietary methionine did not significantly affect neither gut nor skin immunity, whereas tryptophan supplementation seems to induce modulatory mechanisms that might be tissue-specific.

Dietary glutamine supplementation effects on amino acid metabolism, intestinal nutrient absorption capacity and antioxidant response of gilthead sea bream (Sparus aurata) juveniles.

A study was undertaken to evaluate dietary glutamine supplementation effects on gilthead sea bream performance, intestinal nutrient absorption capacity, hepatic and intestinal glutamine metabolism and oxidative status. For that purpose gilthead sea bream juveniles (mean weight 13.0g) were fed four isolipidic (18% lipid) and isonitrogenous (43% protein) diets supplemented with 0, 0.5, 1 and 2% glutamine for 6weeks. Fish performance, body composition and intestinal nutrient absorption capacity were not affected by dietary glutamine levels. Hepatic and intestinal glutaminase (GlNase), glutamine synthetase (GSase), alanine aminotransferase, aspartate aminotransferase and glutamate dehydrogenase activities were also unaffected by dietary glutamine supplementation. In the intestine GlNase activity was higher and GSase/GlNase ratio was two-fold lower than in the liver, suggesting a higher use of glutamine for energy production by the intestine than by the liver. The liver showed higher catalase and glucose-6-phosphate dehydrogenase activities, while the intestine presented higher glutathione peroxidase and glutathione reductase activities and oxidised glutathione content, which seems to reveal a higher glutathione dependency of the intestinal antioxidant response. Total and reduced glutathione contents in liver and intestine and superoxide dismutase activity in the intestine were enhanced by dietary glutamine, though lipid peroxidation values were not affected. Overall, differences between liver and intestine glutamine metabolism and antioxidant response were identified and the potential of dietary glutamine supplementation to gilthead sea bream's antioxidant response was elucidated.

Effects of temperature and dietary protein level on hepatic oxidative status of Senegalese sole juveniles (Solea senegalensis).

Effects of 55 and 45% dietary protein levels (55P and 45P diets, respectively) and temperature (12 and 18 °C) on hepatic activity of superoxide dismutase (SOD), catalase, glutathione peroxidase, glutathione reductase (GR), glucose-6-phosphate dehydrogenase and lipid peroxidation (LPO) levels of Solea senegalensis juveniles were studied. Further, effects of acute thermal shocks provoked by a drop (18 °C to 12 °C) or a rise (12 °C to 18 °C) of water temperature on sole oxidative state was also evaluated. Dietary protein reduction increased LPO levels though no major alterations were found on antioxidant enzyme activities between dietary treatments. At 12 °C GR activity was higher and SOD activity was lower than 18 °C but LPO levels were not affected. In both thermal shock cases, LPO levels increased in 55P group, probably due to insufficient antioxidant enzyme activation. In contrast, fish of 45P group under acute exposition to warmer and colder temperature exhibited no substantial changes and a significant decrease on LPO levels, respectively, along with no major changes in antioxidant enzymes. Overall, results suggest that independently of rearing temperatures 45P group was more susceptible to oxidative stress than 55P group. Thermal shock either due to rise or drop of temperature seemed to induce oxidative stress in 55P group.

Glycemic and insulin responses in white sea bream Diplodus sargus, after intraperitoneal administration of glucose.

A glucose tolerance test was performed in white sea bream Diplodus sargus, juveniles to evaluate the effect of a glucose load on plasma glucose, insulin, triacylglyceride levels, and on liver glycogen storage in order to study the capability of glucose utilization by this species. After being fasted for 48 h, fish were intraperitoneally injected with either 1 g of glucose per kg body weight or a saline solution. Plasma glucose rose from a basal level of 4 to a peak of 18-19 mmol l(-1), 2-4 h after glucose injection and fish exhibited hyperglycemia for 9 h. An insulin peak (from 0.5 to 0.8 ng ml(-1)) was observed 2-6 h after glucose injection, and basal value was attained within 9 h. Liver glycogen peaked 6-12 h after the glucose load and thereafter decreased to the basal value which was attained 24 h after injection. Plasma triacylglycerides in glucose-injected fish were only significantly higher than the basal value 12 h after injection. Glucose-injected fish generally showed lower plasma triacylglyceride levels than control fish. Our results indicate that under these experimental conditions, glucose acts as an insulin secretagogue in white sea bream juveniles. Moreover, insulin may have contributed to restoring basal plasma glucose levels by enhancing glucose uptake in the liver. Further studies are needed to corroborate the lipolytic action of glucose. Clearance of glucose from the blood stream was fast, comparatively to other species, indicating that white sea bream has a good capability of glucose utilization.

Temperature and dietary starch level affected protein but not starch digestibility in gilthead sea bream juveniles.

A study was carried out with gilthead sea bream juveniles to assess the effect of water temperature (18 and 25°C) and dietary pregelatinized starch level (10, 20 and 30%) on digestibility of protein and starch and on the activity of proteolytic and amylolytic enzymes. ADC of pregelatinized starch was very high (>99%) irrespectively of dietary inclusion level, and it was not affected by water temperature. ADC of protein was also high (>90%) but improved at the higher water temperature. Dietary starch interacted with protein digestibility, which decreased as dietary starch level increased. Temperature affected both acid and basic protease activities, with acid protease activity being higher at 25°C and basic protease activity being higher at 18°C. However, total proteolytic activity and amylase activities were not affected by water temperature. Dietary carbohydrate exerted no effect on proteolytic or amylolitic activities. It is concluded that gilthead sea bream juveniles digest pregelatinized starch very efficiently irrespective of water temperature, due to adjustments of amylase activity to cope with temperature differences. Pregelatinized starch interacts negatively with protein digestibility, with the ADC of protein decreasing as dietary starch levels increase.

Growth performance and metabolic utilization of diets including starch, dextrin, maltose or glucose as carbohydrate source by gilthead sea bream (Sparus aurata) juveniles.

The effect of dietary carbohydrate complexity on growth, feed utilization and activity of selected key liver enzymes of intermediary metabolism were studied in gilthead sea bream juveniles. Four isonitrogenous (50% crude protein) and isolipidic (16% crude lipids) diets were formulated to contain 20% of pregelatinized maize starch, dextrin, maltose or glucose. Triplicate groups of fish (117 g initial weight) were fed each diet to near satiation during 6 weeks. No effect of dietary carbohydrate on growth was noticed. Feed efficiency was lower in fish fed the glucose diet than the maltose and dextrin diets. The lowest protein efficiency ratio was observed in fish fed the glucose diet. Six hours after feeding, glycemia was higher in fish fed the glucose diet than the maltose and starch diets. Liver glycogen content was unaffected by dietary carbohydrate complexity. Hepatic glucokinase (GK) activity was higher in fish fed the glucose and the maltose diets, while higher pyruvate kinase (PK) activity was recorded in fish fed the glucose diet than in fish fed the starch diet. Fructose-1,6-bisphosphatase (FBPase) and glucose-6-phosphate dehydrogenase (G6PD) activities were higher in fish fed the starch diet compared to dextrin and glucose diets. Data suggest that dietary glucose and maltose are more effective than complex carbohydrates in enhancing liver glycolytic activity. Dietary glucose also seems to be more effective than starch in depressing liver gluconeogenic and lipogenic activities. Overall, dietary maltose, dextrin or starch was better utilized than glucose as energy source by gilthead sea bream juveniles.

Effect of water temperature and dietary starch on growth and metabolic utilization of diets in gilthead sea bream (Sparus aurata) juveniles.

We evaluated the effect of dietary starch level on growth performance, feed utilization, whole-body composition and activity of selected key enzymes of intermediary metabolism in gilthead sea bream juveniles reared at 18 and 25 degrees C. A diet was formulated to contain 48% crude protein, 12% lipids and 30% gelatinized maize starch (diet 30GS). Two other diets were formulated to include the same level of ingredients as diet 30GS except for the gelatinized starch, which was included at 20% (diet 20GS) or 10% (diet 10GS). No adjustment to diet composition was otherwise made. Each diet was fed to triplicate groups of gilthead sea bream (30 g initial mass) for 8 weeks, on a pair-feeding scheme. The higher temperature improved growth performance but the opposite was true for feed efficiency and protein efficiency ratio. Independently of temperature, growth performance, feed efficiency and protein efficiency ratio were lower in fish fed diet 30GS. No effect of temperature or dietary starch level on whole-body composition was noticed. Hepatosomatic index and liver glycogen were higher at 18 degrees C and, within each temperature, in fish fed diet 30GS. Glycemia was not affected by temperature, but was lower in fish fed diet 10GS. Data on enzyme activities showed that increasing water temperature enhances liver glucokinase (GK) and pyruvate kinase (PK) activities, suggesting that gilthead sea bream is more apt to use dietary starch at higher temperatures. No effect of temperature was noticed on hexokinase (HK), fructose-1,6-bisphosphatase (FBPase), glucose-6-phosphate dehydrogenase (G6PD) and glutamate dehydrogenase (GDH) activities. Dietary starch enhanced PK and FBPase activities while depressed GDH activity, suggesting a lack of significant regulation of hepatic glucose utilization and production in this species. HK, GK and G6PD activities were unaffected by dietary composition. Irrespectively of water temperature, gelatinized starch may be included up to 20% in diets for gilthead sea bream juveniles; at higher dietary levels, growth and efficiency of feed utilization are depressed.

Drenaje percutáneo de quiste hidatídico renal: manejo anestésico / Percutaneous drainage of hydatid cyst: management of anesthesia

La hidatidosis es una infección causada por el echinococus granulosus, de carácter endémico, presente especialmente en la Mesopotamia y Patagonia argentina. Su tratamiento es el quirúrgico, en cualquier localización. Nosotros describimos un caso clínico de localización renal, tratado por drenaje percutáneo, bajo anestesia regional continua. Señalamos las potenciales complicaciones amenazantes de la vida, tales como el shock anafiláctico y el síndrome hiperosmolar por hipernatremia, que pueden presentarse y para las cuales el anestesiólogo debe estar advertido, para su detección y manejo perioperatorio.

Investigation and control of a large outbreak of multi-drug resistant tuberculosis at a central Lisbon hospital.

An increase in the number of new cases of tuberculosis (TB) combined with poor clinical outcome was identified among HIV-infected injecting drug users attending a large HIV unit in central Lisbon. A retrospective epidemiological and laboratory study was conducted to review all newly diagnosed cases of TB from 1995 to 1996 in the HIV unit. Results showed that from 1995 to 1996, 63% (109/173) of the Mycobacterium tuberculosis isolates from HIV-infected patients were resistant to one or more anti-tuberculosis drugs; 89% (95) of these were multidrug-resistant, i.e., resistant to at least isoniazid and rifampicin. Eighty percent of the multidrug-resistant strains (MDR) available for restriction fragment length polymorphism (RFLP) DNA fingerprinting clustered into one of two large clusters. Epidemiological data support the conclusion that the transmission of MDR-TB occurred among HIV-infected injecting drug users exposed to infectious TB cases on open wards in the HIV unit. Improved infection control measures on the HIV unit and the use of empirical therapy with six drugs once patients were suspected to have TB, reduced the incidence of MDR-TB from 42% of TB cases in 1996 to 11% in 1999.

[Perception of university teachers of their ability to teach nursing]. / A percepção dos docentes universitários à respeito de sua capacitação para o ensino em enfermagem.

Teaching Administration Nursing Service we've been worried about several variables of the instructive process that affect the teachers and the students, as advantage, attitudes, thinking and acting manner, values, expectations, previous experiences, among some. These uneasiness take us to check the educational practice experience, considering the teaching's ability. In this study, we intend to reveal the teacher's understanding about the ability to teach nursing throw the education's reality recognition. So, we adopted a quality methodology that allow us a comprehensive analysis of the teaching's speech at a Public University in São Paulo city. According to the methodology it was possible to get back four meaning unities that allowed us to prescribe the emerging subjects; teaching's understanding about technical ability, teaching's understanding about scientific-theretical ability, teaching's understanding about pedagogical ability and the teaching identity. This study permitted us to reveal some points considered outstanding about the teacher's ability, getting it back as the result in a complex and continuous process of technical, theoretical and pedagogical training, contained in a several factors, psychological, social, ethical, economical, political and historical. We still understanding that the teacher's reflections about the teaching reality, in its totality, favouring the awareness and interfering positivly in their criticism formation. Finally there is a necessity to set up schools formation and up-dating centers and establish human political resources compatible with a renewed political of na educational action.

[The phenomenon of recruiting and selecting nurses in a hospital: a phenomenological focus]. / O fenômeno recrutamento e seleção de enfermeiros em hospitais: um enfoque fenomenológico.

This study had the purpose of showing the recruitment and selective process of nurses from their own experiences going through this process. The phenomenology was used as the methodological course, the phenomenon was based on the references by Joel Martins. The study was done from the speeches of eight nurses who went through the recruitment and selective process. The analysis of the speeches followed the moments of the phenomenological description, reduction and understanding until revealing the essence of the recruitment and selective process of nurses. From the phenomenological analysis of the speeches it was possible to get the aspects that represent the general understanding of the recruitment and selective process of nurses. In this way, the essence of the phenomenon was characterized by the relation among the man, the Company and the society, these relations were influenced by several determinants beyond the situation. Through this perspective, new horizons were opened concerning the thoughts about the recruitment and selective process of the nursing staff.

[The significance of nursing administration as seen by graduates. II]. / O significado da administração aplicada à enfermagem segundo a opinião de graduandas: parte II.

The objective of this study was to know the opinions about the significance, felt by the students of the Nursing School of the University of São Paulo, at the end of the theoretical part of the course of administration applied to nursing practice. Therefore the opinion of 30 students at 8th semester of the Nursing School has been collected. The results demonstrated that the students understood, the administration applied to nursing practice, as an instrument for the nurses work and to increase the quality of assistance, as well as for the development of the nursing staff and, the administrative functions as a role which has to be developed in the nursing professional practice.

[The importance of administration applied to nursing practice according to the opinions of nursing graduates]. / O significado da administração aplicada à enfermagem segundo a opinião de graduandas.

The objective of this study was to know the opinions that the students have, when they begin the course of Administration applied of Nursing. The results indicated that the students considered administration a manner how the nurses are organizing their works and that nursing activity administration is to conciliate the assistance with the bureaucratic service.