Oil from transgenic Camelina sativa as a source of EPA and DHA in feed for European sea bass (Dicentrarchus labrax L.).

Aquaculture, the fastest growing food production sector cannot continue to rely on finite stocks of marine fish as the primary source of the omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFA), eicosapentaenoic acid (EPA; 20:5n3) and docosahexaenoic acid (DHA; 22:6n-3), for feeds. A four-month feeding trial was conducted to investigate the impact of a de novo oil, with high levels of EPA and DHA, obtained from transgenic Camelina sativa on growth performance, tissue fatty acid profiles, and expression of lipid metabolism genes when used as a replacement for fish oil in feed for European seabass (Dicentrachus labrax). Triplicate groups of 50 juvenile fish (initial weight 16.7 ± 0.92 g) per tank were fed for 4 months with one of three isolipidic and isoproteic experimental diets consisting of a standard diet containing a commercial blend of fish oil and rapeseed oil (CFO), a diet containing transgenic Camelina oil (TCO), or a blend of fish oil and rapeseed oil with enhanced levels of EPA and DHA (EFO) formulated to match the n-3 LC-PUFA profile of the TCO feed. Final weight of fish fed the GM-derived oil was not different to fish fed either CFO or EFO. Slight lower growth performance of fish fed TCO at the beginning of the trial was related to transient reduced feed intake, possibly caused by glucosinolates in the raw Camelina sativa oil. The GM-derived oil improved the nutritional quality of the fish fillet by enhancing total n-3 PUFA levels compared to the fish fed the other two feeds, and maintained flesh EPA and DHA at the same levels as in fish fed the diets containing fish oil. The metabolic response in liver and intestine was generally relatively mild although diets TCO and EFO seemed to trigger a metabolic response consisting of an up-regulation of both ß-oxidation (cpt1a) and fatty acid transport (fabp1), possibly reflecting higher levels of LC-PUFA. Overall, the present study indicated that an oil of terrestrial origin, Camelina sativa, when engineered to contain high levels of EPA and DHA can replace fish oil in feeds for European seabass with no detrimental impact on growth or feed efficiency, while also maintaining or increasing tissue n-3 LC-PUFA contents.

Prebiotics and phytogenics functional additives in low fish meal and fish oil based diets for European sea bass (Dicentrarchus labrax): Effects on stress and immune responses.

The use of terrestrial raw materials to replace fish meal (FM) and fish oil (FO) in marine fish diets may affect fish growth performance and health. In the last years functional additives have been profiled as good candidates to reduce the effects on health and disease resistance derived from this replacement, via reinforcement of the fish immune system. In the present study, three isoenergetic and isonitrogenous diets with low FM and FO (10% and 6% respectively) were tested based on supplementation either with 0.5% galactomannanoligosaccharides (GMOS diet) or 0.02% of a mixture of essential oils (PHYTO diet), a non-supplemented diet was defined as a control diet. Fish were fed the experimental diets in triplicate for 9 weeks and then they were subjected to a stress by confinement as a single challenge (C treatment) or combined with an experimental intestinal infection with Vibrio anguillarum (CI treatment). Along the challenge test, selected stress and immunological parameters were evaluated at 2, 24 and 168h after C or CI challenges. As stress indicators, circulating plasma cortisol and glucose concentrations were analyzed as well as the relative gene expression of cyp11b hydroxylase, hypoxia inducible factor, steroidogenic acute regulatory protein, heat shock protein 70 and heat shock protein 90 (cyp11b, hif-1α, StAR, hsp70 and hsp90). As immune markers, serum and skin mucus lysozyme, bactericidal and peroxidase activities were measured, as well as gene expression of Caspase-3 (casp-3) and interleukin 1ß (il-1ß). The use of functional additives induced a significant (p < 0.05) reduction of circulating plasma cortisol concentration when confinement was the unique challenge test applied. Supplementation of PHYTO induced a down-regulation of cyp11b, hif-1α, casp-3 and il-1ß gene expression 2h after stress test, whereas StAR expression was significantly (p < 0.05) up-regulated. However, when combination of confinement stress and infection was applied (CI treatment), the use of PHYTO significantly (p < 0.05) down-regulated StAR and casp-3 gene expression 2h after challenge test, denoting that PHYTO diet reinforced fish capacity of stress response via protection of head kidney leucocytes from stress-related apoptotic processes, with lower caspase-3 gene expression and a higher il-1ß gene expression when an infection occurs. Additionally, dietary supplementation with GMOS and PHYTO compounds increased fish serum lysozyme after infection. Both functional additives entailed a better capability of the animals to cope with infection in European sea bass when fed low FM and FO diets.

Feeding European sea bass (Dicentrarchus labrax) juveniles with a functional synbiotic additive (mannan oligosaccharides and Pediococcus acidilactici): An effective tool to reduce low fishmeal and fish oil gut health effects?

The aim of this study was to assess the effects of dietary mannan oligosaccharides (MOS), Pediococcus acidilactici or their conjunction as a synbiotic in low fish meal (FM) and fish oil (FO) based diets on European sea bass (Dicentrarchus labrax) disease resistance and gut health. For that purpose, sea bass juveniles were fed one of 6 diets containing different combinations of MOS (Biomos® and Actigen©; Alltech, Inc., Kentucky, USA) and Pediococcus acidilactici (BAC, Bactocell®; Lallemand Inc., Cardiff, UK) replacing standard carbohydrates as follows (MOS (%)/BAC (commercial recommendation): high prebiotic level (HP) = 0.6/0, low prebiotic level (LP) = 0.3/0, only probiotic (B) = 0/+, high prebiotic level plus probiotic (HPB) = 0.6/+, low prebiotic level plus probiotic (LPB) = 0.3/+, control (C) = 0/0 for 90 days. After 60 and 90 days of feeding trial, fish were subjected to an experimental infection against Vibrio anguillarum. Additionally, inducible nitric oxide synthase (iNOS) and tumor necrosis factor α (TNFα) gut patterns of immunopositivity and major histocompatibility complex class II (MHCII), transforming growth factor ß (TGF-ß), regulatory T-cell subset (CD4+T lymphocytes) and effector T cell (CD8α+T lymphocytes) gene expression patterns in gut by in situ hybridization were evaluated after 90 days of feeding. The effects of both additives on posterior gut through Gut Associated Lymphoid Tissue (GALT) gene expression was also studied. Fish fed the prebiotic and its combination with P. acidilactici presented increased weight regardless of the dose supplemented after 90 days of feeding, however no effect was detected on somatic indexes. For posterior gut, morphometric patterns and goblet cells density was not affected by MOS, P. acidilactici or its combination. Anti-iNOS and anti-TNFα gut immunopositivity patterns were mainly influenced by MOS supplementation and not by its combination with P. acidilactici. MHCII-ß, TCR-ß, CD4 and CD8-α positive cells distribution and incidence was not affected by diet. Fish fed HP dose presented a clear up-regulation of TNF-α, cyclooxygenase-2 (COX-2), CD4 and IL10, whereas P. acidilactici dietary supplementation increased the number of interleukin-1ß (IL1ß) and COX-2 gene transcripts. Synbiotic supplementation resulted in a reduction of MOS-induced gut humoral proinflammatory response by increasing the expression of some cellular-immune system related genes. Fish mortality after V. anguillarum infection was reduced in fish fed LPB and LP diets compared to fish fed the non-suppelmented diet after 90 days of feeding. Thus, overall pointing to the combination of a low dose of MOS and P. acidilactici as synbiont (LPB) as a viable tool to potentiate European sea bass juvenile's growth and disease resistance when supplemented in low FM and FO diets.

Supplementation of arachidonic acid rich oil in European sea bass juveniles (Dicentrarchus labrax) diets: effects on growth performance, tissue fatty acid profile and lipid metabolism.

The aim of this study was to evaluate the effects of increasing dietary arachidonic acid (ARA) levels (from 1 to 6% of total fatty acids) on European sea bass (Dicentrarchus labrax) juveniles' growth performance, tissue fatty acid profile, liver morphology as well as long-chain polyunsaturated fatty acids (LC-PUFA) biosynthesis, triglyceride and cholesterol synthesis and lipid transport. A diet with total fish oil (FO) replacement and defatted fish meal (FM) containing a 0.1-g ARA g-1 diet was added to the experimental design as a negative control diet. Dietary ARA inclusion levels below 0.2 g ARA g-1 diet significantly worsened growth even only 30 days after the start of the feeding trial, whereas dietary ARA had no effect on fish survival. Liver, muscle and whole body fatty acid profile mainly reflected dietary contents and ARA content increased accordingly with ARA dietary levels. Tissue eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA) levels were positively correlated among them. Hepatic lipid vacuolization increased with reduced dietary ARA levels. Expressions of fatty acyl desaturase 2 and 3-hydroxy-3-methylglutaryl-coenzyme genes were upregulated in fish fed the negative control diet compared to the rest of the dietary treatments denoting the influence of ARA on lipid metabolism. Results obtained highlight the need to include adequate n-6 levels and not only n-3 LC-PUFA levels in European sea bass diets.

Disease resistance and response against Vibrio anguillarum intestinal infection in European seabass (Dicentrarchus labrax) fed low fish meal and fish oil diets.

The aim of this study was to assess the effects of low levels of dietary fish meal (FM) and fish oil (FO) on disease resistance and gut associated lymphoid tissue (GALT) response after an experimental intestinal infection with V. anguillarum in European sea bass (Dicentrarchus labrax) For that purpose, sea bass juveniles were fed one of four diets containing combined levels of FO and FM as follows: 20%FM/6%FO, 20%FM/3%FO, 5%FM/6%FO and 5%FM/3%FO during 153 days. At the end of the feeding trial, fish were subjected to either an in vivo exposure to a sub-lethal dose of V. anguillarum via anal inoculation or to an ex vivo exposure to V. anguillarum. Additionally, inducible nitric oxide synthase (iNOS) and tumor necrosis factor α (TNFα) gut patterns of immunopositivity were studied. Growth performance was affected by dietary FM level, however ex vivo gut bacterial translocation rates and survival after the in vivo challenge test were affected by dietary FO level. After 5 months of feeding, low dietary FM levels led to a posterior gut up-regulation of interleukin-1ß (IL-1ß) and TNFα, major histocompatibility complex-II (MHCII) and cyclooxygenase-2 (COX2), which in turn reduced the gut associated lymphoid tissue (GALT) capacity of response after 24 h post infection and conditioned European sea bass capacity to recover gut homeostasis 7 days post infection. Immunoreactivity to anti-iNOS and anti-TNFα presented a gradient of increased immunopositivity towards the anus, regardless of the dietary FM/FO fed. Strong positive anti-TNFα isolated enterocytes were observed in the anterior gut in relation to low levels of dietary FM/FO. Submucosa and lamina propria immunoreactivity grade was related to the amount of leucocyte populations infiltrated and goblet cells presented immunopositivity to anti-iNOS but not to anti-TNFα. Thus, reducing FO content from 6% to a 3% by VO in European sea bass diets increases ex vivo and in vivo gut bacterial translocation rates, whereas reducing FM content from 20% down to 5% up-regulates the expression of several posterior gut inflammation-related genes conditioning fish growth and GALT capacity of response after bacterial infection.

Supplementation of arachidonic acid rich oil in European sea bass juveniles (Dicentrarchus labrax) diets: Effects on leucocytes and plasma fatty acid profiles, selected immune parameters and circulating prostaglandins levels.

The main objective of this study was to assess the effects of graded levels of dietary arachidonic acid (ARA), supplemented from alternative sources, on fatty acid composition of plasma and head kidney leucocytes of European sea bass (Dicentrarchus labrax). For that purpose, sea bass juveniles were fed four diets containing graded levels of ARA as follows: 0.5% (ARA0.5), 1% (ARA1), 2% (ARA2) and 4% (ARA4) during 60 days. At the end of the feeding trial fatty acid profiles of plasma and head kidney leucocytes were analyzed. Besides, plasma prostaglandins levels, head kidney leucocytes respiratory burst activity; peroxidase activity and phagocytic index were assayed. Reducing dietary ARA levels below 1% markedly reduced European sea bass growth performance. However, fish fed diet ARA0.5 tried to compensate this dietary ARA deficiency by a selective deposition of ARA on plasma and head kidney leucocytes, reaching similar levels to those fish fed diet ARA1 after 60 days of feeding. Nevertheless, head kidney phagocytic capacity was reduced as dietary ARA content in relation not only to variations on membrane composition but also to changes on fish basal prostaglandins levels. Results obtained demonstrated the importance to supply the necessary quantity n-6 LC-PUFA, and not only n-3 LC-PUFA levels, in European sea bass diets, in relation to not only growth performance but also immune system function.

Physiological, biochemical, anthropometric, and biomechanical influences on exercise economy in humans.

Interindividual variation in running and cycling exercise economy (EE) remains unexplained although studied for more than a century. This study is the first to comprehensively evaluate the importance of biochemical, structural, physiological, anthropometric, and biomechanical influences on running and cycling EE within a single study. In 22 healthy males (VO2 max range 45.5-72.1 mL·min-1 ·kg-1 ), no factor related to skeletal muscle structure (% slow-twitch fiber content, number of capillaries per fiber), mitochondrial properties (volume density, oxidative capacity, or mitochondrial efficiency), or protein content (UCP3 and MFN2 expression) explained variation in cycling and running EE among subjects. In contrast, biomechanical variables related to vertical displacement correlated well with running EE, but were not significant when taking body weight into account. Thus, running EE and body weight were correlated (R2 =.94; P<.001), but was lower for cycling EE (R2 =.23; P<.023). To separate biomechanical determinants of running EE, we contrasted individual running and cycling EE considering that during cycle ergometer exercise, the biomechanical influence on EE would be small because of the fixed movement pattern. Differences in cycling and running exercise protocols, for example, related to biomechanics, play however only a secondary role in determining EE. There was no evidence for an impact of structural or functional skeletal muscle variables on EE. Body weight was the main determinant of EE explaining 94% of variance in running EE, although more than 50% of the variability of cycling EE remains unexplained.

Should tumour necrosis factor antagonist safety information be applied from patients with rheumatoid arthritis to psoriasis? Rates of serious adverse events in the prospective rheumatoid arthritis BIOBADASER and psoriasis BIOBADADERM cohorts.

BACKGROUND: Information on the safety of tumour necrosis factor (TNF) antagonists frequently arises from their use in rheumatic diseases, their first approved indications, and is later applied to psoriasis. Whether the risk of biological therapy is similar in psoriasis and rheumatoid arthritis has been considered a priority research question. OBJECTIVES: To compare the safety profile of anti-TNF drugs in patients with rheumatoid arthritis and psoriasis. METHODS: We compared two prospective safety cohorts of patients with rheumatoid arthritis and psoriasis that share methods (BIOBADASER and BIOBADADERM). RESULTS: There were 1248 serious or mortal adverse events in 16 230 person-years of follow-up in the rheumatoid arthritis cohort (3171 patients), and 124 in the 2760 person-years of follow-up of the psoriasis cohort (946 patients). Serious and mortal adverse events were less common in patients with psoriasis than in rheumatoid arthritis (incidence rate ratio of serious adverse events in psoriasis/rheumatoid arthritis: 0·6, 95% confidence interval 0·5-0·7). This risk remained after adjustment for sex, age, treatment, disease, hypertension, diabetes, hypercholesterolaemia and simultaneous therapy with methotrexate (hazard ratio 0·54, 95% confidence interval 0·47-0·61), and after excluding patients receiving corticosteroids. Patients with rheumatoid arthritis showed a higher rate of infections, cardiac disorders, respiratory disorders and infusion-related reactions, whereas patients with psoriasis had more skin and subcutaneous tissue disorders and hepatobiliary disorders. CONCLUSIONS: Patients with rheumatoid arthritis clinical practice have almost double the risk of serious adverse events compared with patients with psoriasis, with a different pattern of adverse events. Safety data from rheumatoid arthritis should not be fully extrapolated to psoriasis. These differences are likely to apply to other immune-mediated inflammatory diseases.

Red cell volume response to exercise training: Association with aging.

Red blood cell volume (RBCV) is a main determinant of cardiorespiratory fitness in healthy individuals. However, it remains controversial to what extent exercise training (ExT) enhances RBCV. Therefore, we sought to systematically review and determine the effect of ExT on RBCV in healthy individuals across all ages. We conducted a systematic search of MEDLINE, Scopus, and Web of Science, since their inceptions until February 2016 for articles assessing the effect of ExT interventions (not including hypoxic training) on blood volumes in healthy individuals. A meta-analysis was performed to determine the mean difference (MD) in RBCV between post- and pre-ExT measurements. Thirty studies were included after systematic review, comprising a total of 299 healthy individuals (mean age = 19-71 years, 271 males). Exercise training programs primarily consisted in lower limb endurance training interventions (mean duration = 15.2 weeks). After data pooling, RBCV was not increased following ExT (MD = 49 mL, 95% CI = -11, 108; P = 0.11). In subgroup analyses, RBCV was increased after ExT in young and middle-aged individuals (mean age <60 year) (n = 106, MD = 81 mL, 95% CI = 0, 162; P < 0.05) but not in older study participants (mean age ≥60 year) (n = 110, MD = 13 mL, 95% CI = -76, 102; P = 0.77). Heterogeneity was not detected among studies in young and middle-aged (I2  = 0%) and older individuals (I2  = 0%). In conclusion, RBCV is moderately, yet consistently, enhanced by ExT in young and middle-aged but not in older healthy individuals. Therefore, RBCV adaptations to ExT appear to be age dependent.

Replacement of Marine Fish Oil with de novo Omega-3 Oils from Transgenic Camelina sativa in Feeds for Gilthead Sea Bream (Sparus aurata L.).

Omega-3 (n-3) long-chain polyunsaturated fatty acids (LC-PUFA) are essential components of the diet of all vertebrates. The major dietary source of n-3 LC-PUFA for humans has been fish and seafood but, paradoxically, farmed fish are also reliant on marine fisheries for fish meal and fish oil (FO), traditionally major ingredients of aquafeeds. Currently, the only sustainable alternatives to FO are vegetable oils, which are rich in C18 PUFA, but devoid of the eicosapentaenoic (EPA) and docosahexaenoic acids (DHA) abundant in FO. Two new n-3 LC-PUFA sources obtained from genetically modified (GM) Camelina sativa containing either EPA alone (ECO) or EPA and DHA (DCO) were compared to FO and wild-type camelina oil (WCO) in juvenile sea bream. Neither ECO nor DCO had any detrimental effects on fish performance, although final weight of ECO-fed fish (117 g) was slightly lower than that of FO- and DCO-fed fish (130 and 127 g, respectively). Inclusion of the GM-derived oils enhanced the n-3 LC-PUFA content in fish tissues compared to WCO, although limited biosynthesis was observed indicating accumulation of dietary fatty acids. The expression of genes involved in several lipid metabolic processes, as well as fish health and immune response, in both liver and anterior intestine were altered in fish fed the GM-derived oils. This showed a similar pattern to that observed in WCO-fed fish reflecting the hybrid fatty acid profile of the new oils. Overall the data indicated that the GM-derived oils could be suitable alternatives to dietary FO in sea bream.

Effect of antioxidant vitamin supplementation on endothelial function in type 2 diabetes mellitus: a systematic review and meta-analysis of randomized controlled trials.

Controversy exists among trials assessing whether prolonged antioxidant vitamin supplementation improves endothelial function in type 2 diabetes mellitus (T2DM) subjects. The aim of this study was to systematically review and quantify the effect of antioxidant vitamin supplementation on endothelial function in T2DM subjects. MEDLINE, Cochrane, Scopus and Web of Science were searched up to February 2013 for randomized controlled trials assessing the effect of antioxidant vitamin E and/or C supplementation on endothelial function in T2DM subjects. Ten randomized controlled trials comparing antioxidant vitamin-supplemented and control groups (overall n = 296) met the inclusion criteria. Post-intervention standardized mean difference (SMD) in endothelial function did not reach statistical significance between groups (0.35; 95% confidence interval = -0.17, 0.88; P = 0.18). In subgroup analysis, post-intervention endothelial function was significantly improved by antioxidant vitamin supplementation in T2DM subgroups with body mass index (BMI) ≤ 29.45 kg m(-2) (SMD = 1.02; P < 0.05), but not in T2DM subgroups with BMI > 29.45 kg m(-2) (SMD = -0.07; P = 0.70). In meta-regression, an inverse association was found between BMI and post-intervention SMD in endothelial function (B = -0.024, P = 0.02). Prolonged antioxidant vitamin E and/or C supplementation could be effective to improve endothelial function in non-obese T2DM subjects.

Cáncer de endometrio: experiencia de 10 años en el hospital San Juan de Dios / Endometrial cancer: 10 years experience in the San Juan de Dios hospital

Antecedentes: El cáncer de endometrio es uno de los cánceres ginecológicos más frecuentes. La incidencia de esta enfermedad pudiera ir en aumento dado los cambios epidemiológicos de la población femenina. Objetivo: Evaluar resultados clínicos y características de la población atendida por cáncer de endometrio. Método: Se analizaron las historia clínicas de 100 pacientes tratadas por cáncer de endometrio entre enero de 2000 y diciembre de 2009. En el análisis de los datos se consideró como base la etapificación FIGO 1988. Resultados: La edad promedio fue de 62 años, el 75 por ciento de las pacientes consultaron por hemorragia post menopáusica y en el 64 por ciento de las pacientes el diagnóstico se realizó por dilatación y curetaje. En el 60 por ciento se realizó etapificación completa. El 60 por ciento correspondió a etapa I y el 15 por ciento a etapa II. La sobrevida global en etapa I y II fue del 83 por ciento y 66 por ciento, respectivamente. Conclusión: El cáncer de endometrio se presenta preferentemente en pacientes post menopáusicas en etapas precoces. La mayoría accede a tratamiento quirúrgico con escasas complicaciones y alta sobrevida global.

Background: Endometrial cancer is one of the most frecuent gynecological cancer. The incidence of this disease could arise because of epidemiologycal changes in female population. Aims: To evaluate characteristics and clinical results of atended population with endometrial cancer. Method: Clinical histories of 100 patients treated for endometrial cancer between January 2000 to December 2009 were analized. In the data analysis, the FIGO 1988 staging was considered as base. Results: The age average was 62 years. The 75 percent of patients consulted for postmenopausal hemorrhage in the 64 percent of the patients the diagnosis was made by dilation and curettage. Full staging was made in the 60 percent. Stage I was 60 percent and 15 percent for stage II. Overall survival in stage I and II was 83 percent and 66 percent, respectively. Conclusion: Endometrial cancer presents preferably in early stages in postmenopausal patients. The mayority access to surgical treatment with few complications and a high survival rate.

Adrenocorticotrophic hormone-stimulated cortisol release by the head kidney inter-renal tissue from sea bream (Sparus aurata) fed with linseed oil and soyabean oil.

The mode of action of highly unsaturated fatty acids (HUFA) in regulating gilthead sea bream (Sparus aurata) head kidney (HK) cortisol production was studied through in vitro trials using a dynamic superfusion system. Fish were previously fed with different diets containing several inclusion levels of linseed oil (LO) or soyabean oil (SO) for 26 weeks. Five diets were tested; anchovy oil was the only lipid source for the control diet (fish oil, FO) and two different substitution levels (70 and 100 %) were tested using either LO or SO (70LO, 70SO, 100LO and 100SO). Fatty acid compositions of the HK reflected the dietary input, thus EPA, DHA, arachidonic acid and n-3 HUFA were significantly (P < 0·05) reduced in fish fed vegetable oils compared with fish fed the FO diet. Feeding 70 or 100 % LO increased significantly (P < 0·05) cortisol release in HK after stimulation with adrenocorticotrophic hormone (ACTH), while feeding SO had no effect on this response. Cortisol stimulation factor (SF) was increased in fish fed the 70LO and 100LO diets compared with fish fed the control diet. Moreover, eicosanoid inhibition by incubating the HK tissue with indomethacin (INDO) as a cyclo-oxygenase (COX) inhibitor, or nordihydroguaiaretic acid (NDGA) as a lipoxygenase (LOX) inhibitor, significantly reduced (P < 0·05) the cortisol release after ACTH stimulation in the 70LO and 100LO diets. Cortisol SF was reduced in the FO, 70LO and 100LO diets when incubating the HK with INDO or NDGA, while it was increased in the 70SO diet. The present results indicate that changing the fatty acid profile of gilthead sea bream HK by including LO and/or SO in the fish diet affected the in vitro cortisol release, and this effect is partly mediated by COX and/or LOX metabolites.

Replacement of dietary fish oil by vegetable oils affects humoral immunity and expression of pro-inflammatory cytokines genes in gilthead sea bream Sparus aurata.

Commercial gilthead sea bream feeds are highly energetic, fish oil traditionally being the main lipid source. But the decreased fish oil production together with the increased prices of this oil encourages its substitution by vegetable oils, imposing new nutritional habits to aquaculture species. Partial replacement of fish oil by vegetable oils in diets for marine species allows good feed utilization and growth but may affect fish health, since imbalances in dietary fatty acids may alter fish immunological status. The effect of dietary oils on different aspects of fish immune system has been reported for some species, but very little is known about the effect of dietary oils on immune-related genes expression in fish. Thus, the objective of this study was to elucidate the role of dietary oils on the expression of two pro-inflammatory cytokines, Tumor Necrosis Factor-α (TNF-α) and Interleukine 1ß (IL-1ß) on intestine and head kidney after exposure to the bacterial pathogen Photobacterium damselae sp. piscicida. For that purpose, 5 iso-nitrogenous and iso-lipidic diets (45% crude protein, 22% crude lipid content) were formulated. Anchovy oil was the only lipid source used in the control diet (FO), but in the other diets, fish oil was totally (100%) or partially (70%) substituted by linseed (rich in n-3 fatty acids) or soybean (rich in n-6 fatty acids) (100L, 100S, 70L, 70S). Fish were fed experimental diets during 80 days and after this period were exposed to an experimental intestinal infection with the pathogen. Serum and tissue samples were obtained at pre-infection and after 1, 3 and 7 days of infection. RNA was extracted and cDNA was synthesized by reverse transcription from intestine and head kidney and the level expression of TNF-α and IL-1ß were assayed by using quantitative real time PCR. The expression level of genes analysed was represented as relative value, using the comparative Ct method (2(-ΔΔCt)). Serum anti-bacterial activity was measured as serum bactericidal capacity and lysozyme activity. Reduction of FO tends to reduce basal (pre-infection) genetic expression of both cytokines. However, complete FO replacement caused an over expression of both pro-inflammatory cytokines, particularly after 3 days of induced infection in fish fed soybean oil based diets. On the other hand, fish fed diets with low content of n-6 fatty acids showed better serum bactericidal capacity after infection, suggesting that the substitution of fish oil by vegetable oils containing high levels of n-6 fatty acids may induce imbalances on fish immune response, leading to a lower potential response against infections.

Colangiopancreatografía retrógrada endoscópica: prácticas en un centro hospitalario privado / Endoscopic retrograde cholangiopancreatography: practices in a private hospital

Colangiopancreatografía Retrógrada Endoscópica (CPRE), es un método endoscópico avanzado que posibilita el estudio y tratamiento de la vía biliar y pancreática. Este procedimiento requiere alto nivel de conocimientos y destrezas técnicas para garantizar mínimas complicaciones en el paciente. En nuestro país, existen pocos centros para la formación de gastroenterólogos para desarrollar habilidad en la realización de CPRE. Determinar la casuística en procedimientos de CPRE en un centro privado para proveer los estándares más altos en la capacitación teórica y práctica en las técnicas avanzadas de este procedimiento. Estudio retrospectivo, descriptivo, que incluyó pacientes con patologías bilio-pancreáticas que acudieron a la Policlínica Metropolitana y se les realizó CPRE. Durante el período de estudio se realizaron 815 procedimientos, 486 (59,6%) y 329 (40,36%) eran del sexo femenino y masculino respectivamente. La edad promedio de los pacientes fue 53,34 años, con edades comprendidas entre 2 y 98 años, con 18 menores de 12 años. Las indicaciones más frecuentes: colestasis, litiasis biliar, pancreatitis aguda y crónica. Otras indicaciones: fístula biliar, recambio de prótesis, colangitis y pacientes con tumor bilio-pancreático. Los procedimientos terapéuticos abarcaron desde esfinterotomía hasta ampulectomía, toma de biopsia, colocación de prótesis tanto en vía biliar como pancreática, con resolución del problema en la mayoría de los pacientes. Hubo complicaciones en 36 pacientes (4,17%), las más frecuentes fueron hemorragia (16) y pancreatitis post-CPRE (7), de los cuales 3 fueron severas. No se reportaron muertes debido al procedimiento. En nuestro estudio demostramos que estamos dentro de lo que realiza cualquier centro de entrenamiento reportado en la literatura mundial (número de procedimientos, indicaciones, hallazgos, procedimientos terapéuticos y tasa de éxito...

Endoscopic Retrograde Cholangiopancreatography (ERCP) is an advanced endoscopic procedure that allows the study and treatment of biliary and pancreatic ducts. This procedure requires a higher level of knowledge and technical skills, to ensure a minimal complications outcome of the patient. In our country there are few training centers for gastrointestinal specialists for developing the necessary skills for performing ERCP. To asses the statistics of ERCP procedures that were performed in our private hospital between January 2005 until January 2009, to demonstrate that we possessed the high standars on capacitation, both theorical and practical on performing ERCP. ItÊs a descriptive and retrospective study, including all patients that came to our center with pancreatic or billiary pathology and underwent the procedure. 815 ERCP were performed during the time of the study, 486 (59.6%) were female and 329 (40, 36%) were male. The mean age was 53, 34 years, with range between 2 and 98 years, and 18 patients were younger than 12 years. The main indications for the procedure were cholestasis, billiary litiasis, acute and chronic pancreatitis. Also other indications were billiary fistulae, billiary prothesis placement and replacement, cholangitis and tumors of the pancreas and billiary ducts. The therapeutics procedures performed were sphinctectomy, ampullectomy, biopsy, billiary and pancreatic prothesis placement. In most of the cases the problem was solved. There were complications in 36 patients (4, 17%), the most common being bleeding 16 and post ERCP acute pancreatitis 7 there were no deaths attributed to the procedure. In our study we show that our statistics are well placed among the standards of any reported trainning center in the world, regarding number of procedures, indications for the procedure, findings, therapeutic procedures and a very low morbility/mortality rate...

Total substitution of fish oil by vegetable oils in gilthead sea bream (Sparus aurata) diets: effects on hepatic Mx expression and some immune parameters.

The use of vegetable oils in fish nutrition has been extensively studied; and recent work has focused attention on replacing fish oil with alternative fatty acid sources and their effect on the immune system. However, little is known about the effect of these oils on immune parameters such as the fish interferon system. In this study we evaluate the effect of two vegetable oils (linseed and soybean) on gilthead sea bream Mx expression and other innate immune parameters. Experimental diets were formulated where fish oil was totally replaced by vegetable oils or for a mixture of them (50% linseed and 50% soybean). Another diet prepared with pure fish oil was used as a control. Two experiments were carried out in order to evaluate growth, feed utilization, serum alternative complement pathway activity, serum lysozyme and phagocytic activity of head kidney leucocytes as well as Mx expression in the liver. In the first experiment fish were fed with experimental diets for 6 months and then, growth and feed utilization as well as immune parameters were analyzed. In the second experiment, fish from the previous feeding trial were injected with either a sub-lethal dose of Photobacterium damselae subsp. piscicida (94/99) or a synthetic dsRNA (Poly I:C) in order to stimulate an Mx response. The results show that total substitution of fish oil by vegetable oils decreased the growth of gilthead sea bream juveniles. Furthermore, both phagocytic activity and serum alternative complement pathway activity were significantly reduced by the inclusion of either vegetable oil individually in the sea bream diets, but the diet with mixed vegetable oils had no significant effect. There was no effect on serum lysozyme levels but the basal constitutive levels of Mx transcript expression in the liver were elevated in the fish fed the vegetable oil diets. The time-course of the Mx response to injection of Poly I:C was shorter in the fish fed the fish oil diet and the fish fed the diet based on a mixture of both vegetable oils showed a faster Mx response to bacterial injection. Following stimulation with Poly I:C or PDP the fish fed the vegetable oil based diets still maintained higher basal levels of hepatic Mx expression than the fish fed the fish oil diet which returned to undetectable levels.

Leiomiomatosis peritoneal diseminada y embarazo / Leiomyomatosis peritonealis disseminata and pregnancy

Se presenta el caso clínico de una mujer de 33 años con una leiomiomatosis peritoneal diseminada (LPD) diagnosticada durante cirugía por tumor anexial. Al siguiente año se embaraza. Durante la cesárea efectuada a las 38 semanas, se observa una exacerbación de la enfermedad con sospecha de malignización por lo que se efectúa una histerectomía total más salpingooforectomía bilateral y resección de sólo algunos nodulos de la cavidad abdominal. La biopsia diferida confirma el diagnóstico de LPD. A la fecha completó 8 años de seguimiento sin evidencias clínicas ni imágenes de persistencia.

We report the clinical case of 33 years-old woman with leiomyomatosis peritonealis disseminata (LPD) whose diagnosis becomes evident during a surgery for adnexal tumor. The next year she gets pregnant. During the cesarean section performed at 38 weeks' gestation, it is observed a disease exacerbation with malignant characteristics. Because of that, a total hysterectomy takes place. It is performed a bilateral salpingo-oophorectomy and resection of only some nodules of the abdominal cavity. The deferred biopsy confirms the LPD diagnosis. By this time she has completed 8 years of clinical follow-up without clinical evidences or images of persistence.

Cardiopatía crónica endémica rural chagásica o crónica común en chagásicos y no chagásicos / Rural endemic chronic cardiopathy or common cardiopathy among chagasic and non chagasic people

Se presentan evidencias de que la cardiopatía crónica rural en adultos no es diferente entre los chagásicos crónicos que entre los no chagásicos. Se conjuntaron los resultados epidemiológicos de LabMICE (una encuesta de prevalencia (1978-1983); un estudio de caso-control (1986-1988); y un estudio clínico de cohorte y de sobrevivencia (1978-1989) con las investigaciones clínicas de Diego Dávila y colaboradores (1988-2002). Ambos grupos pertenecen a la Universidad de Los Andes. Las inferencias de ambos contestan interrogantes que plantearon anatomopatólogos venezolanos entre 1937 y 1985. También están de acuerdo con publicaciones internacionales de 1970 a 2000. Los trabajos sugieren que existe una cardiopatía crónica endémica rural que es común entre seropositivos y seronegativos a T. cruzi en el medio rural. Parece claro que el Chagas crónico no es problema de salud pública, pero sí es prevalente una cardiopatía crónica que amerita nuevas investigaciones. Se invita a grupos de investigación interesados a usar el blanco comunitario de datos para deslindar el mito y la realidad en la cardiopatía rural crónica venezolana.