Glucomannan or Glucomannan Plus Spirulina-Enriched Squid-Surimi Diets Reduce Histological Damage to Liver and Heart in Zucker fa/fa Rats Fed a Cholesterol-Enriched and Non-Cholesterol-Enriched Atherogenic Diet.

Glucomannan-enriched squid surimi improves cholesterolemia and liver antioxidant status. The effect of squid surimi enriched with glucomannan or glucomannan plus spirulina on liver and heart structures and cell damage markers was tested in fa/fa rats fed highly saturated-hyper-energetic diets. Animals were fed 70% AIN-93M rodent diet plus six versions of 30% squid surimi for 7 weeks: control (C), glucomannan (G), and glucomannan plus spirulina (GS). The cholesterol-control (HC), cholesterol-glucomannan (HG), and cholesterol-glucomannan plus spirulina (HGS) groups were given similar diets that were enriched with 2% cholesterol and 0.4% cholic acid. G and GS diets versus C diet significantly inhibited weight gain and lowered plasma alanine aminotransferase and aspartate aminotransferase, liver steatosis, lipogranulomas, and total inflammation and alteration scores. The hypercholesterolemic agent significantly increased the harmful effects of the C diet. Liver weight, the hepatosomatic index, all damage markers, and total histological scoring rose for HC versus C (at least P < .05). The addition of glucomannan (HG vs. HC) improved these biomarkers, and non-additional effects from spirulina were observed except for the total liver alteration score. In conclusion, glucomannan and glucomannan plus spirulina blocked the highly saturated-hyper-energetic diet negative effects both with and without added cholesterol. Results suggest the usefulness of including these functional ingredients in fish products.

Dietary fish protein hydrolysates containing bioactive motifs affect serum and adipose tissue fatty acid compositions, serum lipids, postprandial glucose regulation and growth in obese Zucker fa/fa rats.

The world's fisheries and aquaculture industries produce vast amounts of protein-containing by-products that can be enzymatically hydrolysed to smaller peptides and possibly be used as additives to functional foods and nutraceuticals targeted for patients with obesity-related metabolic disorders. To investigate the effects of fish protein hydrolysates on markers of metabolic disorders, obese Zucker fa/fa rats consumed diets with 75 % of protein from casein/whey (CAS) and 25 % from herring (HER) or salmon (SAL) protein hydrolysate from rest raw material, or 100 % protein from CAS for 4 weeks. The fatty acid compositions were similar in the experimental diets, and none of them contained any long-chain n-3 PUFA. Ratios of lysine:arginine and methionine:glycine were lower in HER and SAL diets when compared with CAS, and taurine was detected only in fish protein hydrolysate diets. Motifs with reported hypocholesterolemic or antidiabetic activities were identified in both fish protein hydrolysates. Rats fed HER diet had lower serum HDL-cholesterol and LDL-cholesterol, and higher serum TAG, MUFA and n-3:n-6 PUFA ratio compared with CAS-fed rats. SAL rats gained more weight and had better postprandial glucose regulation compared with CAS rats. Serum lipids and fatty acids were only marginally affected by SAL, but adipose tissue contained less total SFA and more total n-3 PUFA when compared with CAS. To conclude, diets containing hydrolysed rest raw material from herring or salmon proteins may affect growth, lipid metabolism, postprandial glucose regulation and fatty acid composition in serum and adipose tissue in obese Zucker rats.

Safety evaluation of fish protein hydrolysate supplementation in malnourished children.

Amizate® is a proprietary protein hydrolysate preparation derived from Atlantic salmon (Salmo salar) using endogenous hydrolytic enzymes; it contains mostly free amino acids and short peptides, as well as small amounts of micronutrients (i.e., vitamins and minerals). In this study, the safety of supplementation with fish protein hydrolysate (Amizate®) was examined in 438 malnourished children in a randomized, placebo-controlled, double-blind, and parallel study. The children were between the ages of six to eight and met the Gomez classification for mild or moderate malnutrition. They were randomized to receive one of three interventions for four months, including a chocolate drink (control), or Amizate® (3 or 6g/day) in a chocolate drink. Administration of Amizate® was well-tolerated, with no adverse events reported. Growth (i.e., body weight gain, changes in height, and body mass index) was not negatively impacted by administration of Amizate®, and routine biochemical analysis of blood and urine samples did not reveal any abnormalities that were attributable to the intervention. Findings from this study demonstrate that daily consumption of 3 or 6g of fish protein hydrolysate (Amizate®) was safe and suitable for supplementing the diets of malnourished children.

Intussusception secondary to anaphylactic reaction to salmon roe (ikura).

Anaphylactic food reaction often involves gastrointestinal symptoms, such as vomiting and abdominal pain, but to date, there have been no publications documenting the association between food hypersensitivity and intussusception. Herein is reported the case of a 2-year-old boy with intussusception accompanied by anaphylactic food reaction. The patient without known allergies complained of severe abdominal pain following ingestion of salmon roe for the first time. Dyspnea, wheezing and generalized urticaria also developed. Subsequently, he had stools containing jelly-like blood with mucus. At hospital arrival, physical examination identified an abdominal mass in the right lower quadrant; imaging confirmed the diagnosis of colo-colic intussusception. This patient was successfully treated with enema and no pathological findings were identified via radiology. Laboratory results supported the presence of IgE-mediated allergy to salmon roe in the present patient. To our knowledge, this is the first report to describe the possible association between intussusception and a hypersensitive food reaction.

La dieta del paciente renal. ¿Se puede incluir pescado? / Renal patient's diet. Can fish be included?

Introducción: El tratamiento de las enfermedades renales, que son un grave problema de salud pública, es muy complicado. La terapia nutrimental busca retardar la progresión de la enfermedad, mantener un buen estado nutricio y prevenir el desarrollo de comorbilidades. Objetivo: El objetivo del presente estudio fue analizar diez especies de pescado de consumo cotidiano para identificar aquellas que por su bajo aporte de fósforo, proteína de alto valor biológico y su aporte de ácidos grasos n-3 puedan incluirse en la dieta del paciente renal. Material y métodos: Se analizaron las siguientes especies: Bonito, Cabezona, Chucho, Escolar, Espada, Golondrina, Lenguado, Lobina, Mojarra rayada y Pámpano, siguiendo las técnicas de la AOAC y Keller, para determinar su contenido de proteína, fósforo, sodio, potasio, colesterol, vitaminas D3 y E y ácidos grasos n-3 EPA + DHA. Posteriormente se evaluaron las relaciones entre estos nutrimentos. Resultados: Las especies analizadas presentaron valores de proteína desde 16,5 g/100 g de filete (Lobina) hasta 27,2 g/100 g (Cabezona), el valor de fósforo más bajo fue de 28,6 mg/100 g (Mojarra rayada) y el más alto fue 216,3 mg/100 g (Chucho). 80% de las especies presentaron > 100 mg EPA + DHA en 100 g de filete. Por su relación Fósforo/g Proteína todos los pescados excepto Escolar y Espada, pueden incluirse; la relación más baja de fósforo/EPA + DHA se presentó en Bonito, Escolar, Golondrina, Lobina, Mojarra rayada. Conclusiones: El Pámpano es la especie más recomendada para los pacientes renales por las relaciones entre todos sus nutrimentos; aunque todas las especies, excepto Escolar y Espada, pueden formar parte de la alimentación renal (AU)

Introduction: Medical and nutritional treatment for renal disease, now a major public health issue, is highly complicated. Nutritional therapy must seek to retard renal dysfunction, maintain an optimal nutritional status and prevent the development of underlying pathologies. Objective: To analyze ten fish species to identify those that, because of their low phosphorus content, high biological value protein and elevated n-3 fatty acids EPA and DHA, could be included in renal patient's diet. Materials and methods: The following fish species (Litte tunny, Red drum, Spotted eagleray, Escolar, Swordfish, Big-scale pomfret, Cortez flounder, Largemouth blackbass, Periche mojarra, Florida Pompano) were analyzed according to the AOAC and Keller techniques to determine their protein, phosphorus, sodium, potassium, cholesterol, vitamins D3 and E, and n-3 EPA+DHA content. These results were used to calculate relations between nutrients. Results: The protein in the analyzed species ranged from 16.5 g/100 g of fillet (Largemouth black bass) to 27.2 g/100 g (Red drum); the lowest phosphorus value was 28.6 mg/100 g (Periche mojarra) and the highest 216.3 mg/100 g (Spotted eagle ray). 80% of the fish presented > 100 mg EPA + DHA in 100 g of fillet. By its Phosphorus/gProtein ratio, Escolar and Swordfish could not be included in the renal diet; Little tunny, Escolar, Big-scale pomfret, Largemouth black-bass, Periche mojarra and Florida Pompano presented a lower Phosphorus/EPA + DHA ratio. Conclusions: Florida pompano is the most recommended specie for renal patients, due to its optimal nutrient relations. However, all analyzed species, except Escolar and Swordfish, could be included in renal diets (AU)

Sweet potato-based complementary food for infants in low-income countries.

BACKGROUND: In low-income countries, most infants are given cereal-based complementary foods prepared at the household level. Such foods are high in phytate, which limits the bioavailability of nutrients, including iron, calcium, zinc, and in some cases proteins, which are crucial to the development of infants. OBJECTIVE: To compare the levels of macronutrients (protein, fat, and carbohydrate), gross energy, and fructose in sweet potato-based (denoted ComFa) formulations and enriched Weanimix (dehulled maize-dehulled soybean-groundnut blend with fish powder and sugar incorporated). The phytate level was also compared. METHODS: A composite flour of sweet potato and soybeans containing fish powder was processed by oven toasting as a home-based complementary food. Another blend containing skim milk powder was processed by extrusion cooking or roller drying as industrial-based prototypes. The macronutrient composition and the levels of fructose and phytate were determined in the ComFa formulations and enriched Weanimix. RESULTS: The ComFa formulations and the enriched Weanimix met the stipulated values in the Codex Alimentarius Commission standard for energy (400 kcal/100 g), protein (15 g/100 g), and fat (10 to 25 g/100 g) for complementary food, with the exception of the industrial-based ComFa formulations, which satisfied 83% of the protein requirement (15 g/100 g). The ComFa formulations had a quarter of the phytate level of enriched Weanimix. The fructose level in the sweet potato-based complementary foods was more than five times that in enriched Weanimix. CONCLUSIONS: The sweet potato-based formulations were superior to enriched Weanimix as complementary foods for infants in low-income countries, based on the fructose (which makes the porridge naturally sweet) and phytate levels.

From caffeine to fish waste: amine compounds present in food and drugs and their interactions with primary amine oxidase.

Tissue bound primary amine oxidase (PrAO) and its circulating plasma-soluble form are involved, through their catalytic activity, in important cellular roles, including the adhesion of lymphocytes to endothelial cells during various inflammatory conditions, the regulation of cell growth and maturation, extracellular matrix deposition and maturation and glucose transport. PrAO catalyses the oxidative deamination of several xenobiotics and has been linked to vascular toxicity, due to the generation of cytotoxic aldehydes. In this study, a series of amines and aldehydes contained in food and drugs were tested via a high-throughput assay as potential substrates or inhibitors of bovine plasma PrAO. Although none of the compounds analyzed were found to be substrates for the enzyme, a series of molecules, including caffeine, the antidiabetics phenformin and tolbutamide and the antimicrobial pentamidine, were identified as PrAO inhibitors. Although the inhibition observed was in the millimolar and micromolar range, these data show that further work will be necessary to elucidate whether the interaction of ingested biogenic or xenobiotic amines with PrAO might adversely affect its biological roles.

Atopy risk in infants and children in relation to early exposure to fish, oily fish, or long-chain omega-3 fatty acids: a systematic review.

There are two main families of polyunsaturated fatty acids (PUFAs), the n-6 and the n-3 families. It has been suggested that there is a causal relationship between n-6 PUFA intake and allergic disease, and there are biologically plausible mechanisms, involving eicosanoid mediators of the n-6 PUFA arachidonic acid, that could explain this. Fish and fish oils are sources of long-chain n-3 PUFAs and these fatty acids act to oppose the actions of n-6 PUFAs. Thus, it is considered that n-3 PUFAs will protect against atopic sensitization and against the clinical manifestations of atopy. Evidence to examine this has been acquired from epidemiologic studies investigating associations between fish intake in pregnancy, lactation, infancy, and childhood, and atopic outcomes in infants and children and from intervention studies with fish oil supplements in pregnancy, lactation, infancy, and childhood, and atopic outcomes in infants and children. All five epidemiological studies investigating the effect of maternal fish intake during pregnancy on atopic or allergic outcomes in infants/children of those pregnancies concluded protective associations. One study investigating the effects of maternal fish intake during lactation did not observe any significant associations. The evidence from epidemiological studies investigating the effects of fish intake during infancy and childhood on atopic outcomes in those infants or children is inconsistent, although the majority of the studies (nine of 14) showed a protective effect of fish intake during infancy or childhood on atopic outcomes in those infants/children. Fish oil supplementation during pregnancy and lactation or during infancy or childhood results in a higher n-3 PUFA status in the infants or children. Fish oil provision to pregnant women is associated with immunologic changes in cord blood and such changes may persist. Studies performed to date indicate that provision of fish oil during pregnancy may reduce sensitization to common food allergens and reduce prevalence and severity of atopic dermatitis in the first year of life, with a possible persistence until adolescence with a reduction in eczema, hay fever, and asthma. Fish oil provision to infants or children may be associated with immunologic changes in the blood but it is not clear if these are of clinical significance and whether they persist. Fish oil supplementation in infancy may decrease the risk of developing some manifestations of allergic disease, but this benefit may not persist as other factors come into play. It is not clear whether fish oil can be used to treat children with asthma as the two studies conducted to date give divergent results. Further studies of increased long-chain n-3 PUFA provision in during pregnancy, lactation, and infancy are needed to more clearly identify the immunologic and clinical effects in infants and children and to identify protective and therapeutic effects and their persistence.

Frecuencia de consumo de pescado de mar y síntomas de enfermedades alérgicas en adultos de Rosario / Frequency of sea fish consumption and symptoms of allergic diseases in adults from Rosario

Fundamento: El pescado de mar es fuente de AG omega-3 (AGO3). La ingesta de AGO3 ha mostrado disminuir la producción de derivados del ácido araquidónico con actividad inflamatoria, aumentar los valores de derivados del ácido eicosapentaenoico de menor actividad e inhibir linfocitos T helper-2 mediadores de reacciones inflamatorias alérgicas. Por otro lado, el pescado de mar es un importante alérgeno alimentario y también puede actuar como alimento liberador de histamina. El objetivo de este trabajo es evaluar la relación entre el consumo de pescado de mar y los síntomas de enfermedades alérgicas. Métodos: Este estudio transversal se realizó en 765 alumnos (el 83,4%, mujeres) elegidos al azar de la Universidad del Centro Educativo Latinoamericano, con edades entre 17 y 65 años, mediante cuestionarios validados para enfermedades alérgicas e ingesta de pescado de mar. Resultados: Quienes consumían pescado de mar una o más veces al mes, semanal o diario (46,7%), presentaron prevalencia de síntomas de asma del 8% en el último año, mientras que en los que nunca lo consumían o lo hacían menos frecuentemente fue del 12,9% (p < 0,05). Esto mismo ocurrió con síntomas de asma por ejercicio (el 7,9 frente al 12,2%; p < 0,05), tos seca nocturna no asociada a infecciones (el 13,3 frente al 19,6%; p < 0,05) y rinoconjuntivitis alérgica en el último año (el 20,8 frente al 27,5%; p < 0,05) y con síntomas de ambas enfermedades alérgicas respiratorias (el 4,2 frente al 8,7%; p < 0,005). Se mantuvo la significación estadística al estratificar por sexo, edad, obesidad, reflujo y hábito de fumar. También hubo mayor frecuencia de síntomas de urticaria en individuos que consumían pescado de mar más de dos veces a la semana (el 29,5 frente al 12,5%; p < 0,05). Conclusiones: Los resultados señalan que el consumo mensual de pescado de mar podría proteger, por su contenido de AGO3, contra enfermedades como asma y rinoconjuntivitis alérgica. Sin embargo, consumos elevados incrementarían la frecuencia de urticaria, probablemente en relación con fenómenos alérgicos o seudoalérgicos(AU)

Background: Sea fish (SF) is a natural source of omega-3 fatty acids (O3FA). Intake of O3FA reduces the production of arachidonic acid derivatives, which have antiinflammatory activity, and elevates levels of eicosapentaenoic acid derivatives, with lower activity. O3FA also inhibit T helper-2 lymphocytes, which mediate allergic inflammatory reactions. SF is a major food allergen and could also act as a histamine-releasing food. The objective of this study was to analyze the association between SF consumption and the presence of allergic symptoms. Methods: We conducted a cross-sectional study in 765 randomly selected students (83.4% women), aged 17-65 years old, attending the Universidad del Centro Educativo Latinoamericano. The students completed validated questionnaires on allergic diseases and the frequency of SF intake. Results: The prevalence of asthma symptoms in the previous 12 months was 8.0% among participants reporting SF consumption daily, weekly or once a month or more (46.7%) and was 12.9% in those reporting SF consumption less than once a month or never (p<0.05). Similar results were obtained when we evaluated exercise-induced asthma (7.9% vs 12.2%; p<0.05), nocturnal dry cough not associated with infections (13.3% vs 19.6%; p<0.05), allergic rhinoconjunctivitis in the last year (20.8% vs 27.5%; p<0.05) and symptoms of both allergic respiratory diseases (4.2% vs 8.7%; p<0.005). Statistical significance was maintained when stratification by sex, age, obesity, reflux and smoking habits was performed. In contrast, a higher frequency of urticaria symptoms was found in participants who reported SF consumption more than twice a week (29.5% vs 12.5%; p<0.05). Conclusions: These data suggest that SF consumption at least once a month could protect against diseases such as asthma and allergic rhinoconjunctivitis, due to the O3FA content of SF. However, high SF intake could increase the prevalence of urticaria, probably because of allergic or pseudoallergic phenomena(AU)

Scalp hair mercury concentrations in Pakistan.

The presence of mercury in the environment is widespread and persistent, but the extent of exposure of Pakistanis to mercury is virtually unknown. We collected toenail and scalp hair samples from 158 subjects (83 males and 75 females) residing in Lahore and its suburbs. We also conducted a questionnaire survey and personal interviews to obtain information on demographic factors, lifestyles, and socioeconomic factors, among others. Mercury concentration in hair samples was measured by cold vapor atomic absorption spectrometry (CVAAS). In addition, the concentration of selenium in the toenail and hair samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). The mean hair mercury concentration was 0.45 ppm (95% CI = 0.34-0.60) and did not show correlation with fish consumption, age, area of origin, or present residence. Mercury concentration was higher (p = 0.021) in females than in males, and was also higher in subjects with 11 or more years of education (p for trend = 0.013). There were 13 subjects with mercury concentration higher than 10 ppm. Most of them were young females and a few were middle-aged males. When the analysis was confined to subjects with mercury concentrations lower than 0.6 ppm, the amount of fish consumed showed correlation with hair mercury concentration with a marginal statistical significance (p = 0.065). The geometric means of selenium in hair and toenails were 0.87 and 1.01 ppm, respectively. Mercury and selenium concentrations in hair showed no correlation (correlation coefficient = 0.057, p = 0.478). This study shows that mercury exposure levels among residents in Lahore and its suburban areas are relatively low, except among outliers, wherein mercury exposure might be brought about by the use of mercury-containing soaps.

Diphyllobothrium latum: a case of an incidental finding.

Colorectal cancer screening can be performed by fecal occult blood testing, sigmoidoscopy, double contrast barium enema or colonoscopy. Colonoscopy has the significant advantage that polyps can be removed during the same procedure. Occasionally, colonoscopy can also reveal unexpected findings, including parasitic infections, even in asymptomatic patients. Tapeworms or cestodes are hermaphroditic parasites, which can live for considerable periods of time in the human gastrointestinal tract. Fish tapeworm (Diphyllobothrium species) are endemic in various parts of the world, the commonest species being Diphyllobothrium latum. Humans are the main definitive host for D. Latum and the majority of individuals harbouring the parasite are asymptomatic, while 40% of infected individuals may have low vitamin B12 levels. We describe a case of D. latum infection found on routine colonoscopic screening for colorectal cancer in an asymptomatic patient, which was successfully treated with praziquantel. The infection likely arose following raw fish (sushi) consumption.

An in vitro study of the effect of some dietary components on calculus formation: regulation of calcium phosphate precipitation.

OBJECTIVE: We studied the effects of food components on the in vitro formation of calcium phosphate precipitates. MATERIALS AND METHODS: The effects of food components, such as starch, soybean flour, fish meal, rapeseed oil, and coconut oil, on calcium phosphate precipitation were studied using a pH drop method. RESULTS: Although the addition of starch had no effect on the rate of precipitation of amorphous calcium phosphate (ACP), it increased both the rate of transformation of ACP to hydroxyapatite (HAP) and the induction time (i.e. time for the initiation of transformation of ACP to HAP to occur); this was irrespective of the heat treatment of the starch. Amylopectin (insoluble constituent of starch) was effective in increasing the rate of HAP transformation, but amylose (soluble constituent of starch) was not. Oil specimen obtained from rapeseed (400 microl ml(-1)) increased the entire reaction of calcium phosphate precipitation, but that from coconut did not. Protein food, such as soybean flour and fish meal, decreased the rate of transformation of ACP to HAP and increased the induction time, while they had no effect on the rate of ACP precipitation. CONCLUSION: These results suggest that carbohydrate and oil (both are staple diets for the humans) enhance oral calcification (dental calculus formation or re-mineralization of tooth enamel), while side dishes of protein food would decrease it.

Sociodemographic and behavioural correlates of severe dental fluorosis.

OBJECTIVES: The aim of this study was to identify sociodemographic and behavioural factors associated with the prevalence of severe dental fluorosis in moderate- and high-fluoride areas of the Ethiopian Rift Valley. METHODS: Three hundred and six adolescents (12-15 years) and 233 mothers participated in the study. The children were examined for dental fluorosis according to the Thylstrup-Fejerskov Index (TFI). The children and their mothers were subsequently interviewed. Sixty mothers had more than one participating child. In order to perform a paired parent/child analysis, a total of 73 younger siblings had to be excluded. RESULTS: Among the remaining 233 children, the prevalence of severe dental fluorosis (TFI >or= 5) was 24.1% and 75.9% in the moderate- and high-fluoride areas, respectively. According to bivariate as well as multivariate analyses, a number of sociodemographic and behavioural factors were related to severe fluorosis. The odds for having severe fluorosis varied according to the fluoride concentration of the drinking water, age, consumption of tea, length of breastfeeding and method of storing water. The adjusted odds ratios ranged from 2.6 to 26.1. Breastfeeding for > 18 months and the use of clay pots for storing drinking water helped protect against severe dental fluorosis. Bivariate analyses indicated that being male and consuming fish might be associated with higher TFI scores. CONCLUSION: In order to avoid dental fluorosis, low-fluoride drinking water should be provided in the relevant villages. A prolonged period of breastfeeding, the use of clay pots for storing water, and possibly a reduced intake of tea and whole fish in infants might also help to avoid severe fluorosis in children growing up in traditionally fluoride-endemic areas.

Ichthyotoxic ARF after fish gallbladder ingestion: a large case series from Vietnam.

Fish gallbladders are consumed in rural areas of Asia as a traditional medicine to improve symptoms of arthritis, decreased visual acuity, and impotence. Consumption of large amounts of this traditional medicine can result in systemic toxicities; in particular, acute renal failure. We reviewed records of all admissions to Cho Ray Hospital (Ho Chi Minh City, Vietnam) between January 1995 and December 2000 after this ingestion. Clinical courses and outcomes were similar in 16 of 17 patients. Within hours, patients experienced profuse vomiting (n = 16) and diarrhea (n = 15). All developed acute renal failure, with a mean serum creatinine concentration of 14.7 +/- 3.9 mg/dL (1,299.5 +/- 344.8 micromol/L). Four patients administered intravenous fluid (IVF) developed extracellular fluid volume overload, as did 1 patient not administered IVF. Time to peak creatinine concentration was 8.6 +/- 3.0 days, which was accompanied by decreased urine volume (174.7 +/- 161.6 mL/24 h). Blood pressure remained normal, with a mean arterial pressure of 91 +/- 12 mm Hg. Twelve patients required renal replacement therapy. A mean of 1.9 +/- 1.1 hemodialysis sessions was performed per patient. Sixteen patients recovered renal function; 1 patient died of fulminant hepatic failure. Kidney biopsies showed features of acute tubular injury. Acute renal failure after fish gallbladder ingestion is characterized by a failure to respond to IVF, an 8.6-day interval to peak creatinine level, frequent need for dialysis therapy, and findings on renal biopsy consistent with acute tubular necrosis. Acute renal failure after fish gallbladder ingestion has an excellent prognosis. However, death from fulminant hepatic failure can occur.

Fluorosis risk from early exposure to fluoride toothpaste.

UNLABELLED: Swallowed fluoride toothpaste in the early years of life has been postulated to be a risk factor for fluorosis, but the epidemiological evidence is weakened by the fact that most of the relevant studies were done in developed countries where an individual is exposed to multiple sources of fluoride. OBJECTIVES: To quantify the risk of fluorosis from fluoride toothpaste in a population whose only potential source of fluoride was fluoride toothpaste. METHODS: Case-control analyses were conducted to test the hypothesis that fluoride toothpaste use before the age of 6 years increased an individual's risk of fluorosis. Data came from a cross-sectional clinical dental examination of schoolchildren and a self-administered questionnaire to their parents. The study was conducted in Goa, India. The study group consisted of 1189 seventh grade children with a mean age of 12.2 years. RESULTS: The prevalence of fluorosis was 12.9% using the TF index. Results of the crude, stratified, and logistic regression analyses showed that use of fluoride toothpaste before the age of 6 years was a risk indicator for fluorosis (OR 1.83, 95% CI 1.05-3.15). Among children with fluorosis, beginning brushing before the age of 2 years increased the severity of fluorosis significantly (P<0.001). Other factors associated with the use of fluoride toothpaste, such as eating or swallowing fluoride toothpaste and higher frequency of use, did not show a statistically significant increased risk for prevalence or severity of fluorosis. CONCLUSIONS: Fluoride toothpaste use before the age of 6 years is a risk indicator for fluorosis in this study population.

Skin manifestations and immunological parameters in childhood food allergy.

According to Hansen's contact rule, the digestive system should be considered as the main shock organ, yet in food allergy, this is not the case. Very often specific food triggers clinical manifestations not involving the digestive system; that is, reactions are manifested either in the respiratory system, as asthma or rhinitis, or in the skin. In these cases the BALT (broncho-alveolar lymphoid tissue) and GALT (gastrointestinal lymphoid tissue) units play a basic role in the sensitizations. The purpose of this study was to determine the most frequent skin manifestations of food allergy among children, and the most frequently involved foods. We also thought it interesting to evaluate the diagnostic reliability of the different standard immunological parameters utilized by the study team in food allergy. All patients underwent intracutaneous tests with 12 groups of the most frequent food allergens, as well as serum IgE, antigen-specific IgE against foods, and antigen-specific histamine release tests. Antigen-specific IgG4 determination was performed in some cases. The results obtained confirmed previous studies, the most common manifestations being: angioedema (48%), followed by urticaria (31%) and atopic dermatitis (21%). Regarding the frequency of sensitization to different food allergens, in mono- or polisensitization, fish and egg stand out in our environment. Certain food allergens are more frequently responsible for specific skin manifestations. Thus, for fish sensitization, the most frequent skin manifestation is atopic dermatitis (50%); for egg sensitization, angioedema is the most frequent skin manifestation (50%); and for milk, urticaria (50%). Finally, and in agreement with previous works regarding the diagnostic reliability of in vitro techniques, we found that the histamine release test offered the highest percentage of diagnostic reliability. Only for sensitization to milk proteins did antigen-specific IgE demonstrate higher reliability. Once again, we stress that our main problem is the lower reliability of skin tests against food allergens than against inhalant allergens. We emphasize the importance of food as a major factor in the etiopathogenesis of atopic dermatitis, as well as the need to complement the study, when possible, by means of the in vitro techniques described.

Granuloma inflamatorio secundario a la ingestion de espina de pescado: presentación de un caso y revisión de la literatura / Inflammatory granuloma following a fish bone swallowing

La ingestión de objetos extraños ocurre ocasionalmente en los adultos, especialmente en aquéllos que utilizan prótesis dentales. La mayoría de esos objetos transitan por el tracto gastrointestinal sin causar síntomas, aunque algunas veces se pueden presentar complicaciones como perforación, absceso, obstrucción, tumoración, peritonitis localizada o generalizada. Se informa el caso de una paciente que desarrolló una tumoración abdominal dependiente de intestino secundaria a la perforación de éste, como consecuencia de la ingestión de una espina de pescado. Se comunican los síntomas presentados y la dificultad diagnóstica, pues fue valorada por diferentes especialista sin logara llega a un diagnóstico de certeza. Cabe hacer notar la importancia del aspecto macroscópico de la tumoración, que sugería un proceso tumoral de características malignas, y que histopatológicamanete fue señalado como un granuloma inflamatorio libre de células malignas secundario a cuerpo extraño (espina de pescado), caso raro de acuerdo a la bibliografía revisada.

Contact urticaria from mustard in fish-stick production.

At a major fish factory in northern Norway, workers employed in fish-stick and fillet production participated in a survey on skin diseases. 122 (80.1%) of the workers in the fish-stick section responded, but only 60.7% of the fillet workers. Clinical examination and patch testing revealed 16 cases of occupational dermatitis among workers in fish stick production, 3 of whom had contact urticaria from mustard and 8 from fish. There were only found 6 cases of occupational dermatitis among fillet workers; 3 reacted to fish and 3 had irritant contact dermatitis. Working conditions are described for both locations. A greater exposure to irritants may in part explain the 10.7% occupational dermatitis in the fish-stick section compared to only 3.5% in the fillet section.