Plasma and Red Blood Cell PUFAs in Home Parenteral Nutrition Paediatric Patients-Effects of Lipid Emulsions.

Background: Mixed lipid emulsions (LE) containing fish oil present several advantages compared to the sole soybean oil LE, but little is known about the safety of essential fatty acids (EFA) profile in paediatric patients on long-term Parenteral Nutrition (PN). Aim of the study: to assess glycerophosfolipid polyunsaturated fatty acids (PUFA) levels on plasma and red blood cell (RBC) membrane of children on long term PN with composite LE containing fish oil (SMOF), and to compare it with a group receiving olive oil LE (Clinoleic®) and to the reference range for age, previously determined on a group of healthy children. Results: A total of 38 patients were enrolled, median age 5.56 (0.9-21.86) years, 15 receiving Clinoleic®, 23 receiving SMOF. Patients on SMOF showed significantly higher levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), lower levels of arachidonic acid (ARA) and Mead acid (MEAD)/ARA ratio in plasma and RBC compared with patients on Clinoleic® and with healthy children. Triene:tetraene (T:T) ratio of both groups of patients did not differ from that of healthy children-median plasma (MEAD/ARA: 0.01, interquartile rage (IQR) 0.01, p = 0.61 and 0.02, IQR 0.02, p = 0.6 in SMOF and Clinoleic® patients, respectively), and was considerably lower than Holman index (>0.21). SMOF patients showed no statistically significant differences in growth parameters compared with Clinoleic® patients. Patients of both groups showed stiffness class F0-F1 of liver stiffness measure (LSM) 5.6 (IQR 0.85) in SMOF patients and 5.3 (IQR 0.90) in Clinoleic® patients, p = 0.58), indicating absence of liver fibrosis. Conclusions: Fatty acids, measured as concentrations (mg/L), revealed specific PUFA profile of PN patients and could be an accurate method to evaluate nutritional status and eventually to detect essential fatty acid deficiency (EFAD). SMOF patients showed significantly higher EPA, DHA and lower ARA concentrations compared to Clinoleic® patients. Both LEs showed similar hepatic evolution and growth.

A Pharmacological Update of Ellagic Acid.

Ellagic acid is a common metabolite present in many medicinal plants and vegetables. It is present either in free form or as part of more complex molecules (ellagitannins), which can be metabolized to liberate ellagic acid and several of its metabolites, including urolithins. While ellagic acid's antioxidant properties are doubtless responsible for many of its pharmacological activities, other mechanisms have also been implicated in its various effects, including its ability to reduce the lipidemic profile and lipid metabolism, alter pro-inflammatory mediators (tumor necrosis factor-α, interleukin-1ß, interleukin-6), and decrease the activity of nuclear factor-κB while increasing nuclear factor erythroid 2-related factor 2 expression. These events play an important role in ellagic acid's anti-atherogenic, anti-inflammatory, and neuroprotective effects. Several of these activities, together with the effect of ellagic acid on insulin, glycogen, phosphatases, aldose reductase, sorbitol accumulation, advanced glycation end-product formation, and resistin secretion, may explain its effects on metabolic syndrome and diabetes. In addition, results from recent research have increased the interest in ellagic acid, both as a potential protective agent of the liver and skin and as a potential anticancer agent, due to the specific mechanisms affecting cell proliferation, apoptosis, DNA damage, and angiogenesis and its aforementioned anti-inflammatory properties. Taken together, these effects make ellagic acid a highly interesting compound that may contribute to different aspects of health; however, more studies are needed, especially on the compound's pharmacokinetic profile. In this review, we selected papers published from 2005 to the present.

Influencia del programa de educación maternal en el cambio de preferencias del plan de parto en gestantes del Departamento de Salud de La Ribera / Influence of maternal education program in changing birth plan preferences

OBJETIVO: Observar si existen diferencias en las preferencias que las gestantes reflejan en el plan de parto (PP) entre antes y después de recibir el programa de educación maternal (EM). Personas y método: Se trata de un estudio observacional y prospectivo, donde se evalúan las variables (sociodemograficas, preferencias durante el periodo de dilatación, periodo expulsivo, atención al bebe y en todo el proceso del parto y nacimiento) en gestantes que acuden al programa de EM en distintos centros de atención primaria del Departamento de Salud de La Ribera desde enero hasta octubre de 2012. Se utilizó la prueba de McNemar para el análisis estadístico. RESULTADOS: Se estudiaron un total de 249 gestantes. Los elementos identificados más importantes en los PP analizados que mostraron diferencias estadísticamente significativas entre antes y después de recibir las sesiones de EM incluyen: evitar la episiotomía, medidas de comodidad (ingerir líquidos, ir al baño cuando lo deseen, libertad de movimientos, monitorización intermitente, posición de expulsivo cómoda) y otras preferencias como realizar pujos espontáneos, pinzamiento del cordón tardío y cortarlo su acompañante, contacto piel con piel y amamantamiento de la forma más precoz posible. No encontramos diferencias en elementos relacionados con el ambiente (por ejemplo, la privacidad y toma de decisiones) ni durante el periodo de dilatación con la administración de enema, administración de oxitocina, rasurado del pubis, epidural y amniorrexis. CONCLUSIONES: Existen diferencias entre las preferencias del PP que seleccionan las gestantes al termino de las sesiones de EM. Las matronas podrían influir en ese cambio

OBJECTIVE: To see if there are differences between preferences reflecting the pregnant women in the birth plan (BP), between before and after receiving the maternal education sessions. People and method: It's an epidemiological, observational, longitudinal, and prospective study, where we measure the variables of study in pregnant women attending the sessions of maternal education (ME) in different centres of La Ribera Health Department since January to October 2012. The McNemar test was used for the analysis of preferences before and after. RESULTS: We studied 249 pregnant women. The most important elements analyzed BP identified that showed statistically significant differences between before and after receiving the ME sessions include pain (avoid episiotomy) comfort measures (drink fluids, go to the bathroom, freedom of movement, intermittent monitoring, expulsive comfortable position) and preferences (e.g., spontaneous push, delayed cord clamping and cutting his companion, skin-to-skin contact, breastfeeding and as early as possible). Instead we found no differences related to the environment (e.g., privacy and decision making) and dilation (enema, oxytocin, pubic shaving, epidural and amniorrhexis) elements. CONCLUSIONS: There are differences between preferences of the selected BP pregnant at the end of maternal education sessions, and midwives could influence in the change

Intestinal anti-inflammatory activity of ellagic acid in the acute and chronic dextrane sulfate sodium models of mice colitis.

ETHNOPHARMACOLOGICAL RELEVANCE: Pomegranate (Punica granatum L.; Lythraceae) has traditionally been used for the treatment of various inflammatory diseases, including ulcerative colitis (UC). Because its fruits and extracts are rich in ellagitannins, which release ellagic acid when hydrolyzed, consumption of pomegranate products is currently being widely promoted for their potential health effects, including the prevention of inflammatory diseases and cancer. To evaluate the anti-inflammatory effects of ellagic acid on dextran sulfate sodium (DSS)-induced acute and chronic experimental colitis in two different strains of mice and to elucidate its possible mechanisms of action. MATERIALS AND METHODS: In the acute UC model, female Balb/C mice were treated with DSS (5%) for seven days while concomitantly receiving a dietary supplement of ellagic acid (2%). In the chronic UC model, female C57BL/6 mice received four week-long cycles of DSS (1% and 2%) interspersed with week-long recovery periods along with a diet supplemented with ellagic acid (0.5%). RESULTS: In acute model of UC, ellagic acid ameliorated disease severity slightly as observed both macroscopically and through the profile of inflammatory mediators (IL-6, TNF-α, and IFN-γ). In the chronic UC model, ellagic acid significantly inhibited the progression of the disease, reducing intestinal inflammation and decreasing histological scores. Moreover, mediators such as COX-2 and iNOS were downregulated and the signaling pathways p38 MAPK, NF-κB, and STAT3 were blocked. CONCLUSIONS: Our study reinforces the hypothetical use of ellagic acid as an anti-inflammatory complement to conventional UC treatment in chronic UC patients and could be considered in the dietary prevention of intestinal inflammation and related cancer development.

Protective effect of apocynin in a mouse model of chemically-induced colitis.

Apocynin, a constituent of Picrorhiza kurroa, successfully inhibits NADPH oxidase and shows promise as an anti-inflammatory drug. Now, we report anti-inflammatory effects of apocynin in an experimental colitis model induced by dextran sulfate sodium as well as the effects on the mediators involved in this process. Apocynin reduced the colitis induced in mice by administration of 5 % dextran sulfate sodium during 7 days. Mice were fed a control diet or a diet supplemented with 2 % of apocynin or 2 % of rutin. Sulfasalazine (50 mg/kg, p. o.) was used as a positive control. Treatment with apocynin and rutin ameliorated the course of colonic inflammation with results similar to those of the reference drug, as could be seen by reductions in the disease activity index scores and colon length. NO and PGE2 production as well as the iNOS and COX-2 expression were reduced by apocynin and rutin. Moreover, the activation of NF-κB p65 as well as STAT3 in dextran sulfate sodium-treated colon tissues was significantly reduced by apocynin. These results are promising for further experimental studies on treating gastrointestinal diseases and on the potential protective effects of apocynin.

Impairments of prepulse inhibition of the startle response in abstinent alcoholic male patients.

AIMS: Prepulse inhibition (PPI) of the startle reflex, which refers to the ability of innocuous sensory events to reduce the startle reflex, has been described as an operational measure of sensorimotor gating that is reduced in several neuropsychiatric disorders, such as schizophrenia, but experience is lacking in addictions and alcoholism. The aim of this study was to examine the existence of impairments in the startle response and PPI in abstinent alcoholic men. METHODS: Testing for PPI was conducted on 60 abstinent alcoholic men aged 18-65 years (mean 46.37) who met DSM-IV criteria for alcohol dependence and had been abstinent for more than a month at the time of testing. The comparison group were compared with 37 sex- age- and education-matched controls without alcohol dependence. RESULTS: Magnitudes of the startle reflex were lower in patients than in controls. The differences were statistically significant (P < 0.05) in trials with prepulses presented 30 and 120 ms before the onset of the startle stimulus. There was also a statistically significant (P < 0.05) reduced percentage of PPI when the prepulse was presented 30 ms before the startle stimulus. CONCLUSIONS: These data suggest that sensory information processing mechanisms could be damaged in abstinent alcoholic patients. The fact that these findings are common to other psychiatric disorders could indicate the existence of a common vulnerability marker and explain the high degree of comorbidity between alcoholism and other mental illnesses.

Diterpenos en infl amación: las Labiadas como paradigma / Diterpenes in inflammation: Labiatae as paradigm

Esta revisión trata esencialmente sobre los diterpenos antiinflamatorios procedentes de especies de Labiadas. Se estudian las publicaciones posteriores a 2002 referentes a los cuatro tipos estructurales más importantes en esa familia: labdano, abietano, pimarano y kaurano. Además se incluyen algunas moléculas interesantes obtenidas de especies de diferente origen taxonómico. De entre los mecanismos implicados destaca la inhibición del metabolismo del ácido araquidónico a través de ciclooxigenasas y lipoxigenasas, así como el freno a la producción de NO o citocinas. Adicionalmente se ha descrito para algunos principios el aumento de la expresión de hemo-oxigenasa 1. Algunos de los géneros botánicos mejor representados son Lavandula, Isodon, Rosmarinus y Sideritis (AU)

This review is devoted to the antiinflammatory diterpenoids obtained from species of Labiatae. Basically, we study the post-2002 publications concerning the four major structural types in the family: labdane, abietane, pimarane and kaurane. Certain interesting diterpenes derived from plants of different taxonomic origin are also reported. Among the mechanisms involved in the pharmacological effect, we should highlight the inhibition of arachidonic acid metabolism through cyclo-oxygenases and lipoxygenases, and the decrease in the production of NO or cytokines. Additionally, some principles are described as enhancers of the expression of heme oxygenase 1. Some of the botanical genera best represented are Lavandula, Isodon, Rosmarinus or Sideritis (AU)