Surgical treatment of Peyronie's disease with small intestinal submucosa graft patch.

The objective of the study was to report our results using a porcine small intestinal submucosa graft (Surgisis ES, Cook Medical) for tunica albuginea substitution after plaque incision. We retrospectively evaluated patients surgically treated at our institution for Peyronie's disease (PD) by means of plaque incision and porcine small intestinal submucosa grafting (Surgisis) between 2009 and 2013. At the same time a literature review was conducted, searching for similar reports and results. Forty-four patients were identified who had been diagnosed with PD between 2009 and the beginning of 2013, and had been treated with corporoplasty, plaque incision and grafting with Surgisis for a severe curvature of the penis. Curvature of the penis was dorsal in 40 patients (90%) and laterally on the right in 4 patients (10%). Mean duration of surgery was 165 min (range 90-200). Mean size of the graft was 6.5 cm(2) and the mean follow-up was 19.2 months (range 11-48). In patients with severe curvature of the penis due to PD and the need for corporoplasty with plaque incision and graft placement, Surgisis represents a good option with a low risk of complications, below the rate described with previously investigated graft tissues.

[Influence of a program of physical activity in children and obese adolescents; evaluation of physiological stress by compounds in saliva; study protocol]. / Influencia de un programa de actividad física en niños y adolescentes obesos; evaluación del estrés fisiológico mediante compuestos en la saliva; protocolo de estudio.

Different studies4, 5 relate that stress increases in children and adolescents with overweight and obesity, and consequently their salivary physiological responses (AEA salivary alpha-amylase, cortisol, cytokines, leptin), so in this study we relate these two parameters to see their progress through a program of physical activity. If we manage to reduce overweight or obesity, these physiological responses and stress should also be reduced, thus improving the overall health status of these children and adolescents. The overall objective of the study was to determine the influence of physical activity in obese children and adolescents in perceived stress. An observational, descriptive, prospective and longitudinal study will be carried out. The universe is made up of 60 overweight / obese children and adolescents aged between 10 and 18 years. The assessment will take place from September 2012 to September 2013. To collect saliva samples, the ELISA8 method will be used. Variables such as BMI, lifestyle and diet will also be collected Among the expected results are to lower overweight and obesity in children through physical activity program. To reduce stress and to normalize physiological salivary parameters.

Diferentes estudios1,2 relacionan que el estrés aumenta en los niños y adolescentes con sobrepeso y obesidad, y en consecuencia sus respuestas fisiológicas salivales (Alfaamilasa salivar AEA, Cortisol, Citoquinas, Leptina), por eso en este estudio queremos relacionar estos dos parámetros para ver su evolución a través de un programa de Actividad Física. Si logramos reducir el sobrepeso u obesidad se debería reducir también estas respuestas fisiológicas y el estrés, por lo que mejoraría el estado de salud general de estos niños y adolescentes. El objetivo general del estudio es conocer la influencia de la actividad física, en niños y adolescentes obesos, en el estrés percibido. Se realizará un estudio observacional, descriptivo, prospectivo y longitudinal. El universo estará constituido por 60 niños y adolescentes con edades comprendidas entre 10 y 18 con sobrepeso/obesidad. La valoración tendrá lugar desde septiembre de 2012 hasta septiembre de 2013. Para la recogida de las muestras de saliva se utilizará el método ELISA3. También se recogerán variables como el IMC, hábitos de vida y alimentación. De entre los resultados esperados están el bajar el sobrepeso y obesidad en los niños mediante el programa de actividad física. Disminuir el estrés fisiológico y normalizar los parámetros salivares.

[Obesity and its relation with markers of inflammation and erythrocyte fatty acids in a group of overweight adolescents]. / Obesidad y su relación con marcadores de inflamación y ácidos grasos de eritrocito en un grupo de adolescentes obesos.

There is a general consensus that obesity is an eminently inflammatory process. This is justified by alterations observed in obese patients, which affect the secretion of certain cytokines such as ceruloplasmin, leptin, adiponectin, and interleukin-6 (IL-6), among others. In a parallel way, other research has also pointed out alterations in the composition of fatty acids in the erythrocyte membrane of overweight adults. The results obtained in our study confirm the existence of a significant correlation between the serum levels of some of the cytokines studied and the nutritional state of the sample studied. This means that for the population of children evaluated in our study, the serum concentrations of these biomolecules can be an important tool for the prediction of cardiovascular risk when they become adults. Furthermore significant differences were found regarding the composition of saturated fatty acids in the erythrocyte membrane.

Obesidad y su relación con marcadores de inflamación y ácidos grasos de eritrocito en un grupo de adolescentes obesos / Obesity and its relation with markers of inflammation and erythrocyte fatty acids in a group of overweight adolescents

En la actualidad se acepta que la obesidad constituye un proceso eminentemente inflamatorio. Ello tiene su justificación en las alteraciones descritas en sujetos obesos a nivel de la secreción de ciertas citoquinas tales como ceruloplasmina, leptina, adiponectina e interleuquina 6 (IL-6), entre otras. Asimismo y en modo paralelo, otros trabajos apuntan además hacia alteraciones en la composición de ácidos grasos en la membrana de los eritrocitos de adultos obesos. Los resultados obtenidos en este estudio confirman la existencia de una correlación significativa entre los niveles séricos de algunas de las citokinas estudiadas y el estado nutricional de los sujetos, lo que significa que para la población de escolares valorada, las concentraciones séricas de estas biomoléculas pueden constituir una importante herramienta para predecir el riesgo cardiovascular en la edad adulta. Además, se han encontrado diferencias significativas respecto de la composición en ácidos grasos saturados en la membrana de los eritrocitos (AU)

There is a general consensus that obesity is an eminently inflammatory process. This is justified by alterations observed in obese patients, which affect the secretion of certain cytokines such as ceruloplasmin, leptin,adiponectin, and interleukin-6 (IL-6), among others. In a parallel way, other research has also pointed out alterations in the composition of fatty acids in the erythrocyte membrane of overweight adults. The results obtained in our study confirm the existence of a significant correlation between the serum levels of some of the cytokines studied and the nutritional state of the sample studied. This means that for the population of children evaluated in our study, the serum concentrations of these biomolecules can be an important tool for the prediction of cardiovascular risk when they become adults. Furthermore significant differences were found regarding the composition of saturated fatty acids in the erythrocyte membrane (AU)

Triacylglycerol-rich lipoproteins derived from healthy donors fed different olive oils modulate cytokine secretion and cyclooxygenase-2 expression in macrophages: the potential role of oleanolic acid.

PURPOSE: Current evidence suggests that consumption of virgin olive oil (VOO) helps to protect against the development of atherosclerosis and that minor components such as oleanolic acid contribute to this effect. In this study, the effects of triacylglycerol-rich lipoproteins (TRLs) derived from olive oil on inflammatory processes in macrophages and how they are modulated by oleanolic acid was investigated. METHODS: TRLs isolated from healthy volunteers 2 and 4 h after a test meal containing VOO, pomace olive oil (POO) (the second pressing of olive oil, enriched in minor components) or POO enriched with oleanolic acid (OPOO) were incubated with macrophages derived from the human monocyte cell line, THP-1. RESULTS: All types of TRLs caused a decrease of about 50% in the secretion of monocyte chemoattractant protein-1 (MCP-1) by the cells. Interleukin (IL)-6 secretion was also significantly decreased by 2 and 4 h VOO TRLs and by 4 h OPOO TRLs. In contrast, increased IL-1ß secretion was observed with all 2 h TRL types, and increased tumour necrosis factor-α (TNF-α) production with 2 h VOO and POO, but not OPOO, TRLs. TRLs isolated after 4 h, however, had no significant effects on TNF-α secretion and increased IL-1ß secretion only when they were derived from VOO. Cyclooxygenase-2 (COX-2) mRNA expression was strongly down-regulated by all types of TRLs, but protein expression was significantly depressed only by 4 h OPOO TRLs. CONCLUSION: These findings demonstrate that TRLs derived from olive oil influence inflammatory processes in macrophages and suggest that oleanolic acid may have beneficial effects.

[Study of the serum levels of leptin, ceruloplasmin and lipoprotein (a) as indicators of cardiovascular risk in a population of adolescents in Granada (Spain)]. / Estudio de los niveles séricos de leptina, ceruloplasmina y lipoproteína (a) como indicadores del riesgo cardiovascular en una población de adolescentes de Granada (España).

Numerous studies have focused on establishing a relation between the serum values of biomolecules such as leptin, ceruloplasmin, and lipoprotein (a), and the nutritional state and levels of diastolic and systolic blood pressure in subjects with problems of overweight or obesity. However, in many cases, the results obtained have not been conclusive. The results of our study confirm the existence of a statistically significant association between the serum levels of these biomolecules, the nutritional state of the subjects, and levels of diastolic and systolic blood pressure. For the population of overweight and obese adolescents studied, the evaluation of the serum concentrations of these biomolecules was found to be an important instrument that could be used to identify those subjects with an elevated risk of suffering cardiovascular disorders basically derived from a hypertensive status.

[Ceruloplasmin and its clinical relevance as an indactor of cardiovascular risk factor in a school population of Granada]. / Ceruloplasmina y su importancia clínica como factor indicador del riesgo cardiovascular en una población de escolares de Granada.

Also known as ferroxidase ceruloplasmin, belongs to the family of inflammation-sensitive proteins, and its main function to transport copper in the blood. Although, in addition to this transport function, at present, there are numerous studies that have attempted to use the determination of serum concentrations as a predictive indicator of cardiovascular risk in patients who are overweight or obese. The results of this study confirm the existence of a significant correlation between serum ceruloplasmin and nutritional status of the subjects, which means that for the population of students assessed, serum levels of this protein are an important predictor the risk of cardiovascular disease.

Metodología del estudio Guadix sobre los efectos de un desayuno de tipo mediterráneo sobre los parámetros lipídicos y postprandiales en preadolescentes con sobrepeso y obesidad / The Guadix study of the effects of a mediterranean-diet breakfast on the postprandial lipid parameters of overweight and obese pre-adolescents

El exceso de peso corporal de la población ha llevado a la Organización Mundial de la Salud a calificarlo como epidemia global. La prevalencia de sobrepeso y obesidad infantil en España se sitúa entre las más elevadas del continente europeo, y es aún superior en Andalucía. Las consecuencias para la salud de los niños no son tan evidentes como en los adultos, pero la obesidad infantil se está asociando con patologías que se creían eran sólo padecidas por los adultos, tales como el síndrome metabólico. La resistencia a la insulina es el factor de riesgo más importante en sujetos con obesidad severa, que junto con la obesidad visceral, exacerban la trigliceridemia postprandial, lo que incrementa el riesgo cardiovascular. Sin embargo y a nuestro entender, este fenómeno no ha sido debidamente estudiado por el momento en la población infantil. Las propiedades cardiosaludables del aceite de oliva, el ingrediente principal de la Dieta Mediterránea, han sido sobradamente puestas de manifiesto, que incluyen un mejor patrón lipídico postprandial. En este contexto, el objetivo de este estudio es determinar los efectos de un desayuno de tipo mediterráneo sobre parámetros lipídicos postprandiales en preadolescentes con sobrepeso y obesidad. Para ello, se ha llevado a cabo un estudio cuasi experimental prospectivo multicéntrico, que compara los beneficios de una intervención dietética en una sola comida de tipo mediterráneo en el metabolismo lipídico postprandial en sujetos en edades preadolescentes (10-14 años) afectados por obesidad o sobrepeso (grupo estudio), con respecto a los sujetos normopeso (grupo control). Los resultados permiten ampliar el conocimiento sobre la fisiopatología de la obesidad de los niños y contribuir a las recomendaciones dietéticas para el mantenimiento de la población infantil. Más aún, aportan información sobre el desarrollo de aterogénesis durante el periodo postprandial, que puede comenzar a edades tan tempranas (AU)

El exceso de peso corporal de la población ha llevado a la Organización Mundial de la Salud a calificarlo como epidemia global. La prevalencia de sobrepeso y obesidad infantil en España se sitúa entre las más elevadas del continente europeo, y es aún superior en Andalucía. Las consecuencias para la salud de los niños no son tan evidentes como en los adultos, pero la obesidad infantil se está asociando con patologías que se creían eran sólo padecidas por los adultos, tales como el síndrome metabólico. La resistencia a la insulina es el factor de riesgo más importante en sujetos con obesidad severa, que junto con la obesidad visceral, exacerban la trigliceridemia postprandial, lo que incrementa el riesgo cardiovascular. Sin embargo y a nuestro entender, este fenómeno no ha sido debidamente estudiado por el momento en la población infantil. Las propiedades cardiosaludables del aceite de oliva, el ingrediente principal de la Dieta Mediterránea, han sido sobradamente puestas de manifiesto, que incluyen un mejor patrón lipídico postprandial. En este contexto, el objetivo de este estudio es determinar los efectos de un desayuno de tipo mediterráneo sobre parámetros lipídicos postprandiales en preadolescentes con sobrepeso y obesidad. Para ello, se ha llevado a cabo un estudio cuasi experimental prospectivo multicéntrico, que compara los beneficios de una intervención dietética en una sola comida de tipo mediterráneo en el metabolismo lipídico postprandial en sujetos en edades preadolescentes (10-14 años) afectados por obesidad o sobrepeso (grupo estudio), con respecto a los sujetos normopeso (grupo control). Los resultados permiten ampliar el conocimiento sobre la fisiopatología de la obesidad de los niños y contribuir a las recomendaciones dietéticas para el mantenimiento de la población infantil. Más aún, aportan información sobre el desarrollo de aterogénesis durante el periodo postprandial, que puede comenzar a edades tan tempranas (AU)

Olive oil and health: summary of the II international conference on olive oil and health consensus report, Jaén and Córdoba (Spain) 2008.

Olive oil (OO) is the most representative food of the traditional Mediterranean Diet (MedDiet). Increasing evidence suggests that monounsaturated fatty acids (MUFA) as a nutrient, OO as a food, and the MedDiet as a food pattern are associated with a decreased risk of cardiovascular disease, obesity, metabolic syndrome, type 2 diabetes and hypertension. A MedDiet rich in OO and OO per se has been shown to improve cardiovascular risk factors, such as lipid profiles, blood pressure, postprandial hyperlipidemia, endothelial dysfunction, oxidative stress, and antithrombotic profiles. Some of these beneficial effects can be attributed to the OO minor components. Therefore, the definition of the MedDiet should include OO. Phenolic compounds in OO have shown antioxidant and anti-inflammatory properties, prevent lipoperoxidation, induce favorable changes of lipid profile, improve endothelial function, and disclose antithrombotic properties. Observational studies from Mediterranean cohorts have suggested that dietary MUFA may be protective against age-related cognitive decline and Alzheimer's disease. Recent studies consistently support the concept that the OO-rich MedDiet is compatible with healthier aging and increased longevity. In countries where the population adheres to the MedDiet, such as Spain, Greece and Italy, and OO is the principal source of fat, rates of cancer incidence are lower than in northern European countries. Experimental and human cellular studies have provided new evidence on the potential protective effect of OO on cancer. Furthermore, results of case-control and cohort studies suggest that MUFA intake including OO is associated with a reduction in cancer risk (mainly breast, colorectal and prostate cancers).

[The Guadix study of the effects of a Mediterranean-diet breakfast on the postprandial lipid parameters of overweight and obese pre-adolescents]. / Metodología del estudio Guadix sobre los efectos de un desayuno de tipo mediterráneo sobre los parámetros lipídicos y postprandiales en preadolescentes con sobrepeso y obesidad.

The excess weight that characterizes much of the population of the world today has led the World Health Organization to declare a obesity pandemic. The number of overweight and obese children in Spain is among the highest in Europe, and this number is even higher in Andalusia. The health consequences of excess weight for children are not as evident as for adults. However, child obesity is now being associated with pathologies, such as the metabolic syndrome, which were previously believed to be only found in adults. Resistance to insulin is an important risk factor in subjects with severe obesity, which along with visceral obesity, make postprandial triglyceridemia more severe. This increases cardiovascular risk. However, in our opinion, this phenomenon has not been adequately studied in children. The hearthealthy properties of olive oil, the main ingredient of the Mediterranean diet, have been clearly highlighted in various studies. These properties include an improved postprandial lipid pattern. In this context, the objective of this study was to determine the effects of a Mediterranean-diet breakfast on the postprandial lipid parameters in a study group of overweight and obese preadolescents (age 10-14) in comparison to a control group of subjects with no weight problems. The results obtained provide greater knowledge of the physiopathology of child obesity and contribute to the elaboration of dietary recommendations for the maintenance of child health. Additionally, our results give information regarding the development of atherogenesis during the postprandial period, which can begin at a very early age.

[Difficulties and controversies in hospitalized patients with lower gastrointestinal bleeding]. / Dificultades y controversias en el manejo hospitalario de la hemorragia digestiva baja.

OBJECTIVES: Lower intestinal bleeding (LGIB) is a frequent reason for hospitalization; however, the prognostic factors have not been clearly defined. The aim of this paper was to analyze several clinical parameters and the management of this entity in our department from 2005 to 2007. MATERIAL AND METHODS: all hospitalized patients with LGIB were retrospectively (2005-2006) and prospectively (2006-2007) included. Medical records, physical examination (anal digital examination included), blood testing, and colonoscopic examination (in most of patients) were performed. RESULTS: 137 patients were included during 2005-2006: 36% of them required blood transfusion; thirty-one percent of patients showed previous episodes of LGIB, and 62% had a favorable outcome. Time from admission to colonoscopy was 4.1 days, and length of stay was 10.2 days. In the 2006-2007 study 96 patients were included: 42% of them required blood transfusion, thirty-three percent of patients showed previous episodes of LGIB, and 68% had a favorable outcome. Time from admission to colonoscopy was 2.6 days, and length of stay was 7.7 days. The most frequent etiology was diverticulosis in both studies. CONCLUSIONS: Hospital length of stay and time from admission to colonoscopy in patients with LGIB was reduced by 25% and 37%, respectively, in the 2005-2006 period with regard to the 2006-2007 one; however, there were no more bleeding points or a decrease in bleeding recurrence.

[Eosinophilic esophagitis in the adult--clinical, endoscopic, pH-metric, and manometric findings]. / Esofagitis eosinofílica en el adulto: aspectos clínicos, endoscópicos, pH-métricos y manométricos.

OBJECTIVES: Eosinophilic esophagitis (EE) is a condition characterized by dysphagia and frequent food impaction in young adults. The aim of our study was to evaluate the clinical aspects, endoscopic features, pH-metric and motility disorders in EE. PATIENTS AND METHODS: Adult patients with EE were prospectivity included. Endoscopy with biopsy, stationary esophageal manometry, and 24-hour pH-metry were performed. We analyzed the duration of disease, allergies, blood peripheral eosinophilia, prevalence of dysphagia, number of food impaction episodes, and complications during the endoscopic procedure. RESULTS: Eleven male patients with a mean age of 35 years were followed. Endoscopy showed esophageal disorders in all cases: 5 esophageal felinizations, mucosal abnormalities in 4 cases, distal rings in 3 cases, and 2 esophageal stenoses. In two cases mucosal tearing during the endoscopic procedure was described. In 6 patients the manometric study showed motor disorders affecting the esophageal body, 5 of them displaying hypomotility. Two patients showed pathological gastroesophageal reflux during pH-monitoring. Blood peripheral eosinophilia was detected in 3 patients. CONCLUSION: Although endoscopic abnormalities are frequently found, they do not usually explain dysphagia and food impaction episodes in EE. Ineffective esophageal peristalsis is the most prevalent manometric disorder associated with this entity, although it is not clearly related to symptom worsening either.

Dificultades y controversias en el manejo hospitalario de la hemorragia digestiva baja / No disponible

Objetivos: la hemorragia digestiva baja (HDB) es una causa frecuentede ingreso hospitalario; pese a ello, no se conocen con exactitudlos factores que influyen en su evolución. Los objetivos de estetrabajo fueron comparar los cambios en el manejo de la HDB ennuestro Servicio entre los años 2005 y 2007, así como analizar diferentesparámetros que pudieran influir en su pronóstico.Pacientes y métodos: se incluyeron retrospectivamente todoslos ingresos por HDB durante el periodo 2005-2006 y prospectivamentelos del 2006-2007. En todos se realizó historia clínica,exploración –incluyendo tacto rectal– y análisis sanguíneo.Se realizó colonoscopia en la mayoría de los pacientes.Resultados: se incluyeron 137 pacientes en el 2005-2006: requirierontransfusión de hemoderivados el 36%. El 31% había presentadoalgún episodio de HDB previamente. El 62% presentó unaevolución favorable. El tiempo desde el ingreso hasta la colonoscopiay la estancia media fueron de 4,1 y 10,2 días respectivamente. En el2006-2007 se incluyeron 96 pacientes: requirieron transfusión el42%. El 33% había presentado HDB previamente. La evolución fuefavorable en el 67%. El tiempo hasta la colonoscopia y la estanciamedia fueron de 2,6 y 7,7 días respectivamente. Los divertículos fueronel hallazgo más frecuente en ambos periodos.Conclusiones: durante el 2006-2007 la estancia media delos pacientes con HDB ingresados en el Servicio de Aparato Digestivose redujo respecto al 2005-2006 en un 25% y el tiempode realización de la colonoscopia en un 37%; esto no logró máslocalizaciones del punto sangrante ni una disminución en la recurrenciade la hemorragia

Objectives: lower intestinal bleeding (LGIB) is a frequent reasonfor hospitalization; however, the prognostic factors have notbeen clearly defined. The aim of this paper was to analyze severalclinical parameters and the management of this entity in our departmentfrom 2005 to 2007.Material and methods: all hospitalized patients with LGIBwere retrospectively (2005-2006) and prospectively (2006-2007)included. Medical records, physical examination (anal digital examinationincluded), blood testing, and colonoscopic examination(in most of patients) were performed.Results: 137 patients were included during 2005-2006: 36%of them required blood transfusion; thirty-one percent of patientsshowed previous episodes of LGIB, and 62% had a favorable outcome.Time from admission to colonoscopy was 4.1 days, andlength of stay was 10.2 days. In the 2006-2007 study 96 patientswere included: 42% of them required blood transfusion, thirtythreepercent of patients showed previous episodes of LGIB, and68% had a favorable outcome. Time from admission tocolonoscopy was 2.6 days, and length of stay was 7.7 days. Themost frequent etiology was diverticulosis in both studies.Conclusions: hospital length of stay and time from admissionto colonoscopy in patients with LGIB was reduced by 25% and37%, respectively, in the 2005-2006 period with regard to the2006-2007 one; however, there were no more bleeding points ora decrease in bleeding recurrence

Esofagitis eosinofílica en el adulto: aspectos clínicos, endoscópicos, pH-métricos y manométricos / No disponible

Objetivos: la esofagitis eosinofílica (EE) es una entidad de interéscreciente caracterizada en el adulto por disfagia y episodiosde impactación alimentaria recurrentes. Nuestro objetivo fue estudiarlas características clínicas, endoscópicas, manométricas y pHmétricasen los pacientes con EE, así como la relación que pudieraexistir entre ellas.Pacientes y métodos: se estudiaron de forma prospectivadurante un año los pacientes adultos diagnosticados de EE. En todosse realizó endoscopia digestiva alta con toma de biopsias, manometríaesofágica estacionaria y pH-metría ambulatoria. Se documentóademás el tiempo de evolución clínica, los antecedentesde atopia, la presencia de eosinofilia periférica, la frecuencia de ladisfagia y el número de desimpactaciones y complicaciones endoscópicas.Resultados: se estudiaron 11 pacientes (edad media 35años). Todas las endoscopias presentaron hallazgos patológicos:traquealización en 5, alteraciones mucosas en 4, en 3 anillos esofágicosdistales y en 2 estenosis esofágicas. Precisaron desimpactacionesendoscópicas 7 pacientes. Se produjeron desgarros de lamucosa esofágica durante la endoscopia en 2 pacientes. La manometríaesofágica fue patológica en 6 pacientes, de estos, 5 fuerontrastornos de hipomotilidad. La pH-metría fue patológica en2 casos. Presentaron eosinofilia periférica 3 pacientes.Conclusión: aunque los hallazgos patológicos en la endoscopiason frecuentes, no siempre justifican los episodios de impactaciónalimentaria característicos de la EE. Los trastornos de motilidad enforma de peristalsis esofágica ineficaz son el hallazgo manométricomás frecuente, aunque tampoco se han podido relacionar con unmayor número de episodios de disfagia o de impactaciones

Objectives: eosinophilic esophagitis (EE) is a condition characterizedby dysphagia and frequent food impaction in youngadults. The aim of our study was to evaluate the clinical aspects,endoscopic features, pH-metric and motility disorders in EE.Patients and methods: adult patients with EE were prospectivityincluded. Endoscopy with biopsy, stationary esophagealmanometry, and 24-hour pH-metry were performed. We analyzedthe duration of disease, allergies, blood peripheraleosinophilia, prevalence of dysphagia, number of food impactionepisodes, and complications during the endoscopic procedure.Results: eleven male patients with a mean age of 35 yearswere followed. Endoscopy showed esophageal disorders in allcases: 5 esophageal felinizations, mucosal abnormalities in 4cases, distal rings in 3 cases, and 2 esophageal stenoses. In twocases mucosal tearing during the endoscopic procedure was described.In 6 patients the manometric study showed motor disordersaffecting the esophageal body, 5 of them displayinghypomotility. Two patients showed pathological gastroesophagealreflux during pH-monitoring. Blood peripheraleosinophilia was detected in 3 patients.Conclusion: although endoscopic abnormalities are frequentlyfound, they do not usually explain dysphagia and food impactionepisodes in EE. Ineffective esophageal peristalsis is themost prevalent manometric disorder associated with this entity, althoughit is not clearly related to symptom worsening either

Components of the Mediterranean-type food pattern and serum inflammatory markers among patients at high risk for cardiovascular disease.

OBJECTIVE: To evaluate associations between components of the Mediterranean diet and circulating markers of inflammation in a large cohort of asymptomatic subjects at high risk for cardiovascular disease. SUBJECTS/METHODS: A total of 339 men and 433 women aged between 55 and 80 years at high cardiovascular risk because of presence of diabetes or at least three classical cardiovascular risk factors, food consumption was determined by a semi-quantitative food frequency questionnaire. Serum concentrations of high-sensitivity C-reactive protein (CRP) were measured by immunonephelometry and those of interleukin-6 (IL-6), intracellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) by enzyme-linked immunosorbent assay. RESULTS: After adjusting for age, gender, body mass index, diabetes, smoking, use of statins, non-steroidal antiinflammatory drugs and aspirin, a higher consumption of fruits and cereals was associated with lower concentrations of IL-6 (P for trend 0.005;both). Subjects with the highest consumption of nuts and virgin olive oil showed the lowest concentrations of VCAM-1, ICAM-1, IL-6 and CRP; albeit only for ICAM-1 was this difference statistically significant in the case of nuts (for trend 0.003) and for VCAM-1 in the case of virgin olive oil (P for trend 0.02). Participants with higher adherence to the Mediterranean-type diet did not show significantly lower concentrations of inflammatory markers (P<0.1 for VCAM-1 and ICAM-1). CONCLUSIONS: The consumption of some typical Mediterranean foods (fruits, cereals, virgin olive oil and nuts) was associated with lower serum concentrations of inflammatory markers especially those related to endothelial function, in subjects with high cardiovascular risk living in a Mediterranean country.

Modulation of the effects of chylomicron remnants on endothelial function by minor dietary lipid components.

There is emerging evidence that minor components from dietary oils can modulate or even improve events occurring in the development of atherosclerosis. One of the earliest events of the atherosclerotic process is endothelial dysfunction, which is an activation of the endothelium manifested by an increase in pro-inflammatory molecules, such as cytokines and adhesion molecules. Chylomicron remnants, such as LDL (low-density lipoprotein), are considered to be pro-atherogenic lipoproteins because they interact with endothelial cells and macrophages, increasing endothelial dysfunction mainly by the disturbance of the redox state in the cell. However, chylomicrons are, at the same time, the natural carriers of dietary lipids in plasma, which gives minor lipid components the opportunity to interact with the cells implicated in endothelial dysfunction and atherogenesis. Some of these components are known to exhibit antioxidant, anti-inflammatory and anti-atherogenic effects in vitro, even forming part of triacylglycerol-rich lipoproteins, such as chylomicrons.

Influence of minor components of olive oils on the composition and size of TRLs and on macrophage receptors involved in foam cell formation.

Metabolic and epidemiologic studies support the idea that the type of dietary fat is more important than the total amount of fat with respect to the development of atherosclerosis and the risk of cardiovascular heart disease. Dietary fat is carried in CMs (chylomicrons), which can be taken up by macrophages without need of further oxidation, leading to the formation of foam cells and initiating or aggravating the atherogenic process. Evidence from different studies has shown that dietary fat can influence the composition and size of TRLs (triacylglycerol-rich lipoproteins), which might modulate their atherogenicity to a certain extent. In particular, experiments in vitro have shown the anti-atherogenic effects of minor components from olive oil when forming part of TRL, as these particles give minor lipid components the opportunity to interact with the cells implicated in endothelial dysfunction and atherogenesis. However, the exact mechanisms mediating CM uptake by macrophages still remain unclear. Thus further studies are needed to understand how the modifications of TRL composition caused by dietary fats could modulate the expression of macrophage receptors and foam cell formation, or even improve the atherogenic risk of these particles.

Dietary virgin olive oil triacylglycerols as an independent determinant of very low-density lipoprotein composition.

OBJECTIVE: We examined the effects of virgin olive oil (VOO) triacylglycerols (TGs) on the lipid composition of human very low-density lipoprotein (VLDL). METHODS: Twenty-one normocholesterolemic, normotensive, non-diabetic elderly subjects were recruited for the study. Two VOOs (VOO1 and VOO2) of the same variety, with an equivalent composition in minor components and differing only in the oleic and linoleic acid concentrations, were administered for 4 wk each to assess the effect of their TG molecular species compositions. Blood was collected after an overnight fast, VLDLs were isolated by ultracentrifugation, and lipid classes, TG molecular species, and TG fatty acid composition were determined. RESULTS: Dietary VOOs significantly differed in TG molecular species composition. VOO1 represented larger amounts of triolein (P < 0.01), whereas VOO2 was significantly enriched with dilinoleoyl-oleoyl-glycerol, linoleoyl-dioleoyl-glycerol, and linoleoyl-oleoyl-palmitoyl-glycerol (P < 0.01). For VLDL, intake of VOO1 caused an increase of total TG (P < 0.01) due mainly to increases in triolein and linoleoyl-dioleoyl-glycerol. Conversely, VOO2 increased VLDL cholesteryl esters (P < 0.01) and TG rich in arachidonic acid (P < 0.01). CONCLUSIONS: The different TG molecular species compositions of dietary oils may be an independent determinant of the lipid composition of VLDL in elderly people and therefore may play a role in regulating lipoprotein metabolism in these subjects.

Effects of different dietary oils on inflammatory mediator generation and fatty acid composition in rat neutrophils.

Virgin olive oil (VOO) compared with fish oil (FO) and evening primrose oil (PO) on the ability of stimulated leukocytes to produce inflammatory mediators was investigated in rats. Weaned Wistar rats were fed a basal diet (BD) (2% by weight of corn oil) or diets containing 15% by weight of VOO, PO, or FO. After 8 weeks, glycogen-elicited peritoneal polymorphonuclear leukocytes, mainly neutrophils, were isolated. The calcium-ionophore stimulated neutrophils (2.5 x 10(6) cells/mL) obtained from rats fed the different oils produced a higher release of lysosomal enzymes (beta-glucuronidase, lysozyme, and myeloperoxidase [MPO]) compared with those fed BD. The production of reactive oxygen species (ROS) in response to the stimulant, 12-O-tetradecanoyl-phorbol-13-acetate (TPA), by neutrophils from the VOO group (15.44 nmol of O(2)(-) and 6.56 nmol of H(2)O(2)) was similar to the BD group (12.01 nmol O(2)(-) and 8.49 nmol H(2)O(2)) and significantly lower than the PO (20.90 nmol O(2)(-) and 10.84 nmol H(2)O(2)) and FO (20.93 nmol O(2)(-) and 12.79 nmol H(2)O(2)) groups. The cyclooxygenase-derived eicosanoid production was reduced by the lipid enrichment of the diets. Whereas the generation of prostaglandin E(2) (PGE(2)) was significantly decreased in VOO (5.40 ng/mL), PO (4.95 ng/mL), and FO (1.44 ng/mL) groups compared with BD (8.19 ng/mL), thromboxane B(2) (TXB(2)) reduction was especially significant in neutrophils from the FO diet group (14.67 ng/mL compared with 26.69 ng/mL from BD). These experimental data suggest that FO and PO, as well as VOO, could be considered a valuable strategy in preventing the generation of some inflammatory mediators.