Gonadal remodeling and hormonal regulation during sex change of juvenile dusky grouper Epinephelus marginatus (Teleostei, Serranidae), an endangered protogynous hermaphrodite fish.

Sex change was induced in Epinephelus marginatus juveniles using a nonsteroidal aromatase inhibitor (AI), a synthetic androgen (17α-methyltestosterone; MT), and a combination of both (MT + AI) in a 90-day experiment. A detailed remodeling of the gonads, the plasma level of gonadal steroids, and immunostaining of pituitary follicle-stimulating hormone (FSH), luteinizing hormone (LH), and somatolactin (SL) cells were analyzed. Sex inversion reached the final spermatogenesis stages using MT, while AI triggered spermatogenesis, but reaching only the spermatid stage. Estradiol (E2) levels did not change in fish treated with AI but decreased throughout the experimental period in animals treated with MT and MT + AI. Testosterone (T) levels increased in animals treated with MT during the first 60 days (and combined with AI in the first 30 days), decreasing in all experimental groups at 90 days, while AI-treated animals had increased plasma 11-ketotestosterone (11-KT) levels after 90 days. In control fish, FSH- and SL-producing cells (ir-FSH and ir-SL) were restricted to pars intermedia (PI) of the adenohypophysis. Pituitary ir-FSH cells were decreased at the end of the experimental period in all treatments compared with the CT animals. LH-producing cells (ir-LH) were present in proximal pars distalis (PPD) and pars intermedia (PI) of adenohypophysis and did not change after the experimental period. The decreased number of ir-FSH cells at the end of the experiment in all treatments could be related to the negative feedback loop triggered by the increase in natural and/or synthetic androgens.

Embryonic and larval development and fatty-acid profile of Epinephelus marginatus spawned in captivity: tools applied to captive rearing.

Development, ontogeny of the digestive system and the fatty-acid (FA) profile, were analysed during development of Epinephelus marginatus. Larvae were analysed 7 and 17 days post fertilization (dpf) to evaluate fatty-acid profile and morphological variables, respectively. Epinephelus marginatus larvae have relatively slow development of digestive structures, but were able to capture, ingest and digest prey by 5 dpf. Eggs were composed of high percentages of polyunsaturated fatty acids (PUFA) in phospholipids. The percentage of n3 PUFAs was higher than n6, especially docosahexaenoic acid (DHA), which exhibited higher levels compared with other marine species during the first 3 days of development, both in terms of phospholipids and triglycerides. The larvae present a high content of docosahexaenoic acid-eicosapentaenoic acid (DHA-EPA) and, during this phase, live food of small size was required (copepods or SS-strain Brachionus rotundiformes), enriched with DHA-EPA. These results may guide future studies on the contribution of FAs required during this stage of the life cycle of E. marginatus, to advance knowledge of the use of these FAs throughout ontogeny and contribute to the culture of this species commercial production or restocking.

Expression of insulin receptor (IR) A and B isoforms, IGF-IR, and IR/IGF-IR hybrid receptors in vascular smooth muscle cells and their role in cell migration in atherosclerosis.

BACKGROUND: Abnormal proliferation and migration of vascular smooth muscle cells (VSMCs) is a major contributor to the development of atherosclerotic process. In a previous work, we demonstrated that the insulin receptor isoform A (IRA) and its association with the insulin-like growth factor-I receptor (IGF-IR) confer a proliferative advantage to VSMCs. However, the role of IR and IGF-IR in VSMC migration remains poorly understood. METHODS: Wound healing assays were performed in VSMCs bearing IR (IRLoxP+/+ VSMCs), or not (IR-/- VSMCs), expressing IRA (IRA VSMCs) or expressing IRB (IRB VSMCs). To study the role of IR isoforms and IGF-IR in experimental atherosclerosis, we used ApoE-/- mice at 8, 12, 18 and 24 weeks of age. Finally, we analyzed the mRNA expression of total IR, IRB isoform, IGF-IR and IGFs by qRT-PCR in the medial layer of human aortas. RESULTS: IGF-I strongly induced migration of the four cell lines through IGF-IR. In contrast, insulin and IGF-II only caused a significant increase of IRA VSMC migration which might be favored by the formation of IRA/IGF-IR receptors. Additionally, a specific IGF-IR inhibitor, picropodophyllin, completely abolished insulin- and IGF-II-induced migration in IRB, but not in IRA VSMCs. A significant increase of IRA and IGF-IR, and VSMC migration were observed in fibrous plaques from 24-week-old ApoE-/- mice. Finally, we observed a marked increase of IGF-IR, IGF-I and IGF-II in media from fatty streaks as compared with both healthy aortas and fibrolipidic lesions, favoring the ability of medial VSMCs to migrate into the intima. CONCLUSIONS: Our data suggest that overexpression of IGF-IR or IRA isoform, as homodimers or as part of IRA/IGF-IR hybrid receptors, confers a stronger migratory capability to VSMCs as might occur in early stages of atherosclerotic process.

A new red-emitting La(1-x)Pr(x)Sr2AlO5 phosphor powder prepared by combustion synthesis.

New red luminescent powders of La(1-x)Pr(x)Sr2AlO5 (x = 0.01 at.) were prepared by the combustion synthesis method. Microstructural properties were characterized by using X-ray diffraction, scanning electron microscopy and transmission electron microscopy. The La(1-x)Pr(x)Sr2AlO5 X-ray diffraction pattern revealed a tetragonal phase. Morphology of the grains showed nanobars with sizes of approximately 550 nm in length. Photoluminescence, cathodoluminescence and diffuse reflectance were analyzed in detail. Photoluminescence revealed two narrow emission peaks located at lambda(em1) = 497 nm (green) and lambda(em2) = 620 nm and a single maximum excitation peak of lambda(ex) = 287 nm. The cathodoluminescence spectrum confirmed the peaks detected by photoluminescence analysis. The absorbance spectrum showed broad absorption with a maximum around lambda = 280 nm, which agrees with the maximum excitation peak detected by photoluminescence.

Frequency of Neospora caninum-specific antibodies in bulk milk from dairy farms from Mar y Sierras Dairy Basin, Argentina.

The aim of this study was to describe the prevalence of Neospora caninum based on the detection of specific antibodies in bulk tank milk (BTM) from dairy cattle farms in the Mar y Sierras Basin by using an enzyme-linked immunosorbent assay (ELISA). A total of 98 BTM samples from 49 dairy farms were collected during autumn and spring of 2019. Additionally, 147 paired individual milk and serum samples were collected from two dairy farms to assess the prevalence within-herd by ELISA and indirect fluorescent antibody test (IFAT, serum samples). Additionally, 12 individual serum samples were also assessed to test the agreement between IFAT and ELISA (total serum samples 159). Noteworthy, 100 and 91.84% of 49 dairy farms were positive in the BTM in autumn and spring, respectively. For the within-herd individual samples, a good agreement between serum and milk results was obtained for ELISA and IFAT (0.86-0.90). This is the first study in Argentina in which milk samples were tested to determine the N. caninum infection status at herd and within-herd levels in dairy farms, providing a base for further research.

Assessing water use and quality through youth participatory research in a rural Andean watershed.

Water availability, use and quality in a rural watershed of the Colombian Andes were investigated through participatory research involving local youth. Research included the quantification of disaggregated water use at the household level; comparison of water use with availability; monitoring water quality of streams, community water intakes and household faucets; and the determination of land use-water quality interactions. Youth were involved in all aspects of the research from design to implementation, dissemination of results and remediation options. Quantification of domestic and on-farm water use, and water availability indicated that water availability was sufficient during the study period, but that only an 8% decrease in dry season supply would result in shortages. Elevated conductivity levels in the headwaters were related to "natural" bank erosion, while downstream high conductivity and coliform levels were associated with discharges from livestock stalls and poorly maintained septic tanks in the stream buffer zone. Through the involvement of youth as co-investigators, the knowledge generated by the research was appropriated at the local level. Community workshops led by local youth promoted water conservation and water quality protection practices based on research, and resulted in broader community participation in water management. The approach involving youth in research stimulated improved management of both land and water resources, and could be applied in small rural watersheds in developed or developing countries.

Association of ficolin-3 with abdominal aortic aneurysm presence and progression.

Essentials Abdominal aortic aneurysm (AAA) is asymptomatic and its evolution unpredictable. To find novel potential biomarkers of AAA, microvesicles are an excellent source of biomarkers. Ficolin-3 is increased in microvesicles obtained from activated platelets and AAA tissue. Increased ficolin-3 plasma levels are associated with AAA presence and progression. SUMMARY: Background Abdominal aortic aneurysm (AAA) patients are usually asymptomatic and AAA evolution is unpredictable. Ficolin-3, mainly synthesized by the liver, is a molecule of the lectin complement-activation pathway involved in AAA pathophysiology. Objectives To define extra-hepatic sources of ficolin-3 in AAA and investigate the role of ficolin-3 as a biomarker of the presence and progression of AAA. Methods Microvesicles (exosomes and microparticles) were isolated from culture-conditioned medium of ADP-activated platelets, as well as from AAA tissue-conditioned medium (thrombus and wall). Ficolin-3 levels were analyzed by western-blot, real-time PCR, immunohistochemistry and ELISA. Results Increased ficolin-3 levels were observed in microvesicles isolated from activated platelets. Similarly, microvesicles released from AAA tissue display increased ficolin-3 levels as compared with those from healthy tissue. Moreover, ficolin-3 mRNA levels in the AAA wall were greatly increased compared with healthy aortic walls. Immunohistochemistry of AAA tissue demonstrated increased ficolin-3, whereas little staining was present in healthy walls. Finally, increased ficolin-3 levels were observed in AAA patients' plasma (n = 478) compared with control plasma (n = 176), which persisted after adjustment for risk factors (adjusted odds ratio [OR], 5.29; 95% confidence interval [CI], 3.27, 8.57)]. Moreover, a positive association of ficolin-3 with aortic diameter (Rho, 0.25) and need for surgical repair was observed, also after adjustment for potential confounding factors (adjusted hazard ratio, 1.55; 95% CI, 1.11, 2.15). Conclusions In addition to its hepatic expression, ficolin-3 may be released into the extracellular medium via microvesicles, by both activated cells and pathological AAA tissue. Ficolin-3 plasma levels are associated with the presence and progression of AAA, suggesting its potential role as a biomarker of AAA.

Effect of copper-zinc superoxide dismutase on endothelium-dependent vasodilation in patients with essential hypertension.

Patients with essential hypertension have abnormal endothelium-dependent vasodilation related to decreased nitric oxide activity. The specific mechanism responsible for this abnormality is unknown. Recent studies in hypertensive animals have suggested an augmented destruction of nitric oxide by superoxide anions. Therefore, in the present study we aimed to investigate whether this mechanism is responsible for the abnormal vasodilator function of hypertensive patients. To this end, we studied the vascular responses to acetylcholine (an endothelium-dependent vasodilator) and sodium nitroprusside (a direct smooth muscle dilator) before and after combined administration of copper-zinc superoxide dismutase (a scavenger of superoxide anions with poor intracellular penetrance; 6000 U/min) in 20 healthy control subjects (11 men and 9 women; aged 50 +/- 6 years) and 20 hypertensive patients (13 men and 7 women; aged 51 +/- 9 years). Drugs were infused into the brachial artery, and the response of the forearm vasculature was measured by plethysmography. The vasodilator response to acetylcholine was significantly blunted in hypertensive patients compared with control subjects (maximal flow: 8.2 +/- 4 versus 12.7 +/- 3 mL/min per 100 mL; P < .02); however, no difference was observed in the response to sodium nitroprusside (8.1 +/- 4 versus 9.5 +/- 3 mL/min per 100 mL). In healthy control subjects superoxide dismutase infusion did not modify the vasodilator response to acetylcholine (maximal flow: 12.7 +/- 3 before versus 12.1 +/- 3 after superoxide dismutase). Similarly, in hypertensive patients superoxide dismutase infusion did not alter the response to acetylcholine (maximal flow: 8.2 +/- 4 versus 7.7 +/- 4).(ABSTRACT TRUNCATED AT 250 WORDS)

Liver transplantation in patients over sixty years of age.

BACKGROUND: Although some centers have reported very good patient and graft survival in liver allograft recipients, reports from both North America (United Network of Organ Sharing) and Europe (European Liver Transplantation Registry) have failed to confirm this. AIM: We have reviewed our experience of liver transplantation in older recipients and compared their clinical outcome to a younger group. METHODS: Retrospective analyses were conducted on 875 consecutive adult patients undergoing liver transplantation for chronic liver disease, between 1990 and 1999. Group I consisted of patients under 60 years of age (n=701; 80.2%) and group II of patients over 60 years (n=174; 19.8%). RESULTS: The proportion of older patients transplanted increased from 10.15% between 1990-1991 to 20.85% (1997-1999). Actuarial graft survival at 1, 3, and 5 years was 78%, 74%, and 69% and 78%, 73%, and 66% for groups I and II, respectively (P=0.49). The overall actuarial patient survival tended to be better in the younger group (1-, 3-, and 5-year survival of 83%, 79%, and 76% for group I and 81%, 75%, and 69% for group II (P=0.07). Crude mortality probability shows a stable trend until 45 years, a gradual increase in mortality between 45 and 60 years, and then the risk of death is accelerated. The same analysis shows the risk of death is between 1.5 and 2 times greater in Child C patients; this is greater in patients aged more than 66 years. CONCLUSION: There is no statistically significant difference in patient or graft survival in patients aged over 60 compared to younger recipients. However, when age is assessed as a continuous variable, an adverse effect of older age is seen on outcome and this effect is more marked in sicker patients.

Evidence that endothelial dysfunction in patients with hypercholesterolemia is not due to increased extracellular nitric oxide breakdown by superoxide anions.

Patients with hypercholesterolemia have impaired endothelium-dependent vasodilation due to decreased nitric oxide activity. The present study aimed to determine whether this form of endothelial dysfunction is related to enhanced extracellular breakdown of nitric oxide by superoxide anions. To this end, the vascular responses to acetylcholine (an endothelium-dependent vasodilator) and sodium nitroprusside (a direct smooth muscle dilator) were studied before and after combined administration of copper-zinc superoxide dismutase (a scavenger of superoxide anions with poor intracellular penetrance; 6,000 U/min) in 20 normal controls (11 men and 9 women, age 50 +/- 6 years) and in 20 hypercholesterolemic patients (10 men and 10 women, age 49 +/- 9 years). Drugs were infused into the brachial artery and the response of the forearm vasculature was measured by plethysmography. The vasodilator response to acetylcholine was significantly blunted in hypercholesterolemic patients compared with normal controls (maximal flow 8.8 +/- 2 vs 12.7 +/- 3 ml/min/100 ml, respectively; p < 0.03); however, no difference was observed in the response to sodium nitroprusside (9.7 +/- 2 and 9.5 +/- 3 ml/min/100 ml). In normal controls, the infusion of superoxide dismutase did not significantly modify the response to acetylcholine (maximal flow 12.7 +/- 3 vs 12.1 +/- 3 ml/min/100 ml before and after superoxide dismutase, respectively). Similarly, in hypercholesterolemic patients, the infusion of superoxide dismutase did not alter the response to acetylcholine (maximal flow 8.8 +/- 2 and 8.9 +/- 2 ml/min/100 ml). A subset of 19 subjects (8 normal and 11 patients) received a 60-minute infusion of superoxide dismutase at 24,000 U/min without alteration in their response to acetylcholine.(ABSTRACT TRUNCATED AT 250 WORDS)

Pericardial baffle complications following the Mustard operation. Age-related incidence and ease of management.

Pericardial baffle complications with the standard Mustard operation led first to the use of alternative materials of various shapes and finally to the recent popularity of the Senning procedure. At The Oregon Health Sciences University, we have persisted since the mid-1960s in the use of a modified Mustard operation in which a rectangular pericardial baffle is employed. Among 75 patients, there were baffle complications necessitating reoperation in 13. The reoperation-free rates (+/- standard error) at 9 years for patients less than or equal to 6 months, 7 to 12 months, and greater than 12 months of age were 59% +/- 15%, 60% +/- 17%, and 95% +/- 5%, respectively. All 10 patients reoperated upon during the past decade survived with complete relief of symptoms. A double patch to widen both the superior portion of the baffle and the superior vena cava was used most commonly and is our current procedure-of-choice. Baffle complications after the use of pericardium can be managed easily and reoperation on these patients carries a low risk. However, even with experience, the incidence of reoperation remains high in patients under 1 year of age and prompts a critical age-related comparison of these late results with the Senning procedure.

Mitral repair in complete atrioventricular canal. Ease of correction in early infancy.

During the past 5 years all patients with complete atrioventricular (AV) were subjected to surgical correction regardless of age. Thus we were able to assess the ease and reliability of mitral repair in early infancy. Key features of operation include division of bridging leaflets when indicated, selection of a patch sufficiently small to prevent postoperative annular dilation, attachment of the leaflets to the patch with continuous nonpledget-supported sutures at a level determined by the chordal structure, and, based on the size of the mural leaflet, construction of a bicuspid or tricuspid mitral valve. Operative mortality and postoperative morbidity were no greater in patients under 6 months of age than in older patients. Reoperation for mitral regurgitation was required in three patients. In all of them, the primary reason for the failure of repair was that the mitral valve had been left tricuspid; in two of them, the mitral anulus was dilated, as well. Repair was uniformly accomplished by bicuspidization, combined in two instances with a Wooler-type annuloplasty and shortening of the free margin of the aortic leaflet. The absence of secondary scarring of the leaflets in the patients under 6 months of age facilitated repair in this age group. Early repair is possible, and preferable, provided that meticulous attention is paid to the technical features of the repair and a proper decision is made with regard to treatment of the mitral "cleft."

Chronic rejection of the liver: the role of immunosuppression.

Liver transplantation is now widely recognised as an effective treatment option for patients with advanced liver disease. Many units now achieve greater than 85% survival at 1 year, with the majority of patients having a high quality of life. The maintenance of a high quality of life requires careful clinical management to ensure that the continued maintenance of excellent liver graft function is not achieved at the expense of immunosuppressive drug complications or morbidity. Acute liver rejection will occur in between 30 to 45% of patients, although with modern immunosuppressive protocols, usually combining one of the calcineurin agents, either cyclosporin or tacrolimus, with both azathioprine and corticosteroids (prednisolone) ensures that relatively few grafts are lost from severe acute rejection. While the incidence and severity of acute rejection may be one factor in raising the risk of chronic rejection, it may not be the principal one in many patients. It is important to recognise that the frequency of rejection also varies with the primary underlying liver disease, with patients with hepatitis B or alcoholic liver disease having relatively low rejection rates, compared with patients with primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC), which range between 20 to 70%. Chronic rejection will account for some 5% of grafts lost in the first 3 to 5 years. Indeed, there is some evidence that the incidence of chronic rejection is actually declining over the past few years. While the reason for this apparent decline is uncertain, and it could relate to better immunosuppression management, or more likely to the growing recognition that chronic graft dysfunction may be due to recurrent liver disease, such as autoimmune hepatitis, PBC, PSC, or recurrent hepatitis C. The differentiation of recurrent primary liver disease from chronic rejection can prove to be very difficult in clinical practice. Thus, the clinician must carefully monitor liver and graft function, evaluate any biochemical changes, and try to reach a clear diagnosis before considering any modification of immunosuppressive schedules.

Gender and health services use for a mental health problem.

This study addresses whether the predictors of seeking help for a mental health problem differ by gender. An adaptation of Andersen's Socio-Behavioral Model is used to identify factors associated with seeking care for a mental health problem. Data are derived from two waves of a community survey undertaken in 1992-1993 and in 1993-1994 among a probability sample of adults (18-69 years), residing in poor areas of Puerto Rico. Paired data was used from those individuals who responded to both waves of the survey for a total of 3221 community respondents. Responses from wave 1 were used to predict mental health service use in wave 2. The dependent variable is any use of outpatient mental health services in the year preceding the second interview. Logistic regression was used to model the effects of the independent variables on use. Males and females were found to use mental health services in nearly equal proportions. Gender did not have a main effect on use when other covariates were controlled. Significant interactions with gender were found for several predictors of use. The largest intervention effects were encountered in our need for care indicators. Having a definite need for mental health care and poor self-rated mental health had a larger effect on predicting use of services for men than they do for women. It is concluded that strategies designed to improve access to mental health services for minority disadvantaged populations ought to take into account gender differences in the predictors of use. Studies addressing factors influencing health services utilization for a mental health problem should consider stratifying their sample by gender. Future research should establish whether or not these findings are sustained with other population groups.

Heterogeneity in early onset alcoholism suggests a third group of alcoholics.

Data from 141 Brazilian male alcoholics were investigated with the objective of further exploring the heterogeneity of alcoholism and to replicate previous studies. A set of seven variables was studied by different cluster analyses to test hypotheses with two, three, and four groups. The results suggested that the best solution showed three groups of alcoholics, two of them similar to those previously described and a third relatively similar to type 2, but with lower scores in harm avoidance, more positive impact of life events, higher proportion of alcoholic relatives, less frequent use of antianxiety drugs, and less delirium tremens. These results reinforced the model with three groups and may be useful in the delineation of new etiology and treatment studies.

Kikuchi-Fujimoto disease of the neck. Update.

Kikuchi-Fujimoto disease (KFD) is a rare entity of uncertain cause that commonly presents with persistently enlarged cervical lymph nodes unresponsive to antibiotic therapy. Although it usually follows a benign course, KFD has been repeatedly misdiagnosed as malignant lymphoma; hence, clinicians and pathologists alike need to be aware of this disease entity. The newest developments regarding the etiology and course of KFD are presented through a review of the literature and a recent illustrative case.

A current appraisal of the Waterston shunt.

Recent reports have suggested that the classical Blalock-Taussig shunt and its prosthetic modification have a low patency rate in neonates. This prompted a review of 58 neonates undergoing a Waterston shunt for cyanotic congenital heart disease. The 4 mm anastomosis was constructed using a calibrated clamp. There were 20 (35%) hospital deaths, of which 3 were directly related to shunt failure. Operative mortality was associated with increasing complexity of the cardiac lesion, emergency operation, weight less than 3 kg and age less than 48 hours. There were 5 late deaths resulting in an actuarial survival of 52% at ten years. There was one case of late occlusion corresponding to a patency of 92% at 2 years. Anastomotic kinking with preferential flow to one lung occurred in 2 (7%) of 28 patients undergoing repeat angiography at 3 and 5 years respectively. Nineteen patients underwent corrective surgery a mean of 27 months after shunt construction. Six (32%) required an angioplastic repair of the pulmonary artery. Six (16%) of the 38 operative survivors required diuretic therapy for excessive pulmonary flow. The high patency ensures that the Waterston shunt continues to play an important role in the management of low weight neonates who require an emergency systemic-pulmonary shunt. The use of a calibrated clamp reduces the incidence of excessive pulmonary flow. Early corrective surgery and shunt dismantling may reduce the necessity for angioplastic repair.

Analysis of marginal donor parameters in liver transplantation for primary biliary cirrhosis.

The shortage in cadaveric donor livers is pushing the transplant centers to expand the pool by using "marginal" donors. Primary biliary cirrhosis (PBC) remains an important indication for transplantation. We conducted a retrospective analysis of prospectively collected data in a well-defined group of patients with PBC where 301 consecutive donor-PBC recipient pairs transplanted were analyzed to identify donor and operative factors influencing recipient outcome. Mean follow-up was 56 months. The 1-, 3- and 5-year actuarial patient and graft survival was 93.97%, 90.64%, and 81.75%, and 85.49%, 82.57%, and 75.21%, respectively. Factors showing influence in decreased total patient survival were recipient old age (P = 0.003) and low recipient albumin (P = 0.01). However, the only variables showing an association with decreased patient survival within 90 days are old donor age (P = 0.002) and high donor body weight (P = 0.03) or high body mass index (BMI) (P = 0.055). Cold ischaemic time (CIT) of 18 hours showed statistical significance in patient survival (P = 0.025). Obesity did have a significant adverse impact on survival compared with normal or overweight donors (BMI < 30), decreasing survival by 50% at 5 years. In conclusion, this study of several factors considered "marginal" for transplantation in a recipient population with predictable liver disease (PBC), donor BMI and age were shown to be associated with decreased graft and patient survival.

Recurrent and de novo non-alcoholic steatohepatitis following orthotopic liver transplantation.

BACKGROUND: Non-alcoholic steatohepatitis was coined in 1980 to describe pathological and clinical features of non-alcoholic disease associated with pathological features, commonly seen in alcoholic-liver disease itself. It is now a well-recognised cause of end-stage liver disease and a rare cause of orthotopic liver transplantation. A small number of cases with recurrent non-alcoholic steatohepatitis following liver transplantation have been reported, however de novo non-alcoholic steatohepatitis in the liver allograft is not well recognised. AIMS/RESULTS: We report four cases of non-alcoholic steatohepatitis following orthotopic liver transplantation describing the factors related with the pathology. The recurrence of fatty infiltration occurred within 21 months and transition from mild steatosis to non-alcoholic steatohepatitis and early fibrosis was observed within 60 months post transplant in all four patients. All four cases had association with one or multiples risk factors (obesity, type 2 diabetes and/or hyperlipidemia). CONCLUSIONS: Management of this risk factors may play a therapeutic role in the prevention of recurrent and de novo non-alcoholic steatohepatitis following orthotopic liver transplantation.

[Microbiological quality of vanilla ice cream manufactured in Caracas, Venezuela]. / Calidad microbiológica de los helados de crema elaborados en Caracas, Venezuela.

A total of 122 samples of vanilla ice cream, the base product used for all flavors, prepared by eight different large firms at the Metropolitan Area of Caracas, Venezuela, were analyzed for aerobic mesophilic and psicrophilic bacteria, Staphylococcus aureus, Enterobacteriaceae, and Filamentous fungi. Findings revealed that within the sampling, 56.6% complied with the international standards proposed for aerobic mesophilic bacteria, 68% for Staphylococcus aureus, and 23% for Enterobacteriaceae. Three serotypes of enteropathogenic Escherichia coli, one of Salmonella, and one of Shigella were found. Ten genera of Filamentous fungi were isolated and identified.