Protective effects of Rosmarinus tomentosus ethanol extract on thioacetamide-induced liver cirrhosis in rats

The capability of an ethanol extract of Rosmarinus tomentosus to protect rat liver in an experimental model of cirrhosis induced by thioacetamide (TAA) has been evaluated. Four groups of rats were used: Two of them received 300 mg TAA/l in the drinking water for 3 months while the other two, which served as controls, were given water ad libitum. During the same period and for each one of the treatments, one group received a semi-purified (SP) diet and the other one was fed the same diet supplemented with 1% of the dry residue obtained from R. tomentosus ethanol extract (SP+E). There was a significant reduction of TAA toxicity in rats fed the SP+E diet, as assessed by plasma and liver biochemical markers, and by liver histopathology. Plasma total protein concentration was restored, urea concentration and plasma alkaline phosphatase and gamma-glutamyl-transferase activities were reduced. A significant correction of plasma fatty acids concentrations was also evident. Hepatic alkaline phosphatase and gamma-glutamyl-transferase activities were significantly reduced in animals fed SP+E diet and glucose-6-phosphatase activity was significantly enhanced. The results suggest that R. tomentosus ethanol extract administered in the diet affords protection against TAA-induced cirrhosis, preventing most of the histological changes and functionality alterations own to this experimental pathology.

Efficacy and Safety of Amlodipine

BACKGROUND

This study set out to assess the safety and efficacy of amlodipine in two cohorts of patients who were attended in primary- and specialised-care centres, respectively.

METHODS

Prospective, observational, multicentre pharmacovigilance study including patients aged >18 years who presented with a diagnosis of hypertension (systolic blood pressure [SBP] >or=140 mm Hg and diastolic blood pressure [DBP] >or=90 mm Hg) of >6 months' duration, which was either untreated or uncontrolled, and who were followed up by general practitioners and specialists over a period of 4-6 months.

RESULTS

Of the total of 4277 patients included in the study, 2520 (58.9%) were attended in primary care and 1757 (41.1%) in specialised care. 2982 patients (69.7%) were receiving monotherapy, the rest were receiving combined therapy. Over the course of the study, 308 patients (7.2%) experienced adverse events related to the study drug, mostly mild to moderate in nature. There were 20 serious events, although none was related to the study drug. By the end of the study, 1617 patients (37.8%) had achieved the therapeutic goal (SBP <140 mm Hg and DBP <90 mm Hg), with the greatest degree of control being registered among patients receiving combined therapy compared with monotherapy (38.7% vs 35.7%), and in those treated in a specialised-care setting versus a primary-care setting (43.5% vs 33.8%; p < 0.005).

CONCLUSIONS

Amlodipine was shown to be a well tolerated and effective drug in one in three patients, and achieved the therapeutic goal in a higher proportion of patients at specialised-care centres compared with those in primary care, and in those receiving combined therapy compared with monotherapy.

[Incidence of influenza and influenza vaccine effectiveness in the 2004-2005 season]

BACKGROUND

To quantify the incidence of flu in different groups of the population of Navarra in the 2004-2005 season, and to evaluate the effectiveness of anti-flu vaccination.

METHODS

The analysis of influenza cases in the system of compulsory notificable diseases was complemented by the individualised notifications in the network of sentinel doctors that covers a population of 22,339 inhabitants. The coverage and effectiveness of the vaccine was studied.

RESULTS

Vaccine coverage in (3)65 year olds reached 62%. The incidence of influenza was 42.6 cases per 1,000 inhabitants. It reached a maximum in mid-January, exceeding 750 weekly cases per 100,000 inhabitants and 1,900 cases per 100,000 children. The highest rate of influenza was observed in under-15 year olds (49.4 cases per 1,000 inhabitants) and the lowest in non-institutionalised (3)65 year olds (2.6 per 1,000 inhabitants), although it was higher in geriatric residences (62.1 per 1,000; p<0.0001). Seventy-nine percent of the cases from 5 to 64 years resulted in absenteeism from school or work. The flu virus was identified in 42/65 (65%) nasopharyngeal smears, 90% being influenza virus A(H3). The incidence of influenza was 3.08% in the unvaccinated and 0.45% in the vaccinated (p<0.001). The global effectiveness of the anti-flu vaccine was 65%, and in (3)65 years old it was 73%.

CONCLUSION

Although its effectiveness is not total, the vaccine is the main measure for preventing influenza. The network of sentinel doctors provide useful information for the coordination of care and public health activities against flu.

Effect of the Platinum Content on the Microstructure and Micropore Size Distribution of Pt/Alumina-Pillared Clays

The aim of this work is to study the effect of the platinum content (0-1.8 wt % Pt) on the microstructure of an alumina-pillared clay. For this purpose, the nitrogen physisorption data at -196 degrees C, the micropore size distributions of the supported platinum catalysts, and the hydrogen chemisorption results at 30 degrees C have been analyzed and compared. The preparation of the catalysts has modified the textural properties of the Al-pillared clay support, giving rise to a loss of surface area and micropore volume. After reduction at 420 degrees C, the presence of dispersed metallic platinum with mean crystallite size in the 22-55 A range has been found by hydrogen adsorption. Comparison of all results reveals that the platinum species block the micropore entrances by steric hindrance to nitrogen access as the platinum content increases.

Seroprevalence of varicella among children and adolescents in Valencia, Spain. Reliability of the parent's reported history and the medical file for identification of potential candidates for vaccination

This study assessed the seroprevalence of varicella antibodies in children and adolescents in Spain and evaluated the reliability of two methods for detecting susceptible individuals: (1) parental-reported history of varicella and (2) medically-documented histories maintained by the pediatrician. A total of 186 children (6 to 15 years of age) were recruited in 13 pediatric offices of Valencia, Spain. A brief case report form was completed including previous history of varicella referred by the parents, and a 5 mL blood sample was obtained. The pediatrician medical file was reviewed for antecedent of varicella. The overall prevalence of varicella antibodies was 84% and 88% in the 6-9 years and 10-15 years age brackets, respectively. The predictive value of a negative history of varicella disease was 48% by parental recall (52% "false negative"), and only 26% by medical record (74% "false negative"). However, the positive predictive value of a positive parental reported history or a positive medically-documented history was 95%. The most effective strategy for varicella vaccination of older children and adolescents in Spain will be to immunize those individuals with a lack of positive (unknown or negative) history of disease.

Dietary supplementation with monounsaturated and long-chain polyunsaturated fatty acids influences the liver structural recovery and hepatocyte binuclearity in female Wistar rats in experimental cirrhosis induced by thioacetamide

Oral administration of 300 mg/l thioacetamide (TAA) for 4 months causes hepatic lesions comparable to those described in alcoholic liver cirrhosis in humans and associated protein-energy malnutrition. In this sense, direct supplementation with monounsaturated fatty acids (MUFAs) and/or polyunsaturated fatty acids (PUFAs) might provide an advantage in the correction of the fatty acid deficiency in these patients. PUFAs are essential components of cell membranes maintaining its fluidity and function, important energy sources, and precursors of eicosanoids. Moreover, these fatty acids also modulate gene transcription, mRNA stability, and cellular differentiation.

METHODS

Fifty-four female Wistar rats (Interfauna Ibérica, Barcelona, Spain) weighing 110-120 g were used in this study. The animals were divided into two groups: one group was treated with 300 mg/l TAA dissolved in drinking water during 4 months, and the other group, which served as a control, was given water without TAA. To evaluate the changes induced by the administration of TAA for 4 months, TAA-treated (n = 7) and control animals (n = 5) were killed. Then, the TAA treatment was stopped and the rest of the animals in both TAA and control groups were divided into three experimental groups and three control groups which received for 2 weeks different type of diets. Using the TAA-induced liver cirrhosis model in rats, we analysed the effects of dietary supplementation with MUFAs and PUFAs on binuclearity and ultrastructure of hepatocytes. After TAA-induced cirrhosis, we analysed whether dietary supplementation with fatty acids may restore the normal percentage of binucleated cells, as well as the ultrastructure, nuclear area, and nuclear/cytoplasm index of hepatocytes.

RESULTS

Treatment with TAA causes cirrhosis characterized by the appearance of parenchyma nodules and fibrous septae, as well as qualitative and quantitative alterations in liver and plasma lipids. Our results indicate that dietary MUFAs support hepatocyte recovery regarding its ultrastructural and morphometric values. However, PUFAs-enriched diets (n-3 and n-3 + n-6) do not correct hepatomegaly, fibrosis or lipid accumulation. Thus, dietary PUFAs do not enhance hepatocyte recovery from morphological and ultrastructural alterations.

CONCLUSIONS

In our experimental model of cirrhosis, dietary supplementation with a high proportion of long-chain PUFAs (n-3 or n-6) negatively influences liver recovery. This negative effect was likely due to the increased susceptibility of cell membranes to lipid peroxidation, together with an alteration in lipid metabolism.

Systemic lupus erythematosus in Europe at the change of the millennium: lessons from the "Euro-Lupus Project"

The "Euro-Lupus Cohort" is composed by 1000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium--the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.

Binding of PTEN to specific PDZ domains contributes to PTEN protein stability and phosphorylation by microtubule-associated serine/threonine kinases

The tumor suppressor phosphatase PTEN is a key regulator of cell growth and apoptosis that interacts with PDZ domains from regulatory proteins, including MAGI-1/2/3, hDlg, and MAST205. Here we identified novel PTEN-binding PDZ domains within the MAST205-related proteins, syntrophin-associated serine/threonine kinase and MAST3, characterized the regions of PTEN involved in its interaction with distinctive PDZ domains, and analyzed the functional consequences on PTEN of PDZ domain binding. Using a panel of PTEN mutations, as well as PTEN chimeras containing distinct domains of the related protein TPTE, we found that the PTP and C2 domains of PTEN do not affect PDZ domain binding and that the C-terminal tail of PTEN (residues 350-403) provides selectivity to recognize specific PDZ domains from MAGI-2, hDlg, and MAST205. Binding of PTEN to the PDZ-2 domain from MAGI-2 increased PTEN protein stability. Furthermore, binding of PTEN to the PDZ domains from microtubule-associated serine/threonine kinases facilitated PTEN phosphorylation at its C terminus by these kinases. Our results suggest an important role for the C-terminal region of PTEN in the selective association with scaffolding and/or regulatory molecules and provide evidence that PDZ domain binding stabilizes PTEN and targets this tumor suppressor for phosphorylation by microtubule-associated serine/threonine kinases.

Functional definition of relevant epitopes on the tumor suppressor PTEN protein

The binding of PTEN to PDZ-domain-containing proteins appears to play an important role in the control of cell growth, motility and apoptosis. In turn, this binding can be abrogated by cleavage of the PTEN C-terminal region by caspase-3. We have generated and characterized monoclonal antibodies (mAb) directed against distinct epitopes at the C-terminal region of PTEN, and used them to define protein-binding epitopes on PTEN and to study its cleavage by caspase-3. mAb directed against epitopes at the far C-terminus of PTEN blocked binding to PTEN cognate PDZ domains and did not recognize the caspase-3 cleaved PTEN fragments. On the other hand, mAb that recognized an epitope within the C2 domain of PTEN did not prevent binding to PDZ domains, but could detect the caspase-3 cleaved PTEN fragments. The analysis of PTEN cleavage by caspase-3 revealed that the lipid phosphatase activity of PTEN controls its own degradation by interfering with the PI3-K anti-apoptotic activity. Our results define protein-binding sites on the PTEN tumor suppressor at the immunochemical level, and suggest a regulatory link between PTEN phosphatase activity, caspase-3 sensitivity and PTEN-protein interactions.

Usual diet in Bubis, a rural immigrant population of African origin in Madrid

OBJECTIVE

To assess the usual diet of an immigrant Bubis population living in Madrid, the main ethnic group from the Island of Bioco, Equatorial Guinea, and explore how different it is from the predominant diet in West Africa and from the adult population of Madrid.

DESIGN

Cross-sectional study. We randomly selected a sample of 213 Bubis aged 18-84 years, 83 men and 130 women, who were born in Bioco, emigrated and now live in the Madrid area. Participants were interviewed about their usual diet with the use of a food frequency questionnaire. Height and weight were also measured during interviews and prevalence of obesity was estimated as a body mass index (kg m(-2)).

SETTING

The urban area of Madrid in 2001.

RESULTS

The diet of the Bubis living in the metropolitan area of Madrid resembles more the urban diet observed among Spanish people than the traditional rural diet observed among people of West Africa. The percentage of calories from fat, protein and carbohydrates was 33.9, 18.3 and 47.7%, respectively. The Bubi diet presented a much higher protein intake and much lower fat intake than the usual diet in Cameroon. The usual Bubi diet also contained more protein and less fat and alcohol than the predominant diet of adult population living in the Madrid area. Women presented higher prevalence of obesity (23.2%) than men (11.0%), and even higher than that observed among Spanish women.

CONCLUSIONS

The first immigrant generation of Bubis in Madrid showed food and nutrient intakes closer to the prevalent diet in Madrid than to the diet of their native land. The impact of this westernization of the diet of this and other immigrant populations in Spain needs to be monitored in the future.

Effect of the intercalation conditions of a montmorillonite with octadecylamine

Intercalation of montmorillonite with octadecylamine under several conditions is reported. Octadecylamine was protonated in situ with HCl to obtain octadecylammonium cations. Water and water/ethanol mixtures were used as reaction medium, and the ratios amine/clay and HCl/amine were also varied. Intercalation was successful when the amine/clay ratio was in the range 1-3 mmol/g; optimal results were obtained for an amine/clay ratio of 2.0 mmol/g. For a given amine/clay ratio, the HCl/amine ratio also influences the intercalation. Basal spacings of the intercalated solids were between 13.4-36.7 angstroms. The amount of organic matter incorporated into the solids also varied widely; up to 40 wt% is fixed. Specific surface area is very low in all the intercalated solids because of the blockage of the clay porosity by the organic molecules. Co-intercalation of octadecylammonium and of the inorganic polycation [Al13O4(OH)24(H2O)12]7+ was also considered, giving rise to intercalated solids with basal spacings between 17 and 22 A, also with a high fixation of organic matter.

Seroprevalence of varicella antibodies in healthcare workers and health sciences students

The objective of this study was to assess the seroprevalence of varicella antibodies in healthcare workers and students of healthcare professions and to determine the validity of the self-reported varicella history for detecting susceptible subjects. Personnel of a general hospital and students were recruited and a 5 mL blood sample was obtained from all participants. A case report form, including previous self-reported history of varicella, was completed. A total of 91 healthcare workers (mean age, 30.6 years; S.D., 4.0; range, 23-40) and 92 students (mean age, 19.8 years; S.D., 2.5; range, 18-25) were recruited. The prevalence of varicella antibodies was 91.2% in healthcare workers and 92.1% in students. Overall, the sensitivity, specificity, positive and negative predictive values of a self-reported history of varicella were 68.4%, 66.7%, 95.4% and 17.2%, respectively. The preferred approach in these groups at risk of varicella will be to undergo serologic testing before immunization in those with negative or unknown history of varicella.

Expression of HLA-G in inflammatory bowel disease provides a potential way to distinguish between ulcerative colitis and Crohn's disease

In addition to being involved in nutrient uptake, the epithelial mucosa constitute the first line of defense against microbial pathogens. A direct consequence of this physiological function is a very complex network of immunological interactions that lead to a strong control of the mucosal immune balance. The dysfunction of immunological tolerance is likely to be a cause of inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD). HLA-G is a non-classical major histocompatibility complex (HLA) class I molecule, which is highly expressed by human cytotrophoblast cells. These cells play a role in immune tolerance by protecting trophoblasts from being killed by uterine NK cells. Because of the deregulation of immune system activity in IBD, as well as the immunoregulatory role of HLA-G, we have analyzed the expression of HLA-G in intestinal biopsies of patients with UC and CD. Our study shows that the differential expression of HLA-G provides a potential way to distinguish between UC and CD. Although the reason for this differential expression is unclear, it might involve a different mechanism of immune regulation. In addition, we demonstrate that in the lamina propria of the colon of patients with UC, IL-10 is strongly expressed. In conclusion, the presence of HLA-G on the surface of intestinal epithelial cell in patients with UC lends support to the notion that this molecule may serve as a regulator of mucosal immune responses to antigens of undefined origin. Thus, this different pattern of HLA-G expression may help to differentiate between the immunopathogenesis of CD and UC.

[The present state of esophageal laparoscopic surgery]

Laparoscopic surgery has changed the therapeutic approach in the most frequent esophageal diseases. With the excellent results in the control of symptoms and the low associated morbidity, surgical treatment is increasingly indicated in benign esophageal pathology as a superior alternative to a chronic and less efficient medical treatment. For the hiatus hernia and gastroesophageal reflux, Nissen's fundoplication by laparoscopy is the technique of choice. The best results in the treatment of achalasia are obtained with Heller's laparoscopic myotomy. This growing experience includes the resection of tumours of the esophagus combining thoracoscopy and laparoscopy with similar results to those of open surgery.

[Laparoscopic bariatric surgery: proximal gastric bypass]

The spectacular increase in the prevalence of obesity in our society and the significant complications and comorbidities that it gives rise to have stimulated the interest of scientists and public in this pathology. Surgical treatment is at present the only efficient and lasting treatment for morbid obesity and in many cases it appreciably improves, and even definitively cures, associated complications such as the case of diabetes or hypertension. Amongst the different techniques of bariatric surgery, the gastric bypass (GBP) seems to be definitively establishing itself, since it offers an excellent balance between loss of weight (>70% of the excess), surgical risk and subsequent quality of life. The possibility of carrying out this technique employing a laparoscopic approach has improved its acceptance by doctors and patients while it has made it possible to reduce morbidity and mortality, length of hospital stay and costs. Proximal GBP is carried on those patients with an BMI <60 Kg/m2; for BMI >60 Kg/m2 the GBP employed is denominated distal. Between October 2003 and November 2005, our centre performed 55 laparoscopic proximal Roux-en-Y gastric bypasses via laparoscopy. These involved 42 women and 13 males with an average age of 44 years. The average BMI was 43.5 (35-55.8). The average basal weight was 116.15 Kg. There was no peroperative mortality, nor reinterventions. The BMI after 12 months was 28.4. The average basal weight was 74.2 Kg. Laparoscopic Roux-en-Y proximal gastric bypass is a safe and efficient technique for the treatment of morbid obesity.

Ovarian metastases caused by cholangiocarcinoma: a rare Krukenberg's tumour simulating a primary neoplasm of the ovary: a two-case study

INTRODUCTION

Ovarian metastases represent 10% of all ovarian malignancies. They are characterized by their ability to occasionally reproduce mimicking the clinical and morphological appearance of primary tumours, making diagnosis difficult. Most of these tumours originate in the digestive tract, the best known being Krukenberg's tumour in the stomach. Cholangiocarcinomas are rare neoplasias that very rarely affect the ovary. Their retroperitoneal location and low histological specificity in the ovary may lead to a misdiagnosis. This makes it necessary to accurately assess all clinical, radiological and morphological symptoms so as to avoid inappropriate treatments in affected patients.

CASE REPORT

Two cases of biliary cholangiocarcinomas simulating an ovarian neoplasia are reported.

Primary ovarian trabecular carcinoid tumour: a case report with an immunohistochemical study and a review of the literature

INTRODUCTION

Primary ovarian carcinoid tumours are uncommon neoplasias. There are distinct histological types with different behaviours: insular, trabecular, mucinous and mixed. The trabecular subtype is very rare and unlike other carcinoid subtypes, it is characterised by the absence of a clinical carcinoid syndrome and has been related with a better prognosis than the others. No distant metastases have yet been reported.

CASE REPORT

We present a case of a 76-year-old woman diagnosed with a left ovarian tumour. She underwent a radical hysterectomy with bilateral salpingo-oophorectomy and regional lymph node clearance. Histology revealed an ovarian trabecular carcinoid tumour and no adjuvant treatments were performed. The patient is alive and free of disease 70 months following diagnosis.

DISCUSSION

Immunohistochemical staining for p53 protein, and a comparative study with other subtypes of ovarian carcinoid tumours (insular and mucinous) is discussed in this report.

Hormones regulating lipid metabolism and plasma lipids in childhood obesity

OBJECTIVE

To review the mechanisms by which leptin, insulin and adiponectin influence lipid metabolism and plasma lipids in obesity, as well as to describe the associations between these hormones in prepubertal children.

METHOD

Revision of relevant papers published in the last 5 y related to the interactions of leptin, insulin and adiponectin, with special emphasis on those reporting potential mechanisms by which these hormones regulate lipid metabolism and plasma lipids. We also provide original results concerning the relationships found between plasma lipids and leptin, and insulin and adiponectin in prepubertal obese children.

RESULTS

Recent data in the literature shed new light to explain the effects of both leptin and adiponectin in the regulation of lipid metabolism in peripheral tissues. Activation of the AMP-dependent kinase pathway and subsequent increased fatty acid oxidation seems to be the main mechanism of action of these hormones in the regulation of lipid metabolism. In addition, we have found that insulin plasma levels are positively associated to leptin but negatively correlated with adiponectin in obese children. Adiponectin is negatively associated to plasma lipid markers of metabolic syndrome but positively related to HDL-cholesterol, whereas insulin and leptin show opposite patterns. These results support the effect of adiponectin in increasing insulin sensitivity and decreasing plasma triglycerides.

CONCLUSION

Leptin, insulin and adiponectin are associated hormones that regulate lipid metabolism in childhood. Adiponectin appears to be the missing link to explain the alterations in lipid metabolism and plasma lipids seen in obesity.

[Abdominal aortic injury as a complication of laparoscopic cholecystectomy]

A 58-year-old woman with a history of high blood pressure and cesarean section by median laparotomy underwent elective laparoscopic cholecystectomy under general anesthesia. After initiation of pneumoperitoneum, hemodynamic instability developed (blood pressure 75/40 mm Hg, heart rate 47 beats/min) and resolved after volume replacement and administration of vasoactive drugs. The rest of the procedure was completed without further adverse events. After extubation, the patient was transferred to the anesthetic recovery ward, where she tended to hypotension that was unresponsive to volume replacement, with a hematocrit of 18% and hemoglobin concentration of 6.9 g/dL. Hemoperitoneum was suspected, and an emergency median laparotomy revealed 300 cc of blood in the peritoneal cavity, a large hematoma putting pressure on retroperitoneal structures, and 2 infrarenal aortic lesions (anterior and posterolateral). During the reoperation the patient required multiple transfusions and vasoactive drugs to maintain hemodynamic stability. Recovery in the postanesthetic care unit was uneventful. After transfer to the ward, on the 20th day after surgery she developed septic shock with intraabdominal fluid requiring surgical drainage and admission to the intensive care unit. Abdominal aortic injury during laparoscopic surgery usually occurs upon introduction of trocars for initiating pneumoperitoneum. The technique must be performed correctly and monitored properly to assure early detection of adverse events associated with high mortality.

Evolution of the interaction of a new chemical entity, eflucimibe, with γ-cyclodextrin during kneading process

The aim of this study was to enhance the low solubility of eflucimibe, a new chemical entity which can be used as medicine to treat dyslipidemiae, by complexation with gamma-cyclodextrin. The complex was prepared using kneading method. The interaction evolution was studied during process by comparison of the semi-solid and physico-chemical states of the product. The evolution of the semi-solid state was followed by torque measurement when the evolution of physico-chemical state was studied by differential scanning calorimetry, infrared spectroscopy and by determination of the drug solubilisation profile. The interaction, which occurs during the process, is characterised by a modification of the product consistency and by a disappearance of the drug endothermic peaks, a disappearance of a drug spectral band and a widely improvement of the drug solubilisation profile. Indeed, after complete interaction, the drug quantity solubilised in specific conditions increased about 44-fold compared to those of untreated drug. Moreover, the comparison of the physico-chemical and semi-solid states during kneading process clearly shows that when the interaction takes place, a solidification of the paste occurs. The results of these works suggested that the formation of new solid phase allows an enhancement of the solubility of eflucimibe.

Sunflower oil does not protect against LDL oxidation as virgin olive oil does in patients with peripheral vascular disease

BACKGROUND & AIMS

The aim of this study was to compare the in vivo effects of a diet rich in virgin olive oil or sunflower oil on the lipid profile and on LDL susceptibility to oxidative modification in free-living Spanish male patients with peripheral vascular disease.

METHODS

A total of 20 Spanish male subjects diagnosed with peripheral vascular disease were randomly divided into two groups (n = 10) receiving different supplements, virgin olive oil and sunflower oil for 4 months.

RESULTS

The adaptation of patients to the experimental supplements was demonstrated since plasma and LDL fatty acids composition reflected dietary fatty acids. No differences in triglycerides, total cholesterol, LDL-cholesterol or HDL-cholesterol concentrations were found between the groups of patients. A significantly higher LDL susceptibility to oxidation was observed after sunflower oil intake in comparison with virgin olive oil, in spite of an increase in LDL alpha-tocopherol concentration in sunflower oil group.

CONCLUSIONS

The results of the present study provide further evidence that sunflower-oil-enriched diets does not protect LDL against oxidation as virgin olive oil does in patients with peripheral vascular disease.

[Meal replacement as a dietary therapy for weight control. Assessment in males and females with different degrees of obesity]

Obesity is a metabolic disorder characterized by an increase in the fat in adipose tissue above certain limits, manifested by morphological alterations and excess weight. This condition is one of the most significant epidemics of this century due to over-eating and the ease of access to food. On the other hand, the direct relationship between obesity and the greater risk of suffering cardiovascular disease, diabetes or cancer means that consumers are demanding products, whether medicines or foodstuffs, that will allow them to overcome this situation and improve both their physical appearance and their health. The goal of this project was to identify the efficacy and safety of a dietary product, a meal replacement, within the setting of a balanced hypocaloric diet established for weight loss. To this end, a total of 47 volunteers of both sexes between the ages of 23 and 58, all employees of the Hero España, S.A. company, took part in a test in which eleven of them acted as the "control group" and ate only the low-calorie diet while the rest formed a "problem group" and replaced one meal (with a minimum of 500 calories) with a 200-calorie meal replacement. Participants were subjected to anthropometric measurements, blood pressure testing and a blood chemistry analysis before and after the test period, as well as to weekly weight checks. Those individuals with the highest Body Mass Index showed a greater weight loss than those with a lower index. The volunteers did not note any hunger pangs until three hours after consumption of the meal replacement and the health-status parameters analyzed did not show any anomalous values. Therefore, it is concluded that the replacement product studied allows controlled weight loss over 3 weeks when accompanied by a balanced low-calorie diet and it also produces a sensation of fullness in those consuming it.

Exogenous nucleosides modulate the expression of rat liver extracellular matrix genes in single cultures of primary hepatocytes and a liver stellate cell line and in their co-culture

BACKGROUND & AIMS

We have previously reported the antifibrotic effect of dietary nucleotides in cirrhotic rats. In this work, we used primary rat hepatocytes, a liver stellate cell line (CFSC-2G) and co-cultures of both cell types to investigate the effects of exogenous nucleosides on the gene expression of various extracellular matrix components and on markers of liver function, and to ascertain whether the effects found in vivo are due to CFSC-2G, hepatocytes, or are the consequence of cell-cell interactions.

RESULTS

Nucleosides enhanced fibronectin, laminin, and alpha1(I) procollagen levels in CFSC-2G and hepatocytes, as well as collagen synthesis and secretion in CFSC-2G. In contrast, nucleosides lowered fibronectin, laminin and alpha1(I) procollagen levels, and decreased collagen synthesis in co-cultures. Matrix metalloproteinase-13 content and collagen secretion increased in co-cultures incubated with nucleosides. Albumin increased in hepatocytes and co-cultures incubated in the presence of nucleosides.

CONCLUSIONS

Nucleosides modulate the production of extracellular matrix in single cultures of hepatocytes and of CFSC-2G, and in co-cultures. This effect seems to be regulated at the translational level. The opposite behavior of single cultures and co-cultures is probably due to the fact that the latter model reproduces many of the physical and functional relationships observed in vivo between hepatocytes and stellate cells.

Burden of hospitalizations attributable to rotavirus infection in children in Spain, period 1999–2000

The aim of this study is to provide estimates on the incidence of rotavirus infection requiring hospitalization in children <or=5 years of age during the 1999-2000 period in Spain and the associated direct cost of these hospitalizations. Hospital admissions attributable to rotavirus were estimated by using data on confirmed laboratory reports of rotavirus and hospital admissions due to acute gastroenteritis. During the study period a total of 32541 cases of pathogens responsible for acute gastroenteritis were reported to the microbiological information national system (SIM) and 14.0% were rotavirus. The proportion of laboratory-confirmed rotavirus cases was extrapolated to the total number of hospitalizations for acute gastroenteritis in children <or=5 years of age. An annual incidence of 1.0 hospital admissions attributable to rotavirus per 1000 persons <or=5 years of age was found, although during the winter season it reached 2.5 hospitalizations per 1000. Overall, the estimated annual number of days of hospitalization attributable to rotavirus was 8742 days that results in a cost of 3.6 million per year.

The role of transjugular intrahepatic portosystemic shunt prior to abdominal tumoral surgery in cirrhotic patients with portal hypertension

INTRODUCTION

Major abdominal surgery can be contraindicated in some cirrhotic patients because of severe portal hypertension. The present study reports our experience of three patients with abdominal tumours prepared for surgery by transjugular intrahepatic portosystemic shunts (TIPS) in order to reduce portal hypertension and the risk of intraoperative bleeding.

PATIENTS AND METHODS

Three patients with cirrhosis and portal hypertension diagnosed with a right colon carcinoma, an adenocarcinoma of pancreas and a gastric and sigmoid synchronic tumours in the same patient. Because portal hypertension was the leading cause of surgical contraindication, neoadjuvant TIPS placement was proposed before surgery.

RESULTS

TIPS placement was performed without intra-procedure complications. An average reduction of 18 mmHg was achieved in portosystemic gradients. The planned operations were performed with a delay of 14-45 days after TIPS without intraoperative bleeding. Complications occurred in one patient without operative mortality.

CONCLUSION

TIPS placement allows a pre-operative portal decompression in cirrhotic patients with portal hypertension and abdominal tumours that require surgical treatment. This procedure reduces the risk of bleeding by reducing the portosystemic gradient and the varices around the tumoral area. This procedure is less invasive than conventional shunt surgery, but it is not free of complications and should be performed by experienced interventional radiologists on selected patients. This is still an experimental indication of TIPS which efficacy must be confirmed in larger series.

On statistical relationship of solar, geomagnetic and human activities

Data of galactic cosmic rays, solar and geomagnetic activities and solar wind parameters on the one side and car accident events (CAE) in Poland on the other have been analyzed in order to reveal the statistical relationships among them for the period of 1990-2001. Cross correlation and cross spectrum of the galactic cosmic ray intensity, the solar wind (SW) velocity, Kp index of geomagnetic activity and CAE in Poland have been carried out. It is shown that in some epochs of the above-mentioned period there is found a reliable relationship between CAE and solar and geomagnetic activities parameters in the range of the different periodicities, especially, 7 days. The periodicity of 7 days revealed in the data of the CAE has the maximum on Friday without any exception for the minimum and maximum epochs of solar activity. However, the periodicity of 7 days is reliably revealed in other parameters characterizing galactic cosmic rays, SW, solar and geomagnetic activities, especially for the minimum epoch of solar activity. The periodicity of 3.5 days found in the series of CAE data more or less can be completely ascribed to the social effects, while the periodicity of 7 days can be ascribed to the social effect or/to the processes on the Sun, in the interplanetary space and in the Earth's magnetosphere and atmosphere.

Greater dietary variety is associated with better biochemical nutritional status in Spanish children: the Four Provinces Study

BACKGROUND AND AIM

Although dietary variety has been associated with a better nutritional profile, its possible role in obesity raises doubts about its overall health benefits. In this study, we examined the association between dietary variety and anthropometric variables, food intake and various food intake biomarkers in Spanish children.

METHODS AND RESULTS

This was a cross-sectional study of 1112 children aged 6-7 years from Cadiz, Murcia, Orense and Madrid, who were selected by means of the random cluster-sampling of schools. Information concerning food and nutrient intake was obtained using a food frequency questionnaire, and a dietary variety index (DVI) was calculated on the basis of the number of different foods consumed more than once a month. The anthropometric variables (weight and height), and plasma lipid and vitamin levels were determined using standardised methods. Our results show that the body mass index (BMI) did not vary substantially as a function of DVI: it was 16.9 in the lowest DVI tertile and 17.2 in the highest (p=0.20). Unlike BMI, the DVI positively correlated (p<0.05) with the plasma levels of alpha and beta-carotene, lycopene, retinol, alpha-tocopherol and vitamin E, with energy intake, and with most of the foods, particularly vegetables, fruit and sausages (respective correlation coefficients of 0.43, 0.26 and 0.23).

CONCLUSIONS

Dietary variety is associated with a better food and nutritional profile in Spanish children. Nevertheless, the presence of a positive association between the DVI and energy intake, and the consumption of sausages and pre-cooked products calls for the recommendation of a varied diet of healthy foods, such as cereals (especially whole grains), fruits and vegetables.

Intestinal T-cell lymphoma associated with celiac disease masked by cavernous lymphangioma

We present the case of a patient admitted to our emergency ward with a clinical setting of acute abdominal pain and a history of cavernous lymphangioma, diagnosed in another center by exploratory lapartomy. The patient presented complete analysis including serology tests, as well as an abdominal CT scan that revealed multiple large size retroperitoneal cysts. In view of the clinical symptomatology and results of the tests, a second CT scan was carried out upon admission. As a result of the findings obtained, a second exploratory laparotomy was carried out in which intestinal resection of the perforated jejunal loop and largest cysts was performed. Pathological anatomy diagnosed an intestinal lymphoma associated with enteropathy and abdominal cysts compatible with cavernous lymphangioma. In this work we describe both pathologies, the most characteristic aspects are analyzed and the etiology and possible relation between both entities is discussed.

Nutritional risks in the Spanish population: results of the eVe study

OBJECTIVE

To determine the vitamin status of different groups within the Spanish population.

DESIGN

Pooled analysis of cross-sectional population nutritional regional studies and meta-analysis of smaller studies in population subgroups performed in Spain between 1990 and 1999.

SUBJECTS

In total, 10 208 participants in eight random population studies aged 25-60 y and participants in 76 studies included in the meta-analysis.

INTERVENTIONS

The data from different nutritional studies performed on sample populations representative of eight regions of Spain were integrated into a single database. A meta-analysis was also performed on the results of nutritional studies on the Spanish population involving subjects of other ages and status (all published between 1990 and 1999).

RESULTS

The mean intakes observed after the integration of the eight regional studies, and in the meta-analysis study, were similar to those recommended, although a considerable percentage of people had insufficient intakes.

CONCLUSIONS

Further studies are required, but the vitamin status of the Spanish population clearly shows room for improvement, especially with respect to vitamins B(2), B(6), A, E, D and folates. Bearing in mind that adequate vitamin intakes are associated with protection from a range of diseases, steps should be taken to correct the imbalances recorded.

Role of long-chain polyunsaturated fatty acids in infant nutrition

OBJECTIVE

To review briefly the influence of dietary long-chain polyunsaturated fatty acids (LC-PUFA) on tissue composition and functionality in early infancy. Moreover, the influences of LC-PUFA sources on plasma composition as well as the effects of these fatty acids on intestinal repair after malnutrition are discussed.

RESULTS

Human milk not only supplies essential fatty acids but also contains up to 2% of the total fatty acids as LC-PUFA, of which arachidonic acid (AA) and docosahexaenoic acid (DHA) are considered the most important. Plasma and erythrocyte levels of both AA and DHA are decreased in infants fed artificial standard milk formulae. However, the supplementation of formulae with these fatty acids in amounts close to that of human milk leads to tissue LC-PUFA patterns similar to those of breast-fed infants. However, the bioavailability of LC-PUFA depends on the typical LC-PUFA source; egg phospholipids increases both AA and DHA in plasma phospholipids and HDL more than a mixture of tuna and fungal triglycerides.

CONCLUSIONS

Dietary LC-PUFA affects positively the growth and development of the infant and ameliorates the visual and cognitive functions, particularly in preterm infants. Likewise, LC-PUFA improves intestinal repair in severe protein-energy malnutrition; therefore, its qualitative and quantitative dietary supply should be considered.

Virgin olive and fish oils enhance the hepatic antioxidant defence system in atherosclerotic rabbits

BACKGROUND & AIMS

In this study we report the effects of sunflower, virgin olive and fish oils on the lipid profile and antioxidant defence system in liver mitochondria from rabbits with experimental atherosclerosis.

METHOD

An atherogenic control group were fed for 50 days on a diet containing 3% lard and 1.3% cholesterol. Four groups were fed for an additional period of 30 days with a diet enriched in different oils: sunflower oil, virgin olive oil, refined olive oil and fish oil. A control group was fed with a standard chow.

RESULTS

The atherogenic diet caused important changes in the hepatic mitochondria lipid profile and in the enzymatic and non-enzymatic antioxidant defence system accompanied with an increase in the content of hydroperoxides in liver mitochondria. The administration of virgin olive and fish oils showed a better profile in the antioxidant system as well as decrease in the content of hydroperoxides.

CONCLUSIONS

The intake of cholesterol- and lard-enriched diet leads to a high impairment in the hepatic antioxidant defence system. However, the replacement of that diet by other unsaturated fat-enriched diets using virgin olive, sunflower and fish oil enhances hepatic antioxidant defence system, virgin olive and fish oil diet provide the best results.

Exogenous nucleosides alter the intracellular nucleotide pool in hepatic cell cultures. Implications in cell proliferation and function

BACKGROUND & AIMS

Dietary nucleotides are reported to influence the growth and functioning of the liver. The objective of the study was to evaluate the uptake and incorporation of exogenous nucleosides by hepatic cells, and the potential implications for cell proliferation and function.

METHODS

Liver stellate cell line CFSC-2G and primary hepatocytes in single and mixed cultures were exposed to mixtures of nucleosides and the concentrations of nucleoside derivatives were determined in the cultures, by high-performance liquid chromatography. Cell proliferation (DNA synthesis, cell cycle) and function (adenylate charge, albumin content, mitochondrial succinate dehydrogenase activity) were also evaluated.

RESULTS

The exogenous nucleosides increased the intracellular concentrations of UTP, UDP-glucose, CDP-choline and NAD(+), in the single cultures of CFSC-2G and hepatocytes. Modification of the intracellular nucleotide pool paralleled changes in cell functional status, as indicated by increased adenylate charge and albumin content in hepatocyte cultures and in their co-cultures with CFSC-2G, and by increased succinate dehydrogenase activity in hepatocytes.

CONCLUSION

Exogenous nucleosides were taken up by CFSC-2G and hepatocytes, which modified the intracellular concentrations of nucleotides, improved the functional status of hepatocytes, and partially restored the impaired adenylate charge of the co-cultures.

Extension of the Dubinin–Astakhov equation for evaluating the micropore size distribution of a modified carbon molecular sieve

A new method for the characterization of the pore size distribution of microporous solids is applied on data obtained for activated carbon molecular sieve samples. In this method, based on the Dubinin-Astakhov equation, a simple numerical algorithm is used for the reconstruction of the micropore size distribution from the integral equation that represents the experimental nitrogen adsorption isotherm. The results are compared with the ones obtained on the basis of the well-known Horvath-Kawazoe method. The samples used in this study come from a carbon molecular sieve that has been treated with solutions of concentrated HNO3 at various temperatures and with solutions of H2O2 of various concentrations.

Safety and effectiveness of replacing standard doxazosin with doxazosin in the gastrointestinal therapeutic system (GITS) formulation in elderly hypertensive patients

The objective of this paper is to evaluate the safety and effectiveness of using doxazosin standard formulation in elderly hypertensive patients who were either uncontrolled or newly diagnosed, and replacing standard doxazosin with doxazosin in the gastrointestinal therapeutic system (GITS) formulation. We designed a postmarketing surveillance, open-label non-comparative, multicentre, clinical study covering primary care patients aged 65 years or older diagnosed with essential uncontrolled arterial hypertension. The study covered a period of 6-9 months, divided into two phases. Phase I involved a minimum of three and maximum of six months in treatment with standard doxazosin; phase II began with the changeover from standard doxazosin to the GITS formulation and lasted 12 weeks. Of the 1705 patients initially enrolled, 1292 (75.8%) completed the study. Reduction in systolic blood pressure was 22.3 mmHg (13.7%) in phase I, and 3.9 mmHg (2.77%) in phase II; reduction in diastolic blood pressure was 12.4 mmHg (13.2%) in phase I, and 2.4 mmHg (2.9%) in phase II. The percentage of controlled patients was 40.5% (691/1705) by the end of phase I and 45.3% (776/1705) by the end of phase II. A total of 154 patients suffered adverse events (AE), 127 during phase I and 27 in phase II. We conclude that doxazosin in its two formulations is effective and safe for the purpose of lowering blood pressure in elderly patients.

Taipoxin induces F-actin fragmentation and enhances release of catecholamines in bovine chromaffin cells

Adrenomedullary bovine chromaffin cells were used to study the uptake and cellular effects of the phospholipase type A2 (PLA2) neurotoxin taipoxin in a neuroendocrine model. This toxin entered rapidly inside cultured cells. Within 1 h, taipoxin accumulated on the plasma membrane, independently of calcium presence, and caused fragmentation of the F-actin cytoskeleton. Toxin-induced cell death occurred after 24 h of incubation with the appearance of toxin containing large vesicles. Secretory experiments performed in cell populations showed an increased exocytosis in taipoxin-treated cells stimulated by depolarization or by incubation with the calcium-ionophore A23187. Like F-actin fragmentation, this effect is abolished by replacement of Ca2+ with Sr2+ during toxin incubation. The effect of taipoxin on exocytosis is not enhanced by latrunculin A, a F-actin disassembling drug altering secretion. Secretory studies in single taipoxin-treated cells using amperometry, showed an increase in the number of released vesicles without modification of the kinetic parameters of individual vesicle fusions. Taken together, these results suggest that taipoxin causes F-actin fragmentation and enhances secretion by redistribution of vesicles among secretory pools.

Lessons from the "Euro-Lupus Cohort"

The "Euro-Lupus Cohort" is composed by 1,000 patients with systemic lupus erythematosus (SLE) that have been followed prospectively since 1991. These patients have been gathered by a European consortium - the "Euro-Lupus Project Group". This consortium was originated as part of the network promoted by the "European Working Party on SLE", a working group created in 1990 in order to promote research in Europe on the different problems related to this disease. The "Euro-Lupus Cohort" provides an updated information on the SLE morbidity and mortality characteristics in the present decade as well as defines several clinical and immunological prognostic factors.

The role of myosin in vesicle transport during bovine chromaffin cell secretion

Bovine adrenomedullary cells in culture have been used to study the role of myosin in vesicle transport during exocytosis. Amperometric determination of calcium-dependent catecholamine release from individual digitonin-permeabilized cells treated with 3 microM wortmannin or 20 mM 2,3-butanedione monoxime (BDM) and stimulated by continuous as well as repetitive calcium pulses showed alteration of slow phases of secretion when compared with control untreated cells. The specificity of these drugs for myosin inhibition was further supported by the use of peptide-18, a potent peptide affecting myosin light-chain kinase activity. These results were supported also by studying the impact of these myosin inhibitors on chromaffin granule mobility using direct visualization by dynamic confocal microscopy. Wortmannin and BDM affect drastically vesicle transport throughout the cell cytoplasm, including the region beneath the plasma membrane. Immunocytochemical studies demonstrate the presence of myosin types II and V in the cell periphery. The capability of antibodies to myosin II in abrogating the secretory response from populations of digitonin-permeabilized cells compared with the modest effect caused by anti-myosin V suggests that myosin II plays a fundamental role in the active transport of vesicles occurring in the sub-plasmalemmal area during chromaffin cell secretory activity.

Polyunsaturated fatty acids and inflammatory diseases

Inflammation is overall a protective response, whose main goal is to liberate the human being of cellular lesions caused by micro-organisms, toxins, allergens, etc., as well as its consequences, and of death cells and necrotic tissues. Chronic inflammation, which is detrimental to tissues, is the basic pathogenic mechanism of hypersensitivity reactions against xenobiotics. Other frequent pathologies, for instance atherosclerosis, chronic hepatitis, inflammatory bowel disease (IBD), liver cirrhosis, lung fibrosis, psoriasis, and rheumatoid arthritis are also chronic inflammatory diseases. Chemical mediators of inflammation are derived from blood plasma or different cell-type activity. Biogenic amines, eicosanoids and cytokines are within the most important mediators of inflammatory processes. The different activities of eicosanoids derived from arachidonic acid (20:4 n-6) versus those derived from eicosapentaenoic acid (20:5 n-3) are one of the most important mechanisms to explain why n-3, or omega-3, polyunsaturated fatty acids (PUFA) exhibit anti-inflammatory properties in many inflammatory diseases. Dietary supplements ranging 1-8 g per day of n-3 PUFA have been reportedly beneficial in the treatment of IBD, eczema, psoriasis and rheumatoid arthritis. In addition, recent experimental studies in rats with experimental ulcerative colitis, induced by intrarectal injection of trinitrobenzene sulphonic acid, have documented that treatment with n-3 long-chain PUFA reduces mucosal damage as assessed by biochemical and histological markers of inflammation. Moreover, the defence antioxidant system in this model is enhanced in treated animals, provided that the n-3 PUFA supply is adequately preserved from oxidation.