Tamoxifen persistently disrupts the humoral adaptive immune response of gilthead seabream (Sparus aurata L.).

There is increasing concern about the possible effect of pharmaceutical compounds may have on the fish immune system. Bath exposition of 17α-ethynylestradiol (EE2), a synthetic estrogen used in oral contraceptives, altered the immune response of the gilthead seabream (Sparus aurata L.), a marine hermaphrodite teleost. Tamoxifen (Tmx) is a selective estrogen-receptor modulator used in hormone replacement therapy, the effects of which are unknown in fish immunity. This study aims to investigate the effects of dietary administration of EE2 (5 µg/g food) and Tmx (100 µg/g food) on the immune response of gilthead seabream, and the capacity of the immune system to recover its functionality after a recovery period. The results show for the first time the reversibility of the effect of EE2 and Tmx on the fish immune response. Tmx promoted a transient alteration in hepatic vitellogenin gene expression of a different magnitude to that produced by EE2. Both, EE2 and Tmx inhibited the induction of interleukin-1ß gene expression while reversed the inhibition of ROI production in leukocytes following vaccination. However, none of these effects were observed after ceasing EE2 and Tmx exposure. EE2 and Tmx stimulated the antibody response of vaccinated fish although Tmx, but not EE2, altered the antibody response and modulated the percentage of IgM(+) B lymphocytes of vaccinated fish during the recovery phase. Taken together, our results suggest that EE2 and Tmx might alter the capacity of fish to appropriately respond to infection and show that Tmx has a long-lasting effect on humoral adaptive immunity.

Estudio de la función vesicular y resultados a largo plazo de la colecistolitotomía / Gallbladder motility and long term results in cholecystolithotomy

Objetivos. La extracción de la litiasis vesicular conservando la vesícula es una alternativa a la colecistectomía que se viene realizando en nuestro servicio desde hace 25 años. Nuestra revisión tiene como objetivo valorar la tasa de recidiva y la función vesicular. Material y Métodos. A los pacientes intervenidos en nuestro servicio desde 1989 con esta técnica se les realizó una encuesta de problemas digestivos y un estudio ecográfico pre y postprandial tras la ingesta de un alimento graso para identificar la recidiva y para estimar el volumen y la contracción vesicular. Resultados. De los 20 pacientes intervenidos, 10 pacientes participaron en el estudio. Se identificó un cálculo en una paciente intervenida hace 2 años que presenta dolor abdominal (10%). La mediana de volumen preprandial fue 18,37 cc y la postprandial 7,16 cc. La mediana del porcentaje de reducción de volumen, 57,63%. Conclusiones. Solo se identificó un cálculo residual en el postoperatorio temprano. Todos los pacientes conservaron una función vesicular adecuada (valores superiores al 30%) por lo que consideramos que, de forma correctamente seleccionada, la colecistolitotomía es una alternativa a la colecistectomía en el paciente pediátrico

Introduction. Gallstone removal preserving the gallbladder is a therapeutic option in cholelithiasis. Our group has made use of this technique for twenty-five years in pediatric patients. The purpose of this review was to study gallstone recurrence and gallbladder motility. Materials and Methods. Patients who had gallstones removed with this technique from 1989 until 2013 were contacted and asked about digestive or other health problems. A sonographic assessment was made in order to look for gallstone recurrence and to measure gallbladder volumes and contraction after fasting and after consuming a fatty meal. Results. All patients are asymptomatic except a girl who suffered colic pain and who had a gallstone recurrence. The median of volume after fasting was 18.37 cc and after consuming the meal 7.16 cc. The median of gallbladder contraction was 57.63%. Conclusions. A gallstone relapse was identified (10%). Long-term follow up showed an excellent gallbladder function and contraction (greater than 30%) without other recurrences. Based on our experience, in patients properly selected cholecistolithotomy is an interesting option in children

[Gallbladder motility and long term results in cholecystolithotomy]. / Estudio de la función vesicular y resultados a largo plazo de la colecistolitotomía.

INTRODUCTION: Gallstone removal preserving the gallbladder is a therapeutic option in cholelithiasis. Our group has made use of this technique for twenty-five years in pediatric patients. The purpose of this review was to study gallstone recurrence and gallbladder motility. MATERIALS AND METHODS: Patients who had gallstones removed with this technique from 1989 until 2013 were contacted and asked about digestive or other health problems. A sonographic assessment was made in order to look for gallstone recurrence and to measure gallbladder volumes and contraction after fasting and after consuming a fatty meal. RESULTS: All patients are asymptomatic except a girl who suffered colic pain and who had a gallstone recurrence. The median of volume after fasting was 18.37 cc and after consuming the meal 7.16 cc. The median of gallbladder contraction was 57.63%. CONCLUSIONS: A gallstone relapse was identified (10%). Long-term follow up showed an excellent gallbladder function and contraction (greater than 30%) without other recurrences. Based on our experience, in patients properly selected cholecistolithotomy is an interesting option in children.

Diseño y validación de un simulador para el entrenamiento en la capsulotomía circular continua en la facoemulsificación / Design and validation of a simulator for training in continuous circular capsulotomy for phacoemulsification

Introducción: Diseñar y validar un simulador para el aprendizaje y entrenamiento de la técnica de la capsulorrexis. Métodos: El sistema consiste en un soporte de metacrilato con inclinación de 15° para el apoyo de las manos del cirujano y una zona de papel aluminio comercial y otro de similares características donde el alumno realiza la técnica a través de unas hendiduras realizadas previamente en el soporte. Para evaluar la viabilidad de este simulador se toman los datos de 65 oftalmólogos que realizan la técnica durante actividades de formación, dividiéndolos aleatoriamente en un grupo de 30 especialistas que inician directamente su aprendizaje en ojos de cadáver de animal y en otro grupo de 35 especialistas que se inician previamente con este simulador. Resultados: Se desarrolla un simulador para entrenamiento de la técnica de capsulorrexis. El grupo de alumnos del grupo simulador consigue una reducción en el uso de ojos de cadáver y una mayor eficiencia en la realización de capsulorrexis correctas, a diferencia del grupo que se inicia directamente en ojos de cadáver. Conclusiones: Este simulador constituye una novedad en el entrenamiento de la técnica de capsulorrexis en cuanto a sencillez, coste y reutilización, frente a otros simuladores virtuales con equipos informáticos más costosos y más complicados de transportar. Es pieza clave como paso previo a la utilización de piezas de cadáver y de animales de experimentación, disminuyendo el número de ambos y, por tanto, el coste de la enseñanza (AU)

Introduction: To design and validate a simulator for learning and training in the capsulorhexis technique. Methods: The system consists of a methacrylate support inclined 15° for the surgeon's hand, an area of commercially available aluminum foil, and another one of similar characteristics, where the student performs the technique through some slots that are previously made in the support. In order to evaluate the feasibility of this simulator, data were collected from 65 ophthalmologists performing the technique during training activities. The ophthalmologists were randomly divided into one group of 30 specialists who start their learning on the eyes of an animal cadaver, and into another of 35 specialists who previously started with this simulator. Results: A simulator is developed for training in the capsulorhexis technique. The students from the simulator group achieved a reduction in the use of cadaver eyes, and a higher efficiency in correct capsulorhexis, unlike the group who started directly on the cadaver eyes. Conclusions: This simulator is an innovation in training of the capsulorhexis technique as regards simplicity, cost, and reuse, as compared to other virtual simulators with more expensive computer equipment (CE) equipment that are more difficult to transport. It is an important step prior to the use of cadaver parts and experimental animals, decreasing the number of both, and therefore the teaching costs (AU)

[Design and validation of a simulator for training in continuous circular capsulotomy for phacoemulsification]. / Diseño y validación de un simulador para el entrenamiento en la capsulotomía circular continua en la facoemulsificación.

INTRODUCTION: To design and validate a simulator for learning and training in the capsulorhexis technique. METHODS: The system consists of a methacrylate support inclined 15° for the surgeon's hand, an area of commercially available aluminum foil, and another one of similar characteristics, where the student performs the technique through some slots that are previously made in the support. In order to evaluate the feasibility of this simulator, data were collected from 65 ophthalmologists performing the technique during training activities. The ophthalmologists were randomly divided into one group of 30 specialists who start their learning on the eyes of an animal cadaver, and into another of 35 specialists who previously started with this simulator. RESULTS: A simulator is developed for training in the capsulorhexis technique. The students from the simulator group achieved a reduction in the use of cadaver eyes, and a higher efficiency in correct capsulorhexis, unlike the group who started directly on the cadaver eyes. CONCLUSIONS: This simulator is an innovation in training of the capsulorhexis technique as regards simplicity, cost, and reuse, as compared to other virtual simulators with more expensive computer equipment (CE) equipment that are more difficult to transport. It is an important step prior to the use of cadaver parts and experimental animals, decreasing the number of both, and therefore the teaching costs.

Agenesia de vesícula biliar: una causa inusual de hipertransaminasemia / Absence of the gallbladder: an unusual cause of hypertransaminasemia

La agenesia de vesícula biliar es una entidad poco frecuente, y su presentación con algún síntoma asociado es más infrecuente aún. La mayoría de casos se detectan de forma accidental en el curso de una exploración quirúrgica ante un cuadro sugestivo de litiasis biliar. Se presenta el caso de una niña de 4 años de edad con elevaciones transitorias y recurrentes de enzimas hepáticas, en quien sólo se encontró, tras un estudio exhaustivo, una agenesia de vesícula biliar como posible causa de esta alteración. Es un cuadro que hay que tener en cuenta para evitar procedimientos invasivos en estos pacientes(AU)

Abscence of the gallbladder is a very rare malformation and its symptomatic presentation is even more unusual. Most of the cases reported were discovered while a surgical exploration of the abdomen was performed in patients with biliary symptoms. It is reported a rare paediatric case. The patient was 4 years old and presented recurrent and transient elevation of liver transaminases. After a complete study only absence of the gallbladder was found as cause. Awareness of this entity by clinicians and surgeons is important because invasive diagnostic procedures can be avoided(AU)

Metabolic adjustments of Dentex dentex to prolonged starvation and refeeding.

The particular metabolic strategies of the common dentex (Dentex dentex) to face a period of prolonged starvation and subsequent refeeding were assessed. Plasma metabolites, endogenous reserves, and the activity of key enzymes of intermediary metabolism in liver, white muscle, and heart were evaluated. Plasma glucose, total lipid, triglycerides, total-, HDL- and LDL-cholesterol, and protein levels, liver, and white muscle glycogen, and perivisceral, and muscle fat were significantly reduced by starvation, whereas liver lipid content was surprisingly increased. Those enzymes involved in phosphorylation and oxidation of glucose and lipid synthesis, as well as alanine aminotransferase activity, were significantly depressed in liver of starved fish. The increase in ß-hydroxyacyl-CoA dehydrogenase (HOAD) indicated an enhanced fatty acid oxidation during starvation. Part of the acetyl-CoA generated by ß-oxidation was oxidized in the hepatic Krebs cycle, as reflected the increased citrate synthase (CS) activity. The oxaloacetate required for the reaction catalized by CS activity would be supplied by aspartate aminotransferase (ASAT) activity whose activity was also enhanced. Glutamate dehydrogenase also increased to deaminate the glutamate produced by transaminases, especially by the increased ASAT activity. Liver gluconeogenesis of starved fish was maintained at the same rate that in controls, with glycerol playing an important role as glucogenic substrate. The increased hepatic ß-hydroxybutyrate dehydrogenase (ß-OHBDH) activity indicates that part of the acetyl-CoA arriving from ß-oxidation was being diverted for ketone bodies production with dentex liver playing an important role in providing ketone bodies as fuels for other tissues under such circumstances. Most enzyme activities in white muscle of starved dentex were significantly depressed. In heart, starvation induced an important inhibition of those enzymes involved in glucose and protein metabolism, whereas CS, HOAD, and ß-OHBDH activities were maintained at control levels. Although several biomarkers assayed returned to control values after refeeding, many others did not, which indicate that after 3 weeks of refeeding, pre-starved dentex is still experiencing a transient period of metabolic adjustments directed toward the restoration of body mass.

Estrogen-responsive genes in macrophages of the bony fish gilthead seabream: a transcriptomic approach.

The role of sex steroids in the modulation of fish immune responses has received little attention. Previous studies have demonstrated that 17ß-estradiol (E(2)) is able to alter the response of gilthead seabream leukocytes to infectious agents. We have used suppression subtractive hybridization to identify genes upregulated by E(2) (50 ng/ml) in macrophage cultures from gilthead seabream. We isolated 393 up-regulated cDNA fragments that led to the identification of 162 candidate estrogen-responsive genes. Functional analyses revealed the presence of several enriched immune processes and molecular pathways. The E(2) up-regulation of some immune-relevant genes was further confirmed by real time RT-PCR. Bioinformatics analysis revealed the ability of E(2) to orchestrate profound alterations in the macrophage expression profile, especially immune-related processes and pathways. This is the first report on E(2)-dependent modifications of fish macrophage transcriptome and lends weight to a suggested role for estrogen in the immune system, the possible significance of which is discussed.

17ß-Estradiol regulates gilthead seabream professional phagocyte responses through macrophage activation.

In mammals, estrogens regulate the immune system, either directly or indirectly via several leukocyte types through autocrine/paracrine mechanisms. In the gilthead seabream (Sparus aurata L.) gonad, an intensive remodeling process accompanied by the massive infiltration of acidophilic granulocytes (AG) is partially triggered by 17ß-estradiol (E(2)). Once AG infiltrated the gonad, show impaired activities. In this study we first demonstrate that neither testicular nor head-kidney AG express any of the three estrogen receptor (ER) genes (ERa, ERb1 and ERb2) described in the gilthead seabream, while head-kidney macrophages (Mc) and lymphocytes (Ly) constitutively express ERa gene. Moreover, Mc are important in the immune-modulatory role of E(2), as suggested by its ability to induce ERb2 gene expression and up-regulate the expression of genes coding for ERa, ERb1, pro-inflammatory cytokines, chemokines and tissue remodeling molecules. Furthermore, the soluble factors produced by E(2)-treated Mc decreased in head-kidney phagocytes, their phagocytic ability and capacity, while no effects were observed on their reactive oxygen intermediate (ROI) production or their migratory capabilities. However, the role of Ly in the regulation of AG migration and the modulation of phagocytic and ROI production activities triggered by E(2) can not be ruled out, so that further studies are necessary to clarify these issues.

Posthatch development of the axial musculature of the common dentex Dentex dentex, L (Teleostei).

The common dentex is a promising candidate for Mediterranean aquaculture. The present work is aimed at describing the development of the axial musculature from hatching to postlarval life. Transmission electron microscopy, histochemical (NADH-TR and mATPase) and immunohistochemical techniques (S-58 and TUNEL) have been used. At hatching superficial red and deep white muscles can be distinguished. Presumptive dermomyotome (external) cells are initially located over the superficial red muscle but shortly (2 days) tend to concentrate towards the epaxial and hipaxial limits of the myotome. Then, these cells enter the myotome and spread around and within the white muscle thus being apparently responsible for the stratified hyperplasia of the myotome. Mosaic hyperplasia is activated during the second half of the larval period and initially relies on differentiation of a population of atypical premyoblastic cells (APC). APC are mononuclear cells with euchromatic nuclei, cytoplasms full of thin longitudinally projected tubules, occasional mitochondria and scattered ribosomes. By the end of the larval period these cells tend to disappear, partly due to apoptosis, but postlarval mosaic hyperplasia continues by differentiation of presumptive myosatellite cells. APC are an unexpected and singular finding of this study which deserves more research, so as to further characterize their ancestry, developmental programme and fate. In addition to the white and superficial red muscle fibres, intermediate (pink) and tonic fibres appear during larval metamorphosis. Later, during the early postlarval life, a new type of slow twitch red muscle fibre is differentiated (red adult type).

Linfohistiocitosis hemofagocítica familiar: hallazgos neurorradiológicos / Familial hemophagocytic lymphohistiocytosis: neuroradiological findings

La linfohistiocitosis hemofagocítica (LHH) es un síndrome clínico raro, posiblemente infradiagnosticado, más frecuente en niños. Pueden ser cuadros agresivos y evolucionar en poco tiempo a fallo multiorgánico letal. Simula cuadros de sepsis infecciosa, aunque con peor respuesta y evolución. Se debe sospechar ante un niño pequeño con fiebre persistente de origen desconocido, afectación del estado general, hepatoesplenomegalia, citopenias, aumento de triglicéridos y ferritina y disminución del fibrinógeno. En la resonancia magnética cerebral se puede apreciar un realce difuso leptomeníngeo y perivascular, áreas parcheadas hiperintensas en T2 en sustancia blanca de ambos hemisferios cerebrales y atrofia cerebral. La secuencia de difusión es útil en la estadificación de las lesiones. Presentamos un caso clínico de LHH familiar de evolución mortal y realizamos una revisión bibliográfica de las características clínicas, anatomopatológicas y radiológicas de esta entidad (AU)

Hemophagocytic lymphohistiocytosis (HL) is a rare syndrome, although more common in children, that may be underdiagnosed. The clinical presentation can be aggressive, and patients may rapidly develop lethal multiple organ failure.…HL simulates the presentation of infectious sepsis, although the response to treatment and evolution are worse. HL should be suspected in young children with persistent fever of unknown origin, general malaise, hepatosplenomegaly, cytopenia, elevated triglycerides and ferritin, and decreased fibrinogen. Brain MRI shows diffuse leptomeningeal and perivascular enhancement, patchy areas of hyperintensity in the white matter of both cerebral hemispheres on T2-weighted sequences, and cerebral atrophy. Diffusion-weighted sequences are useful for staging the lesions. We present a fatal case of familial HL and review the literature about the clinical, histological, and radiological characteristics of this disease (AU)

[Familial hemophagocytic lymphohistiocytosis: Neuroradiological findings]. / Linfohistiocitosis hemofagocítica familiar: hallazgos neurorradiológicos.

Hemophagocytic lymphohistiocytosis (HL) is a rare syndrome, although more common in children, that may be underdiagnosed. The clinical presentation can be aggressive, and patients may rapidly develop lethal multiple organ failure....HL simulates the presentation of infectious sepsis, although the response to treatment and evolution are worse. HL should be suspected in young children with persistent fever of unknown origin, general malaise, hepatosplenomegaly, cytopenia, elevated triglycerides and ferritin, and decreased fibrinogen. Brain MRI shows diffuse leptomeningeal and perivascular enhancement, patchy areas of hyperintensity in the white matter of both cerebral hemispheres on T2-weighted sequences, and cerebral atrophy. Diffusion-weighted sequences are useful for staging the lesions. We present a fatal case of familial HL and review the literature about the clinical, histological, and radiological characteristics of this disease.

Pattern of expression of immune-relevant genes in the gonad of a teleost, the gilthead seabream (Sparus aurata L.).

Immune responses in the testis are regulated in a way that provides protection for the developing male germ cells, while permitting qualitatively normal inflammatory responses and protection against infection. In addition, germ cells are potent targets for the growth factors and cytokines which regulate the reproductive process. Our study analyzes for the first time the pattern of expression of several immune-relevant genes in the gonad of a seasonal breeding teleost fish. The immune molecules analyzed include (i) inflammatory molecules, such as interleukin-1b (il1b), il6, tumor necrosis factor-a (tnfa), cyclooxygenase-2 (cox2) and the NADPH oxidase subunit p40(phox) (ncf4 gene); (ii) the anti-inflammatory cytokine transforming growth factor-b1 (tgfb1) and its type 2 receptor tgfbr2; (iii) innate immune receptors, including toll-like receptor 9 (tlr9), tlr5, tlr22 and macrophage-colony stimulating factor receptor (mcsfr); (iv) lymphocyte receptors, such as the beta subunit of T-cell receptor (Tcrb) and the heavy chain of immunoglobulin M (ighm); (v) the anti-bacterial molecules lysozyme (lyz), hepcidin (hamp) and complement component 3 (c3); (vi) the anti-viral molecule myxovirus (influenza) resistance protein (mx); and (vii) molecules related to leukocyte infiltration, including the CC chemokine ccl4, the CXC chemokine il8 and the leukocyte adhesion molecule E-selectin (Sele). Notably, all of them show a pattern of expression that depends on the reproductive stage of the first two reproductive cycles when the fish develop and function as males. Furthermore, we demonstrate that some of these immune-relevant molecules, such as Il1b and Mcsfr, are produced by germ cells (Il1b) and ovarian and testicular somatic cells (Mcsfr). These data suggest that, as occurs in mammals, there is a critical balance between immune molecules and that these may play an essential role in the orchestration of gametogenesis and the maintenance of gonad tissue homeostasis in fish.

Bacteriemia por Escherichia coli resistente a ciprofloxacino: factores de riesgo para resistencia a ciprofloxacino e impacto de recibir tratamiento empírico con este antibiótico / Bacteremia due to ciprofloxacin-resistant E. coli: risk factors for ciprofloxacin resistance and impact of receiving empirical treatment with this antibiotic

Antecedentes y objetivos: La incidencia de Escherichia coli resistente a ciprofloxacino (CIP-R) ha aumentado en el Hospital General Universitario Gregorio Marañón (Madrid) durante la última década. CIP continua siendo utilizado como tratamiento empírico de elección en muchas complicaciones sépticas. Nuestro objetivo es analizar los factores que favorecen la adquisición de resistencia a CIP, y en segundo lugar estudiar las consecuencias de administrar empíricamente este antibiótico en casos de bacteriemia por una cepa CIP-R. Material y Métodos: El estudio se ha realizado en el Hospital General Universitario Gregorio Marañón (Madrid). Se revisaron las historias de 224 pacientes con bacteriemia por E. Coli, diagnosticadas en 2001 y 2002. De ellas, 112 eran CIP-R y 112 CIP-S (sensible a ciprofloxacino). Se han estudiado los factores de riesgo posibles para adquirir resistencia a CIP mediante un estudio de “casos y controles”. En una segunda parte hemos estudiado el impacto de recibir empíricamente esta quinolona en aquellos pacientes que tenían una bacteriemia por una cepa resistente. Resultados: De las 224 bacteriemias por E. coli, 161 (23%) fueron cepas CIP-R; de éstas 161 cepas, el 62,5% habían recibido quinolonas en los seis meses previos. Para el segundo objetivo se dividieron los pacientes en aquellos tratados inadecuadamente con quinolonas al menos 48 horas durante los primeros cuatro días de tratamiento: 28 pacientes (25%), y aquellos tratados adecuadamente: 84 pacientes (75%). Los datos obtenidos fueron los siguientes respectivamente: media de días de tratamiento antibiótico global: 15,6 vs 13,2; media de días de estancia hospitalaria: 21,1 vs 18,9; porcentaje de mortalidad: 28,6 vs 6,0; y porcentaje de mala evolución: 50,0 vs 7,1. Conclusiones: El uso previo de quinolonas constituye un factor de riesgo para desarrollar resistencia. Ciprofloxacino podría dejar de ser una elección idónea como tratamiento empírico de episodios de bacteriemia potencialmente atribuible a E.coli, al menos en aquellos pacientes con riesgo de tener una infección por una cepa resistente. La elección equivocada de antimicrobiano no influye en el alargamiento de estancia hospitalaria, pero sí aumenta la morbimortalidad (AU)

Antecedents and objectives: The incidence of ciprofloxacin-resistant E. coli (CIP-R) has increased in the Hospital General Universitario Gregorio Marañón (Madrid) during the last decade. CIP is still in use as the empirical treatment of choice in many septic complications. Our objective is to analyze the factors that favour the acquisition of CIP resistance, and secondly study the consequences of the empiric administration of this antibiotic in bacteremic cases due to a CIP-R strain. Material and Methods: the study has been carried out in the Hospital General Universitario Gregorio Marañón (Madrid).The clinical histories of 224 patients with E.coli bacteremia diagnosed in 2001 and 2002 were revised. Of these histories 112 were CIP-R and 112 CIP-S (ciprofloxacin-sensitive).The possible risk factors for acquisition of CIP resistance were analyzed through a “case-control” study. In a second part we have studied the impact of empirical treatment with this quinolone in those patients who suffered a bacteremia due to a resistant strain. Results: of the 224 E. coli bacteremias 161 (72 %) were CIP-R strains; of these 161 strains 62.5 % had received quinolones in the previous six months. For the second objective the patients were divided in two groups: those who were treated inadequately with quinolones for at least 48 hours during the first four days of treatment, i.e. 28 patients (25 %) and those adequately treated, i.e. 84 patients (75 %). The data obtained were respectively the following: average duration of antibiotic treatment: 15.5 days vs 13.2 days; average duration of hospital stay: 21.1 days vs 18.9 days; percent mortality rate: 28.6 vs 6.0; and percentage of unsatisfactory evolution: 50.0 vs 7.1. Conclusions: the previous use of quinolones is a risk factor for the appearance of resistance. Ciprofloxacin could stop being the best choice for empirical treatment for bacteremic episodes possibly due to E. coli, at least in those patients who risk having an infection with a resistant strain. The wrong choice of antimicrobial agent does not have an impact on the lengthening of the hospital stay but does increase the morbidity and mortality (AU)

Muscle cellularity at cranial and caudal levels of the trunk musculature of commercial size sea bass, Dicentrarchus labrax (Linnaeus, 1758).

In eight specimens of Atlantic sea bass of commercial size (congruent with 350 g) muscle cellularity was studied at two selected sampling levels of the trunk axial musculature: caudal (anal opening) and cranial (fourth radius of the dorsal fin). The following parameters were quantified at both sampling levels: white muscle cross-sectional area, white muscle fibre diameter (900-1200 fibres), muscle fibre number and muscle fibre density. Results showed a higher total cross-sectional area at cranial than at caudal level (P < 0.05), what is related with their different gross morphology. However, the white muscle fibre size distribution, as well as the muscle fibre number and density did not show significant differences between them. This study contributes to typify muscle fibre sampling in sea bass of commercial size what is of great interest for morphometric studies where white muscle cellularity is commonly correlated with textural or organoleptic parameters.

Revisión: desarrollo y crecimiento de la musculatura axial de la lubina Dicentrarchus labrax L / Review: development and growth of the axial musculature of the sea bass Dicentrarchus labrax, L

Se compendian en este trabajo los estudios realizados sobre el desarrollo y crecimiento de la musculaturaaxial de la lubina Dicentrarchus labrax L., incluyéndose también algunos resultados y conclusiones relevDicentrarchus relevantesen otras especies. En el momento de la eclosión, la larva de lubina presenta dos estratos musculares: músculorojo superfi cial y músculo blanco, ambos con un apreciable grado de inmadurez histológica. Desde la eclosiónhasta el momento de la apertura de la boca las fi bras musculares rojas y blancas crecen únicamente por hipertrofia. Sin embargo, con el inicio de la alimentación externa, la larva de lubina inicia un periodo de intenso crecimientomuscular hipertrófi co e hiperplásico. Hasta el fi nal de la fase larvaria, además de importantes cambiosestructurales y en las isoformas de miosina de las fi bras rojas y blancas, se diferencia progresivamente el músculointermedio o rosa. Durante la fase postlarvaria, los procesos de maduración histológica de la musculaturapersisten hasta el comienzo de la edad juvenil (≈ 6 meses). En alevines y juveniles de lubina, la dinámica delcrecimiento muscular está infl uenciada por la época del año, en función de factores medioambientales como latemperatura y el fotoperiodo. Esta infl uencia afecta de forma muy acentuada a la hiperplasia muscular, la cualdescribe una secuencia alternante con valores máximos durante el verano e inicio del otoño

This work summarizes the previous information on the development and growth of the axial musculature ofthe sea bass Dicentrarchus labrax L. Relevant results and conclusions from other teleost species in these subjectsare also included. At hatching, the axial musculature of sea bass larvae has two strata: the superfi cial redand the deep white muscles, both with an evident histological immaturity. Hypertrophy of red and white musclefi bres is the unique mechanism of muscle growth since hatching to mouth opening. After mouth opening, larvae enter a period of intense muscle growth by both hypertrophy and hyperplasia of muscle fi bres. Throughout thelarval phase, red and white muscle fi bres undergo structural changes and a progressive replacement of differentmyosin isoforms. The intermediate pink muscle is evident towards the end of the larval life. Histological maturationof muscle fi bres persist during the postlarval life until the beginning of the juvenile period (≈ 6 month).In fi ngerlings and juveniles, muscle growth dynamics is seasonally infl uenced by environmental factors such astemperature and photoperiod. Muscle fi bre recruitment is particularly affected so that it is maximum in summerand minimum in winter

Revisión: influencia de la temperatura sobre el desarrollo y crecimiento muscular de la lubina Dicentrarchus labrax L / Temperature effect on muscle growth and development of the sea bass, Dicentrarchus labrax L

La presente revisión recopila los principales resultados hallados en la lubina, referidos al efecto de la temperatura(Tª) sobre el desarrollo larvario y el crecimiento muscular a lo largo de las diferentes etapas de su ciclobiológico.Durante las fases iniciales de desarrollo, las altas Tªs aceleran el desarrollo embrionario y larvario de lalubina, aunque este hecho no siempre se acompaña de un mayor crecimiento corporal y del miotomo al fi nal decada estadío de desarrollo. Durante la fase vitelina de esta especie predomina la hipertrofi a fibrilar, siendo dichoparámetro el único que manifi esta cierta influencia de la Tª durante este periodo.Con el comienzo de la alimentación exógena, incrementan ambos parámetros fibrilares: hipertrofia e hiperplasiafibrilares. Las altas Tªs aumentan ambos parámetros, aunque el efecto es más signifi cativo sobre la hiperplasia.Al final de cada estadío de desarrollo (fase vitelina y metamorfosis larvaria), la lubina presenta diferenciasintraespecíficas en la respuesta frente a la Tª. Tales diferencias se manifiestan en una diferente contribución relativade la hipertrofia e hiperplasia fibrilares al total del miotomo, lo que puede estar asociado a diferencias genéticas.Por otra parte, la aplicación de altas Tªs durante las fases iniciales de desarrollo ejerce un efecto positivosobre el crecimiento muscular en estadíos larvarios posteriores y comienzo de la fase postlarvaria, aunque dichoefecto se pierde progresivamente. En el periodo estival, alevines de 15g cultivados siempre en agua a Tª ambiental,presentan un crecimiento muscular muy elevado, lo que les permite al final del verano adquirir el mismonúmero y tamaño fibrilar que ejemplares previamente cultivados a mayor Tª. Posteriormente, la aplicación deincrementos de Tª durante el periodo invernal determina un mayor crecimiento hiperplásico de los juveniles delubina, con respecto a los peces mantenidos a Tª ambiente. No obstante, al final del 2º verano (≈ 350g) la constituciónfibrilar vuelve a equipararse en todos los peces, con independencia del tratamiento térmico previo

This revision presents the main results on sea bass, related with termal effects on both larval developmentand muscle growth throughout the different phases of its biological cycle.During the initial phases, high temperature accelerates the larval development, whereas the growth of bothbody and total myotome is not always greater at higher T at the end of each developmental stage. During thevitelline phase, the growth is mainly due to hypertrophy, being this parameter more infl uenced by T than thehyperplasia.From exogenous feeding, both hypertrophy and hyperplasia increase. Both parameters are infl uenced byhigh T, although hyperplasia is usually more significantly influenced.At the end of each stage (vitelline phase and larval metamorphosis), sea bass shows intraspecifi c differenceson the response to T. Such differences are represented by a different relative contribution on hypertrophy andhyperplasia to the total transverse area of the myotome, that can be associated to genetic differences. On theother hand, the application of high T during initial phases shows a positive effect on muscle growth duringsubsequent larval and postlarval stages. However, the positive effect of the early temperature on the postlarvalmuscle growth is progressively reduced due to the increase of the environmental T during the summer months.In this period, muscle growth of fi ngerlings (15g) reared at ambient T is very high, so that at the end of thesummer fi sh show a similar number and size of muscle fi bres that specimens previously reared at high T. Onthe other hand, water heating during winter months increases hyperplasic muscle growth of sea bass postlarvae,although muscle cellularity at the end of the second summer (≈ 350g) was similar in both preheated and nonpreheatedfish

Distribución fibrilar de la musculatura en lubina, Dicentrarchus labrax (Linnaeus, 1758) Salvaje y cultivada de tamaño comercial: estudio por sectores / Muscle fibre distribution in wild and reared sea bass, Dicentrarchus labrax (Linnaeus, 1758) of commercial size: study by muscle blocks

La constitución fibrilar de la musculatura de la lubina, Dicentrarchus labrax (L.), de tamaño comercial (≅350 g) fue estudiada en dos poblaciones: salvaje y cultivada, en diferentes sectores de la sección transversal de la musculatura axial de las zonas craneal y caudal del miotomo. Los parámetros musculares cuantificados fueron el tamaño fibrilar (diámetro) y la densidad de fibras blancas. Los resultados encontrados muestran diferencias en la constitución fibrilar de los sectores del miotomo analizados. Tanto a nivel caudal como craneal estas diferencias se establecen cuando se comparan los sectores más internos (b y c) con los más externos (a y d), de tal forma que el tamaño fibrilar era menor en los extremos apicales. No obstante, esta tendencia se invierte a nivel caudal de los ejemplares cultivados. Además, a nivel caudal, el sector c presenta diferencias en la media del tamaño fibrilar entre ejemplares cultivados y salvajes (P=0.001) (AU)

Muscle cellularity was studied in wild and reared sea bass, Dicentrarchus labrax L., at commercial size (≅350 g), in different muscle blocks from transversal section of the axial musculature at both craneal and caudal levels of the miotome. Muscle parameters quantified were white muscle fibre diameter and white muscle fibre density. Results show different muscle cellularity among the studied blocks. Such differences are made evident when inner blocks (b and c) are compared with apical zones (a and d) and so, muscle fibre size was smaller on the apical zones. However, this tendency is reversed at caudal level from reared specimens. Also, at caudal level, the muscle fibre size on the block c presented differences between both wild and reared specimens (AU)

Effect of two thermal regimes on the muscle growth dynamics of sea bass larvae, Dicentrarchus labrax L.

Muscle growth was studied in larvae of sea bass, Dicentrarchus labrax L., reared at two temperatures: real ambient temperature ( congruent with 15 degrees C during vitelline phase and increased gradually) and 19 degrees C from fertilization until the end of larval development. Muscle cellularity, body length and body weight were measured. Early temperature influenced larval development and so, pre-larval phase finished earlier at 19 degrees C than at ambient temperature (4 and 6 days, respectively). Temperature also affected muscle growth such that at hatching and at mouth opening hypertrophy of muscle fibres was greater at 19 degrees C (P < 0.05), whereas hyperplasia was similar in both groups. After 25 days, the cross-sectional area of the white muscle was greater at 19 degrees C (P < 0.05), which was mainly associated with a higher proliferation of new white muscle fibres. At this stage the body length was also higher at 19 degrees C. Metamorphosis finished earlier in fish reared at 19 degrees C (52 days) than at natural temperature (82 days). At this developmental stage body length and cross-sectional area of the myotome were similar in both groups. However, muscle cellularity differed between groups. Thus, hypertrophy of muscle fibres was higher in fish reared at ambient temperature (P < 0.05), whereas proliferation of new muscle fibres was higher at 19 degrees C (P > 0.05).

[Diagnosis and monitoring of hypertension in Catalonia. The DISEHTAC study]. / Diagnóstico y seguimiento de la hipertensión arterial en Cataluña. Estudio DISEHTAC.

OBJECTIVES: To evaluate the diagnosis, monitoring and control of hypertension in reformed primary care centres in Catalonia, on the basis of the evaluation indicators proposed in the primary care hypertension guidelines. DESIGN: Multi-centre cross-sectional descriptive study.Setting. Primary care.Participants. 31 reformed PCC in Catalonia. Randomised sampling of centres and hypertense patients (n = 2240). External audit. MEASUREMENTS AND MAIN RESULTS: a) Diagnosis indicator: in 19.4% of cases a triple double-take of blood pressure showed an average of = 140/90 mmHg. b) Monitoring indicator: 77.9% of patients had been seen for blood pressure in the previous 6 months. c) Indicator of degree of control of blood pressure: 38.8% of patients had pressure below the figures then recommended ((3/4) 65 < 140/90 mmHg, and > 65, < 160/95 mmHg). 25.7% of cases were found to have blood pressure figures < 140/90 mmHg. CONCLUSIONS: There was high compliance on the monitoring indicator. The degree of control of hypertense patients treated at reformed PCCs is still low.