Electroencephalographic activity during direct breastfeeding and breast milk expression in primiparous mothers.

Breastfeeding is recognized worldwide as the best option for infant feeding. Expressing breast milk is an alternative for mothers to provide their infants all the benefits of maternal milk. During breast milk expression, mothers receive a distinct kind of sensory stimulation, because there is no direct bodily or affective interaction with their infants, many women report feeling isolated, generating a love-hate relation with pumping, and even low levels of satisfaction while expressing breast milk. While it is well known that the prefrontal, parietal, and temporal cortices play important roles in the emotional and cognitive processing of maternal stimuli, knowledge about how these cortical areas function during breastfeeding is lacking. This study was designed to characterize EEG activity in the prefrontal and parietal cortices and the affective scores of primiparous breastfeeding mothers during two conditions of milk expression: breast milk expression and direct breastfeeding. Participants reported higher valence and arousal and a pleasant state during direct breastfeeding. In the direct breastfeeding condition, both prefrontal areas showed a higher absolute power (AP) of the slow bands, with a lower AP of the alpha band in the parietal cortex. A lower correlation between frontopolar and dorsolateral areas with a higher correlation between prefrontal and parietal cortices was obtained mainly in the right hemisphere. This EEG activity could be linked to an internal state of focused attention and, simultaneously, open monitoring of the environment that suggests an integration of the motive-emotional and cognitive processes necessary for adequate mother-baby interaction during direct breastfeeding.

Activation of Peripheral Cannabinoid Receptors Synergizes the Effect of Systemic Ibuprofen in a Pain Model in Rat.

Pharmacological synergism is a current strategy for the treatment of pain. However, few studies have been explored to provide evidence of the possible synergism between a non-steroidal anti-inflammatory drug (NSAID) and a cannabinoid agonist, in order to establish which combinations might be effective to manage pain. The aim of this study was to explore the synergism between ibuprofen (IBU) and the synthetic cannabinoid WIN 55,212-2 (WIN) to improve pain relief by analyzing the degree of participation of the CB1 and CB2 cannabinoid receptors in the possible antinociceptive synergism using an experimental model of pain in Wistar rats. First, the effective dose thirty (ED30) of IBU (10, 40, 80, and 160 mg/kg, subcutaneous) and WIN (3, 10, and 30 µg/p, intraplantar) were evaluated in the formalin test. Then, the constant ratio method was used to calculate the doses of IBU and WIN to be administered in combination (COMB) to determine the possible synergism using the isobolographic method. The participation of the CB1 and CB2 receptors was explored in the presence of the antagonists AM281 and AM630, respectively. The combination of these drugs produced a supra-additive response with an interaction index of 0.13. In addition, AM281 and AM630 antagonists reversed the synergistic effect in 45% and 76%, respectively, suggesting that both cannabinoid receptors are involved in this synergism, with peripheral receptors playing a relevant role. In conclusion, the combination of IBU + WIN synergism is mainly mediated by the participation of the CB2 receptor, which can be a good option for the better management of pain relief.

Increased kynurenine concentration attenuates serotonergic neurotoxicity induced by 3,4-methylenedioxymethamphetamine (MDMA) in rats through activation of aryl hydrocarbon receptor.

3,4-Methylenedioxymethamphetamine (MDMA) is an amphetamine derivative that has been shown to produce serotonergic damage in the brains of primates, including humans, and of rats. Tryptophan, the precursor of serotonin, is primarily degraded through the kynurenine (KYN) pathway, producing among others KYN, the main metabolite of this route. KYN has been reported as an endogenous agonist of the aryl hydrocarbon receptor (AhR), a transcription factor involved in several neurological functions. This study aims to determine the effect of MDMA on the KYN pathway and on AhR activity and to establish their role in the long-term serotonergic neurotoxicity induced by the drug in rats. Our results show that MDMA induces the activation of the KYN pathway, mediated by hepatic tryptophan 2,3-dioxygenase (TDO). MDMA also activated AhR as evidenced by increased AhR nuclear translocation and CYP1B1 mRNA expression. Autoradiographic quantification of serotonin transporters showed that both the TDO inhibitor 680C91 and the AhR antagonist CH-223191 potentiated the neurotoxicity induced by MDMA, while administration of exogenous l-kynurenine or of the AhR positive modulator 3,3'-diindolylmethane (DIM) partially prevented the serotonergic damage induced by the drug. The results demonstrate for the first time that MDMA increases KYN levels and AhR activity, and these changes appear to play a role in limiting the neurotoxicity induced by the drug. This work provides a better understanding of the physiological mechanisms that attenuate the brain damage induced by MDMA and identify modulation of the KYN pathway and of AhR as potential therapeutic strategies to limit the negative effects of MDMA.

The effect of aromatherapy with lavender (Lavandula angustifolia) on serum melatonin levels.

OBJECTIVE: Physiologically, blood melatonin levels decrease as a person ages and the older adult commonly presents with insomnia and other types of sleep disorders. Alternative therapies can be used to attenuate sleep disturbances. The aim of the present study was to analyze the effect of aromatherapy with lavender on serum melatonin levels in the noninstitutionalized older adult (OA). DESIGN AND SETTING: A pre-experimental, quantitative study with a pre-test - post-test design was conducted on 67 OAs that included both sexes. MAIN OUTCOME MEASURES: Serum melatonin levels were measured before and after eight sessions of aromatherapy with lavender that lasted 4 weeks. The results were expressed as mean ±â€¯standard deviation of melatonin levels (pg/ml). The differences were compared using the Student's t-test and statistical significance was set at a p ≤ 0.05. RESULTS: Blood melatonin levels significantly increased in the total population after the intervention with aromatherapy (pg/ml): 102.3 ±â€¯33.4 VS 132.5 ±â€¯42.3, p = 0.000004. There were significant differences in the pre-test and post-test phases in the women and men measured as separate groups (p = 0.00005 and p = 0.026), respectively. However, those differences were not observed when the measurements were compared between the two sexes, before (p = 0.64) or after (p = 0.31) the intervention. CONCLUSION: Aromatherapy with lavender essential oil similarly favors an increase in blood melatonin levels in both older adult men and women.

Utilidad de los métodos fenotípicos y genotípicos en el estudio de resistencias de Mycobacterium tuberculosis a fármacos antituberculosos de primera línea / Utility of phenotypic and genotypic testing in the study of Mycobacterium tuberculosis resistance to first-line anti-tuberculosis drugs

Objetivo: Conocer la utilidad de las técnicas moleculares para el diagnóstico de resistencias y la situación de las resistencias a fármacos de primera línea en nuestra área geográfica. Material y método: Desde 2004 a 2013, 1.889 cepas de Mycobacterium tuberculosis complex aisladas en Asturias, España, fueron estudiadas mediante pruebas de sensibilidad fenotípicas (directrices del Clinical and Laboratory Standards Institute) y moleculares (INNOLiPA RIF-TB©; GenotypeMDRplus©; GenotypeMDRsl©). Resultados: Mil setecientas cincuenta y nueve cepas (94,52%) eran sensibles a todos los fármacos de primera línea y 102 cepas (5,48%) presentaban alguna resistencia: 81 cepas (4,35%) a un solo fármaco, 14 (0,75%) con polirresistencia y 7 (0,37%) multirresistentes (resistencia a rifampicina e isoniacida). En total hubo 137 resistencias a fármacos: 60 a isoniacida (3,22%), 7 a rifampicina (0,37%), 9 a pirazinamida (0,48%), 11 a etambutol (0,59%) y 50 a estreptomicina (2,68%). El 75,9% de las mutaciones detectadas (63/83) se correlacionaron con resistencia; mientras que un 24,09% de las mutaciones detectadas (20/83) no implicaban resistencia, correspondiendo 16 a una mutación silente en el codón 514 del gen rpoB. Entre un 0 y un 90% de cepas, dependiendo del fármaco que se considere, eran resistentes aunque no presentaban mutaciones en los genes incluidos en los sistemas comerciales. Conclusiones: Las técnicas moleculares resultan muy útiles sobre todo por la rapidez en la obtención de resultados, aunque estos deben confirmarse con las pruebas de sensibilidad fenotípicas de referencia. La tasa de resistencias a fármacos en nuestra región es baja y los casos de multirresistencia (0,37%) son esporádicos

Objective: To determine the utility of molecular techniques in the diagnosis of resistance and the extent of resistance to first-line drugs in our region. Material and method: From 2004 to 2013, 1,889 strains of Mycobacterium tuberculosis complex isolated in Asturias, Spain, were studied using phenotypic (Clinical and Laboratory Standards Institute guidelines) and molecular (INNOLiPA RIF-TB©; GenotypeMDRplus©; GenotypeMDRsl©) sensitivity tests. Results: 1,759 strains (94.52%) were sensitive to all first-line drugs, and 102 strains (5.48%) showed some resistance: 81 strains (4.35%) were resistant to 1 single drug, 14 (0.75%) were polyresistant, and 7 (0.37%) were multiresistant (resistant to rifampicin and isoniazid). In total, 137 resistances were identified: 60 to isoniazid (3.22%), 7 to rifampicin (0.37%), 9 to pyrazinamide (0.48%), 11 to ethambutol (0.59%), and 50 to streptomycin (2.68%). Of the mutations detected, 75.9% (63/83) correlated with resistance, while 24.09% of mutations detected (20/83) were not associated with resistance; 16 of these involved a silent mutation at codon 514 of the rpoB gene. Between 0 and 90% of strains, depending on the drug under consideration, were resistant even when no gene mutations were detected using marketed systems. Conclusions: Molecular techniques are very useful, particularly for obtaining rapid results, but these must be confirmed with standard phenotypic sensitivity testing. The rate of resistance in our region is low and multi-drug resistant cases (0.37%) are sporadic

Utility of Phenotypic and Genotypic Testing in the Study of Mycobacterium tuberculosis Resistance to First-Line Anti-Tuberculosis drugs. / Utilidad de los métodos fenotípicos y genotípicos en el estudio de resistencias de Mycobacterium tuberculosis a fármacos antituberculosos de primera línea.

OBJECTIVE: To determine the utility of molecular techniques in the diagnosis of resistance and the extent of resistance to first-line drugs in our region. MATERIAL AND METHOD: From 2004 to 2013, 1,889 strains of Mycobacterium tuberculosis complex isolated in Asturias, Spain, were studied using phenotypic (Clinical and Laboratory Standards Institute guidelines) and molecular (INNOLiPA RIF-TB©; GenotypeMDRplus©; GenotypeMDRsl©) sensitivity tests. RESULTS: 1,759 strains (94.52%) were sensitive to all first-line drugs, and 102 strains (5.48%) showed some resistance: 81 strains (4.35%) were resistant to 1 single drug, 14 (0.75%) were polyresistant, and 7 (0.37%) were multiresistant (resistant to rifampicin and isoniazid). In total, 137 resistances were identified: 60 to isoniazid (3.22%), 7 to rifampicin (0.37%), 9 to pyrazinamide (0.48%), 11 to ethambutol (0.59%), and 50 to streptomycin (2.68%). Of the mutations detected, 75.9% (63/83) correlated with resistance, while 24.09% of mutations detected (20/83) were not associated with resistance; 16 of these involved a silent mutation at codon 514 of the rpoB gene. Between 0 and 90% of strains, depending on the drug under consideration, were resistant even when no gene mutations were detected using marketed systems. CONCLUSIONS: Molecular techniques are very useful, particularly for obtaining rapid results, but these must be confirmed with standard phenotypic sensitivity testing. The rate of resistance in our region is low and multi-drug resistantcases (0.37%) are sporadic.

Listening to a baby crying induces higher electroencephalographic synchronization among prefrontal, temporal and parietal cortices in adoptive mothers.

Women who adopt babies show caring behaviors and respond to stimuli from their infants just as biological mothers do, but several studies have shown that the cerebral functionality of biological mothers (BM) and adoptive mothers (AM) changes in relation to the type and emotional mean of the stimuli they receive from their babies. The complex perception and processing of different stimuli with emotional content (such as those emitted by babies) require functional synchronization among different cortical and subcortical brain areas. To determine whether the degree of functional synchronization between cortices varies when they perceive such stimuli, this study characterized the degree of cortical electroencephalographic (EEG) synchronization (correlation) among prefrontal, temporal and parietal areas in BM, AM and non-mothers while listening to a recording of a baby crying. BM showed a decreased EEG synchronization between the prefrontal and temporal cortices that may indicate a decrease in the modulatory control that the former exerts on the posterior cortices, and could be associated with deeper emotional involvement and increased sensitivity to the baby crying. The AM, in contrast, had higher degree of EEG synchronization between cortical areas in both hemispheres, likely associated with a greater modulation of the affective information of the crying baby, which allowed them to perceive it as less unpleasant. These data enrich our knowledge of the neurofunctional changes involved in motherhood, and of the neural processes that allow mothers (biological and adoptive) to be sensitive to their infants' cues and respond appropriately.

Photosynthetically active radiation and carbon gain drives the southern orientation of Myrtillocactus geometrizans fruits.

The equatorial orientation of reproductive structures is known in some columnar cacti from extratropical deserts. It has been hypothesised that photosynthetically active radiation (PAR) interception is the main reason for this orientation, because of its key effect on nocturnal CO2 uptake. However, there are no studies addressing both the effect of PAR and its consequence, carbon gain, on fruit orientation. Accordingly, we tested whether PAR and carbon gain could explain the southern fruit orientation of Myrtillocactus geometrizans, an inter-tropical columnar cactus. We studied three populations of M. geometrizans in Mexico. For each population, azimuth of fruits, total daily PAR, nocturnal acid accumulation (NAA) and fruit production were measured. The relationships between rib orientation and number of fruits, as well as total daily PAR, were evaluated using periodic regressions. The effect of total daily PAR and NAA on number of fruits was assessed using generalised linear models. During spring, mean fruit orientation had a south azimuth for three populations. Likewise, rib orientation had a significant effect on fruit production, with the south-facing ribs having the maximum number of fruits. Total daily PAR was highest in the south-facing ribs, at least for those in the northern and central populations. Furthermore, during spring, there was a significant positive effect of total daily PAR and NAA on fruit production. Our results provide strong evidence that the higher carbon gain in equatorial ribs, through a highest interception of PAR, would be the responsible factor for equatorial orientation of fruits in an inter-tropical columnar cactus.

Molecular and epidemiological population-based integrative analysis of human and animal Mycobacterium bovis infections in a low-prevalence setting.

Human Mycobacterium bovis infections are considered to be due to reactivations, when involve elderly people, or to recent transmissions, when exposure is occupational. We determined the cause of M. bovis infections by genotyping M. bovis isolates in a population-based study integrating human and animal databases. Among the 1,586 tuberculosis (TB) cases in Asturias, Northern Spain (1,080,000 inhabitants), 1,567 corresponded to M. tuberculosis and 19 to M. bovis. The number of human isolates sharing genotype with cattle isolates was higher than expected (47%) for a setting with low prevalence of bovine TB and efficient control programs in cattle. The risk of exposure to infected animals was probable/possible in most of these matched cases (77.7%). Recent transmission was the likely explanation of most M. bovis infections in elderly people. A potential human-to-human transmission was found. Our study illustrates a model of collaboration between human and animal health professionals to provide a precise snapshot of the transmission of M. bovis in the human-animal interface.

Observing videos of a baby crying or smiling induces similar, but not identical, electroencephalographic responses in biological and adoptive mothers.

It is well-known that adoptive mothers respond to cues from their babies in similar ways to biological mothers, and that cortical processing is critical for adequate motive-emotional maternal responses. This study used electroencephalographic activity (EEG) to characterize prefrontal, parietal and temporal functioning in biological mothers (BM), adoptive mothers (AM), and non-mothers (NM), while viewing videos of a baby smiling or crying. The BM presented higher absolute power (AP) in the delta and theta bands (associated with pleasant, positive emotional experiences) in the frontal and parietal areas under all conditions. In response to the smiling video, both types of mothers presented a lower AP in alpha1 in the three cortices (indicative of increased attention) and, mainly in temporal areas, a higher AP in the fast frequencies (beta and gamma, reflecting increased alertness to sensory stimuli and cognitive processing). This EEG pattern in the BM and AM could reflect the greater attention and, probably, the positive mood caused by the smiling video, showing that both are sensitive to these pleasant stimuli. When viewing the video of a baby crying, the AM had higher AP in the fast frequencies (temporal and parietal areas), indicating that they were more reactive to this unpleasant video, while the NM presented only a lower AP in alpha1 in all cortices, a finding that could be associated with the general activation induced by these unpleasant stimuli as a consequence of their lack of maternal experience. These findings should help improve our understanding of the neural mechanisms involved in the processing of sensorial stimuli that establish affective-emotional links during motherhood.

Expression and characterization of the gD protein of HSV-2 fused to the tetramerization domain of the transcription factor p53.

The highly immunogenic glycoprotein D (gD) of herpes simplex virus type 2 (HSV-2) is a very important element for entry of this virus into host cells. These characteristics have made this protein a very interesting HSV-2 subunit vaccine candidate. Despite efforts to prevent genital herpes using gD-based subunit vaccines, to date, clinical trials using this antigen have failed. Therefore, using a small animal model, we sought to determine if a tetramerized truncated form of gD subunit vaccine, produced by recombinant baculovirus infected insect larvae, would elicit better protection against genital herpes than a monomeric gD-2 subunit vaccine. Three out of 5 mice immunized with the tetramerized antigen produced in a baculovirus expression vector system, survived a lethal challenge with a wild type HSV-2 strain (for more than 3 weeks after challenge). In contrast, all the mice (5) immunized with the truncated protein, produced by the same methodology, died within 2 weeks after challenge. These results suggest that multimerization (increasing the structural complexity) of the truncated gD antigen might be more likely protective than the monomer form. Also the use of an alternative cost-efficient eukaryotic expression system is described.

Quaternary origin and genetic divergence of the endemic cactus Mammillaria pectinifera in a changing landscape in the Tehuacán Valley, Mexico.

The endemic Mexican cactus, Mammillaria pectinifera, shows low dispersal capabilities and isolated populations within the highly dissected landscape of Tehuacán Valley. These characteristics can restrict gene flow and act upon the genetic divergence and speciation in arid plants. We conducted a phylogeographic study to determine if the origin, current distribution, and genetic structure of M. pectinifera were driven by Quaternary geomorphic processes. Sequences of the plastids psbA-trnH and trnT-trnL obtained from 66 individuals from seven populations were used to estimate genetic diversity. Population differentiation was assessed by an analysis of molecular variance. We applied a stepwise phylogenetic calibration test to determine whether species origin and genetic divergence among haplotypes were temporally concordant with recognizable episodes of geomorphic evolution. The combination of plastid markers yielded six haplotypes, with high levels of haplotype diversity (h = 0.622) and low nucleotide diversity (π = 0.00085). The populations were found to be genetically structured (F(ST) = 0.682; P < 0.00001), indicating that geographic isolation and limited dispersal were the primary causes of genetic population differentiation. The estimated origin and divergence time among haplotypes were 0.017-2.39 and 0.019-1.237 mya, respectively, which correlates with Pleistocene tectonics and erosion events, supporting a hypothesis of geomorphically-driven geographical isolation. Based on a Bayesian skyline plot, these populations showed long term demographic stability, indicating that persistence in confined habitats has been the main response of this species to landscape changes. We conclude that the origin and haplotype divergence of M. pectinifera were a response to local Quaternary geomorphic evolution.

Short communication: Feeding linseed oil to dairy goats with competent reticular groove reflex greatly increases n-3 fatty acids in milk fat.

A crossover experiment was designed to compare the effects of 2 ways of feeding linseed oil on milk fat fatty acid (FA) composition. Ten lactating goats, trained to keep competent their inborn reticular groove reflex, received a daily dose of linseed oil (38 g/d) either with their solid (concentrate) feed (CON) or emulsified in skim milk and bottle-fed (BOT). Two groups of 5 goats received alternative and successively each of the treatments in two 15-d periods. α-Linolenic acid in milk fat rose up to 13.7% in the BOT versus 1.34% in the CON treatment. The n-6 to n-3 FA ratio was significantly reduced in goats receiving bottle-fed linseed oil (1.49 vs. 0.49). Contents of rumen biohydrogenation intermediates of dietary unsaturated FA were high in milk fat of goats under the CON treatment but low in those in the BOT treatment. These results point to a clear rumen bypass of the bottle-fed linseed oil. This strategy allows obtaining milk fat naturally very rich in n-3 FA and very low in trans FA. Translating this approach into practical farm conditions could enable farmers to produce milk enriched in specific FA.

Time-dependent variations in milk fatty acid content of goats fed 3 different plant oils.

The effect of sampling time on milk fatty acid (FA) composition after separately adding 3 plant oils to an oil-free control diet (67% cereal-soybean-based concentrate and 33% alfalfa hay) was studied in 12 Malagueña goats. Individual animals were randomly allocated to 1 of the 4 treatments: control, 48 g/d of added high oleic (OSO) or regular (RSO) sunflower oil, or linseed oil (LO). Individual milk samples were taken at 0 (covariate), 1, 12, 24, 72, 120, 192, 312, and 504 h after the beginning of the experiment. Milk FA contents (g/100g of total FA methyl esters) were analyzed in a completely randomized design with repeated measures using PROC MIXED of SAS (SAS Institute Inc., Cary, NC). Comparing results of 15 chosen FA (for example, medium-chain saturated FA trans-11 C18:1, cis-9,trans-11 C18:2, trans-10 C18:1, and C18:3n-3) indicated that throughout the duration of the experiment, feeding the control diet had little influence on the concentrations of most FA in milk. Most changes in milk FA composition due to oil supplementation had occurred within 192 h since the beginning of the experiment. However, the concentrations of 2 FA (trans-10 C18:1 in RSO and C18:3n-3 in LO treatments) continued to change until 504 h. By comparing FA values in milk fat from oil treatments with those of the control at the same sampling times, typical value differences for the 3 supplementary oils found at 504 h (21 d) were also observed at 312 h from the beginning of the experiment (13 d) and even earlier in some FA, such as medium-chain saturated FA at 120 h in RSO and LO and at 72 h in OSO, cis-9,trans-11 C18:2 and trans-10 C18:1 at 24h in RSO, trans-11 C18:1 at 12h in RSO and LO, and C18:3n-3 at 1h in LO. In the conditions assayed in these experiments, reliable results of milk FA changes were obtained at sampling times shorter than 21 d. Monitoring early changes in milk FA after the addition of plant oils to diets could help in the study of rumen and mammary metabolism of dietary FA.

Serum ferritin and nutritional status in older adults at eldercare facilities.

OBJECTIVES: To identify serum ferritin levels and their association with nutritional status determined by Body Mass Index in older adults at four eldercare facilities. METHODS: An exploratory, cross-sectional study was carried out on 100 older adults residing at eldercare facilities in Colima, Mexico. Association between blood serum ferritin levels and nutritional status determined by Body Mass Index was evaluated. Ferritin levels were determined by means of chemiluminescence of blood samples obtained from subjects under control conditions. Descriptive statistics were used to analyze demographic characteristics. Student's t test and chi-square test were used to compare ferritin levels and Body Mass Index, respectively, between sexes. Statistical significance was considered to exist when P≤ 0.05. Pearson's correlation was used to establish the relation between Body Mass Index and serum ferritin levels. RESULTS: Mean serum ferritin levels were 59.9489 ng/mL in women and 86.9266 ng/mL in men (P= 0.12). In regard to Body Mass Index there was statistical significance between normal vs overweight/obesity (P = 0.008), but not between normal vs underweight (P = 0.34). Body Mass Index/serum ferritin correlation was not statistically significant (Pearson's r = 0.003). CONCLUSIONS: The quantification of a single serum indicator is insufficient for determining nutritional status in the older adult.

Short communication: Linear discriminant analysis and type of oil added to dairy goat diets.

Gas chromatography fatty acid (FA) analysis of 112 milk fat samples from dairy goats fed a basal diet with no added oil or the same diet with 1 of 3 vegetable oils added [high oleic sunflower oil (HOSFO), regular sunflower oil (RSFO), or linseed oil (LO)] was used to identify the type of diet consumed through linear discriminant analysis. Twenty variables (19 FA and 1 FA ratio) were selected as valid predictors out of 84 variables tested. The Mahalanobis squared distance was minimal between HOSFO and RSFO groups and maximal between control and LO groups. Cross-validation showed that only one observation from RSFO group was misclassified into the HOSFO group. We concluded that linear discriminant analysis is a useful method to classify milk fat samples from dairy goats according to the particular vegetable oil (of the 3 oils tested here) added to the basal diet.

Effects of feeding increasing dietary levels of high oleic or regular sunflower or linseed oil on fatty acid profile of goat milk.

In this work, the effects of increasing amounts of 3 plant oils in diets on the fatty acid (FA) profile of goat milk were studied. The study consisted of 3 experiments, one per oil tested (linseed oil, LO; high oleic sunflower oil, HOSFO; and regular sunflower oil, RSFO). The 3 experiments were conducted successively on 12 Malagueña goats, which were assigned at random to 1 of 4 treatments: 0, 30, 48, and 66 (H) g of added oil/d. A basal diet made of alfalfa hay and pelleted concentrate (33:67) was used in all of the experiments. For each animal, milk samples collected after 15 d on treatments were analyzed for fat, protein, lactose, and FA composition, whereas individual milk yield was measured the last 3 d of each experiment. Oil supplementation affected neither dry matter intake nor milk production traits. Increasing the oil supplementation decreased the content of saturated FA (especially 16:0) in milk fat and increased mono- and polyunsaturated FA in a linear manner. Vaccenic acid content linearly increased with the oil supplementation by 370, 217, and 634% to 5.32, 2.66, and 5.09 g/100 g of total FA methyl esters with the H diet in LO, HOSFO, and RSFO experiments, respectively. Rumenic acid content linearly increased with LO and RSFO supplementation by 298 and 354% from 0.53 and 0.41 g/100 g of total FA methyl esters with the 0 g of added oil/d diet. The content of trans-10-18:1 was not affected by LO supplementation but showed an increasing linear trend with HOSFO supplementation and linearly increased with RSFO supplementation. The ratio of n-6 to n-3 polyunsaturated FA in milk fat was decreased by about 70% with the H diet in the LO experiment and it was increased by 54 and 82% with the H diet in the HOSFO and RSFO experiments. In conclusion, LO supplementation in this work seemed to be the most favorable alternative compared with HOSFO or RSFO supplementation.

Animal performance and milk fatty acid profile of dairy goats fed diets with different unsaturated plant oils.

The effect of supplementing a basal diet with 1 of 3 plant oils on productive efficiency and milk fatty acid composition was studied in dairy goats. Sixteen Malagueña goats were used in a 4×4 Latin square experiment with 21-d periods and 4 goats per treatment. The basal diet comprised 30% alfalfa hay and 70% pelleted concentrate. Experimental treatments were control (basal diet without added oil) and the basal diet supplemented with 48g/d of high oleic sunflower oil (HOSFO), regular sunflower oil (RSFO), or linseed oil (LO). Dry matter intake and body weight were not affected by treatments. Milk production was higher in HOSFO treatment and milk fat content was higher in RSFO and LO treatments, although no differences in milk energy production or milk renneting properties were found. The RSFO and LO treatments increased the proportion of vaccenic acid in milk fat more so than the HOSFO diet, and rumenic acid followed the same pattern. The content of trans10-18:1 remained low in all experimental diets (<0.7% of total fatty acid methyl esters) although HOSFO and RSFO diets increased it. The variations in the fatty acid profiles observed with the 4 diets, mainly the unsaturated fatty acid isomer contents, are extensively discussed. Compared with that in the control diet, the n-6:n-3 fatty acid ratio in milk fat substantially decreased with the LO, increased with RSFO, and did not change with HOSFO. The addition of moderate amounts of LO to the diets of dairy goats has favorable effects on milk fatty acid composition from the point of view of the human consumer, without negative effects on animal performance.

Percepción de los médicos de Atención Primaria en el manejo clínico de la osteoporosis. Influencia de los planes de salud / Primary care perception of clinical management of osteoporosis. The influence of healthcare policies

Introducción: El objetivo es conocer el manejo clínico de la osteoporosis y la influencia de los planes de salud en la práctica clínica. Material y métodos: Se realizó una encuesta transversal dirigida a 465 médicos de Atención Primaria (MAP) de España y una revisión sistemática de 15 planes de salud (PS) autonómicos. En la encuesta se evaluó el uso de escalas de valoración de factores de riesgo (FR) de osteoporosis, el uso de pruebas diagnósticas, su accesibilidad en AP y tratamiento farmacológico. Resultados y Conclusión: La revisión de los PS determinó tres grupos de comunidades autónomas (CCAA) según cómo consideraban a la osteoporosis: (1) formulación explícita, (2) formulación implícita como problema de salud y (3) sin referencia a la osteoporosis. El 49% de los MAP utilizaban escalas de valoración de FR. El 98% de los MAP creían que el diagnóstico inicial de osteoporosis debía realizarse en AP, y más del 50% afirmaron que las mujeres diagnosticadas eran tratadas y seguidas en AP. El acceso a la densitometría ósea es más sencillo en las CCAA del grupo 1. El tratamiento más utilizado son los bifosfonatos y el calcio con la vitamina D, sin diferencias por CCAA. Conclusión: Los MAP consideran que la Atención Primaria es un marco inmejorable para la atención preventiva, terapéutica y rehabilitadora de la osteoporosis. A pesar de ello existen ciertas barreras para la utilización de escalas de valoración de FR. Los MAP de las CCAA con PS para la osteoporosis tienen mejor acceso a la densitometría ósea (AU)

Introduction: This study aims to assess the clinical management of osteoporosis and the influence of the health care plans in the clinical practice. Material and methods: A cross-sectional survey was made of 465 general practitioners (GP) from Spain. The survey included the following information: osteoporosis risk factors (RF) scales, diagnostic tests and their accessibility from primary care, and pharmacological treatment. In addition, a systematic review of 15 regional healthcare plans (RHP) was performed. Results and conclusions: The RHP review determined 3 autonomous region (AR) groups according to how they considered osteoporosis: (1) explicit formulation, (2) implicit as a health problem and (3) without any reference to osteoporosis. Forty-nine percent of the GP used risk factor scales. A total of 98% of the GPs thought that the initial diagnosis of osteoporosis should be made in PHC, and over 50% stated that the women diagnosed were treated and followed-up in PHC. Access to bone densitometry is easier in those belonging to group 1 AR. The most used treatments were bisphosphonates and calcium plus D vitamin, there being no differences among AR groups. Conclusions: The GPs consider that primary health care is an excellent framework for prevention, therapeutic attention and osteoporosis rehabilitation. In spite of this, there are still some barriers regarding the use of RF scales. In those ARs with specific osteoporosis health plans, the GPs have easier accessibility to bone densitometry (AU)

Un paciente con ginecomastia

La ginecomastia es el desarrollo de una mama de características femeninas en el varón. Puede aparecer de manera fisiológica durante diferentes etapas de la vida o ser secundaria a un proceso patológico o a terapia farmacológica. Antes de clasificar cualquier ginecomastia de fisiológica debe realizarse un estudio exhaustivo a fin de descartar posibles procesos patológicos subyacentes. La mayor parte de los casos que precisan cirugía corresponden a sujetos jóvenes con ginecomastia fisiológica que no remite en un período prudencial de tiempo y que causan un hondo trastorno psicológico en el paciente (AU)