Compelling evidence exists for the cardioprotective benefits resulting from consumption of fatty acids from fish oils, EPA (20 :5n-3) and DHA (22 :6n-3). EPA and DHA alter membrane fluidity, interact with transcription factors such as PPAR and sterol regulatory element binding protein, and are substrates for enzymes including cyclooxygenase, lipoxygenase and cytochrome P450. As a result, fish oils may improve cardiovascular health by altering lipid metabolism, inducing haemodynamic changes, decreasing arrhythmias, modulating platelet function, improving endothelial function and inhibiting inflammatory pathways. The independent effects of EPA and DHA are poorly understood. While both EPA and DHA decrease TAG levels, only DHA appears to increase HDL and LDL particle size. Evidence to date suggests that DHA is more efficient in decreasing blood pressure, heart rate and platelet aggregation compared to EPA. Fish oil consumption appears to improve arterial compliance and endothelial function; it is not yet clear as to whether differences exist between EPA and DHA in their vascular effects. In contrast, the beneficial effect of fish oils on inflammation and insulin sensitivity observed in vitro and in animal studies has not been confirmed in human subjects. Further investigation to clarify the relative effects of consuming EPA and DHA at a range of doses would enable elaboration of current understanding regarding cardioprotective effects of consuming oily fish and algal sources of long chain n-3 PUFA, and provide clearer evidence for the clinical therapeutic potential of consuming either EPA or DHA-rich oils.

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Neither EPA- nor DHA-rich fish oil supplementation influence platelet-monocyte aggregation or several markers of vascular function after 6 wk in healthy young males. This trial was registered at clinicaltrials.gov as NCT01735357.

The consumption of insects "entomophagy" or insect-based foods is increasingly being recognised as an emerging solution to promote diet diversification and address the multiple burden of malnutrition. Although several studies suggest edible insects as valuable nutrient sources, few have evaluated the effects of processing on nutrient bioavailability and bioaccessibility and provided actual evidence on human nutrition. Moreover, there is limited evidence of their actual contribution to improved food and nutrition security. Therefore, the review evaluated existing evidence on human interventions and the effects of processing methods on bioavailability and bioaccessibility of key nutrients since these directly influence food and nutrition security outcomes. Seven human efficacy studies have been conducted to date and these show limited observable effects on nutrition status therefore more research is required. Findings also suggest that the processing method, insect matrix, composition of the food matrix and interaction with other food components can influence nutrient bioavailability and bioaccessibility. Hence, these should be considered during formulation and upscaling for entomophagy and insect-based foods to be viable intervention strategies against malnutrition.

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Although associations of Sjögren's syndrome (SS) with malignant affections are well known, an association with chronic myelomonocytic leukemia (CMML) is infrequent. Our report concerns an 80-year-old woman with chronic polyarthrosis, hospitalized for an anemic syndrome, who also complained of buccal dryness. Clinical examination showed simply parotid swelling and discrete splenomegaly. The diagnosis of SS appeared to be primary. The hemogram, myelogram and bone biopsy indicated CMML. During SS, the possibility of occurrence of a lymphoproliferative syndrome is well documented, and other malignant affections are much less likely to be found in the absence of immunosuppressive treatment. The particular case of SS and associated CMML detected at the same time suggests either the favorable role of monocytic proliferation on immunity or a stem clonal anomaly affecting monocytes and B lymphocytes.

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