Cap-Assisted Technique versus Conventional Methods for Esophageal Food Bolus Extraction: A Comparative Study

BACKGROUND/AIMS: Food bolus impaction is the most common form of esophageal foreign body impaction observed in adults. Clinical guidelines recommend using the push technique or retrieval methods in such cases. The push technique can cause injuries in certain clinical situations. Notably, conventional retrieval methods are time and effort consuming. Cap-assisted endoscopic extraction of an impacted food bolus is an easy and effective technique; however, more data are needed for its validation. This study compared the capassisted extraction technique with conventional methods. METHODS: This prospective observational multicenter study compared the success and en bloc removal rates, total procedure time, and adverse events in both techniques.. RESULTS: The study included 303 patients who underwent food bolus extraction. The push technique was used in 87 patients (28.7%) and a retrieval procedure in 216 patients (71.3%). Cap-assisted extraction was performed in 106 patients and retrieval using conventional methods in 110 patients. The cap-assisted technique was associated with a higher rate of en bloc removal (80.2% vs. 15%, p<0.01), shorter procedure time (6.9±3.5 min vs. 15.7±4.1 min, p<0.001), and fewer adverse events (0/106 vs. 9/110, p<0.001). CONCLUSIONS: Cap-assisted extraction showed no adverse events, higher efficacy, and a shorter procedure time compared with conventional retrieval procedures.

Salivary gland composition of some old world vector sand fly

The saliva of blood feeding arthropods has a variety of substances that are responsible for blood meal success. The composition and the influence of sand fly saliva vary considerably between species and even between populations of different geographical origin. In Old-World sand flies [Phlebotomus sp.] differences in protein components of the salivary gland homogenate were demonstrated between species and between colonies of the same species. We compared protein components in the salivary glands of sand flies vectors from different species and origins. The salivary gland homogenate [SGH] of laboratory reared Egyptian phlebotomine sand flies, P. papatasi, P. sergenti and P. langeroni Sinai and El-Agamy strains respectively were compared with Spanish naturally caught P. perniciosus and P. ariasi, which were collected from a farm 20 km southwest of Barcelona. Polyacrylamide gel electrophoresis [PAGE] [SDS-PAGE] was done for compare- son. The electrophoresis profiles of SGH differed between all tested species. From 8-14 prominent proteins bands with molecular masses ranging from 8-70 kDa were visualized by Commassie blue gel code staining in each SGH. So, saliva composition varied between species and sub-species, and increased between different sub-genera and geographical areas. The data are important for the characterization of salivary proteins

Immunomodulatory properties of sand fly Saliva and its role on vertebrate host

The salivary glands of Phlebotomus papatasi and P. langeroni were investigated for their immunomodulatory properties on vertebrate hosts. Laboratory reared sand fly, were used for feeding on hamsters and for extraction of salivary gland. To determine the influence of the sand fly saliva homogenate [SGH] were performed ELISA using sera from injected hamsters by SGH. Frequent feeding of P. papatasi on hamsters were carried out to relate the antibody titre with the biting rate. The mosquito Culex pipiens was allowed to feed on pre-exposed hamsters to P. papatasi bites. Antibodies correlated with the saliva of both species showed low titre and not related either to the time [after feeding and injection] or to the number of fed flies. Saliva of P. langeroni [non vector] recorded higher anti-body titre than P. papatasi. The preliminary experiment of the mosquitoes' feeding [C. pipiens] on pre-exposed hamsters on its saliva showed cross reactions between biting of mosquitoes and sand-flies. More investigations are needed to study the effects of sand fly saliva on human immune responses to evaluate the fly salivary proteins as vaccines for leishmaniasis and to prevent or decrease the sand-flies biting or probably mosquitoes