Spanish Intragastric Balloon Consensus Statement (SIBC): practical guidelines based on experience of over 20 000 cases.

BACKGROUND: intragastric balloons (IGBs) are a minimally invasive, increasingly popular option for obesity treatment. However, there is only one worldwide guideline standardizing the technical aspects of the procedure (BIBC, SOARD 2018). OBJECTIVES: to construct a practical guideline for IGB usage by reproducing and expanding the BIBC survey among the Spanish Bariatric Endoscopy Group (GETTEMO). METHODS: a 140-question survey was submitted to all GETTEMO members. Twenty-one Spanish experienced endoscopists in IGBs answered back. Eight topics on patient selection, indications/contraindications, technique, multidisciplinary follow-up, results, safety, and financial/legal aspects were discussed. Consensus was defined as consensus ≥ 70 %. RESULTS: overall data included 20 680 IGBs including 12 different models. Mean age was 42.0 years-old, 79.9 % were women, and the mean preoperative body mass index (BMI) was 34.05 kg/m². Indication in BMI > 25 kg/m², 10 absolute contraindications, and nutritional and medication measures at follow-up were settled. A mean %TBWL (total body weight loss) of 17.66 % ± 2.5 % was observed. Early removal rate due to intolerance was 3.62 %. Adverse event rate was 0.70 % and 6.37 % for major and minor complications with consensual management. A single case of mortality occurred. IGBs were placed in private health, prior contract, and with full and single payment at the beginning. Seven lawsuits (0.034 %) were received, all ran through civil proceeding, and with favorable final resolution. CONCLUSIONS: this consensus based on more than 20 000 cases represents practical recommendations to perform IGB procedures. This experience shows that the device leads to satisfactory weight loss with a low rate of adverse events. Most results are reproducible compared to those obtained by the BIBC.

Neonatal Antibiotic Treatment Can Affect Stool Pattern and Oral Tolerance in Preterm Infants.

Preterm neonates are at high risk of infectious and inflammatory diseases which require antibiotic treatment. Antibiotics influence neonatal gut microbiome development, and intestinal dysbiosis has been associated with delayed gastrointestinal transit. Neonates who take less time to pass meconium have a better tolerance to enteral feeding. We analyzed the effect of neonatal antibiotic treatment on the stool pattern and oral tolerance in 106 preterm infants < 33 weeks gestational age. Neonates were classified in 3 groups according to neonatal antibiotic (ABT) treatment days: no antibiotics, 3−7 d ABT, and ≥8 d ABT. Preterm infants from the ≥8 d ABT group took longer to pass meconium and to start green and yellow stools, took longer to reach 100 and 150 mL/kg/day, and reached reduced volumes in enteral feeds at day of life 14 and 28 than infants from no ABT and 3−7 d ABT groups. Multiple linear regression models showed that neonatal antibiotic treatment, birth weight, invasive mechanical ventilation, surfactant, enteral feeding start day, neonatal parenteral nutrition, and neonatal fasting days are associated with the stool pattern and oral tolerance in preterm infants.

Influence of Bacillus safensis and Bacillus pumilus on the electrochemical behavior of 2024-T3 aluminum alloy.

In this work, electrochemical techniques were employed to evaluate the contribution to the corrosion and corrosion inhibition of 2024-T3 aluminum alloy by two Gram-positive bacteria. In addition, polarized impedance was used to determine the microbial effect on the cathodic and anodic reactions. These microorganisms were collected from a tropical environment due to the favorable bacterial growth of this kind of climate. The alloy was exposed to the sterile medium and inoculated for up to 12 days evaluating the microbiological and electrochemical behavior. The results by linear scanning voltammetry showed that the B. safensis and B. pumilus caused a dual effect of increase and decrease currents, and through electrochemical impedance spectroscopy, showed in some cases, inductive loop, which could be associated with local corrosion and another case, an increasing impedance could be related to protection. In addition, a morphological characterization was performed by scanning electron microscopy before and after exposure, showing an increase in copper precipitation in the vicinity of the intermetallic phases by bacteria, attributed to local corrosion, but, in general, a significant effect of damages was not observed.

Study of an Antarctic thermophilic consortium and its influence on the electrochemical behavior of aluminum alloy 7075-T6.

Common alloys used for the manufacture of aircrafts are subject to different forms of environmental deterioration. A major one is corrosion, and there is a strong body of evidence suggesting that environmental microorganisms initiate and accelerate it. The development of an appropriate strategy to reduce this process depends on the knowledge concerning the factors involved in corrosion. In this work, a biofilm forming bacterial consortium was extracted in situ from the corrosion products formed in an aircraft exposed to Antarctic media. Two thermophilic bacteria, an Anoxybacillus and a Staphylococcus strain, were successfully isolated from this consortium. Two extracellular enzymes previously speculated to participate in corrosion, catalase and peroxidase, were detected in the extracellular fraction of the consortium. Additionally, we assessed the individual contribution of those thermophilic microorganisms on the corrosion process of 7075-T6 aluminum alloy, which is widely used in aeronautical industry, through electrochemical methods and surface analysis techniques.

Effects of Autoclaving, EtOH, and UV Sterilization on the Chemical, Mechanical, Printability, and Biocompatibility Characteristics of Alginate.

Sterilization is a necessary step during the processing of biomaterials, but it can affect the materials' functional characteristics. This study characterizes the effects of three commonly used sterilization processes-autoclaving (heat-based), ethanol (EtOH; chemical-based), and ultraviolet (UV; radiation-based)-on the chemical, mechanical, printability, and biocompatibility properties of alginate, a widely used biopolymer for drug delivery, tissue engineering, and other biomedical applications. Sterility assessment tests showed that autoclaving was effective against Gram-positive and Gram-negative bacteria at loads up to 108 CFU/mL, while EtOH was the least effective. Nuclear magnetic-resonance spectroscopy showed that the sterilization processes did not affect the monomeric content in the alginate solutions. The differences in compressive stiffness of the three sterilized hydrogels were also not significant. However, autoclaving significantly reduced the molecular weight and polydispersity index, as determined via gel permeation chromatography, as well as the dynamic viscosity of alginate. Printability analyses showed that the sterilization process as well as the extrusion pressure and speed affected the number of discontinuities and spreading ratio in printed and cross-linked strands. Finally, human adipose-derived stem cells demonstrated over 90% viability in all sterilized hydrogels over 7 days, but the differences in cellular metabolic activity in the three groups were significant. Taken together, the autoclaving process, while demonstrating broad spectrum sterility effectiveness, also resulted in most notable changes in alginate's key properties. In addition to the specific results with the three sterilization processes and alginate, this study serves as a roadmap to characterize the interrelationships between sterilization processes, fundamental chemical properties, and resulting functional characteristics and processability of hydrogels.

Bioaccumulation of Metals in Cultured Carp (Cyprinus carpio) from Lake Chapala, Mexico.

Chapala, the largest lake in Mexico, has a great potential for aquaculture and a community of some 2500 fishermen who are interested in this activity. However, diverse reports over the past two decades suggest that the fish there are contaminated with heavy metals, raising concern among consumers. Although more recent scientific studies have clarified that the metal content in the edible parts of fish is below allowable limits, the negative perception persists. The present study, therefore, was designed to evaluate the bioaccumulation of the metals Cu, Zn, Pb, As, and Cd in organs such as the muscles, liver, and gills of carp (Cyprinus carpio) cultured in Lake Chapala, and compared the results to fish cultured in a pond. Results after 473 days of monitoring showed that metal bioaccumulation in the muscles of the carp increased by 1.71, 0.50, and 12.36 µg/kg for Cu, Cd, and Pb, respectively, but Zn and As levels decreased by 7.84 and 131.7 µg/kg, respectively. The livers showed concentrations one or two times higher than the muscles in the case of Pb, Cu, Zn, and Cd. According to these results, the metal concentrations in the edible parts of these fish were below international standards for human consumption, and no significant differences were found between the bioaccumulation patterns in the muscles and livers of the carp cultured in the lake and those raised in the pond, except for Cd and Pb in the liver. Finally, no correlations were found between metal concentrations in the fish and lake sediments.

Reporter Cell Assessment of TLR4-Induced NF-κB Responses to Cell-Free Hemoglobin and the Influence of Biliverdin.

Hemoglobin (Hb) released during red blood cell lysis can initiate TLR4-dependent signaling and trigger NF-κB activation in surrounding cells. Observations of chronic bleeding in various cancers leads us to hypothesize that Hb and Hb degradation products released from lysed RBC near cancer nests might modulate local TLR4-positive cells. We addressed the hypothesis in vitro by measuring Hb- and biliverdin (Bv)-induced NF-κB signaling in an engineered human TLR4 reporter cell model (HEK-BlueTM hTLR4). Therein, TLR4 stimulation was assessed by measuring NF-κB-dependent secreted alkaline phosphatase (SEAP). hTLR4 reporter cells incubated with 8 ηM lipopolysaccharide (LPS) or 20-40 µM fungal mannoprotein (FM) produced significant amounts of SEAP. hTLR4 reporter cells also produced SEAP in response to human, but not porcine or bovine, Hb. HEK-Blue Null2TM reporter cells lacking TLR4 did not respond to LPS, FM, or Hb. Bv was non-stimulatory in reporter cells. When Bv was added to Hb-stimulated reporter cells, SEAP production was reduced by 95%, but when Bv was applied during LPS and FM stimulation, SEAP production was reduced by 33% and 27%, respectively. In conclusion, Hb initiated NF-κB signaling that was dependent upon TLR4 expression and that Bv can act as a TLR4 antagonist. Moreover, this study suggests that hemorrhage and extravascular hemolysis could provide competitive Hb and Bv signaling to nearby cells expressing TLR4, and that this process could modulate NF-κB signaling in TLR4-positive cancer cells and cancer-infiltrating leukocytes.

Assessing the effectiveness of green synthetized silver nanoparticles with Cryptocarya alba extracts for remotion of the organic pollutant methylene blue dye.

In the present work, silver nanoparticles (AgNPs) synthetized with Cryptocarya alba (Peumo) leaf extract were studied. The fabrication method was fast, low cost, and eco-friendly, and the final properties of AgNPs were determined by experimental parameters, such as AgNO3 and Peumo extract concentrations used. Setting suitable experimental conditions, crystalline AgNPs with apparent spherical forms and average diameter around 3.5 nm were obtained. In addition, the capability of synthesized Peumo-AgNPs to remove methylene blue dye (MB) in aqueous solution as well as their catalytic effectiveness was also investigated. The results showed that green synthesized AgNPs can remove fast and effectively the MB dye from aqueous medium by itself, but better results were found acting like catalyst by using sodium borohydride (NaBH4) in the reaction. In addition, this green nanomaterial can be recycling several times maintaining initial properties for removal of MB. Thus, AgNPs synthetized with Peumo leaf extracts could be an excellent catalyst candidate for degradation of blue methylene dye in chemical industries.

Candida albicans-derived mannoproteins activate NF-κB in reporter cells expressing TLR4, MD2 and CD14.

The ability of soluble C. albicans 20A (serotype A) mannoprotein (CMP) to serve as a ligand for toll-like receptor 4 (TLR4) and its co-receptors was examined using commercially available and stably-transfected HEK293 cells that express human TLR4, MD2 and CD14, but not MR. These TLR4 reporter cells also express an NF-κB-dependent, secreted embryonic alkaline phosphatase (SEAP) reporter gene. TLR4-reporter cells exhibited a dose-dependent SEAP response to both LPS and CMP, wherein peak activation was achieved after stimulation with 40-50 µg/mL of CMP. Incubation on polymyxin B resin had no effect on CMP's ligand activity, but neutralized LPS-spiked controls. HEK293 Null cells lacking TLR4 and possessing the same SEAP reporter failed to respond to LPS or CMP, but produced SEAP when activated with TNFα. Reporter cell NF-κB responses were accompanied by transcription of IL-8, TNFα, and COX-2 genes. Celecoxib inhibited LPS-, CMP-, and TNFα-dependent NF-κB responses; whereas, indomethacin had limited effect on LPS and CMP responses. SEAP production in response to C. albicans A9 mnn4Δ mutant CMP, lacking phosphomannosylations on N-linked glycans, was significantly greater (p ≤ 0.005) than SEAP responses to CMP derived from parental A9 (both serotype B). These data confirm that engineered human cells expressing TLR4, MD2 and CD14 can respond to CMP with NF-κB activation and the response can be influenced by variations in CMP-mannosylation. Future characterizations of CMPs from other sources and their application in this model may provide further insight into variations observed with TLR4 dependent innate immune responses targeting different C. albicans strains.

Effectiveness of the nutritional supplement used in the Mexican Oportunidades programme on growth, anaemia, morbidity and cognitive development in children aged 12-24 months.

OBJECTIVE: To determine the effectiveness of the nutritional supplement developed for the Oportunidades programme on growth, prevalence of anaemia, morbidity and cognitive function of pre-school children. DESIGN: In a randomised, placebo-controlled longitudinal trial, children were assigned to one of three experimental treatment groups: Oportunidades food supplement (OFS), powdered milk (PM) and placebo (PL). Treatments were administered daily for 6 months. Weight, height and Hb were measured in all participants before and after supplementation. Morbidity was assessed two times per week for 6 months using validated questionnaires. The Bayley Scale of Infant Development Test was administered at baseline and after 6 months. SETTING: Three marginal rural communities of the state of Queretaro, Mexico. SUBJECTS: A total of 224 children, mean age 22·4 (SD 5·9) months, were recruited. After the 6-month intervention, 186 completed the study. RESULTS: No differences were found in the adjusted changes of weight, height or anaemia between treatment groups and PL. No differences were found in the number of episodes of gastrointestinal or respiratory disease, nor were there any differences in cognitive performance between treatment and PL groups after 6 months of supplementation. CONCLUSIONS: Daily supplementation of 12-24-month-old children with OFS has no additional benefits in growth, anaemia, morbidity or cognitive performance.

Anti-inflammatory activity of Croton cuneatus aqueous extract.

The aqueous extract of Croton cuneatus Klotz. (Euphorbiaceae), was tested for its antinociceptive effects using chemical and thermal test models in mice. Anti-inflammatory activity was determined in Sprague-Dawley rats in a model of acute plantar inflammation induced by bovine serum albumin. Croton cuneatus aqueous extract at doses of 7 mg/kg showed a significant anti-inflammatory effect compared with commonly used non-stereoidal drugs as ketoprofen, sodium diclofenac and ASA (acetylsalicylic acid).

Evaluación de las propiedades de los conos de gutapercha y cementos selladores utilizados en la obturación de conductos radiculares. Investigación documental / Evaluation of the properties of gutta-percha cones and sealing cements used to fill root canals. Documentary research

La obturación del conducto radicular ha sido desde hace mucho tiempo de gran interés en la especialidad de la Endodoncia por lo que se ha mantenido un estudio constante sobre cómo obtener una buena obturación. A través de los años muchos han sido los materiales utilizados con éste fin, obteniendo los más variados resultados, desde rotundos fracasos hasta obturaciones biológicamente aceptables. Todas las fases del tratamiento de conductos radiculares deben ser estudiadas y realizadas con la misma atención e importancia, ya que son considerados actos operatorios interrelacionados y la incorrecta ejecución de una de la fases daría como resultado un fracaso parcial o total del tratamiento endodóntico. Es por ello, que llegado el momento de la obturación del conducto radicular, este debe ser realizado adecuadamente, considerando aquellos factores que intervienen en dicha etapa del tratamiento y que determinan el éxito del mismo; dentro de esos factores se encuentran las propiedades que poseen cada uno de los materiales empleados para obturar los conductos radiculares y que deben ser analizadas con el propósito de obtener un resultado satisfactorio en el tratamiento endodóntico como se ha mencionado, la correcta obturación de los conductos radiculares, depende de la adecuada realización de cada una de las etapas del tratamiento endodóntico, y una vez obtenida la preparación adecuada del conducto radicular, es necesaria la utilización de buenos materiales selladores que cumplan con las finalidades de sellado y respeto de los tejidos apicales y peri apicales, así como también otras propiedades físicas y biológicas que han sido enumeradas y resaltadas por diversos autores. A través de los años, y ante la experimentación con diversos tipos de materiales obturadores que han presentado resultados tanto positivos como negativos, la gutapercha y los cementos selladores se han convertido en los materiales de mayor aceptación para la terapia de los conductos radiculares debido a sus características. El cemento de Grossman constituye la base de las investigaciones sobre los cementos selladores, evaluándose su fórmula y componentes, y analizando los resultados obtenidos en el empleo de dicho cemento; a partir de éstos estudios surgen nuevos cementos selladores elaborados a base de diversos componentes que permiten obtener propiedades biológicas y físicas adecuadas. Al igual que los cementos selladores, la gutapercha también ha sido evaluada por diversos investigadores para analizar sus propiedades como material obturador de conductos radiculares. La relevancia que posee la obturación de conductos radiculares ha motivado la realización de estudios y evaluaciones técnicas y científicas sobre los materiales empleados para éste propósito, analizando sus propiedades y características antes, durante y después de la obturación del conducto. Este trabajo consiste en una investigación documental basada en la revisión de literatura sobre diferentes estudios realizados por varios autores para evaluar algunas de las propiedades de los conos de gutapercha y cementos selladores a base de óxido de zinc, hidróxido de calcio y resinas, utilizados para la obturación de los conductos radiculares. Dentro de esas propiedades se encuentran: la estandarización de diámetro y calibre de los conos de gutapercha, la acción antimicrobiana, la adaptación apical, la compatibilidad tisular y el efecto citotóxico, el sellado apical, la radiopacidad, el tiempo de trabajo, escurrimiento y biocompatibilidad

Root canal obturation has long been of great interest in the specialty of Endodontics, which is why a constant study has been maintained on how to obtain a good obturation. Over the years many materials have been used for this purpose, obtaining the most varied results, from outright failures to biologically acceptable fillings. All the phases of root canal treatment must be studied and performed with the same attention and importance, since they are considered interrelated operative acts and the incorrect execution of one of the phases would result in a partial or total failure of the endodontic treatment. That is why, when the time of root canal obturation comes, it must be carried out properly, considering those factors that intervene in said stage of the treatment and that determine its success; Among these factors are the properties of each of the materials used to fill the root canals and that must be analyzed in order to obtain a satisfactory result in the endodontic treatment as mentioned, the correct filling of the root canals. , depends on the adequate performance of each of the stages of endodontic treatment, and once the adequate preparation of the root canal has been obtained, it is necessary to use good sealing materials that meet the purposes of sealing and respecting the apical and peri apicals, as well as other physical and biological properties that have been listed and highlighted by various authors. Through the years, and due to experimentation with various types of filling materials that have presented both positive and negative results, gutta-percha and sealing cements have become the most widely accepted materials for root canal therapy due to their features.Grossman's cement constitutes the basis of research on sealant cements, evaluating its formula and components, and analyzing the results obtained in the use of said cement; From these studies, new sealant cements are made based on various components that allow us to obtain adequate biological and physical properties. Like sealing cements, gutta-percha has also been evaluated by various researchers to analyze its properties as a root canal filling material. The relevance of root canal obturation has led to technical and scientific studies and evaluations of the materials used for this purpose, analyzing their properties and characteristics before, during and after canal obturation. This work consists of a documentary research based on the literature review on different studies carried out by various authors to evaluate some of the properties of gutta-percha cones and sealing cements based on zinc oxide, calcium hydroxide and resins, used for the root canal obturation. Among these properties are: the standardization of diameter and caliber of the gutta-percha cones, antimicrobial action, apical adaptation, tissue compatibility and cytotoxic effect, apical sealing, radiopacity, working time, drainage and biocompatibility.

Comportamiento in vitro de fibroblastos gingivales enfrentados a superficies radiculares con tetraciclina / In vitro response of gingival fibroblasts when co-cultured with tetracycline tretated roots

En este estudio de tipo descriptivo-comparativo y diseño experimental doble ciego, se evaluó el comportamiento de fibroblastos gingivales enfrentados a superficies radiculares diagnósticadas con periodontitis del adulto avanzada. En el estudio se determinó el número de células vivas y muertas luego de las terapias a los 2,3 ,4 y 6 días.

Participation of the Bcl-2 and Fas molecules in experimental apoptosis of spleen B lymphocytes

Antecedentes. La homeostasis en el sistema inmune está basada en el equilibrio entre la generación de células y la muerte celular. Las fallas en los mecanismos para la eliminación de clonas B autoreactivas pueden contribuir a la generación de enfermedades autoinmunes: Objetivo. Estudiar la participación de Bcl-2 y Fas en la regulación de la muerte celular de linfocitos B. Métodos. Usamos dos cepas de ratones caracterizadas por tener mecanismos deficientes de apoptosis: 1) ratones transgénicos C57BL/6-Eµ-bcl-2-22 que expresan oncogen bcl-2 en las células B; 2) mutante C56BL/6-lpr/lpr que son incapaces de expresar una molécula Fas funcional. Ambas cepas desarrollan una enfermedad autoinmune similar al lupus eritematoso generalizado. Como control normal empleamos ratones de la cepa C57BL/6. Se indujo la apoptosis mediante tres diferentes tratamientos: dexametasona, choque térmico, y radicción. El número de células en apoptosis se midió con el método TUNEL. Resultados. Los porcientos (ñ DE) de células en apoptosis inducida fueron 13.5 ñ 2.6 por ciento; 6.0 ñ 1.9 por ciento, y 5.4 ñ 1.4 por ciento; para las cepas C57Bl/6, C57BL/6-lpr/lpryC57BL/6-Eµ-bcl-2-22 respectivamente. La mutación lpr fue más efectiva que el bcl-2 para inhibir la apoptosis inducida por radiación y por hipertermia pero lo contrario ocurrió en la apoptosis por dexametasona. Conclusión. Nuestros resultados muestran que mutación lpr y la sobre-expresión del oncogén bcl-2 confirmen resistencia a la apoptosis inducida por los tratamientos estudiados

Role of interleukin-10 in autoimmunity: physiological and pathological implications / Papel da interleucina 10 na auto-imunidade: implicaçöes fisiológicas e patológicas

Várias doenças reumáticas auto-imunes humanas säo caracterizadas por proeminente hiperatividade de linfócitos B, o que resulta tanto em produçäo aumentada de imunoglobulinas como no surgimento de auto-anticorpos. Recentemente tem sido demonstrado que a IL-10 é um dos mais poderosos ativadores de linfócitos B, induzindo sua proliferaçäo e uma intensa produçäo de imunoglobulinas. Ademais, a IL-10 pode prolongar a sobrevida de linfócitos B mediante a induçäo da produçäo de bcl-2 pelos próprios linfócitos B, protegendo-os assim da apoptose. A desregulaçäo do gene da IL-10 é uma característica frequente na artrite reumatóide, síndrome de Sjögren e no lúpus eritematoso sistêmico. A desregulaçäo desse gene ocorre tanto em linfócitos B como em monócitos e seu papel no estímulo inapropriado de linfócitos B resultaria de vias autócrinas e parácrinas. A produçäo de auto-anticorpos é também uma característica comum em parentes de pacientes com lúpus eritematoso sistêmico e em pessoas idosas saudáveis. Os primeiros produzem altas taxas de IL-10 enquanto os últimos quase näo a produzem. Esta revisäo versa sobre as interaçöes entre IL-10 e o sistema imunológico, bem como seu efeitos nas doenças reumáticas auto-imunes e em condiçöes auto-imunes fisiológicas