Impact of Sleeve Gastrectomy on Weight Loss, Glucose Homeostasis, and Comorbidities in Severely Obese Type 2 Diabetic Subjects

This study was undertaken to assess medium-term effects of laparoscopic sleeve gastrectomy (LSG) on body weight and glucose homeostasis in severely obese type 2 diabetic (T2DM) subjects. Twenty-five obese T2DM subjects (10 M/15 F, age 45 ± 9 years, BMI 48 ± 8 kg/m2, M ± SD) underwent evaluation of anthropometric/clinical parameters and glucose homeostasis before, 3 and 9–15 months after LSG. Mean BMI decreased from 48 ± 8 kg/m2 to 40 ± 9 kg/m2 (P < .001) at 3 months and 34 ± 6 kg/m2 (P < .001) at 9–15 months after surgery. Remission of T2DM (fasting plasma glucose < 126 mg/dL and HbA1c < 6.5% in the absence of hypoglycemic treatment) occurred in all patients but one. There was a remarkable reduction in the percentage of patients requiring antihypertensive and hypolipidemic drugs. Our study shows that LSG is effective in producing a significant and sustained weight loss and improving glucose homeostasis in severely obese T2DM patients

JCV-specific T-cells producing IFN-gamma are differently associated with PmL occurrence in HIV patients and liver transplant recipients

Aim of this work was to investigate a possible correlation between the frequency of JCV-specific T-cells and PML occurrence in HIV-infected subjects and in liver transplant recipients. A significant decrease of JCV-specific T-cells was observed in HIV-PML subjects, highlighting a close relation between JCV-specific T-cell immune impairment and PML occurrence in HIV-subjects. Interestingly, liver-transplant recipients (LTR) showed a low frequency of JCV-specific T-cells, similar to HIV-PML subjects. Nevertheless, none of the enrolled LTR developed PML, suggesting the existence of different immunological mechanisms involved in the maintenance of a protective immune response in LT

Laparoscopic reinforced sleeve gastrectomy: early results and complications

BACKGROUND: Sleeve gastrectomy (SG) was pioneered as a two-stage intervention for super and super-super obesity to minimize morbidity and mortality; it is employed increasingly as a primary procedure. Early outcomes and integrity of laparoscopic SG (LSG) against leak using a technique incorporating gastric transection-line reinforcement were studied. METHODS: Between 2003 and 2009, 121 patients underwent LSG (16, two-stage; 105, primary). Of the patients, 66% were women, mean age 38.8 ± 10.9 (15.0-64.0), and body mass index (BMI, kg/m(2)) 48.7 ± 9.3 (33.7-74.8). Bovine pericardium (Peri-Strips Dry [PSD]) was used to reinforce the staple line. Parametric and nonparametric tests were used, as appropriate. The paired t test was used to assess change from baseline; bivariate analyses and logistic regression were used to identify preoperative patient characteristics predictive of suboptimal weight loss. RESULTS: Mean operative time was 105 min (95-180), and mean hospitalization was 5.6 days (1-14). There was no mortality. There were 6 (5.0%) complications: 1 intraoperative leak, 1 stricture, 1 trocar-site bleed, 1 renal failure, and 2 wound infections. There were no postoperative staple-line leaks. Following 15 concomitant hiatal hernia operations, 3 (20%) recurred: 1 revised to RYGB and 2 in standby. Two post-LSG hiatal hernias of the two-stage series required revisions because of symptoms. BMI decreased 24.7% at 6 months (n = 55) to 37.5 ± 9.3 (22.2-58.1); %EWL was 48.1 ± 19.3 (15.5-98.9). Twelve-month BMI (n = 41) was 38.4 ± 10.5 (19.3-62.3); %EWL was 51.7 ± 25.0 (8.9-123.3). Forty-eight-month BMI (n = 13) was 35.6 ± 6.8 (24.9-47.5); %EWL was 61.1 ± 12.2 (43.9-82.1) (p 70% of patients who experienced <50% EWL at 6 months. At 2 weeks, 100% of type 2 diabetes patients (n = 23) were off medication (mean HbA(1C), 5.9 ± 0.5%; glycemia, 90.0 ± 19.9 mg/dL (p < 0.01) at 3 months). CONCLUSIONS: Laparoscopic PSD-reinforced LSG as a staged or definitive procedure is safe and effective in the short term and provides rapid type 2 diabetes mellitus reduction with a very low rate of complications

a new digital signal processing method for spectrum interference monitoring

Frequency spectrum is a limited shared resource, nowadays interested by an ever growing number of different applications. Generally, the companies providing such services pay to the governments the right of using a limited portion of the spectrum, consequently they would be assured that the licensed radio spectrum resource is not interested by significant external interferences. At the same time, they have to guarantee that their devices make an efficient use of the spectrum and meet the electromagnetic compatibility regulations. Therefore the competent authorities are called to control the access to the spectrum adopting suitable management and monitoring policies, as well as the manufacturers have to periodically verify the correct working of their apparatuses. Several measurement solutions are present on the market. They generally refer to real-time spectrum analyzers and measurement receivers. Both of them are characterized by good metrological accuracies but show costs, dimensions and weights that make no possible a use "on the field". The paper presents a first step in realizing a digital signal processing based measurement instrument able to suitably accomplish for the above mentioned needs. In particular the attention has been given to the DSP based measurement section of the instrument. To these aims an innovative measurement method for spectrum monitoring and management is proposed in this paper. It performs an efficient sequential analysis based on a sample by sample digital processing. Three main issues are in particular pursued: (i) measurement performance comparable to that exhibited by other methods proposed in literature; (ii) fast measurement time, (iii) easy implementation on cost-effective measurement hardware

Design and simulation of a solar assisted desiccant-based air handling unit

Paper presented at the 8th International Conference on Heat Transfer, Fluid Mechanics and Thermodynamics, Mauritius, 11-13 July, 2011.Desiccant-based Air Handling Units (AHU) can guarantee significant technical and energy/environmental advantages related to the use of traditional ones (with dehumidification by cooling). For these reasons, a test facility has been located in Benevento (Southern Italy), in which a silica-gel desiccant wheel is inserted in an AHU which treats outside air only. For this wheel, the regeneration temperature can be as low as 65 °C, therefore energy savings and emissions reductions are more consistent when the regeneration of the desiccant material is obtained by means of available low grade thermal energy, such as that from solar collectors or cogenerators. In the actual configuration, regeneration is obtained by means of thermal energy recovered from a micro-cogenerator (MCHP, Micro Combined Heat and Power) based on a natural gas-fired reciprocating internal combustion engine, eventually integrated through a natural gas-fired boiler. Future activity aims to reduce the regeneration fossil energy requirements by introducing a solar collector system that substitutes or integrates thermal energy supplied by the MHCP. To this aim, a commercial software has been used to design the solar collector system (collectors type, absorber area, water flow rate…) considering the thermal power and temperature requirements of the regeneration process. The existing AHU and the designed solar collector system have been successively simulated by means of TRNSYS software, in order to evaluate operational data and performance parameters of the system in a typical week of operation, e.g. thermal-hygrometric conditions of air in the mean sections of the AHU, solar collectors efficiency and solar fraction.mp201

Search for carbonaceous chondrites evidence on Vesta through the detection of carbonates

NASA’s Dawn mission was launched in September 2007 and orbited asteroids Vesta (2011 2012) and Ceres (2015–2018). Vesta shows surface dark units that have been suggested to be linked to exogenous materials and are therefore useful to understand the initial stages of the Solar System. This work takes advantage of the newly calibrated data of the VIR spectrometer, which are characterized by a better signal to noise (S/N) ratio, giving us the opportunity to search for spectral features that were never seen before due to noise. Considering that hydroxyl has been shown to be present in every dark unit on Vesta and also in carbonaceous chondrites, the goals of this work are the search for and characterization of carbonates that are present in carbonaceous chondrites, i.e., the supposed darkening agents of Vesta. The estimate of the abundances of carbonates is fundamental to identify which carbonaceous chondrite fell on Vesta; this can be crucial for the definition of an evolutionary history of Vesta and the Solar System. The study of a possible feature at 3.9 μm related to the presence of carbonates was analyzed and found to be noise-induced. Although spectral features related to carbonates were not observed, the 3.4 μm absorption band was analyzed anyway in order to fix an upper limit to the abundance of carbonates in carbonaceous chondrites on Vesta. This value is consistent with petrochemical analyses, i.e., no more than 0.2% of carbonates in carbonaceous chondrites

New frontiers in bariatric surgery laparoscopic adjustable silicone gastric banding (LASGB)

LASGB is a minimally invasive procedure indicated for the treatment of morbid obesity. Since January 1996, six patients have successfully undergone the laparoscopic procedure. Preoperative BMI was 42 ± 3.1; range 39-46. Mean operative time was 260 ± 110, range was 160-360. Mean hospital stay was 3 ± 1 days